Chapter 11 Power Point

Chapter 11 Lecture
Chapter 11:
Nutrition
Throughout
the Life Cycle
© 2016 Pearson Education, Inc.

Learning Outcomes
1. Explain why a nourishing diet is important even
before conception.
2. Identify the range of optimal weight gain during
the three trimesters of pregnancy.
3. Discuss nutrient needs and some common
nutrition-related concerns of pregnant women.
4. Discuss the advantages and challenges of
breastfeeding.

Learning Outcomes
5. Discuss nutrient needs, timing of introduction to
and type of solid foods, and common nutrition-
related concerns of infants.
6. Discuss nutrient needs and some common
nutrition-related concerns of toddlers.
7. Identify changes in nutrient needs for school-
age children, as well as the effect of school
attendance on children's nutrition.

Learning Outcomes
8. Explain how adolescents' rapid growth affects
their nutritional status.
9. Discuss changes in an older adult's body,
functions, and nutrient needs.
10.Identify some common nutrition-related
concerns of older adults.

Nutrition Before Conception
• Some deficiency-related problems develop very
early in pregnancy.
• Neural tube defects
• Related to inadequate level of folate
• Affect the embryo in the first few weeks
• Adequate folate (400 mg daily) before
conception can reduce the risks.

• A healthful diet before conception includes:
• avoiding teratogens: substances that cause
birth defects
• Includes alcohol and illegal drugs
• avoiding other possible hazards
• Smoking, caffeine, medications, some herbs
and supplements

• A healthful diet before conception reduces the
risk of developing nutrition-related disorders
during pregnancy, such as:
• gestational diabetes
• preeclampsia
• A man's diet and lifestyle may also impact sperm
quality.

Nutrition During Pregnancy
• A full-term pregnancy lasts 38–42 weeks.
• 1st trimester: conception to 13th week
• 2nd trimester: 14th to 27th week
• 3rd trimester: 28th to 42nd week
• Embryonic stage: 3rd week to the 8th week
• After the 8th week, the developing embryo is
called a fetus.

• 1st trimester
• Fertilized egg travels through the fallopian
tube and implants in the wall of the uterus
• Development of organs, limb buds, facial
features, placenta
• Embryos are extremely vulnerable to
teratogens during this time.

Embryonic Development

• 2nd trimester
• Continued development of organ systems
• More than 10 inches of growth during this
time
• Fetus weighs more than 2 pounds by the end
of the 2nd trimester.

• 3rd trimester
• Period of considerable growth
• Fetus gains 3/4 of its weight in this time.
• Brain growth is also extensive.
• Lungs become fully mature.
• A balanced, adequate diet for the mother is
essential during this time.

• An undernourished mother is more likely to give
birth to a low-birth-weight baby.
• Low birth weight: any baby born weighing
less than 5.5 pounds
• Increased risk of infections, learning
disabilities, impaired physical development,
and death in the first year

• Weight gain during pregnancy
• Women who do not gain enough weight are
at risk of having a low-birth-weight baby.
• Too much weight gain is also risky.
• Women should not diet during pregnancy
since this may deprive the fetus of critical
nutrients.

Weight Gain During Pregnancy

Weight-Gain Distribution During Pregnancy

• The requirement for nearly all nutrients
increases during pregnancy.
• Pregnant women must pay attention to their
intake of:
• macronutrients
• micronutrients
• fluids

Macronutrients
• Energy
• An additional 350–450 kcal/day may be
required in the 2nd and 3rd trimesters.
• Nutrient-dense foods are essential in order to
obtain sufficient nutrients.
• Proteins and carbohydrates
• Protein: 1.1 g/day per kg body weight
• Carbohydrates: 175 g/day

Macronutrients
• Fat
• The percentage of calories obtained from fat
should not change during pregnancy.
• Fat is required by the newborn for
temperature regulation and as an energy
source.
• DHA (omega-3 polyunsaturated fatty acid) is
important in the 3rd trimester.

Micronutrients
• The micronutrients that are most critical during
pregnancy include:
Folate Calcium
Vitamin B12 Iron
Vitamin C Zinc
Vitamin A Vitamin D

Nutrient Recommendations

Micronutrients
• Folate
• Critical in the first 28 days for development of
the neural tube, which becomes the brain
and spinal cord
• Deficiency is associated with spina bifida
and anencephaly
• 400 mg/day for sexually active women
• 600 mg/day for pregnant women

Micronutrients
• Vitamin B12
• Regenerates the active form of folate
• 2.6 micrograms/day during pregnancy
• Vitamin C
• Synthesizes collagen, a component of
connective tissue
• 85 mg/day during pregnancy

Micronutrients
• Vitamin A
• Need increases by 10% in pregnancy.
• Deficiency is linked to low birth weight and
preterm delivery.
• Vitamin D
• RDA does not increase during pregnancy.
• Women with limited sun exposure or who
don't drink milk may need a supplement.

Micronutrients
• Calcium
• 1000 mg/day, same as for nonpregnant adult
women, for women age 19 and older
• Pregnant women absorb calcium better.
• Zinc
• Critical for making proteins, DNA, RNA
• Need increases 38% during pregnancy.

Micronutrients
• Iron
• Increased need for red blood cells increases
the need for iron by 50%.
• Fetal need for iron increases in 3rd trimester.
• Fetus will take iron from mother, causing
iron-deficient anemia.

Fluids During Pregnancy
• The need for fluids increases to 2.3 liters
(10 cups) per day in order to:
• allow for the increase in the mother's blood
volume
• regulate body temperature
• produce amniotic fluid to protect and
cushion the fetus

Nutrition-Related Concerns
• Nutrition-related concerns during pregnancy can
include:
Morning sickness Caffeine
Food cravings Alcohol
Gestational diabetes Smoking
Preeclampsia Illegal drugs
Adolescent pregnancy Food safety
Vegetarianism Exercise

Morning Sickness
• Morning sickness: nausea and vomiting
associated with pregnancy
• Can occur at any time; often lasts all day
• High levels of pregnancy hormones may be
the cause.
• No cure, but symptoms can be reduced

Food Cravings
• Most women crave a certain type of food (sweet,
salty) rather than a specific food.
• Pica: a condition of craving a nonfood item (ice,
chalk, clay, dirt, coffee grounds, etc.)

Gestational Diabetes
• Gestational diabetes: insufficient insulin
production or insulin resistance that increases
blood glucose levels during pregnancy
• Condition resolves after birth occurs.
• Risk of delivering a large baby
• Uncontrolled blood glucose levels may lead
to preeclampsia.

Preeclampsia
• Preeclampsia: pregnancy-induced hypertension
• Can be fatal if left untreated
• Deficiencies in protein, vitamins C and E,
calcium, and magnesium increase the risk.
• Treatment focuses on managing blood
pressure and often includes bed rest.
• Often resolves after birth of child

Adolescent Pregnancy
• The nutritional needs of pregnant adolescents
are higher than those of adult women.
• Adolescent bodies are still growing and
changing, which adds to the nutritional needs of
pregnancy.
• Pregnant adolescents are more likely to have
preterm babies, low-birth-weight babies, and
other complications.

Vegetarianism
• A vegetarian consuming eggs and dairy
products has the same nutritional concerns as a
non-vegetarian.
• A complete vegetarian (vegan) must carefully
watch her intake of:
vitamin D calcium
vitamin B6 iron
vitamin B12 zinc

Caffeine Consumption
• Caffeine is a stimulant that crosses the placenta
and reaches the fetus.
• One to two cups of coffee per day will likely
cause no harm.
• More than two cups of coffee may slightly
increase the risk of miscarriage and low birth
weight.

Alcohol Consumption
• Alcohol is a known teratogen that crosses the
placenta and is associated with various birth
defects.
• Fetal alcohol syndrome (FAS): variety of
characteristics associated with prenatal
exposure to high quantities of alcohol
• Malformations of face, limbs, heart
• Many developmental disabilities

Smoking
• 18–19% of pregnant women smoke.
• Adolescents are more likely to smoke during
pregnancy.
• Smoking greatly increases the risks of:
miscarriage preterm delivery
stillbirth low birth weight
placental problems poor fetal growth

Illegal Drugs
• Most drugs pass through the placenta to the
fetal blood.
• The fetal liver is too immature to break down
these drugs.
• There is no safe level of use for illegal drugs
during pregnancy.

Herbal Supplements
• Herbal supplements may not be tested for purity,
safety or effectiveness.
• Pregnant women should consult their healthcare
provider.

Food Safety
• Foods unsafe for pregnant women may include:
• unpasteurized milk
• raw or partially cooked eggs
• raw or undercooked meat, fish, poultry
• unpasteurized juices
• raw sprouts
• some cheeses from unpasteurized milk

Exercise and Fitness
• Exercise during pregnancy:
• keeps a woman physically fit
• is a great mood booster
• helps compensate for an increased appetite
• helps keep blood pressure down
• makes it easier to lose weight after the
pregnancy

Breastfeeding
• Breastfeeding is the ideal method of infant
feeding because of the nutritional quality and
health benefits of breast milk.
• Colostrum: first milk produced; rich in proteins,
antibodies, vitamins, minerals

Breast Anatomy

Breastfeeding
• The benefits of breastfeeding include:
• high-quality nutrition for the infant
• immunologic protection (e.g., from allergies
and infections)
• assisting post-delivery maternal weight loss
• suppressing ovulation
• bonding enhancement
• convenience and cost-effectiveness

Breastfeeding

Breastfeeding
• Many harmful substances are passed into breast
milk, including:
• illegal drugs
• caffeine and nicotine
• prescription drugs and over-the-counter
medications
• HIV (virus)

Breastfeeding
• Milk production requires 700–800 kcal/day.
• Lactating women should consume an extra
330–400 kcal/day.
• Increase protein intake by 15–25 g/day and
carbohydrate by 80 g/day.
• Lactating women need to consume an extra
quart (about 1 L) of fluid per day.
• Iron needs decrease to 9 mg/day.

Formula Feeding
• Most formula are based on modified cow's milk.
• Cow's milk (unmodified) should not be given to
infants (under 1 year old).
• Be careful not to overfeed.
• Do not allow infants to fall asleep with a bottle
due to baby bottle syndrome.

Infant Nutrition
• Infants' nutritional needs are unique because:
• their energy needs are high to support rapid
growth
• their digestive tracts and kidneys are still
immature
• they are small in size

Infant Nutrition
• Infants need:
• 40–50 kcal per pound of body weight per day
• about 40–50% of calories from fat
• no more than 20% of calories from protein
• vitamin K injection at birth
• may require Vitamin D supplementation
• breastfed infants may require fluoride and
iron supplementation after 6 months
• 2 ounces of fluid per pound of body weight

Infant Nutrition
• An infant's digestive system and kidneys must
develop to maturity before solid food can be
introduced.
• Breast milk or formula should be supplemented
with solid food beginning at 4 to 6 months.

Infant Nutrition
• Infants should NOT eat:
• foods they could choke on
• corn syrup or honey
• goat's milk
• cow's milk
• large quantities of fruit juice
• too much salt or sugar
• too much breast milk or formula after 6
months

Infant Nutrition
• Nutrition-related concerns for infants include:
• allergies
• colic
• gastroesophageal reflux
• iron-deficiency anemia
• dehydration

Infant Nutrition
• Allergies
• Solid food should be introduced one at a time
for a week to watch for allergies.
• Colic
• Uncontrollable crying that can last for hours
• Precise cause is unknown.

Infant Nutrition
• Gastroesophageal reflux
• Occurs in about 3% of infants; common in
preterm infants
• Anemia
• Infants are born with enough iron for only 6
months.
• Anemia can develop after that.

Infant Nutrition
• Dehydration
• Extremely dangerous for infants
• Caused by diarrhea, vomiting, inadequate
fluid intake
• Pediatric electrolyte solution may be used.

Toddlers
• Age 1 to 3 years
• Rapid growth rate of infancy begins to slow.
• Gain 5.5 to 7.5 inches and 9–11 pounds
• Higher energy expended for increased
activity level

Toddlers
• Macronutrients
• Estimated energy requirement (EER) is
about 1,000 kcal/day.
• Up to 40% of total kcal from fat
• 1.1 grams of protein per kg weight per day
• 130 grams of carbohydrates per day

Toddlers
• Fluid needs
• About 4 cups per day
• Encourage water, milk, and soy milk
• Limited amounts of diluted fruit juice

Toddlers
• Nutritious food choices
• Toddlers have an innate ability to match their
intake with their needs.
• Keeping a nutritious variety of foods available
encourages a healthful diet.
• Food should not be forced on a child.
• Portions should be small, and toddlers should
eat every 2 to 3 hours.

Toddlers
• Allergies
• Continue to watch for food allergies.
• Introduce one new food at a time.
• Vegetarian families
• A diet including eggs and dairy can be a
healthful diet.
• A vegan diet may lack essential vitamins and
minerals.

Nutrition Through Childhood
• Macronutrients
• Total fat intake should gradually drop to a
level closer to adult fat intake.
• 25–35% of total energy from fat
• 0.95 grams protein per kg body weight
• 130 grams carbohydrate per day

• Children are influenced by peers and media
and begin to make their own food choices.
• Parents can teach children about healthful
food choices.
• Some foods "help us grow healthy and strong."
• Involve children in meal planning and food
purchasing decisions.

• Micronutrients
• Vitamins and minerals from fruits and
vegetables continue to be a concern.
• Vitamins A, C, E, calcium, iron, and zinc are
of special concern.
• Vitamin and mineral supplements supplying
no more than 100% of the RDA can be
beneficial.

• National School Breakfast & Lunch Program
• 99% of public schools participate in at least
one.
• Fruits, vegetables, and whole grains must be
offered.
• Milk must be low fat or fat-free.
• Average weekly calories must be age
appropriate.
• Sodium, saturated, and trans fats must be
reduced.

• Nutrition-related concerns for children include:
• food insecurity: occurs when the child does
not have a predictable supply of safe and
nutritious food
• overweight and obesity

• Obesity in children
• 19% of children age 6–11 years are
overweight.
• 17% of 12-to 19-year-olds are overweight.
• Caused by eating too much and not
maintaining enough physical activity
• The Institute of Medicine recommends that
children be very active for at least one hour
per day.

Adolescents
• Age 14 to 18 years
• Growth spurts begin at age 10 to 11 for girls
and 12 to 13 for boys.
• An average 20–25% increase in height is
expected.
• Weight and body composition also change.

Adolescents
• Macronutrients
• Estimated energy requirements for
adolescents are based on gender, age,
activity level, height, and weight.
• 25–35% of total energy from fat
• 45–65% of kcal from carbohydrates
• 0.85 gram protein/kg body weight

Adolescents
• Micronutrients
• Calcium intakes must be sufficient for
achieving peak bone density.
• Iron needs are relatively high.
• Vitamin A is critical for supporting rapid
growth and development.
• A multivitamin can be a safety net, but should
not replace a healthful diet.

Adolescents
• Fluid
• The need to maintain fluid intake is increased
by higher activity levels.
• Boys: 11 cups/day
• Girls: 8 cups/day

Adolescents
• Peer influences and a fast-paced lifestyle can
lead adolescents to choose fast foods.
• Parents can act as role models and keep
healthful food choices available.
• Adequate fruits, vegetables, and whole grains
should be encouraged.

Adolescents
• Nutrition-related concerns
• Sufficient calcium is required to develop peak
bone density.
• Adequate physical activity is very important in
reducing obesity.
• Disordered eating and eating disorders can
begin in these years.
• Acne is primarily hormonal.
• Alcohol and tobacco use experimentation
may begin.

Older Adults
• In people age 65 years and older, changes to
the body can include:
• decreased muscle and lean tissue
• increased fat mass
• decreased bone density
• reduced functioning of kidneys, liver, heart,
nervous system
• impaired absorption of nutrients

Older Adults
• Factors that influence the aging process can
include:
• genetics: genes greatly influence the aging
process
• biochemistry: many changes to cells and
tissues occur over time
• lifestyle and environmental factors

Older Adults
• Macronutrients
• Energy needs usually decrease due to
reduced muscle mass and decreased activity
levels.
• Recommendations for fat, carbohydrate, and
proteins intakes are the same as for younger
adults.
• Older adults can consume slightly less fiber.

Older Adults
• Micronutrients
• Calcium and vitamin D requirements increase
due to poor calcium absorption.
• Zinc intake should be maintained for
optimizing immune function.
• Adequate intake of B-vitamins is a special
concern.

Older Adults
• Fluid
• AI for fluid is the same as for younger adults–
at least 8 cups per day.
• Older adults are especially susceptible to
dehydration.

Older Adults

Older Adults
• Many chronic diseases are more prevalent in
overweight or obese adults.
• Underweight may result from illness,
disability, loss of sense of taste or smell,
depression, or social isolation.
• Osteoporosis increases the risk of bone
fractures. Hip fractures are of great concern.

Older Adults
• Cataracts and macular degeneration
• Some medications can alter nutrient
absorption or decrease appetite.

Older Adults
• Older adults can receive help from food
assistance programs such as:
• Supplemental Nutrition Assistance Program
(SNAP)
• Child and Adult Care Program
• Commodity Supplemental Food Program
• Seniors' Farmers Market Nutrition Program
• Nutrition Services Incentive Program

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