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TOPIC 1. WHY WE NEED TO EAT WELL


NUTRITION NOTES

Good meals

Eating good food, especially with family and friends, is one of the pleasures of life.We all know that people who eat healthy, balanced diets are likely to have:

Children who eat well usually grow well.Women who eat well are likely to produce healthy babies. That is why it is important to know which combinations of foods make good meals and what the different food needs of different members of the family are.

Foods and nutrients

Foods provide nutrients so we can grow and be active and healthy

A food is something that provides nutrients. Nutrients are substances that provide:

There are many different nutrients.We divide them into:

Macro (big) nutrients that we need in large amounts. These are:

Micro (small) nutrients that we need in small amounts. There are many of these but the ones most likely to be lacking in the diet are:

BOX 4 · FATS, FATTY ACIDS AND CHOLESTEROL

Fats and oils provide a concentrated source of energy and the essential fatty acids needed for growth and health. They aid the absorption of some vitamins such as vitamin A and improve the taste of meals. Some fatty/oily foods contain important vitamins.

Fats and oils contain different ‘fat-nutrients’. These include unsaturated fatty acids, saturated fatty acids, trans fatty acids and cholesterol.

Unsaturated fatty acids

Two of the unsaturated fatty acids are called ‘essential fatty acids’ because the body cannot make them. They are needed for building cells, especially the cells of the brain and nervous system. Unsaturated fatty acids contain a group called ‘omega-3 fatty acids’, which help to protect the body from heart disease.

  • Examples of foods containing mainly unsaturated fatty acids are most vegetable oils, groundnuts, soybeans, sunflower seeds, sesame seeds and other oilseeds, oily fishes and avocados. Foods rich in omega-3 fatty acids are oily sea fish and some seeds and pulses such as linseed and soybeans.

Saturated fatty acids

  • Examples of foods containing mainly saturated fatty acids are butter, ghee, lard/cooking fat, whole milk, cheese, fats from meats and meat products (e.g. sausages) and poultry, red palm oil and coconuts.

Trans fatty acids

When vegetable oils are processed to make them harder (e.g. for use in margarine and other solid fats), some of the unsaturated fatty acids are changed into trans fatty acids. These behave like saturated fatty acids. We should eat as little of the foods containing trans fatty acids as possible.

  • Examples of foods containing trans fatty acids are margarine and lard (shortening), fried foods, such as chips (French fries) and others, commercially fried foods, such as doughnuts, as well as baked goods, biscuits, cakes and ice creams.

Cholesterol

Cholesterol is found only in animal foods but the body can make it from other fatnutrients. We need some cholesterol for our bodies to grow and function properly.

There are two kinds of cholesterol in the blood.

  • High levels of ‘good’ cholesterol (high-density lipoprotein) seem to reduce the risk of heart disease. Eating foods containing mainly unsaturated fatty acids tends to increase the level of good cholesterol.

  • High levels of ‘bad’ cholesterol (low-density lipoprotein) seem to increase the risk of heart disease. Eating foods containing mainly saturated fats tends to increase the level of bad cholesterol.

Fat needs

Fat needs are expressed as ‘percent of total energy needs’ (see Appendix 2). The percent of total energy that should come from fat in a healthy balanced diet is:

  • 30-40 percent for children on complementary feeding and up to the age of two years;

  • 15-30 percent for older children and most adults; for active adults up to 35 percent is acceptable;

  • At least 20 percent up to 30 percent for women of reproductive age (15-45 years).

This means the diet of a woman of reproductive age who needs approximately 2 400 kcal/day should contain about 480-720 kcal from fat or oil. This is equivalent to 53-80 g of pure oil (or about 11-16 level teaspoons). Part of the fat in a diet is not added in the kitchen at home but is ‘hidden’ in foods such as meat, milk, groundnuts and oilseeds as well as fried foods.

Fat and health

It is recommended that less than one-third of the fat in the diet is in the form of saturated fatty acids. Red palm oil and coconuts/coconut oil are foods rich in saturated fatty acids but, unlike other such foods, they do not seem to increase the risk of coronary heart disease. Moderate intake of coconut, for instance, seems to be acceptable, providing other foods high in saturated fats are eaten as little as possible. This is particularly true where the overall lifestyle lessens the risk of heart disease. Such a lifestyle could, for example, be one with a high physical activity level, high intake of fish, vegetables and root crops, low intake of salt and little or no use of tobacco or alcohol. Red palm oil is also a good source of other important nutrients, such as vitamin A and vitamin E.

Ideally trans fatty acids should provide less than 1 percent of the total energy intake (or not more than 2 g for most adults).

For many families this means they should, when possible, eat more of the foods rich in unsaturated fatty acids (e.g. foods from plants and oily sea fish), less of the foods high in saturated fatty acids, and much less of the foods high in trans fatty acids.


Foods rich in unsaturated fatty acids are better for the health of the heart than foods high in saturated or trans fatty acids

Our bodies use different nutrients in different ways as shown in Box 5.

BOX 5 · IMPORTANT USES OF SOME NUTRIENTS

Nutrient

Main use in the body

Macronutrients

Carbohydrates - starches and sugars

To provide energy needed to keep the body breathing and alive, for movement and warmth, and for growth and repair of tissues. Some starch and sugar is changed to body fat.

Carbohydrates - dietary fibre

Fibre makes faeces soft and bulky and absorbs harmful chemicals, and so helps to keep the gut healthy. It slows digestion and absorption of nutrients in meals, and helps to prevent obesity.

Fats

To provide a concentrated source of energy and the fatty acids needed for growth and health. Fat aids the absorp-tion of some vitamins such as vitamin A.

Proteins

To build cells, body fluids, antibodies and other parts of the immune system. Sometimes proteins are used for energy.

Water

To make fluids such as tears, sweat and urine, and to allow chemical processes to happen in the body.

Micronutrients

Iron

To make haemoglobin, the protein in red blood cells that carries oxygen to the tissues. To allow the muscles and brain to work properly.

Iodine

To make thyroid hormones that help to control the way the body works. Iodine is essential for the development of the brain and nervous system in the foetus.

Zinc

For growth and normal development, for reproduction and to keep the immune system working properly.

Vitamin A

To prevent infection and to keep the immune system working properly. To keep the skin, eyes and lining of the gut and lungs healthy. To see in dim light.

B-group vitamins

To help the body use macronutrients for energy and other purposes. To help the nervous system to work properly.

Folate

To make healthy red blood cells and to prevent abnormalities in the foetus.

Vitamin C

To aid the absorption of some forms of iron (see Box 6). To destroy harmful molecules (free radicals) in the body. To help wound healing.

BOX 6 · IRON ABSORPTION

Iron from meat, liver and other offal, poultry, fish and breastmilk is well absorbed in the gut. Iron from other milks, eggs and all plant foods is poorly absorbed, but other foods in the same meal affect the absorption of this type of iron.

  • Meat, fish and vitamin C-rich foods (fresh fruits and vegetables) increase the absorption of this type of iron so more is absorbed.

  • Some foods, such as tea, coffee and wholegrain cereals, contain ‘antinutrients’ (e.g. phytate) that decrease the absorption of this type of iron.

The best way to make sure that we get enough of each nutrient and enough energy is to eat a mixture of foods. Topic 3 explains how to combine foods to make good meals. Appendix 1 lists sources of each nutrient (see Tables 1 and 3) and the nutrient content of different foods (see Table 2).

Different types of foods

Different foods contain different mixtures of nutrients

Staple foods are usually cheap and supply plenty of starch (for energy), some protein, some micronutrients (especially some of the B-group vitamins) and dietary fibre.

Circle the staple foods used locally and add others to the list.

CEREALS

STARCHY ROOTS AND FRUITS

MAIZE/CORN MEAL

POTATO

MILLET

SWEET POTATO

SORGHUM

YAM

WHEAT FLOUR

FRESH CASSAVA

RICE

CASSAVA FLOUR


PLANTAIN

Legumes and oilseeds. Legumes are good sources of protein, some micronutrients and dietary fibre. High fat legumes and oilseeds provide fat.

Circle the legumes and oilseeds used locally and add others to the list.

LOW FAT LEGUMES

HIGH FAT LEGUMES AND OILSEEDS

COWPEA

GROUNDNUT

PIGEON PEA

SOYBEAN

KIDNEY BEAN

PUMPKIN SEED

LENTIL

SUNFLOWER SEED

CHICKPEA

SESAME (SIM SIM)


MELON SEED

Milk. Breastmilk can supply all the nutrients needed for the first six months of life and a useful proportion of the nutrient needs up to at least 2 years of age. Animal milks, and milk foods, such as curds, yoghurts and cheese, are excellent sources of protein, fat and many micronutrients, such as calcium (but not iron).

Eggs are a good source of protein and fat and several micronutrients.

Meat, poultry, fish and offal from these foods are excellent sources of protein and often of fat. They supply important amounts of iron (especially red meat and red offal) and zinc, and many other micronutrients including some B-group vitamins. Liver of all types is a very rich source of iron and vitamin A.

The best sources of iron are meat, offal, poultry and fish

Circle the animal foods used locally and add others to the list.

MILK AND EGGS

MEAT, OFFAL, POULTRY AND FISH

FRESH COW MILK

BEEF

FRESH GOAT MILK

GOAT

CURDS

SHEEP

YOGHURT

PORK

CHEESE

LIVER

EGGS

OTHER OFFAL


CHICKEN


FRESH FISH


DRIED FISH


CANNED FISH

Fats and oils are concentrated sources of energy. For example, one spoon of cooking oil contains twice as much energy as one spoon of starch or one spoon of sugar. Fats contain fatty acids some of which are needed for growth. In addition to ‘pure’ fats (e.g. butter) and ‘pure’ oils (e.g. maize oil), other rich sources of fats and oils are oilseeds, cheese, fatty meat and fish, avocados and fried foods. Red palm oil is a rich source of vitamin A.

Sugar gives only energy and no other nutrients. It is useful for making foods taste nice and for improving appetite, for instance during illness. However, eating sugary foods too often can be harmful to health for several reasons. Sweet, sticky foods, such as ice lollies, or snacks and pastries prepared with pleanty of sugar, honey or syrup, are bad for the teeth if eaten often. Many sugary foods also contain much fat, which increases the risk of ‘overeating’ for those who should limit their energy intake. People who often eat sugary foods and consume sweet drinks such as sodas (bottled fizzy drinks) are more likely to become overweight and to develop diabetes. These people also often eat less of other, more nutrient-rich foods. There is much sugar in sweets (candy), lollies, sodas, jam and sweet cakes and biscuits.

Eating too much sweet sticky food is bad for the teeth


Eating too much sugary food often means eating less of other, more nutrient-rich foods

Circle the fats, oils and sugars used locally and add others to the list.

FATS

OILS

SUGARS

BUTTER

COCONUT OIL

TABLE SUGAR

MARGARINE

SUNFLOWER OIL

HONEY

FAT FROM MEAT

GROUNDNUT OIL

JAM

GHEE

RED PALM OIL

SUGAR CANE


MAIZE OIL


Vegetables and fruits are important sources of micronutrients and dietary fibre but the amounts vary according to the type of vegetable or fruit. Orange vegetables, such as orange sweet potato and carrots, and orange fruits, such as mango and pawpaw but not citrus fruits (e.g. oranges and lemons), are excellent sources of vitamin A. Most fruit and fresh (notovercooked) vegetables provide vitamin C. Dark green vegetables supply folate and some vitamin A. Many vegetables (e.g. tomatoes, onions) provide additional important micronutrients that may protect against some chronic conditions such as heart disease. The best way to make sure we get enough of each micronutrient and enough fibre is to eat a variety of vegetables and fruits every day.

Circle the vegetables and fruits used locally and add others to the list.

VEGETABLES

FRUITS

TOMATO

MANGO

PUMPKIN

PAWPAW

CARROT

PASSION FRUIT

SPINACH

ORANGE

OTHER LEAVES

PINEAPPLE

ORANGE SWEET POTATO

BANANA

SWEET PEPPER

DATES

EGGPLANT


OKRA


Flavouring foods. Everyone uses salt in cooking and there is salt in many processed foods. Too much salt is harmful and can lead to high blood pressure. Iodized salt is an important source of iodine. Herbs, spices, garlic and onions are examples of other flavouring foods that help to make meals tasty.

Water. We need about eight cups of water each day and more if we are sweating or have a fever or diarrhoea. In addition to drinking water, we get water from tea, coffee, juices and soups, and from fruits and vegetables.

Food needs of the family

The amounts of different nutrients a person needs varies with age, sex, activity and whether menstruating, pregnant or breastfeeding. Needs also vary during sickness and recovery. The nutrient needs of different family members are listed in Appendix 2, Table 4, and are discussed in Topics 3 and 5-10.

SHARING THIS INFORMATION

Before sharing this information with families, you may need to:

1. Find out. What different types of local foods are eaten. What people already know about foods and nutrients.

2. Prioritize. Decide which information is most important to share with groups or individual families.

3. Decide whom to reach. For example: parents and other caregivers, teachers, older school children, youths and leaders of community groups.

4. Choose communication methods. For example: illustrated talks, discussions, and demonstrations of foods.

Examples of questions to start a discussion
(choose only one or two questions that deal with the information families need most)

Why do we need to eat well?

Can you list some important minerals and vitamins?

Which important nutrients are found in: cereals, legumes, milks, meats?

Why is too much sugar bad for us?

Why is the fat in plant foods usually more healthy than the fat in margarine or street foods?

Why do we need iron? Which foods are the best sources of iron?


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