GOAL 6

Nutritional Changes
through the
Life Cycle
 Focus : On changing
nutritional needs as people
move through
life stages.
IMPORTANT:
NEEDS OF
PREGNANT
AND LACTATING
WOMEN, BECAUSE
OF THE LONG
TERM EFFECTS
THEIR DIET MAY
HAVE ON THE
DEVELOPING
 Infancy and
early
childhood
 Also important
nutritionally, due to the
rapid growth of the physical
body and nervous system
during that period
For women:

 Adolescence is another critic

period.
 It is important to understand t
need
for increased nutrients to support
 sexual development and the
 final growth spurt during the teenage
years.
 Nutritional needs
continue to change as we
age
 At the completion of
this goal you will be
 able
* Discussto:
the special nutritional needs of
pregnant and lactating women
 * Relate nutritional needs to various stages
of child development
 * Discuss the effects of gender, social,
psychological, economic and cultural factors
on diet and nutrition throughout life

 Undernutrition vs Malnutrition
 Nutritional Needs during Pregnancy & Lactation

 The definition of a successful

pregnancy includes:
 Protection of the mother’s physical
and psychological health
 Gestation period of 37-41 weeks
 Infant birth weight greater than 2.5
kilograms
 Nutrition is one of the key factors in
normal fetal
ensuring
development, and protecting
the health of the mother.
 Extra nutrients and energy are
needed:
 for fetal growth and development
 to support the changes in the
mother that
help support the pregnancy.
A healthy pregnancy begins
BEFORE the pregnancy
begins

 A lot of critical development occurs BEFORE a

woman realizes she is pregnant!
Fertilizati Early 8 week
on embryo old
fetus
During the first trimester the fetus
develops most of it’s organs

Therefore it’s a critical stage of

development and nutrition is very
 Planning for pregnancy
 Not enough folic acid in the diet (at least 3 months before becoming
pregnant)
 Use of certain medicine, eg aspirin, Ibuprofen, Advil and typical
medicines used to treat colds and flu.
 Any amount of alcohol consumption
 Use of drugs
 Smoking
 Job –related hazards and stresses
 Insufficient intake of nutrients (Iron, magnesium, Zinc)
 Too much Vitamin A
 Too much caffeine
 Poor control of ongoing diabetes or hypertension
 X-ray exposure, including dental Xrays.
 Preparing for pregnancy
 Under Weight BMI is <19.8
 Complications--Low birth weight infants < 2.5kg
Usually preterm Associated with small for
gestational age
↑ risk for mortality
 Overweight BMI > 29
 ↑ risk for NTD,
More difficulty getting pregnant,
gestational diabetes, hypertension, infections
after birth
 Adequate folate intake & iron intake-->
critical time of development
Pregnancy increases Energy
Needs
 Approximately 350 -450 kcal extra
needed in 2nd and 3rd trimesters.
 Protein intake is especially important,
and should be at least 60 g/day.
 Increased nutrient needs
 Vitamin and mineral needs increase 20-
50% during pregnancy.

 Specific increased needs for:

 Calcium (to prevent bone loss due to

needs of developing fetus),
 Iron (to prevent iron-deficiency anemia),
 Folic acid (to prevent spina bifida in the
fetus – necessary in first few weeks of
pregnancy, and preferably before
conception),
 Iodide (to prevent problems with
thyroid),
Healthy Food…
Healthy pregnancy weight
gain
Recommended Weight Gain:
 Varies depending on
 the pre-pregnancy BMI of the mother
 whether there are multiple fetuses.
 Women carrying twins should gain 15
to 20 kg and those carrying triplets
should gain 23 kg.
Prepregnancy BMI Total Weight Gain (kg)

Low BMI (Less than 19.8) 12.5 – 18

Normal BMI (19.8 – 25.9) 11.5 - 16

High (BMI 26 – 29) 7 – 11.5

Obese (BMI greater than 29) 7 or less

A pregnant woman normal gain 10 to 12
kg

11.2 kg  a total weight

3.5 kg a baby’s weight before birth
900 g the uterus
650 g the placenta
800 g  the amniotic fluid
400g  the woman’s breasts
1.25g  the weight of the extra
blood
2 kg  the weight of water retained
in the body tissues
1.7 kg  the weight of the layer of
Where the weight goes
Who is at nutritional
risk during pregnancy?
 Young · low level of
education
 Many previous pregnancies
 Lack of knowledge (Nutritional)
 Lack of money to purchase food
 Lack of family support
 Inadequate normal diet/ special diets
 Smokes, drinks alcohol
 Carrying multiple fetuses
 What to avoid when
pregnant
 Raw or undercooked meat, eggs, and
seafood
 Unpasteurized dairy products (cheeses,
milk)
 Some types of fish (limit tuna)
 Deli meat (processed meat)
 Limit caffeine (2-3 cups of coffee/day max)
 Check that medications are safe during
pregnancy
 Alcohol and smoking
 Vitamin A supplement
Problems in Pregnancy:

 Morning Sickness
 Heartburn
 Constipation
 Hemorrhoids
 Edema
 Anemia
Pre-eclampsia (Pregnancy
induced hypertenstion)
 10% of women develop hypertension during
pregnancy
 More likely in women under 17 or over 35
 A leading cause of pregnancy related death
 Babies may have low birth weight
 Symptoms:
 Sudden weight gain due to edema (fluid retention)
 High blood pressure (hypertension)
 Protein in urine
 Abnormal liver function
Gestational Diabetes (GD)

 4% of women develop GD during pregnancy

 Problems with this:

 Fetus receives too much glucose  excess becomes fat
 Baby has higher chance of becoming overweight kids and
may develop type 2 diabetes as well
 Increases likihood that mother may develop Type 2 Diabetes
later in life
 Tips to relieve
Discomforts
 Nausea
 On waking, rise slowly
 Eat dry toast or crackers
 Chew gum, hard candies
 Eat small, frequent meals whenever
hunger strikes
 When nauseated avoid: citrus juice,
water, milk, coffee, tea
 Constipation
 Eat foods high in fiber
 Exercise daily
 Drink 8 glasses of liquids
/ day
 Respond promptly to the
urge
 Use laxatives only when
physician prescribed
Tips to relieve
discomforts
 Prevent or relieve heartburn
 Eat small frequent meals
 Drink liquids between meals
 Avoid spicy or greasy foods
 Avoid peppermint
 Sit up while eating
 Wait an hour after eating before lying
down.
 Wait 2 hours after eating before
exercising
 Breast feeding
 The number of women breastfeeding has
decreased since the beginning of the
1900’s.
 Goals have been set by Healthy People 2010
to have
 75% of women feeding when the leave hospital,
 50% feeding babies aged 6 months, and
 25% feeding infants at 1 year.
 In the USA about half the mothers leave
hospital breastfeeding, but by 1 month after
delivery, only about 30% are still feeding
Breastfeeding
 Mother burns an extra 800 calories/day

 Only need to increase food consumption

by ~400 calories/day because of excess
fat accumulated during pregnancy

 Mother needs to drink enough fluids and

consider taking prenatal vitamins

 Medications, alcohol, caffeine can be

secreted into milk so be careful of this
 Breast Feeding
 Women who choose to breastfeed normally
find this an enjoyable experience.
 Although bottle feeding is safe for infants
(as long as the equipment used is kept
extremely clean), breast milk provides
many additional benefits to the growing
newborn.

 Nutritional qualities of breast milk:

 high carbohydrate,
 specialized proteins for easy digestion, and
 omega 3 fatty acids
 – none of these are found in infant formulas.
Physiology of Lactation
 Suckling stimulates nipple Hypothalamus
--->pituitary gland
secretes oxytocin
Pituitary Gland

 --->let down reflex results Prolactin

Oxytocin

in milk ejecting cells

contract forcing milk from Uterus
milk cells into milk ducts.
Myoepithelial
 Milk pools in lactiferous Cell

sinuses under the areola. Lacteal

Suckling stimulates milk

to come from the nipple.
Concerns during
Breastfeeding
 Not enough milk
 6 wet diapers a day is enough
 Bowel movements vary from every
feeding to 3-4 per week
 Infant needs about 25 oz breast
milk/day
 Mothers’ extra calorie needs -->
500/d
Benefits of Breastfeeding
INFANT MOTHER
 Provides all the  Reduces risk of
nutrition a baby breast and ovarian
needs for the first 6 cancer
months
 Helps space out
 Is safe from
contamination births
 Provides antibodies  Helps weight
(helps immune control
system)
 Linked to better
health throughout
life
Colostrum:
 Thick yellow fluid produced near the
end of pregnancy which increases for
a few days after birth.
 Contains antibodies and immune
system cells that help the baby to
defend against infection.
 Helps protect the baby against some
gastrointestinal and infectious
diseases, when its own immune
system has not developed enough.
 Encourages growth of protective
bacteria in the baby’s gut.
Mature milk:

 Fat in milk is high in linoleic acid and

cholesterol which are necessary for
baby’s brain development.
 During the feed the amount of fat in
the milk changes from very little at
the beginning to very rich after 20
minutes of feeding.
 It is important for the baby to feed
long enough to get the rich milk at
the end that supplies essential fats
and energy.
 Increased nutritional
needs for mom:
 Milk production requires about
800kcal/day, so an extra 500 kcal/day
recommended above pre-pregnancy
requirements.

 Increased need for vitamins A, E, C &

riboflavin

 Increased need for copper, chromium,

iodide, selenium, zinc.

 If energy needs are not met, this tends

to decrease the amount of milk
available for
Barriers of Breastfeeding

 Misinformation
 Return to an outside job
 Social concerns
 Medical Conditions precluding
Breastfeeding
 Environmental contaminants in
Human milk
Task

 Summarize the advantages of

breastfeeding and
 The barriers to breastfeeding on
p460-462 of the text.
 Think about how you would try to
increase the number of UAE women
breastfeeding – how would you
educate them?
Bottle feeding
 Breast or bottle—both make healthy
babies but there are differences

 Formula is modified cow’s milk (or goat,

soy) so that it is easily digested by the
baby and contains all the nutrition a
young (<6months) baby needs

 Formula does not contain antibodies

 Extra
Readings
 Baby's First Solids
 Check List: Feeding Solids
 Infancy and early
childhood

 Very important nutritionally, due

to the rapid growth of the
physical body and nervous
system during that period
Nutrition from Infancy
to
Infancy Adolescence
 Wardlaw (p477) states that “during
infancy a child’s attitudes towards
food and the whole eating process
begin to take shape”.

This means that parents

should:
Solid foods
 Introduce solid foods slowly—1 at a time to
identify possible food allergies

 DON’T feed honey to a <1 year old! It can

contain deadly toxins

 Food shouldn’t contain added salt or

sugar

 Can make yourself or buy premade

 Feeding Infants
 Breastmilk or Iron fortified formula for first
6 months (don’t add cereal to the formula <4mo)
 At 6 months (or can sit with support and control head
movements), add iron fortified rice cereal, then add other
cereals 1 at a time to minimize allergic reaction may need
to add water to diet
 Then add yellow orange vegetables, then finally fruit
 No fruit juice in a bottle--only in a sippy cup
Early childhood Nutrition
 Nutrition needs to be good during
childhood to support the rapid
growth and development of the
child’s body.

 When essential nutrients are

missing during critical growth
periods, growth may slow or
cease.

 Growth is a good measure of

nutritional status, and growth
charts can be used assess
children’s health generally.
10 signs of good childhood
nutrition
1. Healthy growth
2. Alertness and liveliness
3. Physical activity
4. Good learning ability
5. Good appetite
6. Strong and clean teeth
7. Good posture
8. Strong bones and muscles
9. Uninterrupted sleep
10.Regular bowel motions
Nutrition is VERY
important in the first 2
years
 http://www.unicef.org/nutrition/index_
33721.html

 The situation in the UAE:

 http://www.thenational.ae/apps/pbcs.dll/a
Preschool children (2-5)
 Often go through periods where they
don’t seem to eat enough
 Don’t expect them to eat like adults
 Offer healthy snacks
 Offer nutrient dense foods
 Try not to make a big issue out of eating
habits—they may just be exerting
independence and forcing/nagging will
just make things worse
 Look at the section on
expanding mealtime
choices (p478-482) and
summarize the key ideas.
 Task
 You have been provided with a copy of Canada’s
Food Guide to Healthy Eating: Focus on
Preschoolers.
(http://www.regional.niagara.on.ca/living/heal
th_wellness/parenting/pdf/CFG_Preschooler.pd
f)
 Go through the publication and highlight areas of
interest to you.
 Extra reading:
http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_
 Do you think there is a need for a similar publication
in the UAE? If yes, what should be included?
 Strategies to Promote
Good Eating Habits
 Reduce milk intake and replace with
other healthy snacks
 Encourage fruit and veges by making
plate look exciting eg happy face
 Parents must set a positive example
 Let him go Online and learn for
themself
Extra Readings

 Childhood Obesity Campaign

 Eat a Nutritious Diet
 School-Age Children and
Adolescents
Zn is good for enzymes
 Food choices in this ageleads
Deficiency group
to:

should still be basedskin onrash,

the food
Calcium: diarrhea,
guide pyramid, with emphasis
Bones and teeth decreased appetite
on
limiting Iron:
fat intakesense andof making
taste sure
children
Component have enough
of haemoglobin iron, zinc and
hairloss,
Cognitive development
calcium.
Deficiency: (p491-495)
poor wound healing
Fatigue
 Why Anemia
are these factors important?
Low blood haemoglobin
School-age children

 Eating habits change when kids start

school
 More independence
 More choice
 More unhealthy options
Children’s Food Guide Pyram
 Breakfast is the most
important meal of the day
 Eating patterns more scheduled =
consumption of more regular meals
 Fortified breakfast cereal :
 Greatest source of iron, vitamin A
& folic acid
 Controversy re cognitive ability –
does blood glucose =
energy/enhanced performance
 But meets needs for vitamins and
minerals
Snacks
 Fruit smoothies
 Fruit salad
 Yogurt with granola
 Peanuts
 Pasta salad
 Veggies with dip/hummus
 Leftovers (pizza, macaroni cheese)
 Dried fruit
 Banana bread
Adolescence

 CHILD ADULT
 This involves a lot of changes and a
lot of energy
 Boys 12-15 years old
 Girls 10-13 years old
 Many nutritional habits are
established
Health Concerns

 Type 2 diabetes
 Weight control
 Dental cavities
 Iron/calcium intake
What nutritional
problems may occur
during adolescence?
 Type 2 diabetes
 Overweight & obesity
 Anorexia & Bulemia
 Less milk = lack of calcium
 Iron deficiency – menstruation
 Acne
 Don’t think LONG TERM
 WRONG snacking
What teenagers need in
this stage
1. Vitamins :
 Folate
 Deficiency may cause Anemia, red
tongue, nervous disorders, and confusion
 Vitamin A
 ( For eyes)
 Helps to keep hair, skin, eyes in good
condition
 Deficiency may cause spots, dry skin or
dandruff.
 Vitamin B6
 ( reduce stress)
 Stops skin from being too greasy or dry
 Deficiency may cause poor hair growth or
dandruff.
 Vitamin D
 ( bones, teeth and nails)
Deficiency may cause soft, ridged nails,
tooth decay or rickets
 Vitamin C
( prevents sickness)
Keeps skin firm and hair, eyes and teeth
healthy
Deficiency may be shown in bruising and
broken veins and sores not healing
 Vitamin E
( solve acne problem)
Helps heal scars, soften wrinkles and
improve circulation.
What teenagers need in
this stage
2. Minerals
 Iron
 (for healthy blood)
 part of the hemoglobin in red blood cells
 From lean meats, whole grains, enriched cereals and
eggs
 Too little Iron leads to Iron deficiency anemia
 Calcium
 (growth and bone development)
 They need 1300 milligrams/day
 From milk, yogurt, cheese group, bread and green leafy
vegetables
 Too little calcium lead to osteoporosis in later years
What teenagers need in
this stage

3. Fruits and Vegetables

4. Carbohydrate
5. Proteins: meat, fish and chicken.
6. Water
7. Dairy product: milk, cheese
8. Fats, oil and sweets
What teenagers should
avoid:
 Soft Drinks: In this stage bones grow and soft drinks prevent
absorption of calcium.

 Fast food:
Its unhealthy food causing overweight.

 Cookies
 Candies
 Ice-cream
 Chocolate
They will effect teeth causing cavities, weight and skin.
Problems that are
related to this stage
due to unhealthy food:
 Iron-deficiency:
 Is the most common nutritional deficiency especially in women
 Having iron deficiency anemia may cause you to feel tired and
often look pale
 When diagnosed - treated with iron supplements

 Obesity
 is a condition in which the natural energy reserve, stored in the
fatty
tissue, is increased to a point where
it is associated with certain health conditions or increased
mortality.
 Problems that related to
this stage
 Eating disorders:

 Anorexia nervosa
 A person with anorexia nervosa, has an intense fear of gaining weight.
 Has a low body weight for their height
 Resists keeping a normal body weight
 Thinks they are fat even when very thin

 Eating disorders are a serious issue and you can put yourself in danger
and may even face more serious consequences of:
 Death
 Osteoporosis
 Fatigue
 Dry skin
 Vomiting

 Treat this disease by:

 Restore the person to a healthy weight.
 Restore healthy eating patterns.
 Treat any physical complications or associated mental health problems.
 Address thoughts, feelings and beliefs concerning food and body image.
 Enlist family support.
  Bulimia nervosa
 A person with bulimia eats a lot of food in a short amount of
time (binges) and then tries to prevent weight gain by getting
rid of the food, called purging
 making yourself throw up
 taking laxatives — pills or liquids that speed up the movement
of food through your body and lead to a bowel movement
 A person with bulimia may also exercise a lot, eat very little or
not at all, or take pills to pass urine to prevent weight gain.

 Inadequate calcium intake

 Acne
 It’s a very common in this stage
 It’s a disorder of the hair follicles and sebaceous gland which
are clogged and leads to pimples and cysts.
 What should teenagers
do:

 Healthy dietary habits

 Active lifestyle

 Exercises

 Try to control stress

A good way to educate adole
 Adults
 Adult age ranges from 19 years to 70+.
 There are distinct nutritional needs during this
period related both to age and sex.
 Women have unique dietary needs throughout
life, partly due to:
 reproduction
 hormonal cycle.
 Women of child-bearing age have different
needs to those who are post-menopause.
Adulthood Nutritional
Stages
 19 – 30
Young adulthood
 31 – 50

 51 – 70 Middle adulthood

 Beyond 70 Older adulthood

Adults

 www.Mypyramid.gov for information

on healthy diet

 Important to consider weight control

as well as getting enough nutrients

 Need to be healthy to raise healthy

families
Health concerns

 Obesity
 Diabetes
 Hypertenstion (high blood pressure)
 Cardiovascular disease

 CAN BE INFLUENCED BY DIET

Women

 Often have special nutritional needs due to:

 Pregnancy
 Pre-menopause
 Menopause

 Calcium, Iron, Vitamin D are particularly

important
Task:

Complete the ‘Nutrition Checkup for

Women’ and go to
http://www.nms.on.ca/Secondary/nutritio

Check your answers – do you know why

each piece of advice is given in the
answer section?
Ageing
 Energy needs decrease
 Need fewer calories
 At risk of nutritional deficiencies because of
 Ageing
 Medications affecting nutrition/appetite
 Illness
 Social/emotional health
Nutrition needs in Aging

 Calcium: Needs increase

Leadsafter
to nerve 50 to help
degeneration that
counter the harmful effects ofin eventual paralysis
can result
and death
accelerated bone loss.
 Vit B12 : Nerves and Pernicious anemia
 Need to take it in fortified form
 Vit D: Needs increase by 50% for 51-70.
Over 70 need 3x more than 18-50.
Recommend annual checkups for Vit D
Prevents Osteomalacia –
Softening of bones
Elderly Adults
 Populations of many developed
countries are experiencing a rise in the
number of older people – aged greater
than 70 years. This group has some
specific nutritional needs and potential
problems related to their life stage.
 Life span
 Life expectancy
Maximum no of Is the time an average
years a human can person born in a
live for specific year is expected
to live
Task

 Read the scenario about Frances on

page 501 of your text
 (Nutrition during Adulthood).
 Answer the questions at the end.
 REAL LIFE SCENARIO
 Frances is a 78-year-old woman who suffers from macular
degeneration, osteoporosis, and arthritis. Since her husband died
1 year ago, she has moved from their family house to a small
one-bedroom apartment. Her eyesight is progressively getting
worse, making it hard to go to the grocery store or even to cook
(for fear of burning herself). She is often lonely; her only son
lives 1 hour away and works two jobs, but he visits her as often
as he can. Frances has lost her appetite and, as a result, often
skips meals during the week. She has resorted to eating mostly
cold foods, which are simple to prepare, but at the same time is
seriously limiting diet variety and palatability in her diet. She is
slowly losing weight as a result of her dietary changes and loss of
appetite.
 Her typical diet usually consists of a breakfast that may
include 1 slice of wheat toast with margarine, honey, and
cinnamon and 1 cup of hot tea. If she has lunch, she normally
has ½ can of peaches, ½ of a turkey and cheese sandwich, and ½
glass of water. For dinner, she might have ½ of a tuna fish
sandwich made with mayonnaise and 1 cup of iced tea.
Occasionally, she includes one or two cookies at bedtime.
 What are the potential consequences of such a poor dietary
pattern? What services are available that could help Frances
improve her diet and possibly increase her appetite? What other
convenience foods could be included in her diet to make it more
healthful and more varied?
Nutritional Problems

 High fibre diet and Colon Cancer

 Lack of calcium = Osteoporosis
Importance of Nutrition

 Can improve quality of life at each

stage of life cycle

 Can extend life span—people with

good nutrition have fewer health
problems
References

 Wardlaw, Gordon M. & Smith, A., (2006).

Contemporary Nutrition, 6th Ed. McGraw-Hill
 Insel, P., Turner, R.E. and Ross, D., (2001).
Nutrition. Jones and Bartlett Publishers
 Barasi, Mary E., (2002) Human Nutrition: A
health perspective. Arnold Publishers
 Ministry of Health, Canada (1995). Canada’s
Food Guide to Healthy Eating: Focus on
Preschoolers