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6. Chronic disease is a significant health problem in the United States. Billions of health care dollars are spent on
chronic disease, yet, in reality, little is done about the role of nutrition in the prevention of or recovery from
chronic disease. If you were the Surgeon General, in charge of health care spending, what might be your first
proclamation and why?
Answer: This is an open question for the students aimed at them exploring the role of nutrition in the
prevention or treatment of chronic disease. Students can direct this question either way. I would expect the
7. Bonus: (a) Nutrition assessment is the diagnostic tool of the registered dietitian. In performing a nutrition
assessment, an RD asks many specifics about diet—in detail. Why? (b) The RD also will ask for much detail
about an individual’s behaviors, culture, financial status, etc. Why would the RD delve into one’s personal
history in such detail, and what does this have to do with what one eats? (c) If an RD asks about the person’s
health status, would that be appropriate? Why or why not? (d) If there were questions about a disease or issue
that the RD was not familiar with, where might they go to find additional information?
Answer: (a) The RD needs a great deal of specific, detailed information about the patient’s diet because it is
important to understand servings or volume, all condiments or extraneous items a patient might use on a
8. There are a variety of health professionals in addition to the physician and the nurse. Very frequently the health
care consumer is confused as to who does what and whom to listen to. It seems like everyone is providing
nutrition information these days, and other than the physician and the RN, why should I trust anyone else? You
are an RD in a community hospital and your patient indicates when you come into his room that there have been
several individuals that have already visited him to talk about diet. You find out that the respiratory therapist,
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physical therapist; speech pathologist, MD, and RN have all talked to Mr. X about his diet. Discuss the
differences among the many health care professionals with regard to their nutrition training and scope of
practice and then briefly discuss how you might approach your patient to help him understand how your skills
are unique from those of the other health care professionals.
Answer: Many health care professionals are involved in patient care; therefore, when they are accessible, the
patients will turn to them for nutrition advice, not knowing any different. It is important to understand that the
IM Worksheet Answer Key
Worksheets 1-1, 1-2, and 1–3 – Answers will vary.
Worksheet 1-4: Chapter 1 Crossword Puzzle
Canadian Information10
Introduction
Nutrition instructors in Canada need to provide up–to-date and accurate Canadian information to their students
about: food labelling; food, nutrition, and physical activity guidelines and recommendations; impacts of nutrition,
health, and social programs on food intake; nutrition and physical activity education resources; and current nutrition–
related research. Prior to and since the release of the first set of Dietary Reference Intakes in 1997, effort has been
taken to harmonize nutrition-related policies and standards of Canada with those in the United States. Canadian
nutrition educators and colleagues in the United States use a common research base for describing how nutrients
function in the body and for planning nutrition interventions. However, differences in food intake patterns, health
statistics, and health policies affect the content and format of national nutrition programs.
15
1.1 How to Calculate the Energy Available from Foods in Kilocalories
Energy values found in food composition tables and on food labels in Canada are expressed as Calories
1.2 Dietary Reference Intakes
As Chapter 1 of the textbook indicates, Canada has participated in the development and implementation of the Dietary
Reference Intakes (DRI). The DRI provide a set of nutrient and energy recommendations for both Canada and the
United States, and support harmonization of trade-related issues and freer trade of food across the Canada–U.S. border.
Health Canada provides current information about the DRI on its web site (www.hc-sc.gc.ca/fn-
1.3 Nutrition Assessment of the Canadian Population
Canada does not have a formal, regularly cycled, systematic program of national food and nutrition surveillance,
such as HANES (Health and Nutrition Examination Survey), NFCS (Nationwide Food Consumption Survey), and
NHANES (National Health and Nutrition Examination Survey). Canada’s first comprehensive national nutrition
survey, the Nutrition Canada Survey, was conducted in 1970-1972. During the 1990s, provincial surveys were
servings for all age and gender groups.12 The other food groups showed variable intake results across age and
gender.
Dietetic Practice and Research, 62:61-69.
16
Improving the Health of Canadians 2005-2006 Report Series provides a broad look at the health of Canadians and
the impact of multiple determinants on health. Information from this report can be used when discussing issues of
low income or food insecurity (Chapter 20), or during the appropriate stage of the life cycle. The report series
examines what we know about factors that affect the health of Canadians, ways to improve our health, and relevant
options for evidence-based policy choices. The series is produced by the Canadian Population Health Initiative, and
is available from the Canadian Institute for Health Information web site (www.cihi.ca), an independent, not-for-
Report from CCHS Data
*Nutrient Intakes from Food, Provincial, Regional and National
Summary Data Tables, Volumes 2 and 3
Nutrition – General Health (including Vitamin & Mineral
Supplements) & 24-Hour Dietary Recall Components – User’s
Guide
*Nutrient Intakes from Food, Provincial, Regional and National
*Income-Related Households Food Security in Canada:
Supplementary Data Tables
*Income-Related Household Food Security in Canada
*A Guide to Accessing and Interpreting the Data
Overview of Canadians’ Eating Habits
Overweight Canadian children and adolescents
Adult obesity in Canada: Measured height and weight
Access to all reports labelled with an asterisk is available at www.hc-sc.gc.ca/fn-
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Statistics Canada, and designed to measure the health status of Canadians to add to the existing body of knowledge
about the determinants of health. Self-reported data are collected on the same individuals every two years for up to
20 years, with the original sample selected to be representative of the Canadian population.13 Health Canada added a
number of supplementary nutrition-related questions to the 1994-95 NPHS that focused on two key healthy eating
concerns—increasing starch and fibre consumption, and decreasing fat consumption. In 1997, the report Canadians
and Healthy Eating – how are we doing? was released. Although findings in this document were aligned to dietary
guidance tools that are no longer in use (Canada’s Guidelines for Healthy Eating, Nutrition Recommendations for
Canadians, and Canada’s Food Guide to Healthy Eating), the report does provide a snapshot of Canadians’
awareness of and action on key nutrient messages of the mid-1990s. The 1999 report, Toward a Healthy Future:
1.4 Leading Causes of Death in Canada
In 2004, the top 10 leading causes of death in Canada differed in rank order from those in the United States (Table
Canada
United States
1. Cancers
1. Heart disease
2. Diseases of the heart
2. Cancers
3. Cerebrovascular diseases (stroke)
3. Stroke
4. Chronic lower respiratory diseases
4. Chronic lower respiratory diseases
5. Accidents
5. Accidents
6. Diabetes mellitus
6. Diabetes mellitus
7. Pneumonia and influenza
7. Pneumonia and influenza
8. Alzheimer’s disease
8. Alzheimer’s disease
10. Kidney disease
10. Blood infections
Highlight 1: Nutrition Information and Misinformation—On the Net and in the News
Dietitians’ Credentials in Canada
The qualifications for admission to Dietitians of Canada are similar to those for the American Dietetic Association.
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internship programs, which qualify dietitians to practice. There is no single designation of title or initials for
Canadian dietitians (see table below).
Provincial Regulatory Bodies
Provincial government legislation determines the professional designation for health professionals who practise in
each province. Many provinces have established colleges under their health professions legislation to ensure that the
public receives quality care from dietitians. Dietitians are registered to practice through a college or provincial
regulatory body. The public can take complaints about dietetic practice to the college or regulatory body. Provincial
colleges and regulatory bodies exist for the purpose of ensuring public safety. These regulatory bodies:
Province
Designation
Contact Information
Alberta
RD (Registered Dietitian) or Registered
Nutritionist
www.collegeofdietitians.ab.ca
British Columbia
Dietitian or RD (Registered Dietitian)
www.collegeofdietitiansbc.org
Manitoba
Dietitian or RD (Registered Dietitian)
www.manitobadietitians.ca
New Brunswick
RD (Registered Dietitian) or RDN
(Registered Dietitian-Nutritionist)
www.adnb-nbad.com
Newfoundland and
Labrador
Dietitian or R.D. (Registered Dietitian)
Nova Scotia
Dietitian or Nutritionist or P.Dt. (Professional
Dietitian)
www.nsdassoc.ca
Ontario
RD (Registered Dietitian) or Dt.P. (diététiste
professionnelle)
www.cdo.on.ca
(Professional Dietitian) or R.D. (Registered
Dietitian)
Saskatchewan
P.Dt. (Professional Dietitian) or R.D.
(Registered Dietitian)
www.saskdietitians.org
Canadian Web-Based Resources
1. Most university libraries have on-line resources to help students critically assess the reliability and credibility of
2. As of April 1, 2008, the Canadian Health Network ceased to exist. Instead, Canadians can turn to credible
public health information through the Public Health Agency of Canada (www.phac-aspc.gc.ca/index-eng.php).
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3. The Nutrition Resource Centre (www.nutritionrc.ca) is part of the Ontario Public Health Association. The
4. Canadian Council of Food and Nutrition (www.ccfn.ca) offers a listing of reliable food and nutrition links in its
“In Action” section.
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Worksheet 1-1: Evaluation of Published Nutrition Information
Literature Critique: Critical Evaluation of Published Nutrition Information—
“Should I Believe What I Just Read?”
Assignment for discussion: Carefully read a journal article and answer the following questions
on a separate sheet of paper.
1. Summarize the basic idea of the article in a short paragraph.
2. a. What are the credentials of the author(s)? What do the abbreviations after the name(s)
mean? Do they enhance the authors’ credibility? Explain.
b. Is the author affiliated with an organization or institution? Does the affiliation with the
organization or institution enhance the authors’ credibility? Briefly explain.
c. Does the periodical have an editorial board? Do the editors’ credentials enhance the
article’s credibility? Where does one look in a periodical for the editorial board?
4. a. What is the underlying hypothesis (if/then, cause/effect, etc.)?
b. What are the article’s conclusions/recommendations?
c. Are the conclusions or recommendations supported by the research discussion? Explain
briefly why or why not.
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Worksheet 1-2: Research Project Using the Internet
This research project will employ the use of the Internet as a research tool. The student will be
expected to become familiar with the diversity of Internet resources. The purpose of this project
is to develop research skills using the Internet.
1. Access the world wide web. Access several search engines for locating publications in peer-
reviewed journals.
4. Print out the references of articles that you found.
5. Print out abstracts from selected articles that are most interesting.
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Worksheet 1-3: Influences on Food Choices
We decide what to eat, when to eat, and even whether to eat for a variety of reasons. Examine the factors that
influence your food choices by keeping a food diary for 24 hours. Record the times and places of meals and snacks,
the types and amounts of foods eaten, and a description of your thoughts and feelings when eating. Now examine
your food record and consider your choices.
1. Which, if any, of your food choices were influenced by emotions (happiness, boredom, or disappointment, for
example)?
4. How large a role do availability, convenience, and economy play in your food choices?
5. Do your age, ethnicity, or health concerns influence your food choices?
Compare the choices you made in your 24-hour food diary to the USDA Food Guide recommendations. To obtain a
Food Groups
Suggested Amounts
Amounts Consumed
Grains
Vegetables
Fruit
Milk
Meat and beans
7. Do you eat the suggested amounts from each of the five food groups daily?
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Worksheet 1-4: Chapter 1 Crossword Puzzle
Across
Down
2. a substance or a molecule containing carbon–
carbon bonds or carbon-hydrogen bonds
4. organic, essential nutrients required in small
amounts by the body for health
1. products derived form plants or animals that can
be taken into the body to yield nutrients for the
maintenance of life and the growth and repair of
tissues
1
2 3
4 5
6 7
8
9
10
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Worksheet 1-5: Choosing Party Foods and Snacks (Internet Exercise)
Instructions: Go to the following website to answer questions 1-11:
1. When at a party you should only place 2 food items on your plate at any one time.
a. True
b. False
2. When selecting snacks, fruits are always a good choice.
a. True
b. False
5. It does not matter where you stand or sit at a party, as you are prone to eat more in order to be sociable.
a. True
b. False
6. If you stand near the food table, you are likely to eat more at a party.
a. True
b. False
Watch the Snack Attack Video Podcast to answer questions 7-11.
7. A good beverage selection would be one that contains fruit juice concentrate.
a. True
b. False
11. Products that contain whole grains are considered to be a healthy snack food choice.
a. True
b. False