Community Nutrition in Action. An Entrepreneurial Approach

823 Pages·2016·36.85 MB·English

by  Marie A. Boyle

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Dietary Reference Intakes (DRIs)
The Dietary Reference Intakes (DRIs) include two sets of values that serve as goals for nutrient intake—Recommended Dietary Allowances (RDAs) and
Adequate Intakes (AIs). The RDA reflects the average daily amount of a nutrient considered adequate to meet the needs of most healthy people. If
there is insufficient evidence to determine an RDA, an AI is set. The DRIs also include a set of values called Tolerable Upper Intake Levels (ULs). The UL
represents the maximum amount of a nutrient that appears safe for most healthy people to consume on a regular basis. Turn the page for a listing of
the ULs for selected vitamins and minerals.
Estimated Energy Requirements (EERs), Recommended Dietary Allowances (RDAs), and
Adequate Intakes (AIs) for
Water, Energy, and the Macronutrients
LLGGiirrffeeoo--uuSSppttaaggee Refere(nkcge/ Bm2)MI Referecncm e (ihne)ight, Referekngc e( lbw)eight, WateraAI (L/day) EnergyE ERb (kcal/day)CarboRhyDdAr (atge/ day)Total fiAbI e(r g/day)Total faAtI (g/day) LinoleicA I a(cig/d day)LinolenAiI c (agc/iddcay)ProteiRn DA (g/day)dProteinR DA (g/kg/day)
Males
0–6 mo — 62 (24) 6 (13) 0.7e 570 60 — 31 4.4 0.5 9.1 1.52
7–12mo — 71 (28) 9 (20) 0.8f 743 95 — 30 4.6 0.5 11 1.2
1–3 yg — 86 (34) 12 (27) 1.3 1046 130 19 — 7 0.7 13 1.05
4–8 yg 15.3 115 (45) 20 (44) 1.7 1742 130 25 — 10 0.9 19 0.95
9–13 y 17.2 144 (57) 36 (79) 2.4 2279 130 31 — 12 1.2 34 0.95
1144––1188 yy 20.5 174 (68) 61 (134) 3.3 3152 130 38 — 16 1.6 52 0.85
1199––3300 yy 22.5 177 (70) 70 (154) 3.7 3067h 130 38 — 17 1.6 56 0.8
3311––5500 yy 22.5i 177 (70)i 70 (154)i 3.7 3067h 130 38 — 17 1.6 56 0.8
$ 51y 22.5i 177 (70)i 70 (154)i 3.7 3067h 130 30 — 14 1.6 56 0.8
FFeemmaalleess
0–6 mo — 62 (24) 6 (13) 0.7e 520 60 — 31 4.4 0.5 9.1 1.52
7–12mo — 71 (28) 9 (20) 0.8f 676 95 — 30 4.6 0.5 11 1.2
1–3 yg — 86 (34) 12 (27) 1.3 992 130 19 — 7 0.7 13 1.05
4–8 yg 15.3 115 (45) 20 (44) 1.7 1642 130 25 — 10 0.9 19 0.95
9–13 y 17.4 144 (57) 37 (81) 2.1 2071 130 26 — 10 1.0 34 0.95
1144––1188 yy 20.4 163 (64) 54 (119) 2.3 2368 130 26 — 11 1.1 46 0.85
1199––3300 yy 21.5 163 (64) 57 (126) 2.7 2403j 130 25 — 12 1.1 46 0.8
3311––5500 yy 21.5i 163 (64)i 57 (126)i 22..77 22440033jj 113300 2255 — 1122 11..11 4466 00..88
$ 51y 21.5i 163 (64)i 57 (126)i 2.7 2403j 130 21 — 11 1.1 46 0.8
Pregnancy
11sstt ttrriimmeesstteerr 3.0 10 175 28 — 13 1.4 71 1.1
22nndd ttrriimmeesstteerr 3.0 1340 175 28 — 13 1.4 71 1.1
33rrdd ttrriimmeesstteerr 3.0 1452 175 28 — 13 1.4 71 1.1
Lactation
1st six months postpartum 3.8 1330 210 29 — 13 1.3 71 1.3
2nd six months postpartum 3.8 1400 210 29 — 13 1.3 71 1.3
Note: For all nutrients, values for infants are AIs. Dashes indicate that values have not been ddd TThhee vvaalluueess lliisstteedd aarree bbaasseedd oonn rreeffeerreennccee bbooddyy wweeiigghhttss..
determined. eee AAssssuummeedd ttoo bbee ffrroomm hhuummaann mmiillkk..
aaa TThhee wwaatteerr AAII iinncclluuddeess ddrriinnkkiinngg wwaatteerr,, wwaatteerr iinn bbeevveerraaggeess,, aanndd wwaatteerr iinn ffooooddss;; iinn ggeenneerraall,, fff AAssssuummeedd ttoo bbee ffrroomm hhuummaann mmiillkk aanndd ccoommpplleemmeennttaarryy ffooooddss aanndd bbeevveerraaggeess.. TThhiiss
drinking water and other beverages contribute about 70 to 80%, and foods, the remainder. includes approximately 0.6 L (~3 cups) as total fluid including formula, juices, and
Conversion factors: 1 L 5 33.8 fluid oz; 1 L 5 1.06 qt; 1 cup 5 8 fluid oz. drinking water.
b The Estimated Energy Requirement (EER) represents the average dietary energy intake ggg FFoorr eenneerrggyy,, tthhee aaggee ggrroouuppss ffoorr yyoouunngg cchhiillddrreenn aarree 11––22 yyeeaarrss aanndd 33––88 yyeeaarrss..
that will maintain neutral energy balance in a healthy person of a given sex, age, weight, h For males, subtract 10 kilocalories per day for each year of age above 19.
height, and physical activity level. The values listed are based on an “active” person at the iii BBeeccaauussee wweeiigghhtt nneeeedd nnoott cchhaannggee aass aadduullttss aaggee iiff aaccttiivviittyy iiss mmaaiinnttaaiinneedd,, rreeffeerreennccee wweeiigghhttss
reference height and weight and at the midpoint ages for each group until age 19. Go to for adults 19 through 30 are applied to all adult age groups.
wwwwwwwww...ccchhhoooooossseeemmmyyyppplllaaattteee...gggooovvv ffoorr ttoooollss ttoo ddeetteerrmmiinnee EEssttiimmaatteedd EEnneerrggyy RReeqquuiirreemmeennttss.. jjj FFoorr ffeemmaalleess,, ssuubbttrraacctt 77 kkiillooccaalloorriieess ppeerr ddaayy ffoorr eeaacchh yyeeaarr ooff aaggee aabboovvee 1199..
ccc TThhee lliinnoolleenniicc aacciidd rreeffeerrrreedd ttoo iinn tthhiiss ttaabbllee aanndd tteexxtt iiss tthhee oommeeggaa--33 ffaattttyy aacciidd kknnoowwnn aass
alpha-linolenic acid.
Source: Adapted from the Dietary Reference Intakes series, National Academies Press. Copyright 1997, 1998, 2000, 2001, 2002, 2004, 2005, 2011 by the National Academy of Sciences.
Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-203
Recommended Dietary Allowances (RDAs) and Adequate Intakes (AIs) for Vitamins
d
LLGGiirrffeeoo--uuSSppttaaggee ThiamiRn DA (mg/dRaiyb)oflaRviDnA (mg/dNaiya)cinRDA (mg/dBaiyo)tain AI (mg/day)PantotAhI e(nimc ga/cdiayVV)iittaammiiRnn DBBA (6 mg/dFaoyl)ateRDA (mg/daVViiytt)baammiiRnn DBBA (1m2g/daCyh)olinAeI (mg/day)VitamiRn DCA (mg/dVaiyt)amiRn DAA (mg/daViyt)camiRn DDA (mg/daViyt)damiRn DE A (mg/dVaiyt)aemiAnI (K mg/day)
Infants
0–6 mo 0.2 0.3 2 5 1.7 0.1 65 0.4 125 40 400 10 4 2.0
7–12 mo 0.3 0.4 4 6 1.8 0.3 80 0.5 150 50 500 10 5 2.5
Children
11––33 yy 0.5 0.5 6 8 2 0.5 150 0.9 200 15 300 15 6 30
44––88 yy 0.6 0.6 8 12 3 0.6 200 1.2 250 25 400 15 7 55
Males
99––1133 yy 0.9 0.9 12 20 4 1.0 300 1.8 375 45 600 15 11 60
1144––1188 yy 1.2 1.3 16 25 5 1.3 400 2.4 550 75 900 15 15 75
1199––3300 yy 1.2 1.3 16 30 5 1.3 400 2.4 550 90 900 15 15 120
3311––5500 yy 1.2 1.3 16 30 5 1.3 400 2.4 550 90 900 15 15 120
5511––7700 yy 1.2 1.3 16 30 5 1.7 400 2.4 550 90 900 15 15 120
. 7700 yy 1.2 1.3 16 30 5 1.7 400 2.4 550 90 900 20 15 120
Females
99––1133 yy 0.9 0.9 12 20 4 1.0 300 1.8 375 45 600 15 11 60
1144––1188 yy 1.0 1.0 14 25 5 1.2 400 2.4 400 65 700 15 15 75
1199––3300 yy 1.1 1.1 14 30 5 1.3 400 2.4 425 75 700 15 15 90
3311––5500 yy 1.1 1.1 14 30 5 1.3 400 2.4 425 75 700 15 15 90
5511––7700 yy 1.1 1.1 14 30 5 1.5 400 2.4 425 75 700 15 15 90
. 7700 yy 1.1 1.1 14 30 5 1.5 400 2.4 425 75 700 20 15 90
Pregnancy
1144––1188 yy 1.4 1.4 18 30 6 1.9 600 2.6 450 80 750 15 15 75
1199––3300 yy 1.4 1.4 18 30 6 1.9 600 2.6 450 85 770 15 15 90
3311––5500 yy 1.4 1.4 18 30 6 1.9 600 2.6 450 85 770 15 15 90
Lactation
1144––1188 yy 1.4 1.6 17 35 7 2.0 500 2.8 550 115 1200 15 19 75
1199––3300 yy 1.4 1.6 17 35 7 2.0 500 2.8 550 120 1300 15 19 90
31–50 y 1.4 1.6 17 35 7 2.0 500 2.8 550 120 1300 15 19 90
Note: For all nutrients, values for infants are AIs. ccc VViittaammiinn AA rreeccoommmmeennddaattiioonnss aarree eexxpprreesssseedd aass rreettiinnooll aaccttiivviittyy eeqquuiivvaalleennttss ((RRAAEE))..
aaa NNiiaacciinn rreeccoommmmeennddaattiioonnss aarree eexxpprreesssseedd aass nniiaacciinn eeqquuiivvaalleennttss ((NNEE)),, eexxcceepptt ffoorr rreeccoommmmeenn-- ddd VViittaammiinn DD rreeccoommmmeennddaattiioonnss aarree eexxpprreesssseedd aass cchhoolleeccaallcciiffeerrooll..
dations for infants younger than six months, which are expressed as preformed niacin. eee VViittaammiinn EE rreeccoommmmeennddaattiioonnss aarree eexxpprreesssseedd aass a-tocopherol.
bbb FFoollaattee rreeccoommmmeennddaattiioonnss aarree eexxpprreesssseedd aass ddiieettaarryy ffoollaattee eeqquuiivvaalleennttss ((DDFFEE))..
Recommended Dietary Allowances (RDAs) and Adequate Intakes (AIs) for Minerals
LLGGiirrffeeoo--uuSSppttaaggee SodiumA I (mg/dayC)hlori dAeI (mg/dayP)otassiAuI (mmg/dayC)alciuRmDA (mg/dPahyo)sphRoDrAu s(mg/dMaay)gneRsiDuA m(mg/Idraoy)nRDA (mg/dZianyc)RDA (mg/Idoaydi)neRDA (mg/dSaeyl)eniRuDmA (mg/dCCaooy)ppppeerrRDA (mg/daMya)ngaAIn e(semg/daFyl)uoridAeI (mg/dayC)hromiAIu(mmg/day)MolybRdeDnA u(mmg/day)
Infants
0–6 mo 120 180 400 200 100 30 0.27 2 110 15 200 0.003 0.01 0.2 2
7–12 mo 370 570 700 260 275 75 11 3 130 20 220 0.6 0.5 5.5 3
Children
11––33 yy 1000 1500 3000 700 460 80 7 3 90 20 340 1.2 0.7 11 17
44––88 yy 1200 1900 3800 1000 500 130 10 5 90 30 440 1.5 1 15 22
Males
99––1133 yy 1500 2300 4500 1300 1250 240 8 8 120 40 700 1.9 2 25 34
1144––1188 yy 1500 2300 4700 1300 1250 410 11 11 150 55 890 2.2 3 35 43
1199––3300 yy 1500 2300 4700 1000 700 400 8 11 150 55 900 2.3 4 35 45
3311––5500 yy 1500 2300 4700 1000 700 420 8 11 150 55 900 2.3 4 35 45
5511––7700 yy 1300 2000 4700 1000 700 420 8 11 150 55 900 2.3 4 30 45
. 7700 yy 1200 1800 4700 1200 700 420 8 11 150 55 900 2.3 4 30 45
Females
99––1133 yy 1500 2300 4500 1300 1250 240 8 8 120 40 700 1.6 2 21 34
1144––1188 yy 1500 2300 4700 1300 1250 360 15 9 150 55 890 1.6 3 24 43
1199––3300 yy 1500 2300 4700 1000 700 310 18 8 150 55 900 1.8 3 25 45
3311––5500 yy 1500 2300 4700 1000 700 320 18 8 150 55 900 1.8 3 25 45
5511––7700 yy 1300 2000 4700 1200 700 320 8 8 150 55 900 1.8 3 20 45
. 7700 yy 1200 1800 4700 1200 700 320 8 8 150 55 900 1.8 3 20 45
Pregnancy
1144––1188 yy 1500 2300 4700 1300 1250 400 27 12 220 60 1000 2.0 3 29 50
1199––3300 yy 1500 2300 4700 1000 700 350 27 11 220 60 1000 2.0 3 30 50
3311––5500 yy 1500 2300 4700 1000 700 360 27 11 220 60 1000 2.0 3 30 50
Lactation
1144––1188 yy 1500 2300 5100 1300 1250 360 10 13 290 70 1300 2.6 3 44 50
1199––3300 yy 1500 2300 5100 1000 700 310 9 12 290 70 1300 2.6 3 45 50
31–50 y 1500 2300 5100 1000 700 320 9 12 290 70 1300 2.6 3 45 50
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Tolerable Upper Intake Levels (ULs) for Vitamins
LLGGiirrffeeoo--uuSSppttaaggee Niacin (( mmgg//ddaayy))aVitami((n mmBgg//dd6aayy))Folate ((mg/day)aCholin((e mmgg//ddaayy))VViittaammii((nn mmCCgg //ddaayy))Vitami((nm gA /day)bVitami(nm gD/ day)Vitami(n mE g/day)c
Infants
0–6 mo — — — — — 600 25 —
7–12 mo — — — — — 600 38 —
Children
11––33 yy 10 30 300 1000 400 600 63 200
44––88 yy 15 40 400 1000 650 900 75 300
Adolescents
99––1133 yy 20 60 600 2000 1200 1700 100 600
1144––1188 yy 30 80 800 3000 1800 2800 100 800
Adults
1199––7700 yy 35 100 1000 3500 2000 3000 100 1000
. 7700 yy 35 100 1000 3500 2000 3000 100 1000
Pregnancy
1144––1188 yy 30 80 800 3000 1800 2800 100 800
1199––5500 yy 35 100 1000 3500 2000 3000 100 1000
Lactation
1144––1188 yy 30 80 800 3000 1800 2800 100 800
19–50 y 35 100 1000 3500 2000 3000 100 1000
aaa TThhee UULLss ffoorr nniiaacciinn aanndd ffoollaattee aappppllyy ttoo ssyynntthheettiicc ffoorrmmss bbb TThhee UULL ffoorr vviittaammiinn AA aapppplliieess ttoo tthhee pprreeffoorrmmeedd vviittaammiinn oonnllyy..
obtained from supplements, fortified foods, or a ccc TThhee UULL ffoorr vviittaammiinn EE aapppplliieess ttoo aannyy ffoorrmm ooff ssuupppplleemmeennttaall
combination of the two. a-tocopherol, fortified foods, or a combination of the two.
Tolerable Upper Intake Levels (ULs) for Minerals
m
LGirfeo-uSptage Sodiu(m mg/day)Chlori((demm gg//ddaayy))Calciu(m mg/day)Phosp(homrgu/s day)MMaaggnn((eessiimmuugg//mm ddaayy))dIron (((mmmggg///dddaaayyy)))ZZiinncc (((mmmggg///dddaaayyy)))Iodine ((mg/day)Seleni(ummg /day)CCCoooppppppeee(((rrr mg/day)MMMaaannngggaaa((nnnmmeeeggsss//eee ddaayy))Fluorid((e mmgg//ddaayy))Molyb(dmegn/uday)Boron (((mmmggg///dddaaayyy)))Nickel ((mmgg//ddaayy))
IInnffaannttss
0–6 mo —e —e 1000 — — 40 4 — 45 — — 0.7 — — —
7–12 mo —e —e 1500 — — 40 5 — 60 — — 0.9 — — —
Children
11––33 yy 1500 2300 2500 3000 65 40 7 200 90 1000 2 1.3 300 3 0.2
44––88 yy 1900 2900 2500 3000 110 40 12 300 150 3000 3 2.2 600 6 0.3
AAddoolleesscceennttss
99––1133 yy 2200 3400 3000 4000 350 40 23 600 280 5000 6 10 1100 11 0.6
111444–––111888 yyy 2300 3600 3000 4000 350 45 34 900 400 8000 9 10 1700 17 1.0
AAdduullttss
111999–––777000 yyy 2300 3600 2500f 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0
. 7700 yy 2300 3600 2000 3000 350 45 40 1100 400 10,000 11 10 2000 20 1.0
PPrreeggnnaannccyy
111444–––111888 yyy 2300 3600 3000 3500 350 45 34 900 400 8000 9 10 1700 17 1.0
111999–––555000 yyy 2300 3600 2500 3500 350 45 40 1100 400 10,000 11 10 2000 20 1.0
LLaaccttaattiioonn
111444–––111888 yyy 2300 3600 3000 4000 350 45 34 900 400 8000 9 10 1700 17 1.0
1199––5500 yy 2300 3600 2500 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0
ddd TThhee UULL ffoorr mmaaggnneessiiuumm aapppplliieess ttoo ssyynntthheettiicc ffoorrmmss oobbttaaiinneedd ffrroomm ssuupppplleemmeennttss oorr ddrruuggss oonnllyy.. Source: Adapted with permission from the Dietary Reference Intakes series, National Academies
eee SSoouurrccee ooff iinnttaakkee sshhoouulldd bbee ffrroomm hhuummaann mmiillkk ((oorr ffoorrmmuullaa)) aanndd ffoooodd oonnllyy.. Press. Copyright 1997, 1998, 2000, 2001, 2011, by the National Academy of Sciences. Courtesy
fff TThhee UULL ffoorr ccaallcciiuumm ffoorr 1199––5500 yy iiss 22550000 mmgg//ddaayy;; tthhee UULL ffoorr ccaallcciiuumm iiss rreedduucceedd ttoo 22000000 mmgg//ddaayy of the National Academies Press, Washington, D.C.
for 51–70 y.
Note: An upper limit was not established for vitamins and minerals not listed and for those age
groups listed with a dash (—) because of a lack of data, not because these nutrients are safe to
consume at any level of intake. All nutrients can have adverse effects when intakes are excessive.
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edition
SEVENTH
Community Nutrition
in Action
AN ENTREPRENEURIAL APPROACH
Marie A. Boyle, PhD, RD
College of Saint Elizabeth
Australia • Brazil • Mexico • Singapore • United Kingdom • United States
Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-203
Community Nutrition in Action,
©2017, 2013 Cengage Learning
Seventh Edition WCN: 01-100-101
Marie A. Boyle
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Dedication
In memory of Jesse, Dylan, Kate, and McCauley—my twinkling stars in the
night sky. And to Maggie, Rex, Elvis, and Tess—may there always be time for
footprints in the sand.
—Marie A. Boyle
About the Author
MARIE A. BOYLE, PhD, RD, received her BA in psychology from the University of
Southern Maine and her MS and PhD in nutrition from Florida State University. She is
author of the basic nutrition textbook Personal Nutrition. Dr. Boyle serves as Chair of the
Foods and Nutrition Program and Director of the Graduate Program in Nutrition at the
College of Saint Elizabeth in Morristown, New Jersey. Her other professional activities
include serving as an author and reviewer for the Academy of Nutrition and Dietetics
and the Society for Nutrition Education and Behavior. Dr. Boyle coauthored the current
position paper of the Academy of Nutrition and Dietetics, titled Nutrition Security in
Developing Nations: Sustainable Food, Water and Health, and serves as editor-in-chief of
the Journal of Hunger and Environmental Nutrition by Taylor & Francis. She is a member
of the Academy of Nutrition and Dietetics, the American Public Health Association, and
the Society for Nutrition Education and Behavior.
iii
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Contents in Brief
Preface xi
Section One
Community Nutritionists in Action: Working in the Community 1
1 Opportunities in Community Nutrition 3 6 The Art and Science of Policymaking 191
2 Principles of Epidemiology 41 7 A National Nutrition Agenda for the Public’s
3 Understanding and Achieving Behavior Health 231
Change 73 8 Addressing the Obesity Epidemic: An Issue for
4 Community Needs Assessment 99 Public Health Policy 275
5 Program Planning for Success 149 9 Health Care Systems and Policy 329
Section Two
Community Nutritionists in Action: Delivering Programs 367
10 Food Insecurity and the Food Assistance 13 Healthy Aging: Nutrition Assessment, Services,
Programs 369 and Programs 503
11 Mothers and Infants: Nutrition Assessment, 14 Global Food and Nutrition Security: Challenges
Services, and Programs 421 and Opportunities 547
12 Children and Adolescents: Nutrition Issues,
Services, and Programs 459
Section Three
Community Nutritionists in Action: Planning Nutrition Interventions 595
15 Gaining Cultural Competence in Community 17 Marketing Nutrition and Health Promotion 659
Nutrition 597 18 Managing Community Nutrition Programs 691
16 Principles of Nutrition Education 633 19 Building Grantsmanship Skills 713
Appendixes 753 Index 774
iv
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Contents
Preface xi
Section One
Community Nutritionists in Action: Working in the Community 1
1 Opportunities in Community Nutrition 3 Cohort Studies 58
Case–Control Studies 60
Introduction 4
Controlled Trials 61
The Concept of Community 4
Nutritional Epidemiology 61
Opportunities in Community Nutrition 5
The Nature of Dietary Variation 62
Public Health and Community Interventions 6
Epidemiology and the Community Nutritionist 65
Healthy People: A Report Card for the Nation’s
Health 15 Case Study: Epidemiology of Obesity 66
Community Nutrition Practice 20 Professional Focus: The Well-Read Community
Community versus Public Health Nutrition 21 Nutritionist 67
Entrepreneurship in Community Nutrition 28
Entrepreneurs and Intrapreneurs 28 3 Understanding and Achieving Behavior
Social and Economic Trends for Community Change 73
Nutrition 30 Introduction 74
Leading Indicators of Change 30
Draw from Current Research on Consumer
Watchwords for the Future 35
Behavior 74
Case Study: Ethics and You 35
The Transtheoretical Model (Stages of Change) 77
Professional Focus: Community-Based Dietetics Motivational Interviewing 80
Professionals 37 The Health Belief Model 81
The Theory of Planned Behavior 83
2 Principles of Epidemiology 41 Social-Cognitive Theory 87
Introduction 42 Programs in Action: EatFit Intervention
Program 89
The Practice of Epidemiology 43
Cognitive-Behavioral Theory 90
Investigating Causes of Diseases 43
The Diffusion of Innovation Model 91
Basic Epidemiologic Concepts 47
Findings Regarding Applications of Theory to Nutrition
Rates and Risks 47
Interventions 92
The Epidemiologic Method 48
Put It All Together: Case Study 1 92
Hypothesis Testing 53
Explaining Research Observations 54 Programs in Action: Intrapersonal and
Interpersonal Health Education 93
Types of Epidemiologic Studies 55
Ecological or Correlational Studies 57 Professional Focus: Being an Effective
Cross-Sectional or Prevalence Studies 58 Speaker 94
v
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