Food, Nutrients And Health - Canada
Food, Nutrientsand Health:Interim EvidenceUpdate2018For Health Professionalsand Policy Makers
Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health.Health Canada is committed to improving the lives of all of Canada’s people and to making this country’s population among thehealthiest in the world as measured by longevity, lifestyle and effective use of the public health care system.Également disponible en français sous le titre :Effets des nutriments et des aliments sur la santé : Mise à jour intérimaire des données probantes 2018To obtain additional information, please contact:Health CanadaAddress Locator 0900C2Ottawa, ON K1A 0K9Tel.: 613-957-2991Toll free: 1-866-225-0709Fax: 613-941-5366TTY: 1-800-465-7735E-mail: hc.publications-publications.sc@canada.ca Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2019Publication date: January 2019This publication may be reproduced for personal or internal use only without permission provided the source is fully acknowledged.Cat.: H164-248/2019E-PDFISBN: 978-0-660-28342-5Pub.: 180517
The Evidence Review Cycle for Dietary Guidance (ERC) isHealth Canada’s ongoing systematic approach to gathering,assessing, and analyzing scientific evidence relevant to dietaryguidance. This process helps to ensure that dietary guidancefrom Health Canada on healthy eating, such as Canada’s FoodGuide, remains scientifically sound, current, relevant, anduseful. The ERC examines evidence in three key input areasthat inform dietary guidance: Scientific Basis; Relevance inthe Canadian Context; and Use of Existing Dietary Guidance(Figure 1). The current Food, Nutrients and Health: InterimEvidence Update 2018 focuses specifically on one of thekey areas of the ERC—the Scientific Basis. It aims to:1.ensure that dietary guidance from Health Canadais developed using the latest scientific evidence;2.maintain credibility in Health Canada’s approach togathering evidence on relationships between food,nutrients and health;3.provide an overview of evidence on convincingrelationships between food, nutrients and healthgathered between July 2015 and November 2018;4.summarize the state of the evidence on convincingrelationships between food, nutrients and healthgathered between January 2006 and November 2018.A brief summary of the methodology for the evidence reviewprocess of the scientific basis is described in Annex 1. Whendeveloping dietary guidance, Health Canada uses convincingfindings that are supported by a well-established evidencebase and are unlikely to change in the foreseeable futureas new scientific evidence emerges. Annex 2 provides anoverview of evidence on convincing relationships betweenfood, nutrients and health gathered between July 2015and November 2018. Annex 3 summarizes the state of theevidence on convincing relationships between food, nutrientsand health gathered between January 2006 and November2018.Figure 1: Key input areas to inform decisions about dietary guidanceScientificbasis Nutrient standards Food and healthUse of existingdietary guidanceCanadian context Demographics and health status Food skills, habits and behaviours Attitudes and beliefs about healthy eating Food and nutrient intakes Food supply Policy environment Nutrition information environment1 Food, Nutrients and HealthDecisions aboutHealth Canada’sdietary guidanceand other actions Awarencess and understanding Confidence and acceptance Integration and use
Annex 1: Summary of theEvidence Review ProcessMethodologyHealth Canada used the methodology outlined in the 2015Evidence Review for Dietary Guidance: Technical Report.1 Theoutcomes of interest were chronic diseases/conditions of publichealth concern in Canada—as identified in the 2015 evidencereview—specifically: cancer (various types), cardiovasculardisease/coronary artery disease (including hypertension,dyslipidemia and stroke), obesity (including adiposity andweight gain), osteoporosis (including bone health andfractures), and type 2 diabetes. The following health outcomeswere added to the evidence review process since 2015 basedon expert reviewer suggestions: All-cause mortality Metabolic syndrome Oral healthIn addition, since 2015, there has been an increase in theoverall amount of credible evidence. As a result, recent reportsgenerally provide greater detail on food, nutrients and healthrelationships (for example, specificity of health outcomes,identification of thresholds in the level of exposure to a food ornutrient, stratification of exposures by demographic variables,etc.). Health Canada has refined its approach to gathering andassessing the evidence to accurately reflect the food, nutrientsand health relationships provided in more recent reports.Annex 2: How has HealthCanada’s General Understanding of Food, Nutrientsand Health RelationshipsChanged Since 2015?The 2015 Evidence Review for Dietary Guidance: TechnicalReport1 included a review of 27 reports2-28 published betweenJanuary 2006 and July 2015 by federal agencies andleading scientific organizations. Since 2015, anadditional 33 reports29-61 were reviewed. A total of47 reports2,4-15,24-49,54-61 were retained for this InterimEvidence Update as 13 reports3,16-23,50-53 published between2006 and 2015 were superseded by updated reportspublished since 2015.Consistent convincing evidenceMost of the convincing evidence reviewed since 2015re-affirmed Health Canada’s understanding of food, nutrientsand health relationships. For example, the following convincingevidence is consistent with previous convincing evidencecaptured in the 2015 Evidence Review for Dietary Guidance:Technical Report1:Alcohol: Alcohol intake and increased risk of liver,oesophageal (squamous cell carcinoma), mouth,pharynx and larynx, colorectal, and breast (postmenopausal) cancer. 36,43,44,47,49 Replacement of saturated fat with carbohydrateand improved blood lipid levels.56 Replacement of saturated fat or trans fatwith unsaturated fat (polyunsaturated ormonounsaturated) and improved blood lipid levelsin adults.56,57 Replacement of trans fat with unsaturated fat(polyunsaturated or monounsaturated) and improvedblood lipid levels in adults.57Fats:Interim Evidence Update 2
Fibre: Fibre:Dietary fibre and improved blood lipid levels.34Meat and meat alternatives: Diets high in soy protein and lowered low-densitylipoprotein (LDL) cholesterol.32 Processed meat intake and increased risk ofcolorectal cancer.29,49Patterns: Healthy dietary patterns and lowered LDLcholesterol and cardiovascular disease risk.32Sugars: Dietary fibre and decreased risk of colon cancer,cardiovascular diseases and type 2 diabetes.34Glycemic Index/Load: Higher glycemic index or glycemic load andincreased risk of type 2 diabetes.34Meat and meat alternatives: Diets high in nuts and lowered LDL cholesterol.32 Processed meat intake and increased risk ofcancer.29Sugars:Intake of sugar-sweetened drinks and increasedrisk of weight gain, overweight and obesity.60New convincing evidenceSome of the convincing evidence reviewed since 2015 addedto our understanding of food, nutrients and health relationships.For example, there is new convincing evidence for the followingfood, nutrients and health relationships:Carbohydrates: Diets higher in carbohydrate and lower in fat and/or protein and improved blood lipid levels.34Fats: Increased intake of polyunsaturated fat andimproved blood lipid levels.31,33,54 Replacement of saturated fat with unsaturated fat(polyunsaturated or monounsaturated) and improvedblood lipid levels in children.55 Decreased saturated fat intake in children andimproved blood lipid levels, lower blood pressure andlower risk of obesity.55 Replacement of trans fat with carbohydrate andimproved blood lipid levels.573 Food, Nutrients and Health Intake of sugars-containing beverages, including100% fruit juice, and increased risk of dental decay inchildren.34 Increased intake of sugars and increased risk ofexcess energy intake leading to weight gain.34No longer convincing evidenceOccasionally, some relationships are no longer convincing,which also has important implications for dietary guidance.For example, since 2015, the evidence grade changed from‘convincing’ to ‘probable’ for the following food, nutrients andhealth relationships:Fibre: Dietary fibre (total fibre and fibre found in fruits andvegetables as well as whole grains) and decreasedrisk of colorectal cancer.49Meat and meat alternatives: Red meat intake and increased risk of colorectalcancer.49
Annex 3: Summary of Convincing (strong) Food and Health Relationships and Changes Since 2015OUTCOME(SPECIFIC OUTCOMEOR RISK FACTOR)PREDICTORDIRECTIONOF RISK†, ††CHANGES INCONVINCINGEVIDENCE SINCE2015*, **, ***SOURCE(# OF FINDINGS)AlcoholCancer (Colorectal; Breast - postmenopausal;Oesophageal - squamous cell carcinoma;Liver; Mouth, pharynx, larynx)IncreasedWCRF, 201849 (1); WCRF, 201836 (1);WCRF, 201844 (1); WCRF, 201843 (1);WCRF, 201847 (1)No changeCVD (CHD)DecreasedDGAC, 20105 (1)No changeCVD (Blood lipids: TC)DecreasedSACN, 201534 (1)New findingCVD (Blood lipids: LDL; TC)DecreasedSACN, 201534 (2)New findingDiets higher in carbohydrate, differing in theproportion of fat and proteinaCVD (BP: SBP; DBP); CVD (Blood lipids:CRP; NEFA; LDL; HDL)No effectSACN, 201534 (11)New findingDiets higher in carbohydrate and/or lower fat andaverage proteinaOverweight/Obesity (Body weight; Energyintake)No effectSACN, 201534 (2)New findingT2D (A1c; Fasting insulin; FBG; OGTT)No effectSACN, 201534 (7)New findingCancer (Colorectal; Colon; Rectal)No associationSACN, 201534 (3)New findingOverweight/Obesity (Weight gain, overweight,obesity)IncreasedDGAC, 20105 (1)No changeCVD (BP: SBP & DBD)DecreasedACC/AHA, 20132 (1)No changeCVDDecreasedDGAC, 20154 (1)No changeCVD (Blood lipids: LDL); BP (SBP, DBP)DecreasedACC/AHA, 20132 (2)No changeCVDDecreasedCCS, 201632 (1)No changeMacronutrient profiles that contain 5% to 6%saturated fat, 26% to 27% total fat, 15% to 18%protein, & 55% to 59% carbohydrateCVD (Blood lipids: LDL)DecreasedACC/AHA, 20132 (1)No changeSteps I and II diets from the US NationalCholesterol Education ProgramCVD (Blood lipids: LDL)DecreasedCCS, 201632 (1)No changeAlcoholAlcohol (Moderate drinking)CarbohydratesDiets higher in carbohydrate, lower fatDiets higher in carbohydrates, lower fat & averageproteinDiets higher in carbohydrate, differing in theproportion of fat and proteinaTotal carbohydrate intakeDietary BehavioursFast foodDietary patternsDASH combined with independent loweredsodium intakeDietary patternbDietary pattern higher in vegetables, fruits, & wholegrains; includes low-fat dairy products, poultry,fish, legumes, nontropical vegetable oils, & nuts; &limits intake of sweets, SSBs, & red meatsMediterraneanInterim Evidence Update 4
OUTCOME(SPECIFIC OUTCOMEOR RISK FACTOR)PREDICTORDIRECTIONOF RISK†, ††SOURCE(# OF FINDINGS)CHANGES INCONVINCINGEVIDENCE SINCE2015*, **, ***FatsPUFA (EPA & DHA &/or DPA)All-cause mortalityNo associationAHRQ, 201631 (1)New findingPUFA (EPA & DHA &/or DPA)CVD (Blood lipids: TG; TC:HDL ratio)DecreasedAHRQ, 201631 (2)New findingCVD (Blood lipids: TG)DecreasedHC, 2016 (1)New findingPUFA (EPA & DHA &/or DPA)PUFA (EPA &/or DHA)CVD (Blood lipids: LDL; HDL)IncreasedAHRQ, 201631 (2)New findingPUFA (EPA & DHA &/or DPA)CVD (Coronary revascularization; Majoradverse CVD event; Sudden cardiac death)No associationAHRQ, 201631 (3)New findingPUFA (EPA & DHA &/or DPA)CVD (BP: SBP & DBP)No effectAHRQ, 201631 (1)New findingPUFA (Long-chain omega-3)All-cause mortalityNo effectWHO, 201854 (1)New findingPUFA (Long-chain omega-3)CVD (Blood lipids: HDL)No effectWHO, 2018 (1)New findingPUFA (Long-chain omega-3)CVD (Blood lipids: TG)DecreasedWHO, 201854 (1)New findingPUFA (Long-chain omega-3)CVD (Cardiovascular events)No effectWHO, 2018 (1)New findingPUFA (Long-chain omega-3)Overweight/Obesity (BMI; Body weight)No effectWHO, 201854 (2)New findingCVD (Blood lipids)DecreasedDGAC, 2010 (1)No changeIncreasedDGAC, 20105 (2)No changeCVD (Blood lipids: HDL) – In childrenNo effectWHO, 201755 (3)New findingPUFA (Type not specified)CVD (Blood lipids: LDL, TC); T2D (InsulinSFAresistance)SFAc (Decreased)SFA (Decreased)3354545CVD (Blood lipids: LDL)DecreasedACC/AHA, 2013 (1)No changeSFAc (Decreased)CVD (Blood lipids: LDL; TC) – In childrenDecreasedWHO, 201755 (6)New findingSFA (Decreased)CVD (BP: DBP) – In childrenDecreasedWHO, 2017 (2)New findingSFAc (Decreased)Overweight/Obesity (BMI; Body weight) – InchildrenDecreasedWHO, 201755 (4)New findingCVD (Blood lipids: Apo-B) – In childrenDecreasedWHO, 201755 (1)New findingIncreasedFAO, 20106 (1)No changeDecreasedACC/AHA, 2013 (1)No changeIncreasedFAO, 20106 (1)No changeDecreasedFAO, 20106 (1)No changecSFA (Reduction in diet for those with SFA intakes 10% of total energy)TFA CVD (CHD risk factors & events)TFA (Decreased)CVD (Blood lipids: LDL)2552Replacement of carbohydrate with:MUFA CVD (Blood lipids: HDL)Replacement of SFA with:Carbohydrate5 Food, Nutrients and HealthCVD (Blood lipids: HDL, LDL)f
OUTCOME(SPECIFIC OUTCOMEOR RISK FACTOR)PREDICTORDIRECTIONOF RISK†, ††SOURCE(# OF FINDINGS)CHANGES INCONVINCINGEVIDENCE SINCE2015*, **, ***CarbohydratecCVD (Blood lipids: HDL; LDL; TC; LDL:HDLratio; ApoA-1; Apo-B)lDecreasedWHO, 201656 (24)New findingCarbohydratecCVD (Blood lipids: TG; TG:HDL ratio)lIncreasedWHO, 201656 (8)New findingCVD (Blood lipids: HDL; LDL; TC; TG; TC:HDLratio; LDL:HDL ratio; ApoA-1g; Apo-B)eDecreasedWHO, 201656 (29)No changeDecreasedFAO, 20106 (1)No changeDecreasedWHO, 201755 (3)New findingMUFAdMUFA CVD (Blood lipids: LDL, TC:HDL ratio)MUFAcCVD (Blood lipids: LDL; TC; TG) – In childrenMUFA CVD (Blood lipids); T2D (Blood lipids)DecreasedDGAC, 2010 (2)No changeCVD (Blood lipids: HDL; LDL; TC; TG;TC:HDL ratio; LDL:HDL ratio; TG:HDL ratio;ApoA-1, Apo-B)eDecreasedWHO, 201656 (36)No changePUFAc (Type not specified)CVD (Blood lipids: HDL) – In childrenNo effectWHO, 201755 (1)New findingPUFA (Type not specified)CVD (Blood lipids: LDL; TC) – In childrenDecreasedWHO, 201755 (2)New findingPUFAd (LA & ALA)cPUFA (Type not specified)5CVD (CVD events, coronary mortality)DecreasedDGAC, 2015 (1)No changeUnsaturated Fatty Acids (PUFA & MUFA fromvegetable oils)CVD (Blood lipids: TC, LDL)DecreasedHC, 201210 (1)No changeUnsaturated Fatty Acids, especially PUFA (Typenot specified)CVD (Blood lipids: TC, LDL)DecreasedDGAC, 20154 (1)No changeTFA CVD (Blood lipids: HDL)hDecreasedFAO, 20106 (1)No changeCVD (Blood lipids: HDL; LDL; TC; ApoA-1;TFAApo-B)i, jDecreasedWHO, 201657 (35)New findingCVD (Blood lipids: TG; TC:HDL ratio;LDL:HDL ratio)i, jIncreasedWHO, 201657 (19)New findingCarbohydratekCVD (Blood lipids: Apo-B)pIncreasedWHO, 201657 (6)New findingCarbohydratekCVD (Blood lipids: LDL; TC; TC:HDL ratio;LDL:HDL ratio; ApoA-1)pDecreasedWHO, 201657 (35)New findingMUFAkCVD (Blood lipids: HDL)m, oIncreasedWHO, 201657 (7)New findingMUFAkCVD (Blood lipids: LDL; TC; TG; TC:HDLratio; LDL:HDL ratio; Apo-Bn)mDecreasedWHO, 201657 (40)New findingPUFAk (Type not specified)CVD (Blood lipids: HDL)m, oIncreasedWHO, 201657 (7)New findingPUFAk (Type not specified)CVD (Blood lipids: LDL; TC; TG; TC:HDLratio; LDL:HDL ratio; ApoA-1; Apo-B)m, oDecreasedWHO, 201657 (49)New findingTFAk4Replacement of TFA with:Interim Evidence Update 6
OUTCOME(SPECIFIC OUTCOMEOR RISK FACTOR)PREDICTORDIRECTIONOF RISK†, ††SOURCE(# OF FINDINGS)CHANGES INCONVINCINGEVIDENCE SINCE2015*, **, ***FibreCereal fibreCVD (Coronary events); T2DDecreasedSACN, 201534 (2)New findingDietary fibreCancer (Colon)DecreasedSACN, 201534 (1)New findingDietary fibreCVD (Coronary events; Stroke); T2DDecreasedSACN, 201534 (3)New findingCVD (Blood lipids: HDL, LDL, TC, TG)No associationSACN, 201534 (1)New findingDiets high in viscous soluble fibre, such as oatsCVD (Blood lipids: LDL)DecreasedCCS, 2016 (1)No changeOat bran or beta-glucan supplementationCVD (Blood lipids: HDL)No effectSACN, 201534 (1)New findingOat bran or beta-glucan supplementationCVD (Blood lipids: LDL)DecreasedSACN, 2015 (1)No changeOverweight/Obesity (Energy intake)No effectSACN, 201534 (1)New findingT2D (FBG)No effectSACN, 2015 (1)New findingCVD (Blood lipids: LDL, TC)DecreasedHC, 201014 (1); HC, 201211 (1);HC, 201113 (1); HC 20149 (1)No changeCancer (Colorectal); T2DNo associationSACN, 201534 (4)New findingOverweight/Obesity (Body weight); CancerNo associationDGAC, 20105 (2)No changeGlycemic index or glycemic load (Higher)T2DIncreasedSACN, 201534 (2)New findingGlycemic loadT2DNo associationDGAC, 2010 (1)No changeCVD (Blood lipids: TC, TG); T2D (FBG;Fasting insulin concentration; Insulinsensitivity)No effectSACN, 201534 (4)New findingDiets high in nutsCVD (Blood lipids: LDL)DecreasedCCS, 201632 (1)New findingDiets high in soy proteinCVD (Blood lipids: LDL)DecreasedCCS, 201632 (1)No changeProcessed meatCancer (General)IncreasedIARC, 2018 (1)New findingProcessed meatCancer (Colorectal)IncreasedWCRF, 201849 (1)No changeCVD (Blood lipids: TC, LDL)DecreasedHC, 2015 (1)No changeOverweight/Obesity (Weight control)No associationDGAC, 20105 (1)No changeDietary fibre (From mixed sources)Oat fibre, barley fibre or β-glucan supplementsOat bran or beta-glucan supplementationSingle grains (i.e. Beta-glucan oat fibre; Barleygrain products; Psyllium fibre); Ground wholeflaxseedVegetable or fruit fibre323434Glycemic Index/LoadGlycemic index or glycemic load5Grain ProductsWhole grainsMeat and meat alternativesSoy proteinq298Milk and milk alternativesMilk & milk products7 Food, Nutrients and Health
OUTCOME(SPECIFIC OUTCOMEOR RISK FACTOR)PREDICTORDIRECTIONOF RISK†, ††CHANGES INCONVINCINGEVIDENCE SINCE2015*, **, ***SOURCE(# OF FINDINGS)MineralsPotassiumr, sCVD (Blood lipids: TC)No effectWHO, 201227 (2)No changePotassiumsCVD (BP: Resting SBP)DecreasedWHO, 201227 (1)No changeSodium & salt (Decreased)CVD (Blood lipids: TC)No effectWHO, 2012 (2)No changeSodium & saltt (Decreased)CVD (BP: Resting SBP)DecreasedWHO, 201228 (2);No changeCVD (BP: SBP & DBP)DecreasedACC/AHA, 2013 (1);DGAC, 20105 (1); NHMRC, 201115 (1)No changeOverweight/Obesity (Obesity); T2DIncreasedDGAC, 20154 (2)No changeOverweight/Obesity (Weight gain, overweight,obesity)IncreasedWCRF, 201860 (1)No changeSugar-sweetened beveragesOverweight/Obesity (Adiposity) – In childrenIncreasedDGAC, 20105 (1)No changeSugarsOverweight/Obesity (Excess energy intake)IncreasedSACN, 201534 (1)New findingOral health (Dental caries in deciduousdentition) – In childrenIncreasedSACN, 201534 (1)New findingCancer (Colon)No associationSACN, 201534 (1)New findingCVD (CVD events)No effectCCS, 201632 (1)New findingCVD (CHD)DecreasedHC, 20167 (1)No changetSodium & salt (Decreased)282SugarsAdded sugars (Food &/or SSBs)Sugar sweetened drinksSugars-containing beverages (Amount andfrequency)Sugars-sweetened beveragesSupplementsPUFA (Omega-3)Vegetables and FruitFruit and vegetablesAbbreviationsACC/AHA: American College of Cardiologists/American Heart Association; AHRQ: Agency for Healthcare Research and Quality; ALA: Alpha-linolenic acid; ApoA-1: Apolipoprotein A-1; Apo-B: Apolipoprotein B; BMI: Body mass index; BP: Blood pressure; CCS: Canadian Cardiovascular Society; CRP: C-reactive protein; CVD: Cardiovascular disease; CHD: Coronary heart disease; DASH: DietaryApproaches to Stop Hypertension; DBP: Diastolic blood pressure; DGAC: Dietary Guidelines Advisory Committee (US); DHA: Docosahexaenoic acid; DPA: Docosapentaenoic acid; EPA: Eicosapentaenoic acid; FAO: Food and Agriculture Organization of the United Nations; FBG: Fasting blood glucose; HC: Health Canada; HDL: High density lipoprotein; IARC: International Agency for Researchon Cancer; LA: Linoleic acid; LDL: Low density lipoprotein; MUFA: Monounsaturated fatty acid; NEFA: Non-esterified fatty acid; OGTT: Oral glucose tolerance test; PUFA: Polyunsaturated fatty acid;RCT: Randomized controlled trial; SACN: Scientific Advisory Council on Nutrition (UK); SFA: Saturated fatty Acid; SSB: Sugar-sweetened Beverage; SBP: Systolic blood pressure; T2D: Type 2 Diabetes; TC: Total cholesterol; TFA: Trans fatty acid; TG: Triglyceride; WCRF: World Cancer Research Fund/American Institute of Cancer Research; WHO: World Health Organization.Interim Evidence Update 8
Footnotes* Changes are assessed based on 2015 Evidence Review for Dietary Guidance: Technical Report1.** No change: Convincing findings gathered since 2015 that do not change Health Canada’s understanding of food, nutrients and health relationships or previous convincing findings (i.e. gatheredbetween 2006 and 2015) that remain convincing to this date.*** New convincing finding: Convincing findings gathered since 2015 that added to Health Canada’s understanding of food, nutrients and health relationships or findings that became convincing since2015 (for example, the evidence grade changed from probable to convincing).No association: There is convincing evidence (mainly from observational cohort studies) that there is no association between the predictor (i.e. food or nutrient) and the specific outcome or riskfactor of interest.†††No effect: There is convincing evidence (from RCTs) that there is no effect between the predictor (i.e. food or nutrient) and the specific outcome or risk factor of interest.Examined effects in diets with various proportions of carbohydrates, fats or proteins.aDietary pattern characterized by higher consumption of vegetables, fruits, whole grains, low-fat dairy, and seafood, and lower consumption of red and processed meats, refined grains, and sugarsweetened foods and beverages. Regular consumption of nuts and legumes and moderate consumption of alcohol also are shown to be components of a beneficial dietary pattern in most studies.Additionally, research that includes specific nutrients in their description of dietary patterns indicate that patterns that are lower in saturated fat, cholesterol, and sodium and richer in fibre, potassium,and unsaturated fats are beneficial for reducing cardiovascular risk.bExamined effect of replacement in 3 general population groups: general children population, general children population with intakes 10% of total energy from SFA, and general children populationwith intakes reduced to 10% of total energy from SFA.cExamined effect of replacement in four general population groups: general adult population, general adult population with intakes 10% of total energy from SFA, general adult population with intakesreduced to 10% of total energy from SFA, and general adult population with a starting intake of 10% of total energy from SFA.dEffect is the opposite when the unsaturated fatty acid is replaced with SFA in adults with a starting intake of 10% of total energy from SFA.eFinding also states no change in TC:HDL ratio.fgApoA-1 only convincing for MUFA replaced with SFA in adults with a starting intake of 10% of total energy from SFA.Finding also states increased TC:HDL ratio.hEffect is the opposite when TFA is replaced with SFA.iAlso examined with industrial TFA only and found similar results, with the exception of TG finding not being convincing.jExamined effect of replacement in the nine general population groups: reduction in industrial TFA in adults, increase in industrial TFA in adults, reduction in ruminant TFA in adults, increase in ruminantTFA in adults, reduction in TFA in adults, reduction in TFA in adults with intakes 1% of total energy from TFA, reduction in TFA in adults with intakes 1% of total energy from TFA, increase in TFA inadults, increase in TFA in adults with intakes 1% of total energy from TFA.kEffect is the opposite when the carbohydrate is replaced with SFA.lmnopqrstEffect is the opposite when the unsaturated fatty acid is replaced with TFA.When industrial TFA was examined alone, Apo-B was not convincing.Same findings with just industrial TFA.Effect is the opposite when the carbohydrate is replaced with TFA.This finding is based on evidence demonstrating a causal relationship between the consumption of processed meat and cancer of the colorectum.Examined effect of increased potassium intake relative to a lower intake in adults.Examined effect of an increase in potassium intake to at least 90mmol/day relative to a lower intake in adults.Examined effect of decreased sodium intake relative to a higher intake in adults and the effect of a decrease in sodium intake to 2g/day relative to an intake of 2g/day in adults.9 Food, Nutrients and Health
References1.Health Canada. Evidence review for dietary guidance: technical report, 2015. Ottawa: Health Canada; 2016.2.Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Miller NH, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestylemanagement to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Associationtask force on practice guidelines. Circulation. 2014;129(25 Suppl 2):S76-99.3.Anderson TJ, Gregoire J, Hegele RA, Couture P, Mancini GB, McPherson R, et al. 2012 Update of the CanadianCardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovasculardisease in the adult. Can J Cardiol. 2013;29(2):151-67.4.Dietary Guidelines Advisory Committee. Scientific report of the 2015 Dietary Guidelines Advisory Committee: advisoryreport to the Secretary of Health and Human Services and the Secretary of Agriculture. Washington: U.S. Department ofAgriculture, Agricultural Research Service; 2015.5.Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelinesfor Americans, 2010: to the Secretary of Health and Human Services. Washington: U.S. Department of Agriculture,Agricultural Research Service; 2010.6.Food and Agriculture Organization of the United Nations. Fats and fatty acids in Human Nutrition: Report of an ExpertConsultation. Rome: Food and Agriculture Organization of the United Nations; 2010.7.Health Canada. Summary of Health Canada’s assessment of a health claim about vegetables and fruit and heart disease[Internet]. Ottawa: Health Canada; 2016 [cited 2018 Sep 14].8.Health Canada. Summary of Health Canada’s assessment of a health claim about soy protein and cholesterol lowering[Internet]. Ottawa: Health Canada; 2015 [cited 2018 Sep 14].9.Health Canada. Summary of Health Canada’s assessment of a health claim about ground whole flaxseed and bloodcholesterol lowering [Internet]. Ottawa: Health Canada; 2014 [cited 2018 Sep 14].10. Health Canada. Summary of Health Canada’s assessment of a health claim about the replacement of saturated fat with monoand polyunsaturated fat and blood cholesterol lowering [Internet]. Ottawa: Health Canada; 2012 [cited 2018 Sep 14].11. Health Canada. Summary of Health Canada’s assessment of a health claim about barley products and blood cholesterollowering [Internet]. Ottawa: Health Canada; 2012 [cited 2018 Sep 14].12. Health Canada. Summary of Health Canada’s assessment of a health claim about whole grains and coronary heartdisease [Internet]. Ottawa: Health Canada; 2012 [cited 2018 Sep 14].13. Health Canada. Summary of Health Canada’s assessment of a health claim about food products containing psyllium andblood cholesterol lowering [Internet]. Ottawa: Health Canada; 2011 [cited 2018 Sep 14].14. Health Canada. Summary of assessment of a health claim about oat products and blood cholesterol lowering [Internet].Ottawa: Health Canada; 2010 [cited 2018 Sep 14].15. National Health and Medical Research Council. A review of the evidence to address targeted questions to inform therevisions of the Australian Dietary Guidelines. Canberra: National Health and Medical Research Council; 2011.16. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and liver cancer. Washington: American Institute for Cancer Research; 2015.17. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and gallbladder cancer. Washington: American Institute for Cancer Research; 2014.18. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and ovarian cancer. Washington: American Institute for Cancer Research; 2014.19. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and prostate cancer. Washington: American Institute for Cancer Research; 2014.20. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and endometrial cancer. Washington: American Institute for Cancer Research; 2013.21. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and pancreatic cancer. Washington: American Institute for Cancer Research; 2012.Interim Evidence Update 10
22. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and colorectal cancer. Washington: American Institute for Cancer Research; 2011.23. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report: Diet,nutrition, physical activity and breast cancer. Washington: American Institute for Cancer Research; 2010.24. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and theprevention of cancer: a global perspective. London: World Cancer Research Fund; 2007.25. Hooper L, Martin N, Abdelhamid A, Smith GD. Reduction in saturated fat intake for cardiovascular disease (Review).Cochrane Database Syst Rev. 2015;11(6):CD011737.26. Te Morenga L, Montez JM. Health effects of saturated and trans-fatty acid intake in children and adolescents: Sys
food, nutrients and health gathered between July 2015 and November 2018. Annex 3 summarizes the state of the evidence on convincing relationships between food, nutrients and health gathered between January 2006 and November 2018. Figure 1: Key input areas to inform decisions about dietary guidance Scientific basis Canadian context Use of existing
Lesson 2: Nutrients We Need 29 2. Nutrients We Need. OBJECTIVES . To emphasize the similarities between humans and plants in the need for nutrients To learn about the six classes of nutrients and why we need all six of them To learn how to identify good food sources of selected nutrients To learn how plants provide us with nutrients
NUTRIENTS Food provides nutrients to help the body perform properly. It is important to enjoy a well-balanced, healthy diet by consuming a variety of foods to provide all the nutrients our bodies need. Some nutrients are water soluble, meaning that they dissolve in aqueous solutions. Other
Marine-derived nutrients (MDN)-Nutrients acquired by an anadromous fish and deposited in a freshwater or terrestrial ecosystem when that fish dies. Oligotrophic- Containing few nutrients and therefore unable to support much life . Eutrophic- An ecosystem containing high levels of nutrients and therefore supporting
Manure contains both macro- and micro-nutrients needed for crop production in organic and inorganic forms. Inorganic nutrients are readily available to the growing crop, while the organic nutrients become available gradually over time. A crop responds to inorganic nutrients in soil, whether they originate from manure or commercial fertilizer.
Module - Classes of Nutrients Learning Objectives Beginner List the five classes of nutrients. Identify common sources for each nutrient. Intermediate Explain functions of common nutrients in horses. Discuss the difference between micro- and macro-nutrients. Seniors Discuss the concept of "most limiting nutrient."
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1. Introduction to nutrition – definition of nutrition, Food as a source of nutrients. Functions of foods 2. Inter relationship between nutrition and health, visible symptoms of good health. 3. Food guide-basic five food groups and usage of food guide. 4. Use of food in body-digestion, absorption, transport, utilization of nutrients in the body.
Contents Chapter 1 Welcome to the AutoCAD Civil 3D Tutorials . . . . . . . . . . . . 1 Getting More Information . . . . . . . . . . . . . . . . . . . . . . . . . 2
