Chapter 1 Notes (1)

Chapter 1 Have you ever considered what drives your food choices? You obviously need food to survive, but beyond your basic instinct to eat are many other factors that affect your food choices. These factors include taste and enjoyment; culture and environment; social life and trends; nutrition knowledge; advertising; time, convenience, and cost; and habits and emotion Research confirms that when it comes to making food choices, taste is the most important consideration. This preference for sweet, salty, or creamy foods begins during infancy, may be influenced by our genes,4 and changes as we age. We have a taste for fat, which may also be genetically linked. When fat is combined with sugar, such as in a sugar-laden doughnut, our taste for that food is even stronger. Researchers have suggested that these preferences for sweetness, high fat, and specific textures begin early in life and this makes them resistant to change. The environment in which its people live significantly influences a culture’s cuisine. Foods that are available and accessible are more likely to be regularly consumed than foods that are scarce. For example, native Alaskans feast on fish because it is plentiful, but eat less fresh produce, which is difficult to grow locally Our food environment—the variety of food choices available, the size and shape of plates and glassware, the packaging of foods, and the types and amounts of food that are visible—has a strong influence on what and how much we consume. We eat more food when the serving plates are larger, or drink less when beverages are served in taller glassware. Environmental cues also affect eating patterns. You are more likely to linger over a meal when the light is dimmed, or quickly finish your meal when you are standing rather than sitting. Physical cues, such as a friend’s empty appetizer plate covered with disposed-of cocktail sticks, may signal you to eat more Every year on the fourth Thursday in November, over 85 percent of Americans gather with family and friends to consume close to 736 million pounds of turkey as they celebrate Thanksgiving.12 A person is likely to eat more on Thanksgiving than on any other Thursday, and this is partly because of the number of people eating with them. Eating dinner with others has been shown to increase the size of the meal by over 40 percent, and the more people present at the meal, the more you’ll eat. For many people, activities such as watching a football game with fellow fans or going to a movie with friends often involve particular foods. More pizzas are sold on Super Bowl Sunday than on any other day of the year. Movie theater owners bank on their patrons buying popcorn, candy, and beverages at the concession stand before heading in to watch the film, and moviegoers are more likely to buy these snacks if they’re with a group of friends. Food choices are also affected by popular trends. For instance, home cooks in the 1950s bought bags of “newfangled” frozen vegetables in order to provide healthy meals in less time. Today, shoppers pay a premium for bags of fresh veggies, like carrots, that have been prewashed and peeled, sliced, or diced, and they pay even more of a premium if the food is labeled “organic.” In 2011 alone, Americans spent more than $29 billion on organic foods. Now most markets provide dozens of choices in flavored and enhanced bottled teas, a popular beverage for many college students. Individuals may choose certain foods because they perceive them as being healthy, or avoid other foods that are associated with weight gain or loss. For example, Americans consume more vegetables and fruits to control blood pressure and prevent colon cancer. At the same time, Americans worry about fried eggs causing heart disease and butter-laden pastries or sugar-sweetened beverages leading to obesity. The latest research suggests that consumers are paying more attention to nutrition labels when purchasing foods now than in 2011. The more aware you are of the effects of food choices on health, the more likely you are to make an effort to improve your eating habits, even when dining out.20 If you believe that low-sodium foods decrease blood pressure or eating Greek yogurt with active cultures improves your digestion, you are more likely to choose these foods. Manufacturers spend $10 billion to $15 billion annually on food advertising, over $700 million of which is spent to market breakfast cereals, candy, and gum. Another $500 million is spent to advertise carbonated soft drinks. You probably saw at least a few processed food ads as you surfed online, watched TV, or drove to campus today. In comparison, when was the last time you saw an advertisement for broccoli? Food companies spend these large sums on advertising for one reason: They work, especially on young people.22 American children view up to 40,000 television commercials annually. On Saturday morning, more than half of the between-cartoon ads are for foods. Of these, over 40 percent are for items such as candy, soft drinks, chips, and sugary breakfast cereals. When the dairy industry noted a decline in milk consumption among Americans in 1994, it launched the Got Milk? ad campaign, which featured celebrities wearing milk mustaches. Milk sales increased by nearly 1.5 billion pounds: the equivalent of about 45 pounds of milk sold for each advertising dollar spent. Americans, especially working women with families, spend less than 30 minutes preparing a meal, including cleanup. For reasons related to both time and convenience, people eat out more often today than they did a few decades ago. In the 1970s, Americans spent about 33 percent of their household food budget on eating out, compared with over 49 percent today. Epidemiological research suggests that low-cost, high-kilocalorie diets, such as those that incorporate lots of burgers, fries, tacos, and soft drinks, increase the risk of obesity, especially among those at lower socioeconomic levels. Researchers have found that lowering the cost of fresh fruits, vegetables, and lower-fat snacks improves the consumption of these nutritious foods.29 Results were consistent across various food types and populations. These studies demonstrate that price reductions are an effective strategy to increase the purchase of more-healthful foods. Habits and Emotions Your daily routine and habits often affect both when you eat and what you eat. Ready-to-eat cereals are the number-one breakfast food choice among Americans, and citrus juice is their top juice in the morning. Many individuals habitually snack when watching television or sitting at the computer. For some individuals, emotions can sometimes drive food choice: feeling happy or sad can trigger eating. In some cases, appetite is suppressed during periods of sadness or depression. For many, food is used as an emotional crutch during times of stress, depression, or joy What is Nutrition? The science of nutrition is the study of food and the nutrients we need to sustain life and reproduce. It examines the way food nourishes the body and affects health. The science of nutrition has explored how food is digested, absorbed, transported, metabolized, and used or stored in the body. Nutritional scientists study how much we need of each nutrient, the factors that influence our needs, and what happens if we don’t consume enough. The body is one large organism made up of millions of cells that grow, age, reproduce, and die, all without your noticing. As cells die, nutrients from food provide the building blocks to replace them. Nutrients also provide the energy we need to perform all body functions and processes, from maintaining heart beat to playing tennis. What are nutrients and what are the six classes of nutrients? Nutrients- Compounds in foods that sustain body processes. There are six classes of nutrients: carbohydrates, fats (lipids), proteins, vitamins, minerals, and water. There are six categories of nutrients found in foods and in the body: carbohydrates, lipids (fats), protein, vitamins, minerals, and water. Foods also often contain nonnutrient compounds, such as phytochemicals or zoochemicals, nondigestible fiber, and other chemicals added by food manufacturers to enhance color, flavor, or texture, or extend shelf life. Water is the most abundant nutrient found in foods and in the body. Carbohydrates, fats, protein, vitamins, and minerals make up the rest. A healthy human body is about 60 percent water. The other 40 percent is made up of protein and fat, as well as a small amount of stored carbohydrates, minerals in the bone, and small amounts of vitamins. Thus, the old saying is true: we are what we eat, from the carbohydrates in broccoli to the proteins in meat; What are the organic vs inorganic nutrients? What is an essential and nonessential nutrient? Carbohydrates, proteins, lipids, and vitamins are the most complex of the six classes of nutrients. These nutrients are organic because their chemical structures contain carbon. Minerals are the least complex of the nutrients and are inorganic because their chemical structure does not include carbon. In general, nutrients are essential and must come from foods, because either they cannot be made in the body, or they cannot be made in sufficient amounts to meet the body’s needs. A few nonessential nutrients can be made in sufficient quantities in the body. An example of this is vitamin D, which is synthesized in the skin upon exposure to sunlight. Under some circumstances, nonessential nutrients can become essential. We refer to these nutrients as conditionally essential. In the case of vitamin D, if you are not exposed to enough sunlight, you will not be able to synthesize an adequate amount of the vitamin. You must then obtain vitamin D from foods. What is energy? What are the energy providing nutrients? How much energy do the energy providing nutrients provide? What is a Kilocalorie? All creatures need energy in order to function, and humans are no exception. Energy is defined as the capacity to do work and provides a source of heat. The body derives chemical energy from certain nutrients in foods, which store energy in their chemical bonds. During digestion and metabolism, the bonds are broken, and the energy is released. This chemical energy released when the foods are digested can be converted into adenosine triphosphate (ATP), a form of energy the body can use. Carbohydrates, lipids (fats), and proteins are defined as the energy-yielding nutrients because they contribute energy to the body. Alcohol, although not a nutrient, also provides energy. To add to the confusion, the term Calorie (with an uppercase “C”) is used on nutrition labels to express the energy content of foods and is often used in science textbooks to mean kilocalories. This textbook will refer to the units of energy found in foods as kilocalories, abbreviated kcalories or kcals. Each energy-yielding nutrient provides a set number of kilocalories per gram. Carbohydrates and protein provide 4 kilocalories per gram Fats yield 9 kilocalories per gram, more than twice the number of kilocalories in either carbohydrates or protein. Alcohol contains 7 kilocalories per gram Calculating Kilocalories in a Meal Suppose you ate an entire bag of potato chips and drank a 16-ounce cola while you studied for an exam. Together these two items contain 144 grams of carbohydrate (in the cola and chips), 12 grams of protein (from the chips), and 60 grams of fat (also in the chips). How many kilocalories did you consume? To calculate the total kilocalories in this snack, multiply the total grams of each energy nutrient times the number of kilocalories per gram of that nutrient. Remember, a gram of carbohydrate and protein each contain 4 kilocalories and a gram of fat contains 9 kilocalories. (144 g × 4 kcals/g) + (12 g × 4 kcals/g) + (60 g × 9 kcals/g) = 1,164 kcals 576 kcals + 48 kcals + 540 kcals = 1,164 kcals In one sitting, you consumed more than 1,100 kilocalories, which for some people may be more than half of the amount they need to meet their daily energy requirement. If behaviors like this become habits, they can quickly result in weight gain. (b)Another useful measure for assessing the nutritional quality of the snack is the percentage of fat, protein, and/or carbohydrate found in the food (you will learn in later chapters that there are ranges for each nutrient that are considered part of a healthy diet). For example, what percent of kilocalories in the chips and soda is from fat? To answer this question, divide the fat kilocalories by the total kilocalories in the food and multiply by 100: (540 kcals ÷ 1,164 kcals) × 100 = 46% fat Almost half of the kilocalories in this snack are from fat. Do you think this is likely to be a desirable proportion? How does energy needs of people vary? People’s energy needs vary according to their age, gender, and activity level. Males generally need more energy because they weigh more, and have more muscle mass (which requires more kilocalories to function) and less body fat. A younger person requires more energy than an older adult because he is still growing and is therefore synthesizing more new tissue. Physically active individuals require more energy than sedentary people to fuel their activities and meet their body’s basic energy needs. What happens to the energy not used as fuel after eating? Energy that is not used to fuel the body will be stored, predominantly as fat, for later use. If you regularly consume more kilocalories than you expend, you will accumulate stored fat in adipose tissue and gain weight. The opposite is also true. Eating fewer kilocalories than the body needs will result in the breakdown of stored energy and weight loss. What are the functions of the nutrients in the body? Individual nutrients supply energy, regulate metabolism, and provide structure (Table 1.1 ). Some nutrients, including carbohydrates, lipids, proteins, and water, are called macronutrients (macro means large) because they are needed in much larger amounts to support normal functioning. Vitamins and minerals, though equally important to health, are considered micronutrients (micro means small) because they are required in smaller amounts to perform their key roles. What is the primary energy source for the body? What foods provide carbohydrates? Carbohydrates Are the Primary Energy Source All forms of carbohydrates are composed of carbon (carbo-), hydrogen, and oxygen (hydrate means water). Carbohydrates supply the simple sugar, glucose, which is the primary source of energy for several body cell types, including red blood cells and brain cells. Carbohydrates are found in most foods. Breads, cereals, legumes, nuts, fruits, vegetables, and dairy products are all rich in carbohydrates. The only foods that do not provide significant amounts of carbohydrates are animal products other than dairy, such as eggs, meat, poultry, and fish. What are lipids? What foods provide fat? The term lipid refers to a diverse group of organic compounds including fats (also called triglycerides), oils, phospholipids, and sterols that are insoluble in water. The difference is that lipids are much more concentrated than carbohydrates and contain less oxygen and water. Triglycerides make up the majority of the lipids we eat and are found in margarine, butter, oils, and animal products. Triglycerides are an important energy source for the body, especially during rest and sleep. The body stores excess energy as triglycerides in the adipose tissue beneath the skin, which insulates the body and cushions the organs. What are the functions of protein in the body? What foods contain protein? Proteins provide the building blocks for tissue synthesis Proteins contribute the basic building blocks, known as amino acids, to synthesize, grow, and maintain tissues in the body. The tissues in muscles, bones, and skin are primarily made up of protein. Proteins also participate as neurotransmitters in the complex communication network between the brain and the rest of the body, and they play a role in the immune system and as enzymes that catalyze chemical reactions. But proteins are unique in that they all contain the element nitrogen, and some also contain sulfur. Proteins can be used for energy but are usually not the primary energy source. Protein is found in a variety of foods, including meats, dairy products, and legumes such as soy, nuts, and seeds. Whole grains, vegetables, and some fruits contain smaller amounts of protein. Meats and dairy products are excellent sources of protein. Plant products, such as nuts, seeds, and legumes, also provide protein to the diet. What are the functions of vitamins and minerals? Vitamins and minerals do not provide energy, but they are involved in numerous key functions in the body. They are essential to help regulate metabolism, for example, and without them we would be unable to use carbohydrates, fats, and proteins for energy or to sustain numerous chemical reactions. How are vitamins classified? There are 13 known vitamins, and each has a unique chemical structure. They are grouped into two classifications according to their solubility, which affects how they are absorbed, stored, and excreted. Water-soluble vitamins, which include vitamin C and the eight B-complex vitamins, are easily absorbed and excreted by the body, and need to be consumed daily. The fat-soluble vitamins, A, D, E, and K, are stored in the liver and other organs and thus don’t need to be consumed on a daily basis. What are minerals and how are they classified? Minerals are inorganic substances that assist in body processes and are essential to the structure of hard tissues, such as bone, and soft tissues, including the red blood cells. Minerals such as calcium and phosphorus work with protein-containing hormones and enzymes to maintain and strengthen teeth and bones. Falling short of daily iron needs, for example, can cause fatigue and impair your immunity. Minerals are classified by the amount needed in the diet and total content found in the body. Major minerals are needed in amounts of at least 100 milligrams per day, and are found in amounts of at least 5 grams in the body. Calcium and magnesium are two examples of major minerals. Trace minerals are needed in amounts of less than 100 milligrams per day and are found in amounts of less than 5 grams in the body. Iron and zinc are two examples of trace minerals. What are the functions of water in the body? Some of the essential roles of water in the body probably seem obvious, as it makes up the majority of all body fluids, including digestive secretions, blood, urine, and perspiration. Less obvious is the fact that water is part of every cell in the body, from muscle and bone cells to brain and nerve cells. It is essential during metabolism Water functions in digestion and absorption, and as a transport medium that delivers nutrients and oxygen to the cells and excretes waste products through the urine. Because the body can’t store water, it must be replenished every day to maintain hydration. What will happen if you are deficient in any of the six classes of nutrients? How can you meet your needs of all the essential nutrients? There is no question that you need all six classes of nutrients to function properly. A chronic deficiency of even one nutrient will impact the body’s ability to function in the short term. Over time, chronic deficiencies, excesses, and imbalances will affect long-term health. The Best Approach to Meet Nutrient Needs Is a Well-Balanced Diet Most credible nutrition experts will tell you that the best way to maintain nutritional health is to eat a variety of whole foods, including whole grains, fruits, vegetables, lean meats, and low-fat dairy. Whole foods and a well-balanced diet will also provide other dietary compounds, including phytochemicals, zoochemicals, and fiber, which have been shown to help fight many diseases. Further, whole foods almost always contain more than one beneficial compound. What are functional foods, phytochemicals, and zoochemicals? Americans have been consuming functional foods to improve their health since the late 1920s, when iodine was first added to salt. Today’s functional foods include whole foods such as oatmeal, genetically modified foods that are developed to have a higher nutrient content, and foods that contain or have been fortified with phytochemicals and zoochemicals. Functional foods-Foods that may provide additional health benefits beyond the basic nutrient value. Phytochemicals-Nonnutritive plant compounds, found in fruits and vegetables, that may play a role in fighting chronic diseases. Zoochemicals-Nonnutritive animal compounds that play a role in fighting chronic diseases. Phytochemicals are nonnutritive plant chemicals found in foods that reduce your risk of developing certain diseases. At least 900 different phytochemicals have been identified in foods and more are likely to be discovered. For example, lutein is found in spinach, lycopene is found in tomatoes, and anthocyanins are found in dark purple grapes. The disease-fighting properties of phytochemicals may be due to more than the compounds themselves. It is the interactions between the phytochemicals and fiber, nutrients, or other unknown substances in the food itself that provide the health benefits. These compounds can’t be extracted from foods and put in a pill and still produce the same positive health effects. Foods with phytochemicals added, such as phytosterols added to margarine, have the same appearance and taste as your favorites but provide added health benefits. Zoochemicals are naturally occurring chemicals found in animal foods that have health-enhancing properties such as strong antioxidant benefits. Examples include lutein found in egg yolks, which may protect against macular degeneration or the formation of cataracts. and omega-3 fatty acids from fish, added to butter substitutes and eggs, may improve heart health and reduce inflammation, protecting us against heart disease, cancer, and a decline in cognitive function. How Can You Use Diet to Improve Your Health? Good nutrition reduces the risk of four of the top ten leading causes of death in the United States, including the top two—heart disease and cancer—as well as stroke and diabetes Eating well will also improve body weight, which in turn will reduce the risk of developing obesity, diabetes mellitus, and high blood pressure. How Do We Assess Nutritional Status? A person’s state of nutrition is usually described as either healthy or malnourished. Someone who lacks a specific nutrient, or isn’t consuming enough energy, is undernourished, which means that person is at risk of losing too much weight or developing a disease related to a nutrient deficiency. In contrast, an individual who overconsumes a particular nutrient, or eats too many kilocalories, is described as being overnourished. This person runs the risk of becoming overweight, developing diseases such as diabetes or heart disease, and potentially accumulating toxic amounts of a specific nutrient in the body. Registered Dietitian Nutritionist (RDN)-A health professional who is a food and nutrition expert; RDNs obtain a college degree in nutrition from an Academy of Nutrition and Dietetics–accredited program, and pass a national exam to become a Registered Dietitian Nutritionist. Part of evaluating a person’s current nutrition status is to look at that person’s health history, including any experiences with acute or chronic illness, and diagnostic procedures, therapies, or treatments that may increase nutrient needs or induce malabsorption. Does the patient have a family history of diabetes or heart disease? Has the patient been overweight or underweight in the past? Does the patient have an acute, chronic or malabsorption disease? Acute-Describes a sudden onset of symptoms or disease. Chronic-Describes a symptom or condition that lasts over a long period of time. Malabsorption-A problem associated with the lack of absorption of nutrients through the intestinal tract. What are some ways we collect anthropometric data? Data about body size or body composition is also called anthropometric data. In adults, this usually means height, weight, body mass index (BMI), waist-to-hip ratios, and waist circumference. For children, growth charts have been developed that compare height to weight, as well as how a child’s height and weight compare with others of the same age. All of these measurements are easily obtained with a scale and tape measure. Body mass index (BMI)-A measurement calculated using the metric formula of weight in kilograms divided by height in meters squared; used to determine whether an individual is underweight, at a healthy weight, or overweight or obese. The BMI is a measure of weight relative to height, and waist circumference measures abdominal fat. Body composition measurements can provide data on an individual’s lean body tissue and the percent body fat, depending on the tool used. These measurements can be assessed with specialized equipment, such as skin calipers, or more expensive equipment, such as the Bod Pod. How Healthy Is the Average American Diet? The Quality of the American Diet Needs Improvement In general, Americans eat too much added sugar, sodium, and saturated fat, and too little fiber and some vitamins and minerals. Our low fiber intake is partly due to inadequate consumption of fruits and vegetables and overconsumption of refined grains.38 While dietary fiber intakes are below recommended levels, added sugars account for almost 16 percent of America’s daily kilocalories. This is largely due to Americans’ love of soft drinks, other sugary beverages, and sweets and treats. The fat intake of most Americans ranges at the high end of the recommendation, at about 33 percent. The American diet contains too much saturated fat, but most Americans don’t exceed the recommended dietary cholesterol intake limit of 300 milligrams per day. American men meet their recommendations for most vitamins and minerals, but women fall short of many nutrients—iron, for example. Americans in general eat too much sodium, but not enough vitamin D, potassium, and calcium.41 In an attempt to balance their poor choice in foods, 50 percent of Americans take at least one vitamin or mineral supplement per day. The lack of a healthy diet may be due to where we eat. Today, many Americans eat their meals away from home.43 Some of us eat in the car, or buy prepared foods from the supermarket or takeout meals. When we eat at home, it’s often in front of the television or the computer screen. Research reports that meals eaten while watching television are usually lower in fruits and vegetables and higher in fat and soft drinks. The majority of Americans understand the positive benefits of eating breakfast but only 34 percent actually take the time to eat it. Breakfast provides about 18 percent of the fiber and energy, and 25 percent of the vitamins A and C, folate, calcium, and iron that we need to consume each day. As people take in more kilocalories than they burn, usually due to sedentary lifestyles, they create a recipe for poor health. This is reflected in the high rates of overweight and obesity in the United States (see Figure 1.6 ). Over 35 percent of American adults are obese regardless of their gender, age, race, ethnicity, socioeconomic status, education level, or geographical region. These rates are too high, and reducing them is a top priority. Overweight-For adults, having a BMI greater than 24.9. Obesity-For adults, having a BMI greater than 29.9. Healthy People 2020 Provide Health Objectives for Americans The U.S. Surgeon General has issued calls for a nationwide health improvement program since 1979. The latest edition of this report, Healthy People 2020, contains a set of health objectives for the nation to achieve over the second decade of the twenty-first century.47 consuming adequate amounts of fruits and vegetables is beneficial to managing one’s weight. Americans should increase their intake of both of these food sources to help them improve their nutrition and weight status. What Is Credible Nutrition Research? If you Google the word nutrition, you will get a list of about 103,000,000 entries in 0.25 second. Obviously, the world is full of nutrition information at our fingertips. But is it credible? Anyone who has attempted to lose weight can probably tell you how hard it is to keep up with the latest diet advice—because it seems to keep changing. In the 1970s, waist watchers were told that carbohydrates were the bane of their existence and that a protein-rich, low-carbohydrate diet was the name of the game when it came to shrinking their waistline. A decade later, avoiding fat was the key to winning the battle of the bulge. By 2000, carbohydrates were being ousted again, and protein-rich diets were back in vogue. But recently protein-heavy diets seem to be less popular and high-carbohydrate diets are once again becoming the way to fight weight gain. So . . . are you frustrated yet? Advice from an authoritative health organization or committee, such as the American Heart Association or the Dietary Guidelines Committee, which is based on a consensus of research information, is sound information that can be trusted for the long term. Peer-reviewed journal- A journal in which scientists publish research findings, after the findings have gone through a rigorous review process by other scientists. Sound nutrition advice is based on years of research using the scientific method. Several methods can be used to conduct nutrition research, including laboratory experiments (on animals), experimental research (on humans), and observational, particularly epidemiological, research. Double-blind placebo-controlled studies mean that neither the subjects nor the researchers are aware of who is receiving treatment, and such studies are therefore considered the gold standard of experimental research. Findings from observational and epidemiological research are only considered valid if the study was conducted with an adequate sample size of subjects. Health Connection How Can You Find and Recognize Credible Nutrition Information? Who is a credible expert with training in the field of nutrition? Different health professionals have varying levels of nutrition training, but by far, the professional with the most nutrition training is the Registered Dietitian Nutritionist (RDN). An RDN has completed at least a bachelor’s degree from a university or college accredited by the Academy of Nutrition and Dietetics (AND) and has passed the national exam administered by the credentialing body of the AND. The Academy of Nutrition and Dietetics is the largest professional organization in the United States, with a membership of almost 67,000 nutrition experts. RDNs must maintain registration with the national organization and participate in continuing professional education to remain current in the fast-changing world of nutrition, medicine, and health. RDNs are trained to administer medical nutrition therapy and work with patients to make dietary changes that can help prevent diseases such as heart disease, diabetes, stroke, and obesity. Many physicians, based on the diagnoses of their patients, refer them to RDNs for nutrition advice and guidance. RDNs must participate in continuing professional education in order to remain current in the fast-changing world of nutrition, medicine, and health and to maintain their registration. RDNs work in hospitals and other health care facilities, private practice, universities, medical schools, professional athletic teams, food companies, and other nutrition-related businesses. Be careful when taking nutrition advice from a trainer at the gym or the person who works at the local health food store. Whereas some of these people may be credible, many are not, and thus, less likely to give you information based on solid scientific evidence. Anyone who calls himself or herself a nutritionist may have taken few or no accredited courses in nutrition. Nutritionist-A generic term with no recognized legal or professional meaning. Some people may call themselves a nutritionist without having any credible training in nutrition. Quackery-The promotion and selling of health products and services of questionable validity. A quack is a person who promotes these products and services in order to make money. To avoid falling for one of their shady schemes, there are certain “red flags” that should alert and warn you to be leery of infomercials, magazine ads, mail-order catalogs, and websites that try to convince you that: There is a quick fix for what ails you. Their product is all natural and miraculously cures. One product does it all. You can lose a lot of weight in a short amount of time and without dieting or exercising. The product contains a secret ingredient. The product shrinks tumors. There is no risk, as there is a money-back guarantee. (Good luck getting your money back!) Examples of reliable nutrition and health websites include: Agricultural Research Service: www.ars.usda.gov American Cancer Society: www.cancer.org American College of Sports Medicine: www.acsm.org Academy of Nutrition and Dietetics: www.eatright.org American Medical Association: www.ama-assn.org Center for Science in the Public Interest: www.cspinet.org Centers for Disease Control and Prevention: www.cdc.gov Food and Drug Administration: www.fda.gov Food and Nutrition Information Center: www.nal.usda.gov/fnic National Institutes of Health: www.nih.gov NHANES Surveys: www.cdc.gov/nchs/nhanes.htm Shape Up America!: www.shapeup.org Tufts University Health and Nutrition Newsletter: www.healthletter.tufts.edu Nutrition.gov: www.nutrition.gov Vegetarian Resource Group: www.vrg.org