Transcript Chapter One - University of Windsor

Nutrition: A Functional Approach
Janice Thompson Melinda Manore Judy Sheeshka
16
Nutrition Through the
Life Cycle:
Childhood to Late
Adulthood
PowerPoint® Lecture Slides prepared by
AMY MARION
New Mexico State University
SUSAN J WHITING
University of Saskatchewan
Copyright © 2007 Pearson Education Canada
Toddlers
Age 1 to 3 years
• Rapid growth rate of infancy slows down
• Gain 14 – 19 cm (5.5 – 7.5 in) and
4 – 5 kg (9 – 11 lb)
• Energy requirement/kg < for infants
BUT
Total energy requirement is higher, since
toddlers are larger and more active (!)
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Toddlers
Macronutrients:
• Estimated energy requirement (EER) is
kcal/day = (89 x weight(kg)-100)+20
• 30-40% of total kcal from fat
• 1.1 grams of protein per kg body weight
• = ~ 13 gm daily
• ~130 g carbohydrates per day (45-65%)
• Up to ~19 grams fiber per day
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Toddlers
Micronutrients:
• Ensure adequate intake of the
micronutrients that should be obtained
from fruits and vegetables, including:
• Vitamins A, C, E, calcium (500 mg), zinc
• Iron deficient anemia is the most
common nutrient deficiency in young
children
• RDA 7 mg per day
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Toddlers
Fluid needs:
• 1.3 liters per day (~ 5½ cups)
Supplements:
• Toddlers may need supplements
• especially if water is non-fluoridated
• if extremely “picky” eater
• Supplements should not exceed 100%
RDA for any nutrient
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Toddlers
Nutritious Food Choices:
• Toddlers have an innate ability to match
their intake with their needs.
• Offer only nutritious variety of foods to
be confident of a healthful diet.
• Food should not be forced on a child.
• Do not use bribery to encourage children
to eat.
• use “choices”
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Toddlers
Food “jags” are common and no cause for
worry.
Look at nutrition profile over time.
Do NOT restrict fat.
Eat in extremely small amounts, several times
per day.
Develop good mealtime habits.
Introduce new foods slowly (avoid
casseroles).
Involve toddler in food preparation.
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Toddlers
Allergies:
• Continue to watch for food allergies
Vegetarian families:
• A diet including eggs and dairy can be a
healthful diet
• A vegan diet may lack essential vitamins
and minerals
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Preschoolers
Age 4 to 5 years
• Growth rate continues to slow
• Will gain 7.5 – 10 cm (3 – 4 in) and 2.3 –
2.7 kg (5 – 6 lb) per year
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Preschoolers
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,
45 – 65%
• 19 grams fiber per day
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Preschoolers
Micronutrients:
• Vitamins and minerals from fruits and
vegetables continue to be a concern
• Need minimum 5 servings daily to meet
vitamins A, C, E requirements
• AI of calcium increases to 800 mg/day
• RDAs for iron and zinc increase to 10 mg
and 5 mg
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Preschoolers
Fluid:
• 1.7 liters per day (~ 7 cups, 5 cups as
drinks)
Supplements:
• May be recommended when particular
food groups are not eaten regularly
• Supplements should be appropriate for
the child’s age
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Preschoolers
Nutritious Food Choices:
• Parents can teach preschoolers about
healthful food choices:
• Some foods “help us grow healthy and
strong”
• Some foods are better used as occasional
treats
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Preschoolers
Obesity in children:
• Childhood overweight: a BMI at or above
the 85th percentile
• Childhood obesity: a BMI above the 95th
percentile.
Overweight children are at greater risk of
becoming overweight adults.
Avoid restrictive diets.
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School-Aged Children
Age 6 to 13 years
• Growth is slow and steady, at 5 – 7.5 cm
(2 – 3 in) per year
• Children begin to make their own food
choices
• Activity levels vary
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School-Aged Children
Macronutrients:
• 25 – 35% of total energy from fat
• 0.95 grams protein per kg body weight
• 130 grams carbohydrates
• 45 – 60% of kcal from carbohydrates
• 14 grams fiber per 1000 kcal per day =
~ 25 grams
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School-Aged Children
Micronutrients:
• The need for most micronutrients
increases slightly through age 8.
• Micronutrient needs rise sharply as
children approach puberty.
• Calcium 1300 mg, age 9 – 13 years
• Iron 8 mg
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School-Aged Children
Fluid:
• Adequate Intake (AI) of fluids varies by
age and gender, ranging from 1.7 liters to
2.4 liters per day
Supplements:
• A vitamin/mineral supplement supplying
no more than 100% of the daily values
can be used (but not usually required).
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School-Aged Children
Nutritious Food Choices:
• Peer pressure can influence a child’s food
•
•
•
choices.
Healthy role models, such as athletes, can be
used to encourage good choices.
Involvement in food preparation encourages
active role in health.
Parents should continue as role models.
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School-Aged Children
Obesity in Children:
• Obesity is now epidemic among schoolaged children in Canada
• Caused by eating too much and not
enough physical activity
• Children should be very active for at least
one hour per day.
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School-Aged Children
Nutrition Related Concerns:
• Body image and appearance become
more important to children as puberty
approaches.
• Inadequate calcium intake can result as
children make their own choices and may
avoid milk in favour of other beverages.
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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
• ♀ 5 – 20 cm (2 – 8 in); ♂ 10 – 30 cm
(4 – 12 in)
• Weight and body composition also
change and are extremely variable
• average ♀16 kg (35 lb) and ♂ 20 kg (45 lb)
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Adolescents
Macronutrients:
• Estimated energy requirements (EER) for
adolescents is 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
• 26 grams of fiber per day
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Adolescents
Micronutrients:
• Calcium 1300 mg / day
• Iron needs ↑
• ♀ 15 mg, ♂ 11 mg
• Vitamin A is critical for supporting rapid
growth and development
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Adolescents
Fluid:
• The need to maintain fluid intake is
increased by higher activity levels
• Girls: 2.3 liters/day (10 cups, 8 as drinks)
• Boys: 3.3 liters/day (14 cups, 11 as
drinks)
Supplements:
• A multivitamin can be a safety net, but
should not replace a healthful diet
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Adolescents
Nutritious Food Choices:
• Peer influences and 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
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Adolescents
Nutrition-Related Concerns:
• Onset of obesity is common
• Adequate physical activity is very
important in reducing obesity
• Disordered eating and eating disorders
can begin in these years
• Cigarette smoking, alcohol, and illegal
drugs can also have an impact on
nutrition
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Young and Middle Adults
The primary concerns of these years
include:
• Maintenance of health
• Eating a balanced diet
• Staying physically active
• Reducing the risks of chronic diseases
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Older Adults
Life expectancy in 1900 was 49 years.
In 2001, 13% of population was ≥ 65 years
of age.
In 2011, those over 80 will increase by
43%!
Three categories:
age 65 to 74 – the “young-old”
age 75 to 84 – the “old-old”
age > 85 – the “oldest-old”
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Older Adults
95% of seniors are non-institutionalized.
Nutrition is one of the major determinants of
successful aging.
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Older Adults
PHYSIOLOGIC CHANGES
1. Body composition
2. Basal metabolic rate
3. Senses: vision, hearing , taste and smell
4. Gastrointestinal tract
• Oral cavity
• Esophagus, stomach, small intestine
• Colon
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Older Adults
5. Respiratory system
6. Cardiovascular system
7. Neuromuscular system
8. Skeletal tissue
9. Kidney function
10.Endocrine system
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Older Adults
NONPHYSIOLOGIC FACTORS
1. Physical
2. Economic
3. Psychosocial
4. Health status
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Older Adults
CHALLENGE:
Reduced energy needs (due to ↓ lean body
mass and ↓ physical activity)
Combined with
Increased micronutrient needs
Leaves little room for “empty calorie”
foods.
Can be changed with physical activity.
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Older Adults
Macronutrients:
• Energy needs usually decrease due to
reduced activity levels
• Recommendations for fat, carbohydrate,
and protein intakes are the same as for
younger adults
• Older adults can consume slightly less
fiber
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Older Adults
Micronutrients:
• Calcium and vitamin D requirements
increase due to poor absorption
• Calcium 1300 mg
• Vitamin D 10 µg, 15 µg after 70 years
• Iron needs decrease to 8 gm
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Older Adults
• Zinc intake should be maintained for
optimizing immune function
• Red meat, poultry, fish – relatively
expensive and difficult with poor
dentition
• Adequate intake of B-complex
vitamins is a special concern
• Vitamin A absorption ↑
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Older Adults
Emphasis must be on nutrient dense foods.
Top priority for micronutrient intake is
prevention of osteoporosis.
Antioxidants are likely involved in
prevention of cataract formation and
macular degeneration.
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Older Adults
Fluid:
• AI for fluid is the same as for younger
adults:
• Men: 3.7 liters/day
• Women: 2.7 liters/day
• Older adults are especially susceptible to
dehydration
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Older Adults
DEHYDRATION
Is a form of malnutrition
Require ~ 30 ml fluid / kg body weight
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Older Adults
Impact of Dehydration
1. Electrolyte imbalance → confusion,
delirium, weakness, irregular heartbeat
2. Fluctuating blood pressure
3. Hypoxia
4. Reduced waste elimination
5. Reduced skin turgor
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Older Adults
6.
7.
8.
Hemoconcentration
Constipation
Kidney failure
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Older Adults
Symptoms of Dehydration
1. Dry mucous membranes
2. Decreased skin turgor
3. Skin breakdown
4. Rapid weight loss < 1 week
5. Decreased urine output
6. Changes in mental status
7. Constipation
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Older Adults
Other Nutrition Related Concerns:
• 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, social isolation
• Dental health issues may cause older
adults to avoid meats, firm fruits and
vegetables
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Older Adults
Nutrition Related Concerns:
• Some medications can alter nutrient
absorption or decrease appetite
• Pronounced ↑ in incidence of anemia
with increasing age, despite ↓ iron needs
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Older Adults
Alzheimer’s Disease
Excess fat and calories, as well as obesity →
increased risk AD.
No link to aluminum.
No link between aspartame and mental function
changes.
AD is associated with vascular disease, so
antioxidants may ↓ risk.
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