 Hi everybody. Dr. O here. Welcome to chapter one in our nutrition course. This is just a basic overview. Like most science courses, the first chapter is really just an overview of things to come. We'll talk about, we'll introduce topics here in the first chapter that are really going to be covered in much greater detail. A lot of them have their own chapter coming up later. Let's go ahead and dive in. The first, we have just an icebreaker here. We all know we should eat healthy when we can, but often we make less healthy choices. What contributes to our choice of food? We'll talk about why we eat and why we choose what we eat in this chapter and really throughout the course. We all understand that food should be nourishment and food should be fuel, but food is clearly so much more than that. We make a lot of food choices based on habits, based on how we're feeling. We use food to maybe feed our emotional states as much as we do, feed our biological systems. That's something we'll talk about. That's why psychology is so important when it comes to nutrition. Most people do understand the basics of what they should eat, but most people don't eat those things either. That's something that I like to focus on a lot of this idea of how our ancestors treated food compared to us. Our ancestors, they had a sacred connection with their food and it was nourishment and it was super, super important to them in many cultures anyhow. But now it's just, we just eat based on taste and convenience and price these types of things. All right, so I'm sure you can kind of answer this question for yourself as well. So learning objectives, you can go through these, but we'll try to hit all these things here in this chapter as we go through, but we talked about food choices. We will cover, we'll introduce the major classes of nutrients. We'll talk about the scientific method and how nutrition is a type of science and what makes it a good type of science, what makes it a kind of a poor type of science. So we'll cover those types of things. The categories of the DRIs, which are your dietary reference intakes, you've probably heard of the RDA, the recommended allowance of different things with your foods. That's one of the DRIs and we'll cover all of them. Explain how the four assessment methods are used to detect energy and nutrient deficiencies. So we'll talk about the, if you were evaluating a patient or a client and evaluating their nutritional status, what types of tools might you use. And then we'll look at the relationship between food and nutrition and chronic diseases. All right, so let's jump in talking about food choices here. So why do we choose to eat? And why do we choose what we eat? What time we eat? All these types of things, right? There's tons of answers here, but you see the first choice is just preference. When you survey people about what they eat, you know, generally speaking, taste, convenience and cost are going to be the top choices, not nourishment, right? So we eat what we want to eat, basically. And unless we're purposefully trying to maintain a diet where we are eating a specific way, maybe, you know what, you're on a low carb diet, a low fat diet, a gluten-free diet. Unless you're specifically trying to eat a certain way, we basically eat what tastes good, right? So what, and that might be, it might be, you know, the chemical taste of the food. It could be a mouthfeel thing. I know there are foods that I don't eat just because I don't like the mouthfeel. Peas are a great example for me. So we eat the foods that we want to eat, right? And I think everyone should to some extent, right? We'll talk in these early chapters about the idea of sustainable diets and treat meals or cheat days, whatever terminology you want to use, right? The term diet actually just means a way of living. So we always think of it as this structured thing where we power through and white-knuckle our way through it as long as we can, but your diet is just the way that you eat, right? So one thing I want you to think about, though, is when it comes to your diet is ask yourself, if you consider yourself more of a moderator or an abstainer. So we'll talk about moderation later, but a moderator is someone that can follow that 80-20 rule, right? They can have a snack every day, or they can have a treat meal once or twice a week, and they don't really fall off the rails, right? They can have a couple of cookies, they can have a piece of pie. An abstainer is someone that does better if they completely avoid things rather than eating them in moderation. Like personally, I'm an abstainer. It is so much easier for me to just say that, no, I'm not going to have ice cream, than to decide how much ice cream I can eat, how often I can eat it. It's actually really freeing. People look at my diet sometimes and think that it's super, super strict, but I find it very freeing. If you ask me if I want an ice cream, the answer is no. I don't have to think about it, right? Because I don't have to hem and I don't have to think about, oh, maybe I can have a little bit of it. It's just easier for me to say no. It doesn't mean that I never have ice cream, but I rarely do, whereas a moderator might be able to follow more of that 80-20 rule. So habit, right? We eat when we're bored. We eat certain times of day. We eat the foods that we've always eaten. These are habits, right? And I think that these things can be changed, right? It takes some willpower and some effort to change your habits, but habits can be changed over time. So now, you know, maybe you reset this, and now your habit is to reach for healthier foods instead of foods that maybe aren't as good for you. Ethnic heritage and regional cuisines. So this, you know, I've taught students from all over the country and all over the world, and people eat the foods that they were raised eating. And I think that's really cool, right? That's one of the cool things about having a diverse student population is I get to learn so much about the cuisine and different parts of the world. And there's a lot of similarities, but obviously every area has its own flavor, even just in the United States, different parts of the country eat things differently. My wife used to live in Tennessee, and they eat foods that are much different than we do here in South Dakota and Iowa. Social interactions. This is something that, you know, over time, right? The default used to be that you ate your three meals, right? If you asked your parents if you could have a snack, they would say, no, it'll spoil your appetite for your meals. You eat your breakfast, your lunch, and your dinner. But now, food is related to everything we do, right? You go to an office and there's donuts or cupcakes sitting out. We eat when we go to the movies and the baseball games and the birthday parties and all, you know, wine and cheese mixers or whatever you want to call them. So food has become a really big part of our social interactions, for better or for worse. Marketing, right? You think about it. You know, companies are spending millions and billions of dollars to try to convince you to eat in a certain way, right? So there's the way that you, so every time you watch TV, every time you read something, every time you go on social media, you're being influenced to make purchasing decisions and that goes with your food as well. Availability, convenience, and economy. This is, you know, I said cost and convenience matter a lot. I know how busy my students are. I know how busy we are, right? It's just sometimes you have to just choose the healthiest food that you can make quickly, right? So convenience and then of course cost, right? We live at a time when food prices are skyrocketing and you have to make decisions based on cost. So there's, you know, we'll talk throughout the semester about ways to eat healthy on a budget and these types of things. This is where you see the benefits of home cooked meals. Obviously, you know, when you eat at home, food can still be kind of expensive, but it's generally much cheaper than when you eat out and meal maybe spending Sunday meal prepping and having food that you can take with you when you go to work or school will save you a lot of money because you're not you're not stopping at Starbucks and spending $7 or you're not stopping at McDonald's and spending $7 there as well. All right, positive and negative associations. This is like I love eggs but my stepdaughter can't stand them. She threw them up one time when she was a kid and she just doesn't like them. So I know that I have a family member that won't eat things that are white, right? Just because because of a bad experience. So positive and negative associations. You might, you know, you think about foods that, again, when you go to a baseball game, you're kind of craving a hot dog. I don't really crave hot dogs any other time, but it's just part of my childhood. Then there are some foods and different things that I don't like to eat because of negative associations as well. So emotions. This is what I meant earlier when I said we don't just feed, we're not just using our body to fuel ourselves, right? We use it to alter our emotional state, right? If we're happy we eat, if we're sad we eat, if we're bored we eat. All these types of things can impact our food choices. And the problem is if you're sitting around bored or stressed, you're not like, you know, I really want some kale now. It's usually I want cookies, I want soda, I want ice cream. It's these types of foods. So generally, certain emotional states make us more likely to eat at the same time. They make us less likely to make good food choices and that's a big deal. It's something that we have to confront. Our values. This might be, you know, maybe because of your concerns about animal welfare that you practice a vegetarian or vegan diet. That would be a good example there. Or maybe focusing on food quality. You know, personally we really believe in eating animal products in my household, but we also believe in animal welfare. So we get our eggs from someone that we know takes good care of their chickens. We get our milk from a Mennonite family in the area. We consume raw dairy here. We get our meat from farms that we trust, right? Where they say that, you know, the animals have really good lives and I've been out there and I've seen these places. So values certainly play a role when it comes to food choices. Body weight and health. Are you eating to maintain weight, eating to gain weight or eating to lose weight, right? And there are people that are doing all these types of things. So you look at like, you know, studies show that people that consume diet soda are more likely to be overweight. Well, that's the problem with nutritional research. Doesn't mean that consuming diet soda makes you gain weight. It means that people that are overweight and are trying to lose weight are going to consume more diet sodas. So these types of things. So nutrition, just do you eat whole foods versus processed foods versus ultra-processed foods? We'll cover that throughout the next couple chapters as well. But really all food has been processed. If you think about it, you know, your milk has been pasteurized and your meat has been cut up for you and these types of things. But even cooking food is processing it. But this is a big deal because studies show that people that consume a lot of highly refined and processed foods, they eat a lot more calories, right? You might consume, if you eat a lot of packaged ultra-processed foods, you might consume 500 calories a day more than someone that eats more whole foods and less processed foods. All right, so distinguish between processed foods and ultra-processed foods. Why is some degree of processing acceptable? At what point does processing become unhealthy? Right? This is, again, we can't do all the discussions on this video like this. This is what we talk about in class. But I think that if the processing has made the food less nutrient dense, that's when it starts to become a problem. So you see here like freezing vegetables, you know, turning milk into cheese. This is an example of a minimally processed foods that's actually kept as nutritional value or in some situations made it more nutritional for you. But when you turn corn into corn syrup, right, or you turn, you see here candy, canned cheeses, pop tarts, right? These things are examples of ultra-processed foods. Let me read that last line. Ultra-processed foods tend to be attractive, tasty, and cheap, as well as high in fat and sugar. That's a really bad situation, right, when you look at, and that's where we see this paradox, right, where we have, you know, people that have less money to spend on food are more likely to be obese and you would think, wait a minute, if you're eating, if you have less money to spend on food, wouldn't you be underweight? But the cheapest foods are generally the foods that are highest, they're dense in calories and fat and sugar. What they don't have a lot of is nutritional value. So people are being starved of nutrients while getting too many calories at the same time. So that's a bad thing, right? So you decide where you fall on this continuum, but generally speaking, that's what I look at when I think of an ultra-processed food. When you've removed the vitamins and minerals, when you remove the fiber, that's when these things become a problem. All right, so the nutrients, the six different classes of nutrients we're going to cover throughout this semester. Each of these, except for water, is going to have its own chapter, but then there will be, we'll talk about water a lot as well. So we have carbohydrates, proteins, vitamins, minerals, lipids or fats, and water. So here you see the human body on the right-hand side. You see that we know we're made of basically 50 to 70% water, mainly depending on how much fat and lean tissue we have. We have a lot of fat reserves. Even if you have a low body fat level, you still have way more energy in your fat reserves than you do in your carbohydrate reserves. Then at the top of the pictures there, you see carbs, vitamins, minerals, proteins, etc. So really, you're a big bag of water that's got some protein and some fat. All right. So let's go ahead and we'll look at these here. So some of these nutrients are going to actually provide to provide energy. That's going to be your macronutrients, your carbohydrates, your fats and your proteins. They have caloric value, whereas water, vitamins and minerals do not. So there's no calories in a vitamin or in a mineral. Doesn't mean they're not super, super important, but they don't directly provide energy. All right. And then the term essential. You're going to see this. There's a couple of terms in nutrition that you have to kind of define and one of them is essential. When you say that something is essential, what it means is you have to eat it because your body can't make it or can't make enough of it. So just because, excuse me, so we'll have like essential amino acids and non-essential amino acids. Well, you need all of them, but the non-essential amino acids aren't any less important, but your body can make them. So you can make them if you need them. So for example, there are essential fatty acids. There are fats we have to eat because our body can't make them. There are essential amino acids, like I mentioned, but there technically aren't essential carbohydrates, and that's because your body can produce them. It doesn't mean that you shouldn't eat carbohydrates. They're a phenomenal fuel source, but your body can technically make them. So they're not considered essential. So that's the word essential, what that means. All right. So let's start with, excuse me, itch, my nose is itching. Let me get a drink here. I'm not used to these longer videos. Most of my videos are four or five minutes long. All right. So let's start with the energy yielding nutrients. These would be your macronutrients, your carbs, your fats, and your proteins. So macronutrients just means you need a lot of them, right? We need grams and grams of them, whereas we need milligrams and micrograms of our vitamins and minerals. So first of all, when I say the word calorie, I'm talking about a calorie which technically should have a capital C, which you don't see here, but a Kcal is the same thing as a calorie with a capital C. So when I say a calorie or when you look at how many calories are in the muffin you're eating this morning, that actually is a thousand true calories, but don't worry about that. I don't want to confuse you. So when we're talking about calories, we actually mean Kcals or Kila calories. All right. So it's just a measure of energy, right? Carbs, fat, and protein have different amounts of energy in them, but that's what we're talking about. If you eat 400 calories for breakfast or 600 calories for breakfast, it's just a measure of how much energy was made available from the food that you did consume. Okay. So energy density is a measure of energy a food provides per gram. So this would be if you're trying to consume less calories to lose weight, then you'd want to eat foods that have less energy density. You're getting a lot more volume of food for less calories. If you're trying to gain weight, you'd want to eat foods that give you a lot of calories per gram. All right. So you see here, fat provides more energy per gram than carbs or protein. A really important point here is that so carbohydrates there are four calories per gram. Protein, also four calories per gram. And fat is nine calories per gram. So make sure you know that and then also note that alcohol is seven calories per gram. So why does fat have so much more energy than carbs and protein? It's because it has less oxygen. If you look at a periodic table, oxygen is pretty big. So fat has less oxygen so you can cram more hydrogens and carbons into a gram of fat than you can carbs or protein. So carbs, four calories per gram, protein, four calories per gram, fat, nine calories per gram, and then alcohol, seven calories per gram. All right. So why do we need energy? Well, we have to, we need energy for our metabolism. Your metabolism is a sum of all the chemical and physical processes occurring in your body. So we have to, we need, we need energy to build things and break things down and all of that. All right. So then we have the rest of the nutrients. So we just, we just covered the three macro nutrients really quickly. They have their own chapters coming up later. Now we have vitamins and minerals. So one of the first things you're going to notice here is vitamins are organic and minerals are inorganic. Here's another, another bit of terminology that you have to understand. Organic just means carbon-based. Doesn't mean that you buy it from a, from a farmer's market, right? So that, that, that means that too, but not in this sense. Organic, so vitamins are built around carbon and minerals are not. So like it says here, minerals are the simplest nutrients. They're just found on the periodic table. So calcium, magnesium, those types of things. So the, the minerals are on the periodic table. They're in the simplest form. They are not carbon-based. Whereas vitamins, so we'll look at your water-soluble and fat-soluble vitamins, they are built around carbon, which is why they're organic. Now notice that neither of these provide energy. I mentioned that before. There's no calories in vitamins or minerals, but we need them to release energy and that's especially the vitamins. So when, when, when I talk about energy vitamins, you probably think of B vitamins, right? Look at all these energy drinks that are loaded with B vitamins. There's no calories in B vitamins, but what they're needed for is the B vitamins are going to be, are going to be the, the coenzymes that are, they're going to power the enzymes that allow you to get energy from your carbs, your fats, and your proteins. So they don't directly provide energy, but you can't make energy without them. And that, that's going to be your vitamins. So minerals, we think about, you know, the minerals in our bones and our teeth and these types of things. Then water, you know, we'll talk about water a lot. I've done several videos already on, on water that I'll certainly share with you in the course shell, but water is critically important because it, like you see here at the bottom, it provides the environment in which nearly all the body's activities take place. So water is needed. We remove water from things. When we build structures, we use water to break structures apart. Water, like think about the plasma in your blood. Water carries nutrients all around your body. So water is critically important. Right. You can, you know, you can survive a few days without food. You can survive without vitamins and minerals for short periods of time. But water, we need a constant supply of water to keep us alive and healthy. And it's one of the simplest things we can do. You know, make sure you're getting enough water from a nutritional standpoint. Before you worry about anything else, make sure you're getting enough water. Right. Students will often reach out to me and say, is this good for me? Or should I try this or should I try that? Like you've got to make sure you're hitting the basics first. Okay. So what's the following facilitates the release of energy from carbs, fats and protein without actually providing energy? So we just talked about that. That would be the vitamins. So you're, I always think of your B vitamins. Right. They, and we'll cover this in the chapter on metabolism. But for example, riboflavin and niacin, two year B vitamins, they're need, they are actually what our electron carriers are built on that power the entire process of generating ATP. So if it weren't, if it weren't for vitamins, we could not generate the energy that our, that our cells need. All right. Case study. So calculate the energy available from a bean burrito with cheese. So I'll have, you know, pause this and do this yourself, but I'll, but I'll walk you through how you would do this. So you take 55 grams of carbohydrates, take that times the four calories that you'd find in every gram of carbs, 15 grams of protein, also take that times four. So because there's four calories per gram of protein, and then the 12 grams of fat, you would take that times nine. So 55 times four, 15 times four, and then 12 times nine. So let me, I'm actually going to quickly get the number because I'll need that for the next part. So 55 times four is 220 plus 60. So that's going to be 280 so far. And then 12, 12, oops. 12 times nine is 108 plus 280. So I think I got that right number, 388 calories there. But we need that for the next part. Determine the percentage of calories from each of the energy nutrients. And notice, notice how when I see K-cals, I just say calories. That's, that's calories of the capital C. So if you want to figure out the percent of calories you would take. So let's, so we got 388 calories as our total. Well, let's take that. I'll just do one of them. 108. So there's 108 calories from fat. And we divide that by the 388 calories that was total. And that would mean, so the number I get on my calculator is 0.278. So that would be 27.8% of the calories in this burrito come from fat. So make sure you can figure out that total and then make sure you can figure out the percent of calories from all three of these macronutrients. Okay. So you can, you can go through all that there, but make sure, you know, pause the video and make sure you can do that. The science of nutrition. So we won't spend a ton of time on here, but just understand that there's, there is a lot of science being done when it comes to nutrition. Nutrition is a science, but it's a very muddy science. And the problem is, you know, we're trying to figure out how we should eat to be healthy. Well, there are lots of issues with that. Number one, we have an amazing adaptive metabolism. Look at, there are people that are extremely healthy that eat high fiber diets. And then there are some people that eat carnivore diets and don't have any fiber and they seem to be okay. And I wouldn't recommend that, but there are people that eat really high carb diets and really high low carb diets and seem to be super healthy. So the problem is, the key is, you need to find out the best way you should eat, right, based on your genetics and your lifestyle. And so there is no perfect human diet. And so we're studying diets, trying to find a perfect human diet that I don't think really exists. The other big issue is, we're looking at how changes in our diet make us more or less healthy. The problem is, there are, we make millions of decisions in our lifetime that impact our health. And yes, diet is a big part of it. But let's say you have the perfect diet, but you're not sleeping well, you're stressed, you're not drinking enough water, you smoke cigarettes, you're not exercising. You're not going to be healthy. And then someone else can have a diet that's not as good, but checks all those other boxes and they're doing great. So it's really, really difficult to determine if your diet is what's making you healthy or unhealthy. Let me give you another example. So years ago, studies used to show that people that ate vegan diets lived quite a bit longer than people that didn't. And I'm not saying anything against a vegan diet. We'll cover them more later. But what they basically found is it's called the healthy user bias. People that were vegetarian or vegans and took their diets really seriously, also made tons of other positive, healthy decisions. They're less likely to smoke, more likely to exercise, more likely to do things like meditation or other self-care practices, more likely to drink enough water, less likely to drink soda, right, these types of things. So they made hundreds of positive, healthy choices every day and yes, they were healthier. But studies have now compared healthy vegan diets to healthy diets that have animal products. Instead of comparing a healthy vegan diet to the standard American diet full of pizza and french fries, if you compare, let's say, the healthy vegan diet to a healthy paleo diet, which is based on food quality as well, the health disparities disappear. So it's very, very difficult to treat nutrition like other scientific fields. So, all right. So what we're learning a lot, we're learning a lot. I'm really fascinated by the research being done now using continuous glucose monitors. So they're studying people like constantly monitoring their blood sugar. But the main things that I've learned from those studies is how different we are. Right, you take two people that seem exactly the same. Give them both a cookie. One of them gets a huge blood sugar swing. Other one doesn't. But then you give them both ice cream and the opposite happens. Right, the person that whose body didn't seem to tolerate that cookie very well, when they consume the ice cream, they didn't see a big swing in their blood sugar. But the person that, you know, the other person had a major, major change. And then the other things we're learning is how much other factors play. Right, both of them, if they both have a cookie and one of them slept well and was managing their stress, the cookie's going to be less of an issue than the person that's sleep-deprived and stressed out and all these types of things. So it really is, the hard part about teaching a class like this is I can kind of give you these general ideas, these general rules to follow. You know, I think that making sure your diet is more nutrient dense is never going to hurt you. But I cannot tell you how to eat because we are all so different. Okay, so the scientific, using the scientific method for research, here's another big weakness in nutrition research. It's real easy to do a drug trial. Right, you do a randomized double-blind controlled trial where two groups of people, one's given a fake pill, one's given a real pill. Everything else about them is the same. And then you see if the pill works better than nothing, right, than a fake pill. But nutrition just doesn't like that, right, because we eat so many times, we make lots of decisions. So a gold standard nutrition research study would be what's called a metabolic ward study where they would basically lock you in a metabolic ward and they would control everything you eat. They would make sure you eat everything on your plate. They would weigh your urine and fecal material. They would analyze every single thing. Studies like this are really expensive. So when they are done, they have to be pretty short and they have to only have a few people. Right, so it's easy to test a vaccine on tens of thousands of people. A metabolic ward study, you're only going to have a handful of people for a short period of time. So there are a lot of inherent weaknesses in nutrition research. But and that's why we need to kind of weigh the evidence, right? We have to understand that we don't have as good of this gold standard research for nutrition. So it's a part of the decision-making process when it comes to what we should eat and what we shouldn't eat. But it's not that gold standard like it is in some of their fields. Okay, so a control. What is a control? Looking at research studies, a control is a standard of comparison. If you want to see if adding dairy products makes someone more or less healthy, then you have a control where you don't change their diet and then you have the test group that you add dairy products to. I'm just thinking of an example. Placebo, so the reason you want controls is because you do want to see if there's a placebo effect. So a placebo effect would be if someone thinks they're getting treated or someone thinks something's going to make them healthier, to some extent it will. The opposite of that's called the no-cebo effect where if someone thinks something's going to cause a problem, it is more likely to. So if you and they do this, they do these kind of studies in nutrition research like they I saw a study recently where they had people ingest like oatmeal-like substance prior to working out that had carbs and had calories in it and they had a second group that had a control. It was like a sludgy mush that was similar to this oatmeal and similar in flavor and texture and everything else, but it didn't have calories. It used artificial sweeteners in it. So both groups thought they were getting breakfast. One was getting calories and one wasn't. And then they actually looked at the difference. And the placebo, the group that thought they were getting breakfast, did better than a group that didn't get breakfast. So the placebo effect does matter. All right, I mentioned the double blinds already. Actually, I didn't. A double blind would be so a blind that experiment means I don't know if I'm getting a real pill or a fake pill. A double blind means the person giving me the pill doesn't even know if it's a real pill or a fake pill. Someone else in the background knows. So everyone's blinded to minimize placebo effect, to minimize bias. So the scientific method, we make observations about the world. Basically, you identify a problem and you start asking questions. So then you formulate a hypothesis, which is an educated guess to what you think the answer to that question is going to be. Then we make predictions. I like to call these if then predictions. So if my hypothesis is true, then this is what we'd expect. And then we test it. And then you design the best study you can to test it. And when you analyze the results, you determine if your hypothesis was true. And if it was, like I said here, if your hypothesis supported, then you test it over and over and over again. You have other groups test it. And if they all come back to the same result, then the hypothesis can become a theory, which has a high probability of not being wrong. If you go and your results of your tests show that your hypothesis was incorrect, then you make new predictions, ask new questions, and you continue the scientific process. That's the process, right? So when you look at, when you ask someone a question about science, especially when it comes to nutrition, and if they say the answer is it depends or they say they're not sure, then they're being truthful. If they're certain about the answer, you need to be really careful because that's just not how science works. People should always be changing their minds as data changes and more information comes out. Different types of research, let's go through this pretty quickly, but epidemiological studies, so we're just observing people. So a cross-sectional study, you basically have, you know, you're just gonna, you're following people over time. A cross-sectional study, you basically look backwards and say, okay, what these people have a disease, these people don't, what they do differently. That would be one example. Case control, you've got a group that did something and a group that didn't, and we look for differences. Cohort studies, you follow, so this would be prospective, you follow a group of people over time, and you see how the choices they make impact their health. So those would be some ways to observe people. The big problem with these types of studies is they are observational, and like I mentioned before, whether or not you eat carrots is a pretty small part of the picture of how healthy you're going to be. We've got genetics and environment and other factors. So it's really hard to determine how big of a deal eating carrots is, you know, just as an example. So observational studies can't answer questions, right? They basically tell us which questions to ask when we do real experimental studies. So that's really the best you can get with observational studies. Now, I still believe in them, and they are part of the evidence that we weigh, but we just have to be careful not to put too much stock in observational studies. All right, experimental studies. So lab-based studies that use animals. Lab-based studies in vitro, I believe it means in glass. So you think about like in Petri dishes, in test tubes, in cell cultures. So those would be some different lab-based studies we can do. And then human intervention trials. So I try not to put too much stock in anything until we get to human trials. I feel like the epidemiological studies and the animal and cell culture studies, they can really help us decide what type of studies to do in humans. But I want to know how diets impact humans. Not how diets impact rodents, right there. Rodents are similar to us and we can answer some questions there. But the human trial data is what we really, really need to get to before we can really truly answer a question. All right, analyzing research findings. Correlations only show association. So what they say there is correlation is not causation. I think there's an example here later on the PowerPoint but about how as ice cream consumption goes up, so do shark attacks. So there's a link between ice cream consumption and shark attacks. That's a correlation. There's no causation there. What do they both have in common? They happen during the summer when it's warm out, right? So that's a good example of correlation not equaling causation. All right, so that's why we have to be careful when we interpret nutritional research and we have to let it accumulate, right? If you show me 10 studies that say the same thing, I will put more stock in that than a single study that says something else. So we weigh the evidence basically. All right, publishing research, I'm just, you can read through this. It's not a huge deal at least for the level of class that I'm teaching. So you can just read through these here. But I would say this, you know, when you're looking at nutrition research, you always want to check the references, right? Make sure that the person that wrote the abstract, the person that did the study that they actually, the references they used actually make sense in the light of what they're saying. But all right, actually I mentioned this earlier. This would be the correlation. This is a correlation between shark attacks and ice cream consumption because when it's hot, you get in the ocean. When it's hot, you eat ice cream. That's basically what we're talking about there. All right, dietary reference intakes. So now we're getting to something else that's really important again. So the dietary reference intakes are the nutrient intake values for healthy people in the US and Canada. So you see here, we have several here. The EAR is the estimated average requirement. The RDA is the recommended dietary allowance. The adequate intake is the AI, or AI is the adequate intake. And the UL is the tolerable upper intake level. Then there are some calorie ones as well. All right, so let's look at these four individual examples coming up here. So first of all, you've never seen, like on a label, you've never seen the EAR. The estimated average requirement is how much of a nutrient we need for 50% of the population to be healthy, which is way too low of a number. So the EAR's job is we use it to set the RDA. So if you look at your food packaging, you will see the RDA, the recommended dietary allowance. So the EAR is what we use to get to the RDA. So the RDA or the recommended dietary allowance is how much of a nutrient do we need to meet the needs of about 98% of the population, of healthy people. So the RDA is the floor. I look at the RDA as the floor. It's the bare minimum we need for most people to be healthy. So it's the minimum. It's not your goal. So make sure when you're looking at your food labels that you understand that. It is not your goal to reach the RDA. That is the bare minimum you need. You want to be somewhere between the RDA and the UL. So the EAR is just used to set the RDA. The RDA is our floor. So what's the ceiling? The UL, or tolerable upper intake level, is if you consume more than that, now you're risking toxicity. So if you consume less than the RDA, you're risking deficiency. Like if you're not consuming the RDA of vitamin C, you'll get scurvy. The UL, if you consume, like let's say calcium, if you're consuming way too much calcium, above the UL, or tolerable upper intake level, you can start to see calcification of your soft tissues. So if the RDA is the floor, the UL is the ceiling, we want to eat somewhere in the middle. So somewhere in the middle is optimal. The problem is we don't know exactly where it is. We just know it's between the RDA and the UL. But that's how we use those. So what is the AI, or adequate intake? This is going to be, it's like the RDA, but for things that we can't have an RDA. So let me explain. So like with vitamin C, we've studied it for decades and we know exactly how much vitamin C you need to reach the RDA and not be at risk of getting scurvy for a typical healthy person. But with some nutrients, we can't do that. One good example would be vitamin D. Vitamin D has an AI or an adequate intake. So if we can't prove what the RDA would be, then we have to make our best guesses. And that's what the adequate intake would be. It's like an RDA for something that you can't actually create the RDA. So why can't we tell you, why can't I tell you exactly how much vitamin D you need to eat today? Well, we all metabolize it differently, but the big thing is we get it from sunlight too. So where do you live? How much are you outside? Right? How many clothes do you wear when you're outside? All the, do you wear sunscreen? All these types of factors would impact how much vitamin D you make. So I don't know how to tell you how much to eat. If you're a lifeguard and you're outside shirtless all day long, you probably don't need any of it. But if you're indoors and you don't see much artificial or sunlight and it's the middle of winter, you're going to need more of it. So that's why I can't tell you how much to consume. That's why it doesn't have an RDA. Vitamin K is another example because about half the vitamin K you get comes from the bacteria in your gut. So I don't know how much vitamin K your gut produces. So it's really hard for me to tell you exactly how much you should eat. All right, so we'll go through these. The estimated average requirement meets the needs of half the population. So again, not a valuable number. It's just useful to create the RDA. The tolerable upper intake level protects against toxicity, getting too much of something. The recommended dietary allowance or RDA meets the needs of 98% of the healthy population. So that healthy is a key word there. If you have some sort of GI problems, if you have some sort of gastrointestinal disease, you're going to need more. Or if you have any sort of condition that impacts your ability to digest and absorb nutrients, then you're going to need more than the RDA. The adequate intake is when there isn't enough evidence to establish the EAR and it's used instead of the RDA. We mentioned that. And the RDA will always be set above the EAR, which makes sense, because the EAR only meets the needs of half the population. And then another one of the DRIs is our EER, Estimated Energy Requirement. The average dietary energy intake to maintain energy balance is basically, so how many calories do you need to eat a day? Which you need to eat as many as you burn if you're trying to maintain your weight. So there's tons of ways to look online and try to figure out your energy requirement. But the only real way to do it for you, if you've seen these calculators online, they're all over the place, you need to eat a certain number of calories and basically know how many you're eating. If you're gaining weight, you're eating too many. If you're losing weight, you're eating too few unless you want to, of course. If you're maintaining weight, you're eating the right amount. So really, that's how you determine your energy requirement. I go to a lab and I get my rested energy expenditure tested. You can do that. But that still only tells me how many calories I burn at rest. It doesn't tell me how many calories I burn. My total daily energy expenditure would be a different number. So you use the online calculators to get in the right ballpark, but then you have to change it up and down. If you're gaining weight, you're eating too much. If you're losing weight, you're eating too little. If your goal is to maintain weight, that's your estimated energy requirement. All right. So now we have the last DRI is the Acceptable Macronutrient Distribution Range, or AMDR. This is what the government recommends as far as the macronutrient breakdown of your diet. So you'll see here, looking if you match these, that the AMDR for carbohydrates is 45 to 65% of your energy expenditure. The AMDR for protein then would be 10 to 35% of your calories, and the AMDR for fat would be 25 to 35% of your calories. So a lot of people think that's a high number for fat, but that is the AMDR. Obviously, there's going to be a lot of variation here. It depends on if you're an endurance athlete, then you'd want to be closer to 65% of your carbs, which means that your fat would have to be a little lower, protein a little lower, these types of things. There are people that, and I'm not saying everyone needs to eat this way. I certainly don't. I eat a lower carb diet. I don't eat, I'm not on a ketogenic diet or anything, but I'm on the lower end when it comes to carbohydrates for sure. So I eat a diet that's lower carb, moderate protein, and then moderate to fat. And I actually like a lot of protein as well. But so everyone's different, but this would be the government recommendations that you start here. So just like with the calories, I think this is a great place to start, and then you play with it and see what diet works best for you. Okay. How do we use these recommendations? I mean, like I said, they're just, they're a great jumping off point, but you've got to figure out what works for you. So here you see three different examples. You see someone that, on the far left, they're eating a lot. This would be like maybe an endurance athlete. So they're getting a lot more carbohydrate calories because they need to fuel their training. Whereas someone in the middle, you see they're on a more of a high protein diet. And then on the right, you got more of a, kind of a moderate diet throughout, but all three of these people would satisfy those AMDRs. So assessment. A couple of terms here that are important. And I'm not, you know, this is an introductory course, so I'm not going to spend a ton of time here, but there are some terms you need to understand. Malnutrition, I think it's really important we talk about this because when I say malnutrition, you probably think of someone that's starving or has some sort of deficiency disease. And that can be true, but let me read the definition. Caused by excess or deficient food energy or nutrient intake or by an imbalance of nutrients. So if you're eating too many calories or too much sugar or too much of a nutrient, you're malnourished, right? Or malnutrition, sorry. So malnutrition is either an excess or a deficiency. So under nutrition is deficient energy or nutrients and over nutrition is excess energy or nutrients. This would be most people on the standard American diet are both. So we eat a diet where we were getting too few vitamins, too few minerals, maybe too little fiber, but then we're getting, that's under nutrition. And then over nutrition, too many calories, too much sugar, too much saturated fat, etc. So most people are experiencing both at the same time, which is clearly not a good thing. All right, so what are some symptoms of severe malnutrition? You see here, GI problems, these types of things. That would be the situation where someone would have to evaluate that and figure out what's going on. But so what kind of nutrition assessments will we see here? So first, if you see historical information, so this, you know, health histories, socioeconomic status, drug use, kind of like an intake you'd see at the doctor's office, certainly can help. If you find out that someone is an alcoholic, for example, you would look for certain things when it comes to malnutrition. Diet history, I think diet record or diet diaries a great tool. So you see here, measures of the intake over several days. Sometimes you have people use like things like my fitness pal or chronometer. Sometimes you have them take pictures of everything they eat. Then you can, or you can just do a diet record where someone writes down everything they eat. A gold standard diet record would be seven days, basically three to seven days, but seven days would be ideal. If you're going to do a three day diet diary, I recommend at least one of those days be a weekend day. So you can get like, cause a lot of people eat a lot differently during the week than they do on the weekends. But really the longer a diet diary, the better. Those certainly work better than just asking someone generally what they eat, right? Actually knowing what someone eats is a big deal. Anthropymetric measurements, things like height, and weight. That'll be how you determine a BMI, for example, which we'll cover later. Waste circumference is going to be really, a really big deal. So those are the some measurements you can use. Physical exam, looking for signs of problems, like signs of deficiencies, nutrient deficiencies, or signs of toxicities, and lab tests, right? If you want to know how, what someone, if someone needs to consume more vitamin D, the simplest thing to do is to test their blood levels of vitamin D and see if they're normal or not. All right. So you can read through this. Again, this is a pretty small part of what we're going to be covering here. But, if you do a diet history and a health history, you run some lab tests and you examine a patient, then you can learn an awful lot about the nutritional status. Okay. What type of deficiency is caused by something other than an inadequate intake? So it's a primary deficiency is when you're not consuming enough of something. A secondary deficiency is when you're consuming enough of it, but it's not being properly digested, absorbed, or stored, etc. So that would be so a secondary deficiency. Okay. Nutrition assessment of populations, we have our national nutritional surveys that, you know, the like NHANES would be an example here. These are all great things, but they just, they're limited in how much value they have because people suck. No offense. People suck at remembering what they eat and or keeping track of it. So when we take, when we survey people and ask them how much block of the eat, they're generally going to say they eat more block than they actually do. When you survey people and ask them, so does they drink, they're generally going to say they drink less than they do. Things like that. Like just as an example of how kind of inaccurate these surveys can be, if you believe this information, we can only account for half of the alcohol that's purchased in the United States. So, so either half of it's being poured down the drain or people are, I'm not saying people are lying, but they're not really good at remembering or tracking. One study even showed registered dietitians were 10% off when they, when they, when they, when they were surveyed as far as what they actually consumed versus what they thought they consumed. So if a professional has problems, then of course the rest of us will as well. People that are overweight generally are going to underestimate their food intake more than people that are not. And same thing with physical activity. People underestimate how much they eat. They overestimate how physically active they are. So there's, so this, this stuff is important. I'll take any evidence I can get, any data I can get, but we have to remember that. All right. The Healthy People Program is just its initiatives to try to get people to consume more fruits and vegetables and these types of things. It's all, all good. All right. So how important is your diet to staying healthy? Right. It's obviously, if you look at the big ones, sleep, water, stress reduction, physical activity and exercise and diet though, if you do those things that's like, besides genetics, right? That's like 95, 99% of what's going to impact how healthy you are. So here you see the leading causes of death in the United States. We have the first two, heart disease and cancer. We have, you see accidents, lung diseases, then you go strokes, Alzheimer's, diabetes, immune system issues, almost all of these, nutrition and lifestyle factors are going to play a huge role. So if you, I always say your goal should be to die of nothing, right? Should be to die of old age and if you want to die of nothing then you have to reduce your risk of dying of these types of things. And some of these, you know, diet has a huge impact on heart disease risk and cancer risk and blood pressure and diabetes, all these types of things. So diet plays a huge, huge role. Okay. So risk factors for chronic disease is, you know, obviously we just mentioned them. Do you smoke or not? Are you overweight or obese or not? Your diet and physical activity, those are the big ones. Despite evidence linking certain behaviors with chronic diseases, many Americans continue to engage in unhealthy behaviors. What can you do as a student to improve health behaviors? This is what, you know, we mentioned, we just said these things. We know this, right? We, now knowing something and doing something are two different things, right? We absolutely know we shouldn't smoke. We know we should be more physically active. We know we should exercise. We know we should try to control our body weight. And, you know, we should sleep, all these kinds of things. So I don't know. You just got to want it, right? And, you know, I said I've actually lost 150 pounds. And I know that, you know, that I had to make changes. I didn't smoke, but I had to make changes in every other facet of my life in order to do that. And I'm so happy that I did. And now it's just part of my new life. There's no going back. But it wasn't easy in the beginning, right? So you have to be motivated. You have to want it. And then over time, your motivation is going to wane and you have to be disciplined. And you got to stick with it until your new life becomes the habit that you fall back to. So feel free to ask questions about that. I love talking about it. But it just shows you that the psychology and behavior change are critically important when it comes to diet and lifestyle. Okay. So we're done with our first chapter here together. So you can, you know, hopefully you've learned a little bit about all these types of things. And this is awesome. So I will, I will do one of these videos for every chapter. And then I plan on doing a whole bunch of shorter little topical videos as well like I normally do. But I'm really excited about this to help you learn. All right. So you reach out if you need anything. Have a wonderful day. Be blessed.