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Enabling patients to make informed food choices: Appropriate Applications of Food Composition Data

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... ready-to-eat, CHEERIOS. Value per 100grams. Nutrient ... Emphasis has been placed on mixed dishes rather than individual ingredients. More ethnic foods ... – PowerPoint PPT presentation

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Title: Enabling patients to make informed food choices: Appropriate Applications of Food Composition Data


1
Enabling patients to make informed food choices
Appropriate Applications of Food Composition Data
  • April 3, 2009
  • Diabetes Update 2009
  • Toronto, Ontario

2
Disclosure
  • As a federal government employee of Health Canada
    no external support or affiliations are permitted
  • There exists no apparent conflict of interest
    concerns with this presentation

3
Objectives
  • Introduction to nutrient data in Canada
  • Introduction of our national reference food
    composition database
  • Demonstration of how to access the nutrient data
  • Investigation of the sources of nutrient data
  • Applications of nutrient data concepts of
    generic foods, types of nutrient data, mean
    values /- a range
  • Complexity and limitations with carbohydrate data
  • Grain of salt informed decision making
    recognizing all of the facts and limitations

4
Canadian Nutrient File (CNF)
  • Canadas computerized national reference food
    composition database
  • 143 food components described for over 5500 foods
  • Reflective of Canadas regulations, culture,
    market
  • Bilingual food names, metric measures
  • 2007b version is the 11th edition since inception
    in 1981
  • 2009 version due late in the year

5
Activity 1
  • How do you access nutrient data?
  • 1 Use the CNF online application/download
  • 2 Use the Nutrient Value of Some Common Foods
  • 3 Use USDAs website
  • 4 Use the Nutrition Facts Table
  • 5 Use software

6
My own curiosity
  • How did you access nutrient data prior to 2005?
  • 1 Downloaded the CNF data files
  • 2 Used the Nutrient Value of Some Common
    Foods
  • 3 Used USDAs website
  • 4 Used label data when available
  • 5 Used software

7
Traditional Applications of the CNF
  • A tool to support surveillance, policy
    formulation, risk assessments, research,
    nutritious food baskets, general compliance
    guidance
  • Commodity group promotion, product development,
    clinical, food inventory, media, nutrition
    students
  • Self-knowledge, healthy food choices
  • Health Canada
  • AAFC
  • Statistics Canada
  • Ministry of Indian and Northern Affairs
  • Canadian Food Inspection Agency
  • Canadian food industry
  • Dietitians/hospitals
  • Educators
  • General public

8
Basic Foods in the CNF
  • Generic Foods
  • Very little brand name data
  • Supports nutrition survey programs
  • Prevents misleading information in the database
    when companies reformulate
  • Favoured by government agencies for any nutrition
    related projects

9
CNF Generic Food Name Examples
  • COOKIE, CHOCOLATE CHIP, COMMERCIAL, 18-28 FAT
  • CHEESE, MOZZARELLA, PARTIALLY SKIM, (52 WATER,
    16.5 M.F.)
  • PINEAPPLE, CANNED, JUICE PACK, SOLIDS LIQUID
  • CORN, SWEET, YELLOW, FROZEN KERNELS OFF COB,
    BOILED, DRAINED, SALTED

10
Nutrient Values in the CNF
  • Provides the average amounts of nutrients in
    foods available in Canada.
  • Nutrient composition of a specific apple or
    cookie are not found in the CNF.
  • Local foods may have a different profile than the
    national average.
  • Ideally a mean value /- SE

11
Mean SE
12
The Canadian Nutrient File (CNF) Sources of
Nutrient Data
CNF
13
CNF Source Codes
14
(No Transcript)
15
USDA Standard Release 21
http//www.nal.usda.gov/fnic/foodcomp/search/
16
USDA Nutrient Database vs. CNF
  • Foods
  • Exclusion of those foods not sold in Canada
  • Addition of foods unique to the Canadian food
    supply
  • Cuts and grades of beef
  • Food and Drug Act and Regulations
  • Fortification
  • Specific nutrients which should not be added or
    must be added at certain levels
  • Metric system
  • Bilingual

17
Cereals, ready-to-eat, CHEERIOS
Value per 100grams Nutrient Units USDA
CNF Iron mg 32.0 13.5 Zinc mg
16.0 2.1 Vitamin C mg 24.0
0 Vitamin A IU/RE 2888.0 0
18
USDA dictates CNF
  • High level of dependency on USDA
  • Consistent nutrient codes
  • Sum of nutrient category components another
    nutrient
  • i.e., sum of fatty acids total fat
  • Traditional nutrient list is easiest to
    maintain
  • i.e., Unspecified fatty acids versus cis and
    trans isomers

19
CNF on the Web
  • Downloadable files
  • Searchable application
  • Recipe proportions
  • Nutrient Value of Some Common Foods

www.healthcanada.gc.ca/cnf
20
Recipe Proportions
21
CNF Online
www.healthcanada.gc.ca/cnfonline
  • User-friendly application launched in 2005
  • Search by Food
  • Search by Nutrient

22
Food list
23
Activity 2
24
Activity 2
  • Entering milk in the search box would return 205
    foods containing the word milk. If you wanted to
    narrow that down to find just milk (2) which
    additional term would best accomplish this?
  • 2
  • Fluid
  • Drink

25
Serving size
26
Nutrient Profile Report
27
CNF Online
www.healthcanada.gc.ca/cnfonline
  • User-friendly application launched in 2005
  • Search by Food
  • Search by Nutrient

28
Search by Nutrient
29
Nutrient Report
30
Nutrient Value of Some Common Foods - Updated
31
Nutrient Value of Some Common Foods - Updated
List of nutrients Energy in Kcal Energy in KJ
Protein Carbohydrate Total fat Total Dietary
Fibre Saturated Fat Cholesterol Calcium Iron Sodi
um Potassium Magnesium Phosphorus Vitamin
A Vitamin C Vitamin B12 Folate Total
Sugars Thiamin Niacin Lycopene Beta-carotene Vita
min D Caffeine DHA EPA Trans Fat Monounsaturated
Fat Polyunsaturated Fat Vitamin E Alcohol
  • Set of 19 nutrients varies for different food
    groupings (ex cholesterol present in meat but
    not in fruits and vegetables)
  • 1100 foods
  • Values are taken from the 2007b version of the
    CNF
  • Given in terms of common household measure of the
    ready-to-eat form of the food
  • Emphasis has been placed on mixed dishes rather
    than individual ingredients
  • More ethnic foods

32
(No Transcript)
33
Activity 3 You choose the nutrients
  • Which of the following would you exclude for the
    vegetable category?
  • 1 Protein
  • 2 Phosphorus
  • 3 Folic acid
  • 4 Calcium

34
Activity 4
  • Which of the following would you exclude in the
    poultry category?
  • 1 Carbohydrates
  • 2 Iron
  • 3 Vitamin B12
  • 4 Polyunsaturated fat

35
Nutrient Value of Some Common Foods
  • To order a booklet (cost0)
  • By internet www.healthcanada.gc.ca/nvscf
  • By phone 1-866-225-0709
  • By email publications_at_hc-sc.gc.ca
  • Also available in PDF version on the same website
    page

36
Resources that use the CNF
Beef Information Centre
Microgesta Logiform (FUEL) CANDAT FORMDAT Foodsmar
t ESHA
37
Nutrition Facts Tables
  • Found on all pre-packaged foods
  • 13 nutrients plus energy
  • Per serving size as stated
  • Product specific values
  • must be within 20
  • of the amount found in
  • the serving size stated
  • No range about the mean

38
Activity 5
  • Which of the following foods would require a
    Nutrition Facts Table
  • 1) fresh fruit salad
  • 2) bakery bread
  • 3) bag of carrots
  • 4) bag of chips
  • 5) deli potato salad

39
CNF Value result of sampling and
analysis 71.0g/100g Or 23g/32.55g bar
40
Carbohydrates A Mixed Bag Degree of
Polymerization
  • Sugars (1-2) Monosaccharides Glucose
    Fructose Galactose
  • Disaccharides Sucrose
  • Lactose
  • Maltose
  • Sugar Alcohols Sorbitol
  • Mannitol
  • Oligosaccharides Malto-oligosacc Maltodextri
    ns
  • (3-9) Other Raffinose etc.
  • Fructo-oligosacchs
  • Polysaccharides Starch Amylose/amylopectin
  • (9) Modified Starches
  • Non-starch polysacc Total Dietary Fibre

41
Functional Classification
  • Digested in the small intestine
  • Most glycemic (provide glucose for metabolism)
  • Glucose, maltose, galactose
  • malto-oligosaccharides (dextrins)
  • amylopectin
  • Less glycemic
  • Fructose, sucrose
  • amylose
  • Fermented in the intestine
  • Raffinose, stachyose, fructo-oligosaccharides
  • Modified and retrograde starch
  • hydrocolloids
  • Any energy yield unlikely
  • Cellulose, Lignin, psyllium

42
Carbohydrates in Food Tables
  • North American databases by difference
  • 100 (protein fat moisture ash)
  • UK and some European databases
  • Monosaccharide equivalents a sum
  • Australia, New Zealand, Denmark
  • By difference minus the fibre available CHO

43
Available CHO
  • CHO by difference Total Dietary Fibre (TDF)
  • In potatoes which have been cooked and cooled is
    this accurate?
  • In oatmeal?
  • In a product high in fructose?
  • In a product containing high amylose corn starch
    (modified corn starch)?

44
Carbohydrate fractions in Food Tables
  • Total Sugar
  • Both in the CNF database and on the Nutrition
    Facts Tables
  • Sum of monosaccharides and disaccharides
  • Other sugars removed from the database
  • Starch very little data
  • Resistant Starch not quantified/qualified
  • Total Dietary Fibre

45
Activity 6
  • Carbohydrate and total sugar in Corn Syrup
  • 77g CHO 0g Fibre 26g Total Sugar
  • What is the remaining 51g of the CHO?
  • 1. Starch
  • 2. Fructose
  • 3. Dont know
  • 4. Maltodextrin

46
Energy kcal and kJ
  • Metabolic yield of CHO
  • Digested carbohydrates 4kcal/g
  • Fermented carbohydrates 2kcal/g
  • Modified or retrograded ?kcal/g
  • Calculation of energy values
  • General Atwater factors 4/9/4
  • Specific Atwater factors used in the CNF
  • Nutrition Facts Tables - either

47
Activity 7
  • Energy in a high bran cereal
  • Atwater Factor
  • CHO 76 1.82
  • Protein 12 2.80
  • F at 3 8.37
  • Energy using 4/9/4 379 kcal/100g
  • Energy using Atwater factors specific to this
    food 187 kcal/100g

48
Total fat
  • Crude fat
  • Includes TGs, sterols, phospholipids, other minor
    lipid fractions
  • Triglyceride equivalents
  • Accounts only for the energy yielding TG
  • Used for labelling
  • Not a good indicator of food quality for making
    healthy food choices

49
Fatty Acids (46)
  • Saturated fatty acids
  • Trans fatty acids
  • Monounsaturated fatty acids
  • Polyunsaturated fatty acids

Cis and trans isomers Double bond positioning
isomers
50
Glycemic Index
  • Not in the CNF
  • Limitations
  • Dependence on available CHO calculations
  • Serving size dependent
  • Large standard deviation even with subjects under
    experimental conditions
  • Comparison of foods between categories with no
    educational component
  • Glycemic Glucose Equivalents

51
Strengths of the CNF
  • National Canadian resource
  • Unbiased, quality control measures, metadata
  • Easy access in different formats
  • Backbone of nutrition policy and programs in
    Canada
  • Guide for informed food choices

52
Limitations of the CNF
  • Limited resources
  • Dependency in large part on external data sources
  • Size
  • Keeping pace
  • Food markets
  • Research
  • Generic data versus product specific data
  • Different applications require different types of
    nutrient data
  • Carbohydrate by difference
  • What are we missing? phytosterols, flavonoids,
    antioxidant index etc.

53
RD Role
  • Inform patients about the limitations and
    appropriate use of such tools which they now have
    access to
  • Know the evidence and translate it into practice
  • Teach patients to understand their food product
    labels and not necessairily on generic data
  • Teach the functional role of foods in health
  • Learn about diverse cultural foods that our
    patients use , etc..

54
Contact Us
  • cnfusers_at_hc-sc.gc.ca
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