NUTRITION ACROSS THE LIFESPAN/ LIFE STAGES 2.

Provide adequate nutrition to meet increased

- Ways in which nutritional needs & considerations change maternal and fetal nutrient demands.
throughout life
- growth & dev’t through the stages of life A. PHYSIOLOGICAL BASIS OF NUTRITIONAL
- nutritional needs unique to each stage of life NEEDS
- nutritional problems common in each stage of life
Characteristics of Pregnancy:
I – PREGNANCY - Pregnancy or gestation – lasts for a period of 266 –
280 days (37 – 40 wks.)
Of all the periods in the human life cycle, the period of - consists of 3 trimesters – corresponding to three
pregnancy is the most critical & unique. main phases: - implantation
- Organogenesis growth
- CRITICAL – because the foundations of new life is
being laid that will influence the future of succeeding Nutrition in Pregnancy
generations CALORIE ALLOWANCES
- Pregnancy has social importance affecting not only - during the course of pregnancy,
individuals but also their families & society as a o total energy cost of storage - 300 kcal/ day
whole. – intake should be 36 kcal/ kg of pregnant
weight/ day
- UNIQUE – at NO other time in life does the well being of an o plus maintenance (additional work for
individual depends so much on the well being of another maternal heart & uterus) -
- mother & infant in the womb have an intimate & inseparable o & a steady rise in basal metabolism
relationship
- Health of the mother before & during pregnancy has - amounts to approximately 80, 000 kcal.
profound effects on the status of her child in the womb &
at birth
- therefore efforts are directed to the mother to ensure a safe WEIGHT GAIN
& successful delivery & that her infant will be born well - average gain during pregnancy = 24lbs.
- a sudden gain in wt. after the 20th week – may
- A woman’s body changes dramatically during indicate water retention & possible onset of pre-
pregnancy --- everything is increased - size & eclempsia.
strength of uterus & its supporting muscles
- blood volume ↑ by half – to carry the additional nutrients & Components of weight gain during pregnancy
other materials COMPONENT WT GAIN WT GAIN
- her joints become more flexible in preparation for childbirth (Kg) (lbs)
- breast grow in preparation for lactation Fetus 3 – 3.2 7-8
- to best prepare to handle these changes – have nutritious Placenta 0.5 – 0.7 1 – 1.5
diet Amniotic fluid 0.9 2 – 2.5
- regular physical activity Blood volume 1.4 – 1.8 3-4
- plenty of rest Extracellular fluid 1.8 – 2.3 4-5
- caring companions/ support system Breast tissue 0.5 1
- diet --- increase --- ↑ Calories/ CHON Enlargement of uterus 0.9 – 1.4 2-3
- ↑ vitamin – folic acid, ascorbic acid, Vit. B vitamins Maternal stores (mostly 2.3 – 3.6 5-8
fats)
TOTAL 11.3 – 14.9 25 – 35lbs.
Garantisadong pambata – April + Oct. because of Vit. A kg
supplements of every 6 months.
Maternal Weight
LACTATING 1. Underweight
↑ CHON (+10g then 12g) a. High risk of having low birth weight infants
↑ Caloriers (+500)
b. Higher rates of pre-term deaths & infant death
↑ minerals + ↑ vitamins
2. Overweight & Obesity
DBW – pregnant = a. High risk of complications like hypertension,
1lb/ mo. – first trimester = 3 – ( total of 1.5 – 3 lbs) gestational diabetes, and post partum infections
1 lb/ wk – 2nd trimester = 12 – ( 0.8 lbs / wk for the b. Complications of labor & delivery
remaining period) c. Large newborns increase the likelihood of a difficult
1 lb./ wk. – 3rd trimester = 12 labor & delivery, birth trauma and caesarian section
27 d. May double the risk of neural tube defects.
PREGNANCY & LACTATION NUTRIENT NEEDS/ REQUIREMENT
OBJECTIVES: - During the total pregnancy period, the basal
1. Ensure optimum nutrition before, during and after metabolic rate increases from 6 – 14%
pregnancy & during lactation - Calorie requirements proportionately increase
 - Mother’s nutrition & health status influences the
growth & development of the fetus
- It can even affect the ability to conceive a
pregnancy
FETAL DEVELOPMENT
1st TRIMESTER – Embryo - Critical stage
- organs develop (4 – 12 weeks) – formation of
organs occurs – heart, brain, liver, intestinal tract –
nutritional counseling should cover the
preconception & postpartum period
- CNS develops (4 – 12)
- Skeletal structure hardens from cartilage to bone (4
weeks)
2nd TRIMESTER – FETUS
- growth & development continue (13 – 40) teeth
calcify (20 weeks)
- fetus can survive outside womb (24 wks)
3rd TRIMESTER – BIRTH
- growth & dev’t continue
- storage of iron & other nutrients (36 – 40 wks) –
premature babies are often deficient in IRON
- development of necessary fat tissue
Adequate nutrition – help prevent some birth defects
EX: - spina bifida – associated with inadequate folate (a form
of folic acid – should be consumed within the 1st few weeks
of pregnancy when the spinal column closes) intake
- neural tube defects – are among the most common
& serious birth defects
- food fortification with folate & Vit. B12 began & has
resulted in decrease incidence of neural tube
defects
- Vit. B12 – deficiency interferes with the cellular use
of folate
- Choline – important for normal development of the
brain & is essential for the normal function of all
body cells
- Deficiency is also associated w/ Down syndrome
- Orofacial clefts (lip / palate) – appears related to
adequate iontake of the B vitamins folic acid,
thiamin, niacin, & pyridoxine at the time of
conception
COMMON problems/ concerns/ complications:
1. Appetite is usually lessened during 1st
trimester – may be difficult to maintain
calorie requirements.
2. Nausea & vomiting
- morning sickness – commonly occurs in the first
trimester – some throughout pregnancy
- probably related to hormonal changes during
pregnancy
- NAUSEA – related to low blood glucose levels
- Eat dry toast or crackers before getting out of bed –
helpful
3. Constipation – reduced motility throughout
the GIT occurs - to allow for the increased
absorption of nutrients
- can also lead to feeling of fullness & nausea.
- High fat food should be avoided unless tolerated –
further slows the movement of food through the
GIT.
- Also related to Iron supplementation
- ↓ peristalsis – is 2° to increased production of the
hormone progesterone
- Adequate fiber & fluid intake (2li) + appropriate
exercise
4. ANEMIA
- from Iron deficiency may occur during pregnancy
when iron intake & stores do not meet the demand.
- Preventable & treatable by daily supplements of 30
– 60mg of ferrous salts
- PHYSIOLOGIC ANEMIA – results from expanded
blood volume
5. Heartburn
- Believed to be caused by the pressure of the
growing fetus on the stomach – resulting in HCL
acid being forced into the esophagus.
- Eat small, frequent meals
- Avoid reclining position after eating
- Excess fat intake can contribute by causing food to
remain in the stomach for longer periods
- Advise to ↓ fat intake
6. PICA ( eating nonfood items, especially
clay or laundry starch)
- a carry over of the tradition in Africa
- clay can provide Calcium, Iron and other
minerals – however it can also provide toxic
contaminants
- consumption – can interfere with absorption of
adequate nutrients – should be discouraged.
7. Closely Spaced Pregnancies
- at least 12 – 18 months apart
- longer spacing helps the mother reestablish good
nutritional stores & recover from childbirth.
8. Pregnancy – Induced Hypertension (PIH)
- Gestational hypertension-preeclampsia & toxemia
- May occur during the third trimester of pregnancy
- Cause is unknown – leading cause of maternal &
fetal morbidity & mortality
- Risk to the fetus include premature delivery, growth
retardation, & death
- Characterized by proteinuria, ↑ BP, rapid weight
gain
- Regular physical activity during pregnancy is
advised
- Avoid excessive salt intake
- 2300 - 2400mg of Na – appropriate for women who
are pregnant
9. DIABETES – gestational Diabetes
2
 - usually develops during the second half of
pregnancy, with subsequent return to normal after
childbirth.
NUTRITIONAL ADVICE
1. Weight gain
- ideal wt. gain – 25 – 35 lbs. for normal weight
women ( those w/ BMI of 20 – 26)
- FALLACY: Because a pregnant woman is “eating
for 2” – she should eat twice as much
- FACT: overall caloric need should increase by only
15% amounting to about 150 kcal/ day – for the 1st
trimester
 ENERGY: 200 - 300 - 350 kcal/day (THIS EQUALS
ONLY 2 EXTRA CUPS
OF LOW-FAT MILK & 1
SLICE OF BREAD) for
the remainder of the
pregnancy
 TOTAL = 2,700 – 3000 Kcal/ DAY
- Therefore it is important that a pregnant woman –
consume mainly nutrient-dense foods (foods having
lots of nutrients for the number of kcal)
2. encourage to consume at least the minimum
number of servings recommended by the food guide
pyramid
- focus on the use of whole grains, unprocessed
foods
 adequate CHO intake – to prevent low birth weight – at
least 100g/ day
 adequate CHON intake – EXTRA 6 – 10/ day (51 - 60g
(increase 10 – 15g/ day)
to ensure a healthy
pregnancy
 FAT – 30g – required to provide all the essential fatty
acids for fetal growth &
dev’t
- Vegetarians can be advised to consume – walnuts,
canola oil, flax, or seaweeds (for alternative sources
of omega-3 fatty acids)
 FOLATE – daily recommended intake = 600µg
- Sources: oranges, orange juice, pineapple juice
 CALCIUM – needed for the formation of fetal skeleton &
teeth
- Additional 300mg is recommended – for a total of
1,300 mg/ day (women 14 – 18 y/o)
- 1,000 mg/ day for women ages 18 – 50
VIT. D – regular sunlight exposure – DO NOT need vit D
supplements.
- ONLY w/ the approval of a health care provider –
high doses can be toxic
- Some fortified foods – like some soy milk, orange
juice & some cereals – are one way to meet VIT. D
needs.
 IODINE – essential for the production of thyroxine ( the
thyroid hormone responsible for controlling the
increased metabolic rate that occurs during pregnancy)
 IRON – prenant woman needs an extra 30mg/ day
during the last 2 trimesters (twice the requirement of a
nonpregnant woman
- because of the increase in the amount of the
mother’s blood & because of blood formed for the
baby
- SOURCES: whole grains, dried beans, tofu & green
leafy vegetables
 VITAMIN B12
- plays an important role in the developing fetus
II - LACTATING/ BREASTFEEDING MOTHERS
- have almost the same nutritional needs
- Folate & Iron – decreases after birth
 ENERGY – 2300 – 2700 kcal/ day when breastfeeding
 Adequate hydration – encourages ample milk production
- 2 – 3 L/ day
- 8 oz. glass – every after nursing
- Avoid beverages w/ alcohol & caffeine
- Check with the pediatritian before taking in any
medication
LACTATION MANAGEMENT GOALS & CONCERNS:
- adequate diet becomes more critical
- caloric intake can affect the quantity of milk
produced
- the food requirements – are NOT uniform during the
entire period of lactation
- depend on the demands of the infant
- generally suggested – extra food calories should be
about twice those secreted in the milk of
approximately 700 – 1500 calories of food for 500 –
1000 calories above the normal requirement for an
average production of 850 ml of milk – w/ an energy
value of about 600 calories
- human milk is approximately 0.70 calories/ ml or
approx’ly 20 cal/ ounce & it contains 1.2gms CHON
/ 100 ml.
 Calories – additional 1000 calories
- 120 cal – required to produce 100ml of milk
- 1000 cal – to produce 850 ml (daily production)
 CHON
- average CHON allowance = additional 20.2 gms to
her normal requirement
- 2 gms of food protein – required to produce 1 gm of
milk protein
- Sources; milk, eggs, animal protein & legumes
 Calcium, Phosphorus & Vit. D allowances
- Ca + phosphorus = + ↑ 0.5mg
 Calcium = 1.0 gm/ day for milk production
 Vit. D = 400 I.U remains the same as during pregnancy
 VIT. B! – additional thiamin – needed for thiamin
secreted in milk
3
 - “GLYOXALIN” – toxic substance secreted by a
mother w/ a diet very low in thiamin, which
accumulates in thiamin deficiency
- Unpolished rice, legumes, veggies, milk
 VIT. A = additional 2000 IU – to provide amount of Vit. A
secreted in milk
- green leafy veg, yellow veg, milk, eggs
 Iron – some tend to be anemic
- same as during pregnancy
 Riboflavin, Vit. C – additional allowance
 FLUIDS
HEALTH BENEFITS ASSOCIATED W/ LACTATION
1. Jaundice – a condition that turns eyes and skin
yellow from buildup of bile pigments & bilirubin that
comes from the breakdown of hemoglobin & RBCs.
- Frequent bowel movements assoc’d w/
breastfeeding reduces the risk of jaundice through
increased excretion of bilirubin
- Withhold supplementary feedings
B- R- E- A- S- T- F- E- E- D- I- N- G
- Breast-fed babies have been shown to spend about
half as much time receiving antibiotics during THE 1ST
YEAR OF LIFE – COMPARED to FORMULA- fed
babies.
- result of transferal of the mother’s immune factors
through
 COLOSTRUM ( the substance that precedes
breast milk)
- first 3 – 4 days
- has high protein content
- Acts as laxative
- Contains antibodies – help resist infection
- substance called IMMUNOGLOBULIN A - IgA – helps
guard against intestinal organisms & antigens,
the latter of which are cause of allergy development.
- prevents diarrhea – through increased immunity,
reduced inflammation, & other factors
- Cognitive & intellectual development
- Breast milk varies in flavor depending on the mother’s
diet
- Primary rule of thumb – the more frequently a woman
nurses, the more breast milk she will produce
- “supply & demand”
- weight gain of infant = 1 -2 lb/ month ( 8 – 12 nursings/
24 hours; at least 6 wet diapers per 24-hour period
– infant NOT given any bottles of water
- Formula milk – is dominant in CASEIN (protein in milk)
- forms curds when exposed to acid & is difficult to
digest by the infants
- BM – in WHEY – proteins lactalbumin that form soft
light curds
“let-down reflex” – occurs when the milk descends from
the upper parts of the breast (hind milk) & comes down
to the areola
Oxytocin ( a hormone) – promotes this reflex
Lactating woman – can usually identify when the let-
down reflex is occurring – there is a momentary “pins-
and-needles” feeling in the breast area.
CALCIUM
- deposition – 30 – 35 y/o
- in bones & teeth – 99%
- serum – 1%
- 6 – 10 y/o – peak of Calcium absorption
- 16 – 18 – highest need of Calcium
Proper positioning
1. Football/ the clutch
2. Cradling
3. Cross-over/cross cradle hold
4. Lying down/ reclining/ side-lying
WEANING
- accustomizing the baby to nourishment other than breast
milk
NUTRITIONAL CONCERNS
1. Artificial sweeteners
- low-nutrient foods- poor substitute for nutrient-rich
food
2. Alcohol
- can easily cross maternal-fetal pathway – may
cause birth defects, mental retardation, &
developmental disorders
3. Caffeine
- may cause miscarriage, increased heart rate,
stimulation of the CNS, acts as diuretics
4. Supplements
- Iron – only recommended supplement during
pregnancy
5. Smoking
- may result to low birth weight
6. food-borne illness
- more prone to food-borne illnesses because of high
progesterone levels
- avoid raw fish, oysters, soft cheeses, raw or
uncooked meat, unpasteurized milk
7. Socio- economic & Cultural Factors
- Low income groups tend to have big families, one
reason for the decrease in kind & amount of food
available to the pregnant mother
- Unusual eating habits – frequent snacks rich in
CHO, irregular meals, special cravings (raw white
rice/ green mangoes) – deprive the mother of
wholesome foods
- Fallacies – eating eggplant – causes beri-beri in the
mother
- Dark food results in dark complexion of babies
- Crabs produce physical abnormalities
- ALL of these should be ignored
8. Adolescent Pregnancy
4
 - may be perfectly normal or extremely high risk
- dietary habits – foods low in essential nutrients
- concerns about body image – may result in
inadequate weight gain
- offer social support, encouragement to seek good
medical care
- assistance in completion of school
TEACHING POINTS
1. Avoid too much fried foods, pickles & highly-
seasoned foods
2. Avoid stimulants – drugs, nicotine, caffeine, theo-
bromide, morphine & alcohol
3. exude a calm, happy spirit
4. live a quiet, contented life
5. exercise in the fresh air
6. do some pleasant work
7. promote successful breastfeeding – esp 1st few
hours of delivery
8. have periods of rest & relaxation, both physical &
mental
9. we should be aware of potential biopsychosocial
barriers to adequate nourishment during pregnancy
- poor attitude ( denial of pregnancy or desire to
maintain slimness)
- misinformation
- insufficient money for food
- lack of/ inadequate preparation facilities
III - INFANCY
- refers to a person NOT more than 12 months of age
- a healthy full term infant weighs 2.7 – 3.2 (6 – 7 lbs)
& measures 48 – 50 cm (14 in)
- w/ skin – moist, elastic & not wrinkled
- rapid growth & development during the 1st year of
life – provide nutritional base – the baby grows
faster than at any other time of life
- stomach capacity = 20 – 30 ml (90 ml)
o gastric emptying = 2.5 – 3 hours
- recommend small, frequent feeding
- digestive enzymes are produced in small quantities
at birth --- breast ilk & formula milk are only given
- 3 mos. – begins the secretion of digestive enzymes
--- sufficient to digest starches in cereals
o 6 mos. – bile & lipase are produced which
can aid in FAT digestion
- Allows solid foods to be introduced to infants
- each infant has an individual rate of growth, but all
grow faster in weight than in length
- ASSESS – growth = height-to-weight ratio
- Should be consistent
- Infant growth follows the curve --- nutrition is most
likely adequate
o Birth Wt. – doubles during 4 – 6 mos. Of
life
o Triples by end of the 1st year
o Infants increase their wt. by 50% during
the first year & double by 4 y/o
o 6 – 7 mos. – learn to chew
NUTRITIONAL REQUIREMENTS/ FEEDING GUIDELINES
 Calories – high bec. The proportionately larger skin
surface leads to large heat loss.
- at birth – baby requires about 350 – 500 cal
- 1 year – 800 – 1200 cal.
- 2nd – 7th month – 120 cal/ kg body weight
- ↓ 6 mos. = 108 cal/kg BW
- 6 – 12 mos. = 98 cal/kg
- 7th – 12th months – 100 cal/ kg
- AVERAGE requirement for growth in the 1st year –
50 cal/ lb of expected weight
- 2/3 of this calorie needs supplied by milk
- 1/3 – by added carbohydrates
 CHON
- allowances of 1.5 – 2.5 gm of CHON/ kg BW from 6
– 12 mos
- ↓ 6 mos. = 2.2 g/kg BW
- 6 -12 mos. = 1.6 g/kg
 FAT – 3 – 5 % of fat
 FLUID – infants need about 2 oz. of fluid/ lb of BW
 VIT. K – injected to all infants at birth
 VIT. D – recommended for breast milk-fed infants
 CHO – 1/10 ounce/ lb BW = 1 ounce/ 10 oz. of milk
= 1% of the BW
- 1/3 CHO should be derived from milk
TEACHING POINTS:
1. Importance of Breastfeeding
- teachings on proper & successful breastfeeding
2. GUIDELINES FOR THE INTRODUCTION OF SOLID
FOODS:
1. Introduce iron-fortified baby rice cereal at about 6
mos. (no earlier than 4 mos.)
- avoid wheat-based cereals
2. add pureed vegetables & fruits, one at a time, at
about 7 – 8 mos (starting w/ veg. may help to
increase acceptance by the infant not yet exposed
to the sweet taste of fruits)
- one at a time – waiting 5 – 7 days between foods
- to gauge food preferences
- observe for food intolerance & allergies
3. Add pureed meats at about 8 – 9 mos.
4. Add juice when the infant is old enough to drink
from a cup, at about 9 – 10 mos.
5. add foods w/ more texture & finger foods at about 9
-10 mos. (chopped meats, crackers)
6. add allergenic foods, such as egg whites ( or whole
eggs), whole milk, wheat products, & orange juice,
after 1 year (especially important for the infant w/
family history of allergies or asthma)
7. keep baby in upright position when feeding
- let baby decide on how much to eat
3. INAPPROPRIATE FOODS:
1. avoid Honey & corn syrup– contain botulism spores
2. very salty & sweet foods
5
 - canned foods – high Na content – can be detrimental
to the immature renal functioning of infants
- Renal system – 6 weeks - ability to concentrate urine
3. avoid foods that have a hard texture (ex: raw apple
or carrot, hotdog) – prevent choking – until the child
is old enough to chew adequately
- act as plugs in the air passage until they develop
adequate chewing & swallowing skills
4. SIGNS OF WELL-NOURISHED INFANT:
1. steady gain in weight & length ( w/ some
fluctuations from week-to-week)
2. happy & vigorous
3. sleeps well
4. has firm muscles
5. has some tooth eruption at about 5 – 6 months
(about 6 – 12 teeth will have erupted by 12 mos.)
6. good elimination characteristic
5. NUTRITIONAL CONCERNS
a. Iron deficiency anemia
b. dental health
c. colic
d. diarrhea
e. constipation
f. food allergies
IV – CHILDHOOD
A. TODDLER ( 1 – 3 y/o )
- toddler years – are a time of transition, esp’ly bet.
12 – 24 months
- when they’re learning to eat table food & accepting
new tastes & textures
- challenging when it comes to feeding
- several dev’tal changes occur at this time
- they strive for independence & control
- growth rate slows down - w/ this comes a decrease
in appetite
- easily distracted from eating
- offer small portions of food
- these changes can make meal time difficult
- important for parents to provide structure & set
limits
- Wt. gain = 0.5 lb/ mo.
- Ht. = 1 cm/ mo.
SUGGESTIONS FOR TODDLERS TO GET THE
NUTRITION THEY NEED:
1. Avoid battles over food & meals
2. provide regular meals & snacks
3. be flexible w/ food acceptance as toddlers are often
afraid of new things
4. be realistic about food amounts – should be ¼ size
of an adult portion
5. limit juice intake to about 4 – 6 oz./ day
6. dessert should not be used as rewards – try serving
it w/ the rest of the food
7. make food easy for them to eat
 cut food into bite size pieces
 make some foods soft & moist
 serve foods near room temperature
 use ground meat instead of steak or chops
 use a child-size spoon & fork w/ dull
prongs
 seat your child at a comfortable height in a
secure chair.
8. prevent choking by:
 slowly adding more difficult-to-chew foods
 avoiding foods that are hard to chew &/
swallow (nuts, raw carrots, gum drops, jelly
beans, peanut butter by itself)
 modifying high-risk foods
- cut hotdogs in quarters, cut grapes in quarters &
cook carrot until soft
- always superise your child when he/ she is eating
- keeping your child seated while eating
NUTRITIONAL GUIDELINES:
- regular daily meals – w/ demonstration of healthy
eating behaviors
- involve them in the selection & preparation of foods
& teach them to make healthy choices by providing
opportunities to select foods based on
theirnutritional value
 ENERGY
 CALCIUM – 500 mg/ day
- easily met w/ 2 servings of dairy foods every day
- an important part of a toddler’s diet
- milk provides Ca & Vit. D t help build strong bones
 IRON
- 7 mg/ day
- Cow’s milk is low in iron
- ↑ iron-rich foods : meat, poultry, fish, enriched
grains, beans, tofu
- Serve w/ Vit. C-rich foods : tomatoes, broccoli,
oranges, strawberries – for iron absorption
 CHON – 16 gms
 VIT. A – 400 µg RE
 VIT. C – 40 mg
 THIAMIN – 0.7 mg
 RIBOFLAVIN – 0.8 mg
 NIACIN – 9 mg
 VIT. B6 – 1.0 mg
 FOLATE – 50 µg
B. PRESCHOOLER – 3 – 5 Y/O
- Wt. gain = 4 – 5 lb (1.8 – 2.3 kg)
- Ht. = 5.1 cm/ mo.
- respond best to regular meals
- snacks are recommended as part of regular eating patterns
- Snack provide 20% of the children’s total caloric intake
- Involve children in meal- related activities
- food habits are formed – child is receptive to learning
COMMON NUTRITION PROBLEMS
1. Protein- Energy Malnutrition (PEM)
- 2° lack of protein 7 energy in the diet
2. Iron deficiency anemia (IDA)
3. Vit. A Deficiency – VAD
4. Iodine Deficiency Disorder – IDD
6
5. Obesity ages 4-6, gains 4-5 lbs (1.8kg-2.3kg),
6. Dental Caries grows 2” (5.1 cm)/year
- responds best to regular mealtime, 3 meals aren’t
C. SCHOOL AGE – 6 – 10 enough for this age-group
- snacks provide 20% of children total caloric intake.
- Wt. & Ht. should double on what was the wt. & ht. at age 1. -include to meal-related activities. Eg. Food
- more independent preparation
- Marginally supervised at lunchtime
- Aware of peer’s behavior-exposed to different types of food doubles weight ( to what it was at age 1)
eating
- Begin to make choices on what food to eat III. SCHOOLAGE
- are more independent of adults
-nutrition needs must be balanced with their need
NUTRIENT NEEDS for decision making & peer acceptance.
Preschoolers = 1300 – 1500 cal/ day -expose to different types of food & eating behavior.
School age = 72 – 92 cal/ kg/ day
ENSURING CHILDHOOD HEALTH
 CALORIES • Schedule mealtime & allow to
- allowances decline to about 80 – 90 kcal/ kg for participate in planning,
children 7 – 9 y/o preparation, serving & clean up.
- 70 – 80 kcal/ kg = 10 – 12 y/o • Maintain variety of foods
• Have nutritional snacks readily
 PROTEIN available
- approximately 37 gm of protein daily = 7 – 9 y/ o • Prepare mildly flavored single
- 43 – 48 gm = 10 -12 y/o food dishes
• Children to wake up early
 VITAMINS & MINERALS • Encourage physical activity
- Vit. C = 55mg = 7 – 9 y/o; 65 – 70 mg = 10 -12 y/o
- IRON = 1.4 mg/day – esp’ly for girls who starts to NUTRITIONAL CONCERN
menstruate at age 11 – 12 • Caffeine eg. Tea, chocolate & softdrinks
- Calcium = 500 – 1000 mg/ day • Irregular eating habits
- Iodine = 120 mcg – children 7 – 10 y/o • Overeating / Obesity
• Lead poisoning

NUTRITIONAL CONCERNS Nutrition during ADOLESCENE

1. Caffeine – tea, chocolates, soft drinks --- limit - More individualized than during other periods of life
2. irregular eating habits - Depends on timing & duration of the growth Spurt
- food jags – one preference of food vary from person to person
- physiologic anorexia – lack of interest in food
- skipping meals Growth & Development ( growth spurt, body mass, skeletal
mass, body fat)
3. overeating & obesity Girls Boys
- obesity – being 20% or more above the mean wt.
for children of the same height Growth spurt: ages 10-11 12-13
- develops after age 3 – likelihood of lasting into Peak: 12 14
adulthood is increased Stop: 15 19
- lack of physical activity

4. lead poisoning Caloric needs: lower =more fat deposition

increase= muscle mass, bone &
CHILDHOOD lean body tissue

1. TODDLER 2. PRESCHOOL-AGE 3. NUTRIENT NEEDS

SCHOOLAGE • Niacin, Thiamin & riboflavin = participate in sports
• Zinc - sexual maturation = (male) growth failure
I. TODDLER & delayed sexual
ages 1-3, gain weight 0.2kg, grows development
3/8” (1 cm)/month • Folate – DNA & RNA role decrease in female
- exploration & sense of individuality (develop)
- demonstrate change in appetite & easily distracted NUTRITIONAL CONCERN
from eating. 1. Dieting & eating disorder (peer acceptance)
2. Calcium Deficiency (osteoporosis)
II. PRESCHOOL 3. Tobacco & Alcohol

7
 4. Oral Contraceptive use
5. Special Diet (athletes, vegetarians)
Nutrition & THE ADULT ( YOUNG)
- wt. mgmnt is a key factor in achieving health & wellness.
- in order to remain healthy, adults must be aware of
changes in their energy needs, based on their level of
physical activity --- and balance their energy intake
accordingly
19 y/o early adulthood
- Maintaining healthy body weight, physical fitness,
avoiding excess weight & continuing to build
strength.
Fighting illness before they begin
40 & 60 y/o
- Heart disease, HPN, DM
- Establishing healthful food & exercise habit,
reducing fat intake, eat fruits & vegetable
NUTRITION & THE OLDER ADULT
- Have special nutritional needs because their tissue
& Organ system are aging
- Suffer from arthritis, HPN , heart disease, DM
- CALCIUM 1,200mg …age 51 & older, Leads to
colon CA & HPN
MAGNESIUM =leads to irritability & aggressiveness, vertigo,
muscle spasm, weakness & seizure.
= over consumed = s/s diarrhea, dehydration, impaired
nerve activity.
VIT. D skin decrease ability to synthesize VIT.D, limited
exposure to sunlight
= less consume milk, cereals, liver, salmon & liver
VIT. B -leads to decrease secretion of gastric acid =
inability to breakdown foods
TEACHING POINTS
• Choose high fiber.
• Increase water absorption
• Supplements as recommended
Nutritional assessment for the OLDER ADULT
- P.A = bedridden or obese
- History of diet (social & economical)
NUTRITIONAL CONCERN
- Dehydration = cause lethargy & confusion
- Decrease Immunity eg. Pressure ulcers & other
wounds.

PHYSIOLOGIC CHANGES
1. GI SYSTEM
• Loss of dentition
• Saliva production decrease
• Secretion of gastric digestive enzymes fall off (milk)
• degenerates absorption of nutrients in the intestine
• Intestinal motility slows
2. METABOLIC slows = glucose intolerance
3. CNS
• Tremors, slowed reaction time, shorter memory loss
• Cognitive deterioration (alzheimer’s Dse) &
depression
4. RENAL SYSTEM fails to regenerate renal tissue =
urinary incontinence,
males: prostate dysfunction
5. SENSORY
• Hearing loss develop at age 30
• Visual Acuity (low-light setting at 40)
• Smell / olfactory
• Taste buds decrease = risk for dehydration
=manifestation of confusion or lethargy.
6. ECONOMIC & SOCIAL CHANGES
• SPARES CHANGES limit a person’s ability to eat a
well balanced diet.
Eg. Meat, dairy product
• ISOLATING PROBLEM

NUTRIENTs NEED
- CALORIES
- PROTEIN = impaired GI tract function & medication
= decrease absorption of amino acids &
micronutrients = leading to increase requirement
- IRON - decrease to stomach acid
- blood loss from dse or medication