UNIB10009

Food for Health

Mark Hargreaves
Department of Physiology
m.hargreaves@unimelb.edu.au
 www.eatforhealth.gov.au

www.csiro.au/science/TWD.html

www.hsph.harvard.edu/nutritionsource/index.html
Deaths due to selected risk factors

WHO World Health Report, 2002

Metabolic Syndrome

Insulin resistance
Obesity (visceral)
Dyslipidemia
Hypertension

(VicHealth)
Physical activity and diabetes risk

F.W. Booth & S.J. Lees. Physiol. Genomics 28: 146-157, 2007
(data from F.B. Hu et al. JAMA. 282: 1433-1439, 1999)
Physical activity levels in an
Amish community

D.R. Bassett et al. Med. Sci. Sports Exerc. 36: 79-85, 2004
P.T. Katzmarzyk. Diabetes. 59: 2721, 2010
Science. 325: 201-204, 2009
 age in reaching very old ages (60) (Fig. dietary restriction applied to adult rhesus mon-
ossibly because of developmental defects keys was shown to reduce age-related deaths (66).
e increased mortality at younger ages (61). The incidence of neoplasia and cardiovascular
jects with GH receptor and IGF-1 deficien- disease was 50% lower than in the controls (66),

Caloric restric9on (7 yrs) in humans

81.6 kg; BMI = 26 kg.m2 60.8 kg; BMI = 19 kg.m2

. (A) Individual with normal levels of GH receptor (right) and a GH receptordeficient subject in
ountains of southern Ecuador (left). (B) Composite photograph of a dietary restriction practitioner
L. Fontana
starting dietary restriction with adequate nutrition et a[left:
l. Science.
weight 180 328:
lb,3or 21-326,
81.6 kg; 2010
body mass
2
(BMI) 26.0 kg/m ) and after 7 years of dietary restriction (right: weight 134 lb, or 60.8 kg; BMI
g/m2).
What is a healthy diet?

Energy
Water
Carbohydrate
Fat
Protein/amino acids
Vitamins, mineral, trace elements
Alcohol?
GUIDELINE 1 To achieve and maintain a healthy weight, be physically active and choose amounts of
nutritious food and drinks to meet your energy needs.
t
Children and adolescents should eat sufficient nutritious foods to grow and develop
normally. They should be physically active every day and their growth should be
checked regularly.
t
Older people should eat nutritious foods and keep physically active to help maintain
muscle strength and a healthy weight..

GUIDELINE 2 Enjoy a wide variety of nutritious foods from these five groups every day:
t
Plenty of vegetables, including different types and colours, and legumes/beans
t
Fruit
t
Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as
breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
t
Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
t
Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat
milks are not suitable for children under the age of 2 years)

And drink plenty of water.

GUIDELINE 3 Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
a. Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries,
pies, processed meats, commercial burgers, pizza, fried foods, potato chips,
crisps and other savoury snacks.
t
Replace high fat foods which contain predominantly saturated fats such as
butter, cream, cooking margarine, coconut and palm oil with foods which
contain predominantly polyunsaturated and monounsaturated fats such as oils,
spreads, nut butters/pastes and avocado.
t
Low fat diets are not suitable for children under the age of 2 years.

b. Limit intake of foods and drinks containing added salt.

t
Read labels to choose lower sodium options among similar foods.
t
Do not add salt to foods in cooking or at the table.

c. Limit intake of foods and drinks containing added sugars such as confectionary,
sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and
sports drinks.
d. If you choose to drink alcohol, limit intake. For women who are pregnant, planning
a pregnancy or breastfeeding, not drinking alcohol is the safest option.

GUIDELINE 4 Encourage, support and promote breastfeeding.

GUIDELINE 5 Care for your food; prepare and store it safely.

2011
 delines therefore em- lation to heart disease withinLudwig), most prevailing Departments of Epidemiology
dietary patterns. 7 (Dr Mozaffarian) and Nutrition (Drs Mozaf-
ic. TheThisRDAs
iencies. empha-areTypical
methodologi-
recommendations to farian
consumeand Ludwig),
at least half Harvard
of totalSchool of Public Health, and Optimal Weight for Life
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ppropriate
food shortages forof thethis purpose,
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as carbohydrate, for which humans have no
impelling
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as requirement,
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Corresponding Author: Dariush Mozaffarian, MD, DrPH, 665 Huntington Ave,
Bldgfoods 2-319, withBoston,
widely MA divergent
02115 (dmozaffa@hsph.harvard.edu).
ion, and US Depart- physiologic effects (eg,COMMENTARY
nimum requirements
ciation. All rights reserved.
a Time for Food
brown rice, white bread, apples). Foods
are grouped based on protein content (chicken, fish, beans, JAMA, August 11, 2010Vol 304, No. 6 681
(Reprinted)
horus, iron, and vari- nuts) despite demonstrably
Dariush Mozaffarian,differentMD, health DrPHeffects. With few intakes and acceptable macronutrient distribution ranges.
However, these newer nutrient-based metrics are ham-
rst recommended di- exceptions (eg, David omega-3 fats, trans
S. Ludwig, MD,fat,PhD salt), individual com-

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pered by imprecise definitions and inconsistent usage. More-
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HE DISCOVERY OF SPECIFIC DIETARY INSUFFICIENCIES over, translation of nutrient-based targets to the public has
tary guidelines. These Thus, little of the information
Dietary Guidelines in the 21st Century
found on fooddiseaselabelsplayed
nutri-
2 as the cause of human a central role proven difficult. Few individuals can accurately gauge daily
in the development of modern nutritional science. consumption of calories, fats, cholesterol, fiber, or salt.
this day, for the cre- tion facts panels provides useful guidance for selecting
a Time for Food
In 1753, one of the first clinical trials showed that Nutritional science has advanced rapidly, and the evi-
g nutrient targets and healthier foods citrus to prevent chronic
fruit could disease.
prevent scurvy in sailors, leading to the dence now demonstrates the major limitations of nutrient-
od recommendations. identification of vitamin C as essential for health. By the based metrics for prevention of chronic disease. The propor-
COMMENTARY
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a NewMozaffarian,
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03/22/2015 nutrients tion of total
intakes and energy
acceptable frommacronutrient
fat appears largely unrelatedranges.
distribution to risk
4-6
for deficiency diseases had been shown, including thia- However, of cardiovascular
these newerdisease,nutrient-based
cancer, diabetes,metrics or obesity. Satu-
are ham-
f Chronic Disease In contrast with David S. Ludwig,
discrete MD, PhD
nutrients, specific
(pellagra),foods andDdi-

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mine (beriberi), niacin vitamin (rickets), vi- pered rated byfattargeted by nearly all nutrition-related
imprecise definitions and inconsistent usage. More- profes-
tamin A (night
to the increasing bur- etary patterns substantially affect chronic disease risk, as
HE blindness),
DISCOVERY OF iron (anemia),
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emphasizing disease
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cholesterol, at least
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century, protective effects of many nutrients tion of total energy from fat appears largely unrelated to risk protein content (chicken, fish, beans,
cedent. Accordingly, tality, belying categorization
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health
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fats, allmore
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salt), individual
nutrition-related com-
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of 1980 remained pri- versely, processed etary
packaged
allowances (RDAs)
fast foods,
were formulated
sugar-
in 1941, estab- pounds in isolation have small effects on chronic diseases. 8
sional organizations
tamin A (night blindness), iron (anemia), and iodine (goiter).cus on foods increases the likelihood of consuming more and governmental agencieshas little re- lic,correspondwiths
ice to avoid too much sweetened beverages lishing
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apopulation-wide
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foods
carbohydrate, the
to prevent a opposite
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nutrient has
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which arguably
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have no spreadmisperception
translating these targets into food recommendations.
Great Depression and World War II, impelling the Leaguethrough absolute requirement, conflate foods with widely divergent
re similarly nutrient- ods, fatty acid ofprofile, carbohydrate quality (eg, glycemic The Need decades for of nutrient-focused
a(eg,
New Approach guidelines. Although this app
Nations, British Medical Association, and US Depart- physiologic effects brown rice, white bread, apples). Foods
Dietary Guidelines in thenew Ageminimum
of and
Chronic Disease The nutrient-based approach mayspecific
fosterfoods dietary prac- resents a return to m
science paralleled and index, fiber content), ment ofprotein
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create phy-
requirements In contrast
are grouped with
baseddiscrete
on protein nutrients,
content (chicken, fish,and di-
beans,
By the
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calories, the contribution of diet to the increasing
calcium, phosphorus, iron, and vari- bur-tices thatdespite
etary
nuts) defy demonstrably
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first recommended shown
exceptions
di-products by controlled
(eg, omega-3 trials of
fats,in risk
trans factors
fat, salt), and prospective
individual com-
o extend the nutrient Author Affiliations: Division
cer wasof Cardiovascular
known. In Medicine and
response, the Channing
goals Laboratory,
of dietary guidelines cohorts
are
of
now
disease
marketed
end points.
which
9
Fruits,
refined
vegetables,
carbohydrate
whole
generations among s
etary allowances (RDAs) were formulated in 1941, estab- pounds in isolation have small effects on chronic diseases.8
Brigham and Womens Hospitaltoandinclude
Harvard prevention
Medical Schoolof(Drs Mozaffarian and deficien-
evolved
ntion of chronic dis- Ludwig), Departmentslishing a scientific basis for modern not onlyguidelines.
dietary
of Epidemiology (Dr Mozaffarian) and Nutrition (Drs Mozaf-
nutrient 2
Thesereplaces
Thus, fat,
andproviding
grains,little nuts
of theare an aurafound
consistently
information ofassociated
healthiness
on foodwith but
lower
labels without
risk
nutri- science now provides
cies but also
efforts School chronic
set a ofprecedent, diseases.
Public Health,followed
For implementation,
to Weight
this day, for the cre-actual
this new tion health
of disease. benefits.
Fish
facts panels Schooluseful
consumption
provides nutrition
reduces risk
guidance guidelines
of cardiac
for selectingspecify
mor- food-based patterns a
DAs are methodologi- farian and Ludwig), Harvard and Optimal for Life
emphasis borrowed heavily from precedent. Accordingly, tality, belying categorization with other protein sources. Con-
If we could give every individual the
right amount of nourishment and
exercise, not too little and not too
much, we would have found the safest
way to health

Hippocrates
(460 377 BC)