1.2: Nutrition in Health, Disease and Wellness
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- 80484
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Nutrition: From Science to the Refrigerator
The word nutrition first appeared in 1551 and comes from the Latin word nutrire, meaning “to nourish.” Today, we define nutritional science as the investigation of how an organism is nourished and incorporates the study of how nourishment affects personal health, population health, and planetary health. Nutritional science covers a wide spectrum of disciplines. As a result, nutritional scientists can specialize in particular aspects of nutrition, such as biology, physiology, immunology, biochemistry, education, psychology, sustainability, and sociology.
Without adequate nutrition, the human body does not function optimally, and severe nutritional inadequacy can lead to disease and even death. The typical American diet is lacking in many ways, from not containing the proper amounts of essential nutrients to being too speedily consumed to being only meagerly satisfying. Registered Dietitians are nutrition professionals who integrate their knowledge of nutritional science into helping people achieve healthy food habits. The Academy of Nutrition and Dietetics (AND) is the largest organization of nutrition professionals worldwide. To learn more from the AND’s nutritional advice, visit EatRight.Org.
Nutrition is a science, but its impact reaches far beyond the lab or research article. Your ability to wake up, to think clearly, to communicate, to hope, to dream, to go to school, to gain knowledge, to go to work, to earn a living, and to do all of the things that you like to do are dependent upon one factor—your health. What we eat impacts our health. Our goal is to figure out what to eat (including nutrients) to achieve and maintain good health. We have a lot of work to do. Mark Menjivar’s portrait exhibition, “You Are What You Eat,” provides snapshots of the insides of the refrigerators of American mechanics, doctors, school teachers, hunters, short-order cooks, college students, vegans, and more. Menjivar hopes these images will invoke new thoughts about “how we care for our bodies. How we care for others. And how we care for the land,” principles that we will discuss throughout this book.
Mark Menjivar has traveled around the United States taking photographs of the contents of refrigerators of different kinds of people. Please see Mark Menjivar's portrait gallery. As you look at these images, think about how the contents of your refrigerator impact your own health, the health of your family and friends, and the health of this planet.
Figure \(\PageIndex{2}\): ("Current Contents of
Nutrition in Health, Disease and Wellness
In 1946, the World Health Organization (WHO) defined health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” This definition was adopted into the WHO constitution in 1948 and has not been amended since. Disease is defined as any abnormal condition affecting the health of an organism and is characterized by specific signs and symptoms. Signs refer to identifying disease characteristics such as swelling, weight loss, or fever. Symptoms are the features of a disease recognized by a patient and/or their doctor. Symptoms can include nausea, fatigue, irritability, and pain. Diseases are broadly categorized as resulting from pathogens (i.e., bacteria, viruses, fungi, and parasites), deficiencies, genetics, and physiological dysfunction. Diseases that primarily affect physical health are those that impair body structure (as is the case with osteoporosis) or functioning (as is the case with cardiovascular disease). Mental illnesses, originally thought to affect only mental and social well-being, can also impact a person's physical status, finances, and job.
This expanded concept, known as wellness, goes beyond WHO’s original idea of health and definition of disease. Wellness has been defined as “functioning optimally within your current environment.”3 This idea of living to one’s full potential is commonly framed as the “dimensions of wellness.” Looking at our daily choices of what we eat from each dimension supports why making these choices can be so complicated! In this book, we will consider eight Dimensions of Wellness (Figure \(\PageIndex{3}\)) and their impact on making healthy food choices.
The Eight Dimensions of Wellness
Figure \(\PageIndex{3}\): Dimensions of Wellness.4 Each dimension has an impact on our daily food choices.
| Dimension of Wellness | How the dimension impacts healthy food choices |
| Physical | Structure and function of the body |
| Emotional | Feelings you experience and coping strategies used |
| Social | Family, friends, and others you interact with during the day |
| Environmental | Your physical surroundings/location |
| Occupational | Daily demands related to where, when, or why you work |
| Intellectual | Ability to receive, process, and use accurate information |
| Spiritual | Values, as well as religious or cultural principles that drive choices |
Let’s take a college student as an example: The student is carrying extra weight (physical) that they gained over the summer while working multiple jobs (occupational) to save up for tuition (financial). The student is feeling self-conscious about their weight (emotional) and is stressed out about the upcoming school year (emotional). The students' roommates are always ordering out (social, financial, physical), and it is hard to say no to that! The refrigerator is filled with restaurant to-go containers and soda bottles. Long work hours (occupational) limit the ability to do any outside fitness activities (physical) because it is not safe to be outside alone at night (environmental). Social media has been confusing on what to eat (intellectual), although the student values their body and deep down knows what better food choices should look like (spiritual). The student wants to start the new school year healthier, but you can see how complicated this could be when you consider all eight dimensions of wellness! Can you think of any shifts this student could make in their current habits?
Nutrition Guidelines to Support Public Health
In 1894, the first congressional funds were appropriated to the US Department of Agriculture (USDA) to study the relationship between nutrition and human health. Dr. Wilbur Olin Atwater was appointed as the Chief of Nutrition Investigations and is regarded as the “Father of Nutrition Science” in the US. Under his guidance, the USDA released the first bulletin to the American public that contained information on the amounts of fat, carbohydrates, proteins, and food energy in various foods. Nutritional science advanced considerably in these early years, but it took until 1980 for the USDA and the US Department of Health and Human Services (HHS) to jointly release the first edition of Nutrition and Your Health: Dietary Guidelines for Americans.
The Dietary Guidelines for Americans are based on current scientific evidence and medical knowledge for all life stages, genders, and various racial and ethnic backgrounds. Its intended use is to help individuals and families make healthy food choices, guide public policy for federal nutrition programs, and provide background for consistent nutrition education communication to consumers. “The purpose of the Dietary Guidelines for Americans is to provide advice on what to eat and drink to build a healthy diet that can promote healthy growth and development, help prevent diet-related chronic disease, and meet nutrient needs."6
Although the Dietary Guidelines for Americans were not widely distributed until the 1980s, their release followed many historical events that demonstrated the importance of diet to health. Assessments of the American diet in the 1930s led President Franklin D. Roosevelt to declare in his inaugural address on January 20, 1937, "I see one-third of a nation ill-housed, ill-clad, ill-nourished. The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little."7
In the latter part of the twentieth century, nutrition scientists, public health organizations, and the American public recognized that eating too much of certain foods was linked to chronic diseases. We now know that diet-related conditions and diseases include hypertension (high blood pressure), obesity, Type 2 diabetes, cardiovascular disease, some cancers, and osteoporosis. It is estimated that “6 in 10 Americans have a chronic condition and 4 in 10 Americans have 2 or more chronic conditions.”8 These diet-related conditions and diseases are some of the biggest killers of Americans.
Let’s look at obesity as an example. The Dietary Guidelines for Americans reported that 74% of all adults and 40% of children and youth are either overweight or obese.9 This level of obesity comes with an economic cost. It has been reported that the annual medical cost of obesity in the US was $173 billion. Medical costs for obese adults were $1,861 higher than medical costs for people with healthy weight. This annual cost exceeds $200 billion if the overweight population is included in the statistics.10
Poor dietary patterns and lack of physical activity are considered key contributors to these diseases, including obesity. In 2011, as part of the Dietary Guidelines for Americans, the US federal government released a multimedia tool to help Americans choose healthier foods from the five food groups (grains, vegetables, fruits, dairy, and proteins). The tool, called “MyPlate,” is available at https://www.myplate.gov/. (Figure 1.2.4). We will study MyPlate in detail in another chapter. In addition to MyPlate, the U.S. Department of Health and Human Services released Physical Activity Guidelines for Americans11 and related Move Your Way® resources regarding the benefits of physical activity and tips on how to get started. These resources are available at https://health.gov/our-work/nutritio...ity-guidelines.
From the time of Atwater until the onset of the Great Depression, nutrition scientists had discovered many of the vitamins and minerals that are essential for the functioning of the human body. Their work and the acknowledgment by President FDR of the nutritional inadequacy of the American diet evoked a united response between scientists and government, leading to the enrichment of flour (adding vitamins and minerals), the development of free or reduced-cost school lunch programs, and advancements in nutrition education in this country. In this course, we will look at the impact of inadequate and excessive diets on our society.
My Plate
Figure \(\PageIndex{4}\): The Federal Government's Tool of Nutrition Communication.12 This tool is designed to help Americans choose healthier foods.
Attributions
- Zimmerman, "An Introduction to Nutrition (Zimmerman)(opens in new window)," CC BY-NC-SA 3.0. The original material was reorganized and updated. New figures were added. New references were added.
References
- Ihara M. Vegetables in Whole Foods Market. Flickr. https://www.flickr.com/photos/17206921@N00/2808759067. Published August 29, 2008. Accessed May 15, 2023.
- Maynor N. Current contents of a refrigerator. Flickr. https://www.flickr.com/photos/93178668@N00/5198697590 Published November 22, 2010. Accessed May 15, 2023.
- National Wellness Institute. NWI's Six Dimensions of Wellness. Nationalwellness.org. 2023. Accessed May 22, 2023. https://nationalwellness.org/resources/six-dimensions-of-wellness/.
- Shanle E. The Eight Dimensions of Wellness.
- Dowell J. Overview of the Dimensions of Wellness.
- Dietary Guidelines for Americans. About the Dietary Guidelines. Dietaryguidelines.gov. Accessed May 23,2023. https://www.dietaryguidelines.gov/about-dietary-guidelines.
- Quotations. Nps.gov. Updated April 10, 2015. Accessed May 22, 2023. https://www.nps.gov/frde/learn/photosmultimedia/quotations.htm.
- Dietary Guidelines Advisory Committee. Part A. Executive Summary. Dietaryguidelines.gov. December 2020. Accessed June 14, 2023. https://www.dietaryguidelines.gov/sites/default/files/2020-07/PartA_ExecSum_first-print.pdf.
- Dietary Guidelines for Americans 2020-2025. Make Every Bite Count With the Dietary Guidelines. dietaryguidelines.gov. Published December 2020. Accessed July 27, 2023. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.
- Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sex. PLoS ONE. 16(3):e0247307. doi:10.1371/journal.pone.0247307.
- Physical Activity Guidelines for Americans. Health.gov. Updated June 23, 2023. Accessed July 28, 2023. https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines.
- United States Department of Agriculture. My Plate Style Guide and Conditions of Use for the Icon. USDA; December 2020. Accessed June 22, 2023. https://myplate-prod.azureedge.us/sites/default/files/2021-01/MyPlateStyleGuide_2020-2025.pdf.