Nutrition, Metabolism, and Diabetes

CONTENTS OF CURRICULUM UNIT 08.06.03

  1. Unit Guide
  1. Overview
  2. Rationale
  3. Objectives
  4. Strategies
  5. Instructional Content Background
  6. Classroom Activities
  7. Unit Assessment
  8. Teacher Resources
  9. Student Resources
  10. Appendix 1
  11. Appendix 2

Healthy Choices Lead To Healthy Bodies! A Child's Guide to Good Nutrition and Exercise

Brian Donald Coons

Published September 2008

Tools for this Unit:

Instructional Content Background

Walter C. Willet's "Healthy Eating Pyramid" vs. the USDA's "MyPyramid"

Walter C. Willit M.D., faculty member at the Harvard Medical School and author of "Eat, Drink, and Be Healthy" has developed what he calls the "Healthy Eating Pyramid." His pyramid comes into direct competition with the USDA's new campaign called "MyPyramid" which has replaced its original food guide pyramid. Willit claims his pyramid is based upon solid science, and offers better guidance for healthy eating than the advice from the USDA. (Willet et al. 2005, 21)

The former USDA pyramid gave consumers some idea of what they should eat daily by listing food groups and servings per day. The major flaw that plagued the USDA's original pyramid was that it was not updated or revised to address new nutritional research for almost 13 years. Ideas presented to the public were already coming under serious scrutiny and being openly challenged. (Willet et al. 2005, 12)

Originally, the USDA claimed all fats were bad. Willit and other researchers have since determined some fats are good for you, especially Omega 3 and 6-fatty acids. (Willet et al. 2005, 16) The USDA had claimed that all carbohydrates were good; however, we have since learned that some are, and some are not. This was the case when carbohydrates replaced fats as a food of choice. Over consumption in turn led us down the road to diabetes and heart disease, according to Willett. (Willet et al. 2005, 17) Protein was another area of concern with consumers believing that proteins were exchangeable. However, the choice of proteins present in terms of saturated fat content varies. Chicken and turkey for example, beat red meat as a meal choice; however, the old system did not deal with this. (Willet et al. 2005, 18) The USDA said dairy products are essential, however, it is calcium and not the fat in dairy products we need. Things such as whole milk are loaded with saturated fats, which definitely are not good for us. The USDA recommended Americans eat more potatoes. Willit points out that this is ok, for the very physically active. For the rest of us, we do not need the high level of starch consumption gained from them unless we are looking to add extra pounds. Lastly, Willet points out that the old pyramid never addressed alcohol consumption, vitamins, or gave guidance on weight or exercise. (Willet et al. 2005, 19)

When the USDA finally released its new "MyPyramid" program to the public in 2005, the dietary guidelines used in its creation were a vast improvement over the previous version. It finally stressed exercise and physical fitness; however, the "MyPyramid" diagram itself was nothing more than a rainbow band of colors vertically aligned inside a pyramid. (Willet et al. 2005, 20) It did not include any information about what to eat or how much to eat whatsoever. This left many more confused than before. Lastly, for those without web access, the new USDA information and guidelines were almost beyond their reach because you could only primarily access the information via the Internet. This lack of availability hurts those that needed its help the most, often the most disadvantaged in our society.

Dr. Willet's "Healthy Eating Pyramid" on the other hand is based upon on current ongoing scientific research, subject to revision. It is more accurate and helpful to consumers; all the while, it tries to be unbiased. Willet's main aim is to inform and educate the public using the latest findings available. He admits that his pyramid is not set in stone; it is open to further findings and research so it can help all. (Willet et al. 2005, 21) In his regimen, we are reminded to watch our weight. He suggests that we need to examine our weight and its long-term effects on our over-all health. Eating fewer bad fats and more good fats, combined with eating fewer refined carbohydrates and more whole-grain carbohydrates are some ways for us to start. Choosing healthier sources of protein opens options for eaters to consume fewer saturated fats. Eating plenty of fruits and vegetables boosts vitamin and mineral intake, all the while cutting down on refined sugars and high-fructose corn syrup. Fewer potatoes also reduce excess starch in our diets. For adults, Willet seems to direct us to use alcohol in moderation. A little bit can be beneficial, however a lot can lead to disease and damage to bodily function. (Willet et al. 2005, 22) Lastly, Willet advocates the use of a daily multi-vitamin. He admits that it will not make up for poor eating habits; however, it cannot hurt ones health either. (Willet et al. 2005, 24)

The "Children's Activity Pyramid"

The "Children's Activity Pyramid" was originally designed by Barbara Willenberg, however in 2006; the University of Missouri Extension published it as a new conceptual model to correspond the USDA's MyPyramid. The Activity Pyramid illustrates easy to engage in physical activity that children could relate to and engage in to support overall health and metabolism. The new physical activity pyramid was a tool intended to help youth; ages 6-11 amass the necessary amount and assortment of activities in each category. The Activity Pyramid also attempts to organize activities into categories that children can complete: 1) Everyday Activities; 2) Active Aerobics; 3) Flexibility and Strength; 4) Inactivity. The pyramid recommends amounts of each category given. The Activity Pyramid also depicts youth from communities of color as well as a child with physical disabilities. Girls and boys are engaged in pertinent but recognizable physical activities. The Activity Pyramid recognized nationally and internationally, promoted by numerous organizations including National Association for Sport and Physical Education. This project funding came in part by USDA's Food Stamp Program. (Science Direct 2007)

The Human Digestive System

Digestion is the breaking down of food into forms that our bodies can use. Our bodies use food as fuel to provide energy for work, play, and growth. The digestive system is responsible for changing the food eaten into energy for our bodies to use. Digestion is the breaking down of food into small molecules that will be absorbed into our bloodstream. The digestive process often begins for most of us when we feel hungry. Stomach growling occurs when the stomach receives signals from your brain to begin digestion but the stomach is empty. The movement of the muscles mixing the acids of the stomach in the hollow space of the stomach produces vibrations we hear as growling, or rumbling, or gurgling. The obvious solution to this problem is to eat, but this is not always practical. However, once food is ingested the digestive process really proceeds.

When you put food in your mouth and begin to chew. Your teeth help to break the food apart, saliva helps to soften the food, and your tongue helps to push the food into your throat when you are ready to swallow. When we swallow the food, it goes into a tube called the esophagus. The esophagus is a muscular tube that is connected to the stomach. The muscles that surround the esophagus help to squeeze and push the food into the stomach.

The stomach is an expandable sack that receives the food from the esophagus. Your stomach is located just below the heart. The stomach makes digestive juices, like acids and enzymes, which help to break our food down into a thick liquid or paste. This thick liquid or paste is called chyme. Your stomach is a muscular organ that is able to move in order to mix the food with digestive juices. Food usually remains in the stomach for about two hours. After leaving the stomach, the food enters the small intestine.

Your small intestine is a 20-25 foot tube that is coiled up in your abdomen. The center of your small intestine is right behind your belly button. Some of the most important aspects of digestion takes place in the small intestine. As the thick liquid food paste travels through your small intestine the nutrients, such as vitamins, minerals, proteins, carbohydrates and fats, are absorbed by millions of tiny finger-like objects called "villi" and sent into your bloodstream where the nutrients can travel to all your body cells. The body does not digest all the food that we eat. The undigested food leaves the small intestine and then enters the large intestine.

The large intestine is about five feet long so it is shorter than the small intestine. The large intestine is however thicker or wider than the small intestine and that is why it is called the large intestine. The undigested food enters the large intestine as a liquid paste. In the large intestine, water is removed from the liquid paste turning what is left into solid waste. The solid waste collects in the rectum at the end of the large intestine. It will finally leave the body through an opening called the anus.

Healthy Body Weight

Family lifestyle and traditions play a much larger roll in the problem of obesity than heredity. (Larimore et al. 2005, 36) What does healthy body weight mean? As in figuring out what it means, there are some well-known markers for healthy weights. Different measures of healthy weights take into account gender, age, and height. Sources indicate that a healthy body weight takes into account ones "body mass index." (IamGeekFit, 2007)

What is weight?

If you were to ask the average person on the street "How much do you weigh?" you might get the response "Whatever the scale says." This definition however does not answer this fundamental question when it comes to the human body. A more precise definition of weight could be stated, as "an object's weight equals the force required to support it." (Batesville, 1999) For the purposes of this unit, weight will measured using a bathroom scale, either measuring pounds, or using a balance scale, using grams. Weight is measured in one of two ways around the world. In the United States, the pound (lb) is the main standard unit of measurement. A pound is made up of 16 ounces (oz) while in all other countries; the kilogram (kg) is the standard unit of measure. A kilogram is made up of 1,000 grams.

How do children maintain proper weight?

To maintain a proper weight based upon their age, children normally need a certain number of calories each day that their bodies use as energy for normal daily activities This ranges for boys from 2000 calories for a 7-10 year old, 2500 calories for an 11-14 year old, and 3000 calories for a 15-18 year old. For girls the ranges are from 2000 calories for a 7-10 year old, to 2200 calories for an 11-18 year old. These are only estimates and some children need more or less of an energy allowance for daily activities. (About.com, 2003)

Body Mass Index (BMI)

Body mass index (BMI) is a calculation that uses your age, gender, height, and weight to estimate how much body fat you have. BMI is measured in either percentages or numbers based upon age. BMI results are different for children and adults. Adult BMI is calculated in the same manner as a child; however, numbers and not a percentage are derived. A child's BMI can be calculated between the ages 2-20 and it is ranked into percentiles not numbers. These percentiles determine if a child is in one of four categories: "Under weight" less than the 5th percentile, "Healthy weight" greater than or equal to 5th but less than 85th percentiles, "Overweight" greater than or equal to 85th but less than 95th percentiles or lastly "Obese" being greater than or equal to the 95th percentile (Kids Health, 2008.)

Too much body fat is a problem because it can lead to variety if illnesses and other health problems. BMI, although not a faultless method for judging someone's weight, is often a fine way for student's parent to see how the child is growing at any age. However, it needs to be mentioned that a child that is muscular and has a higher weight and BMI may not be fat.

Calories

A calorie is a unit of energy available in the food you digest. (Wishinsky & MacLeod 2008, 103) A calorie is a unit of measurement; however, it does not measure weight or length, and energy. It can be used by the human body as a fuel to accomplish a variety of necessary functions. (Kirschmann, et al. 2007, 209) A calorie is the amount of heat (energy) required to raise the temperature of 1 gram (g) of water 1 degree Celsius (°C). (Science Buddies, 2008)

The caloric content of any food item can be measured using an instrument called a calorimeter. According to the reputable science website "Science Buddies" the formula used to calculate calories in a calorimeter is as follows: (Qwater = mcΔT.) Qwater is the heat captured, in calories (cal); m is the mass of the water, in grams (g); c is the specific heat capacity of water, which is 1 cal/g°C (1 calorie per gram per degree Celsius); and ΔT is the change in temperature (the final temperature of the water minus the initial temperature of the water), in degrees Celsius (°C). (Science Buddies, 2008)

When something contains calories, it is a way of describing how much energy your body could get for those functions from eating or drinking it. Calories are not harmful in themselves. The human body needs calories for energy. However, eating too many calories and not "burning" enough of them off through physical activity is the main reason for weight gain. The body burns a certain amount of food, converting it into calories needed for energy; the body converts the excess energy into glycogen or fat, which is stored all over the body. (Kirschmann, et al. 2007, 209)

Carbohydrates and Sugars

People seem to love foods that are loaded with carbohydrates. Carbohydrates are the best source of immediate energy for all body function, especially the brain and central nervous system, and for muscle exertion. (Kirschmann, et al. 2007, 11) All forms of starch and sugar are also carbohydrates. Sugars may taste sweet; but there are many forms of sugars, and not all are alike. All sugars are derived from carbohydrates because when you consume carbohydrates they can be broken down in the body into sugars.

Glucose, also known as "blood sugar" is one of the simplest sugars. Glucose is also needed as a fuel supply for the human brain, which only functions using glucose and not other sugars. Eliminating all sugars from the diet is impossible and in glucose's case, it would be fatal, because the brain uses only glucose for its energy. Fructose, another simple sugar, found in fruit is also the sweetest of all sugars. Galactose is another simple sugar. It is released into the body during digestion, where it and fructose are converted to glucose by the liver. The simple sugars, such as glucose, are also known as monosaccharides.

A more complex double sugar such as cane sugar is also known as a disaccharide. (Netdoctor.co.uk, 2008) Lactose, found in milk, and maltose, found in sprouting plants and beer malt are other examples of disaccharides. Complex carbohydrates are broken down into their respective sugars are digested and absorbed at various points along the digestive tract.

The mouth's salivary glands excrete enzymes, which along with mechanical chewing begin the digestion of starches to polysaccharides and maltose. (Kirschmann, et al. 2007, 6) As food moves into the stomach, acid and enzymes present in the stomach, digest the salivary enzymes, thus stopping the further digestion of starch. Maltose and sucrose are partially broken down at this point by the stomach acids present. (Kirschmann, et al. 2007, 6)

Food is then passed through onto the small intestine. The pancreas releases carbohydrase and other enzymes into the small intestine at the same time. This carbohydrase breaks down polysaccharides into maltose. Enzymes on the surface cells, that line the small intestinal wall, break down the polysaccharides into disaccharides and then into monosaccharides. As a last stop, monosaccharides are absorbed through the cells and then into the blood stream. The large intestine plays no role in absorption of carbohydrates.

Fats

Fats are also known as "lipids." Fats, or lipids, are calorie-rich nutrients in food that the body uses to build nerve tissue, most notably in the brain, as well as hormones. The body also uses fat as fuel because it is so calorie-rich. If lipids eaten are not burned as energy or used as building blocks, the body stores them in fat cells. (KidsHealth.org, 2008) The storage of these of these excess fat cells is determined by genes; however, the gender of the person also is a factor. Men have a tendency to store it in the "belly" or abdominal region, where as women have a tendency to store it in the region of the hips and buttocks. This is the body's way of planning for future use. By storing fat for future use, the body plans for times when food might be scarce. (KidsHealth.org, 2008) Fat is also referred to as adipose tissue. Adipose cells are lighter, but larger in volume than muscle cells, which is the reason why many people look upon excess adipose tissue as unsightly.

Fatty foods, such as hotdogs, hamburgers, and pizza can cause many serious and potentially life-threatening health risks. They are very calorie-rich and loaded with excess amounts of lipids. One cup of whole milk has as much artery-clogging saturated fat as one hot dog, five strips of bacon, a Snickers candy bar, or a fast-food hamburger. (Larimore et al. 2005, 140) Fat gives many foods their distinct taste and consistency. For many children, desserts and snacks such as nachos, candy bars, fast foods, doughnuts, pastries, and cookies are a significant source of fat. Kids also get fat from whole-milk products and high-fat meats, such as bacon, hot dogs, cheeseburgers, and non-lean red meat. Of course, fast food and take-out meals have a tendency to have more fat than home cooking; and in restaurants, fried dishes are the highest in fat content. Fat often "hides" in foods in the form of creamy, cheesy, or buttery sauces or dressings on our sandwiches and salads. Still, fat is an important part of a healthy diet when we eat the right kinds of fats, especially those from certain kinds of fish in the form of Omega 3 & 6 fatty acids in recommended amounts. When you go shopping at the supermarket, you need to be aware of the fat content on the "Nutritional Facts Label." "Fat-free" foods can contain no more than 0.5 grams of fat per serving; however, "Low-fat" foods may contain 3 grams of fat or less per serving. (KidsHealth.org, 2008)

Types of Fats

There are three main forms of lipids which are either unsaturated, saturated and trans fats. Saturated and unsaturated fats occur naturally; trans fats, however, are a manufactured creation. Unsaturated fats found in plant foods and fish are even beneficial to heart health. The best of the unsaturated fats are monounsaturated. Saturated fats are in meat and other animal products such as butter, shortening, lard, cheese, and milk. Eating too much saturated fat can raise blood cholesterol levels and increase the risk of heart disease. Trans fats are found in margarines, manufactured snack and baked goods, and some fried foods. Trans fats—another name for trans fatty acids-are created when vegetable oils are hydrogenated.

Hydrogenation means that hydrogen atoms are bonded to the fat molecules so they remain solid at room temperature. Like eating too many saturated fats, trans fat can raise cholesterol and increase the risk of heart disease. Food manufacturers must list the amount of trans fats on food labels. In some jurisdictions, such as New York City, bans on trans fats have been put in place where they cannot be used in food preparation in restaurants. This major turn of events might mirror the return of more "traditional foods" to menus not loaded with plenty of modern trans fats.

Food Products vs. Whole Foods

The current movement toward "whole foods" can trace its roots back to the early 20th century and the efforts of Dr. John Harvey Kellogg and his brother Will Keith Kellogg. Their work to bring cereal, which has been around for over 20,000 years, to the modern breakfast table needs to be commended. By shear accident, they cooked wheat and left it sitting out. When it was discovered stale, they were too cheap to throw it away. The brothers decided to force the mixture through large rollers, thinking the dough would come out in long sheets. Instead, it broke off into small flakes. The brothers decided to toast these and, alas, the first modern cereal came about. Later, when they decided to experiment with other grains such as corn and rice, Corn Flakes and Rice Krispies were born. (Wishinsky & MacLeod 2008, 25) This was also the birth of what some now call "whole" or "natural" foods movement.

Ironically, most people are actually aware of the fundamentals of a healthy diet and the necessity of eating more vegetables and fruits while avoiding too much starch, sugar, and saturated fats. Yet having fruits and vegetables every day and breaking long-standing dietary habit seem to be the greatest challenges people face. (Seinfeld 2007, 9) Pollan, author of "In Defense of Food," seems to agree with Seinfeld's observation that the consumption of vegetables is the cornerstone of any diet. If you observe the cover of his latest best seller, he states "Eat Food. Not too much. Mostly plants." (Pollan 2008) This is a straightforward proposal, which comes to sum up the main idea of his book.

The modern science of "whole foods or natural foods" rests on the art of selecting foods that are naturally grown or raised, rather than "edible food like substances" as Pollan calls them. In his new book, In Defense of Food: An Eater's Manifesto, Pollan helps average American's make sense of all the nutritionist information in the media. He suggests some common sense concepts that most consumers can easily follow.

Pollan suggests that we do not eat anything your great-grandmother would not recognize as food. (Pollan 2008, 148) He suggests that an item like "tube yogurt" is something she would not even know what to do with, let alone know what is in it. This test can be applied to almost anything in a supermarket because it is so simple to follow. Pollan also suggests avoiding foods containing ingredients that are unfamiliar, unpronounceable, more than five in number, or that include high-fructose corn syrup. Foods that fall into these categories have a great possibility of being loaded with "food like substances" made in a laboratory. Many of these food products now carry "health claims" of some sort. Pollan is quick to suggest that we avoid these items from companies simply looking for FDA approval. Just because it says that certain nutrients are in it does not guarantee that it is good for you. Pollan recommends shopping the peripheries of the supermarket and staying out of the middle. The middle of the store is where he claims most "food like substances" reside. The local farmer's markets have many organically grown foods with better selections than most "chain" food stores. Pollan informs us that we need to eat plants and, of those, mostly ones with leaves. Eating dark green leaves are beneficial to overall health. They are nutritiously loaded with vitamins, minerals, Omega-3 fatty acids, and antioxidants.

Most humans, being omnivores, are essentially tied to what they eat. No matter what animal food you put in your mouth, you are also a product of their eating habits, so it pays to eat free-range animals rather than corn-fed cattle and chicken. It is not normal in nature for a cow to feed on corn, however most beef produced today is raised on corn feed. When a good source of pasteurized "free-range" or grass-fed meat is located, it pays to buy in bulk. The same can be said about the plants we eat as well. The more diverse the human diet, the more variety that is grown or raised. Healthy organic farming methods ensure that soil is free of contamination by pesticides that are potentially harmful to the food supply. Most "non-organic" farms today grow fewer than half of the crops they did several generations ago.

The French, Greeks, Italians, Japanese, and Indians have a tendency to have better overall health, mainly because they eat a traditional diet. Traditional diets have a tendency to be more nutritious, lower in fats, and better for heart health. They often will pay more but eat less. Higher quality foods, which often cost more, are of superior quality to "edible food products." Time spent eating a sit down meal, wholly prepared in your kitchen, makes for a dining experience. Anything less than the kitchen or dining room table is not acceptable. Walt Larimore, like Pollan notes, "We have lost the habit of sitting down together, the whole family, and eating." (Larimore et al. 2005, 77) Eating alone is an opportunity to eat more than you should. Eating in the presence of others often acts a form of regulation for our caloric intake. We need to learn to stop eating when we are full, not when your plate is clean. Lastly, when need to eat slowly, chew more often, and savor the flavors. We will tend to eat less and feel more satisfied and full. Larimer seems to concur by suggesting, "If you have food on your plate when you are done, leave it. It is much better to go into the waste than onto your waist." This goes along with the idea that as humans we should dine, not graze like animals.

America is a country on the go. We do almost everything these days in our car. Pollan addresses this by saying, "Don't get your fuel from the same place your car does." (Pollan 2008, 192) Gas stations sell high calorie, highly processed snack foods loaded with high-fructose corn syrup. They should stick to selling gas. (Larimore et al. 2005, 162) "Cook and, if you can, plant a garden." (Pollan 2008, 197) Americans need to learn how to cook. The time and effort put into cooking ones meal from scratch is well worth it. The results obtained are often more nutritious meals, often containing less harmful fats than fast food. Planting a garden will result in fresh, vitamin and mineral packed herbs and plants that are more nutritious and cost saving. The benefit to ones health far outweighs the time and effort.

Another author who seems to support the idea of consuming more whole & natural foods is Henry Legere, M.D. He suggests in his book "Raising Healthy Eaters: 100 Tips for Parents" that children should eat a well balanced diet, one adequate in vitamins, one that incorporates nonmeat sources of protein, one rich in fiber and whole grain, one that avoids excess sugars, and one that contains vegetables. (Legere, 2004)

Vitamins

Vitamins are naturally occurring organic food substances. The body needs vitamins for normal growth, metabolism, and development. There are 13 essential vitamins your body needs for these processes. They are the vitamins A, C, D, E, K, and the B vitamins: biotin, folate, niacin, pantothenic acid, riboflavin, thiamine, vitamin B-6, and vitamin B-12. Most people can get all the vitamins they need from the foods they eat, however, the body can also manufacture it's own vitamins in the forms of D and K. (National Library of Medicine 2008) People who are vegetarians or vegans may need to take vitamin supplements to ensure their body receives proper dosages of each type of vitamin. Each of the essential vitamins has a specific job or function that it performs in the human body. If someone has very low levels of specific vitamins, they may develop a deficiency disease. This is especially true as a person ages or suffers from chronic illness. One must be careful however; high doses of certain vitamins can make you sick. (National Library of Medicine 2008) Some vitamins may aid in the prevention of certain medical problems. The best way to obtain sufficient levels of vitamins in the body is to eat a balanced diet with a variety of foods from all food groups. Notably, the quality of the soil in which our foods are grown has a direct effect on their overall quality.

However, in some cases, you may also need to take a daily multivitamin for optimal health because many of today's processed foods have lost their vitamin richness. Vitamin supplements can be either natural or synthetically created in a lab. The need for vitamin supplements is especially important as a person ages or suffers from chronic illness. One must be careful, however; high doses of certain vitamins can make you sick. (National Library of Medicine 2008) Vitamins can be categorized in two ways. They are either "water-soluble or fat-soluble." Soluble means, "to be able to be dissolved in another." Your body easily absorbs a "water-soluble" vitamin. Unlike a "fat-soluble" vitamin, they do not have to be absorbed using bile acids, fluids used to digest fats. Your body does not store large amounts of water-soluble vitamins. Your kidneys do not remove water-soluble vitamins. They come out in your urine. (Family Doctor, 2008)

Minerals

Minerals are nutrients that exist in the body and in food in organic or inorganic combinations. Approximately seventeen minerals are necessary or essential to human nutrition. All tissues and internal fluids of the human body contain minerals. All bodily systems utilize minerals. The human body is composed of approximately 80% water. Minerals help to maintain the delicate water balance in our bodies. Minerals, just like vitamins act as a catalyst for many biological reactions within the human body. Minerals coexist with vitamins, and their work is interrelated. Most minerals are not absorbed into the human body as easily as vitamins are. Mineral deficiencies can result in illness, much in the same way as vitamins. The need for a well-balanced diet is no less important for minerals as it was in the case of vitamins. Common minerals found in the body are Aluminum, Beryllium, Bismuth, Boron, Cadmium, Calcium, Chloride, Chromium, Cobalt, Copper, Fluoride, Iodine, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silicon, Sodium, Strontium, Sulfur, Tin, Vanadium, and Zinc.

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