Barbara,
I would like to set up an
appointment with you to discuss
our MSEI grant application. I am
thinking sometime next week,
anyday after next monday
The Life would
Cycle:
be good for me. Please
Conception
let me know your schedule, I will
Through arrange
the the meeting.
Chapter 11
Later Years
Thanks, Lifang
© 2007 Thomson - Wadsworth
Ask Yourself
1.
2.
3.
4.
5.
The poor nutrition of a pregnant woman can
impair the health of her grandchild, even
after that child has grown up.
A woman needs twice as many calories per
day in late pregnancy as she did before she
was pregnant.
Even one alcoholic beverage, if taken at the
wrong time during pregnancy, can damage
the development of the nervous system in
the unborn infant.
A woman who craves a food during
pregnancy instinctively knows that she
needs the nutrients in that food.
Substances in a mother’s milk can protect
the infant against certain diseases to which
the mother has been exposed.
© 2007 Thomson - Wadsworth
Ask Yourself
6.
If a child loses his or her appetite, the
caretaker must insist that the child eat his or
her meals anyway.
7. School lunches provide all of the nutrients
children need in a day.
8. For older adults, age-related weight gain is
inevitable.
9. Caffeine is fine for young adults, but older
people may suffer anxiety attacks if they
ingest too much caffeine.
10. Phytochemicals may increase a person’s risk
for developing certain types of cancers.
© 2007 Thomson - Wadsworth
Nutrition for the Life Cycle
• Nutritional needs change at each
stage of the life cycle.
Pregnancy
Infancy
Early and middle childhood
Adolescence
Adulthood
Senior adulthood
© 2007 Thomson - Wadsworth
Pregnancy
• The only way
nutrients can reach
the developing fetus
is through the
placenta, the
special organ that
grows inside the
uterus to support
The close association between the
new life.
fetus’s and mother’s circulatory
systems permits the mother’s
bloodstream to deliver nutrients and
oxygen and remove waste products
© 2007 Thomson - Wadsworth
Pregnancy
• Malnourished
mothers are more
likely to have infants
who become ill, have
birth defects and
suffer retarded
mental or physical
development.
• Malnutrition in the
prenatal (prior to
birth) and postnatal
(after birth) periods
also affects learning
ability and behavior.
© 2007 Thomson - Wadsworth
Pregnancy
• Trimester: onethird of the normal
duration of
pregnancy.
 First trimester is 0
to 13 weeks.
 Second trimester
is 13 to 26 weeks.
 Third trimester is
26 to 40 weeks.
© 2007 Thomson - Wadsworth
Nutritional Needs During
Pregnancy
• Nearly all nutrients are recommended in
increased amounts during pregnancy and
lactation.
• An average increase of only about 17% of
maintenance calories is recommended to support
the metabolic demands of pregnancy and fetal
development.
 2nd trimester - add 350 calories per day
 3rd trimester - add 450 calories per day
• Nutrients deserving special attention during
pregnancy include protein, folate, iron, zinc, and
calcium, as well as vitamins known to be toxic in
excess amounts.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Nutritional Needs During
Pregnancy
• The recommended intake for protein is an
additional 20 grams/day over nonpregnant
requirements.
 Many women already consume enough protein.
• A pregnant woman’s recommended intake for
folate is 50% greater.
 Folate supplements given around the time of
conception are known to reduce the recurrence of
neural tube defects.
 Women are advised to get recommended amounts of
folate before becoming pregnant and during the first
trimester.
 As of 1999, all refined grains are fortified with folate.
© 2007 Thomson - Wadsworth
Nutritional Needs During
Pregnancy
• Neural tube defects: include
any of a number of birth
defects in the orderly
formation of the neural tube
during early gestation.
• Both the brain and the spinal
cord develop from the neural
tube; defects result in various
central nervous system
disorders. The two main types
are:
 Spina bifida: incomplete
closure of the bony casing
around the spinal cord.
 Anencephaly: a partially
or completely missing
brain.
© 2007 Thomson - Wadsworth
Nutritional Needs During
Pregnancy
• The recommended intake for
iron during pregnancy is 27
milligrams per day.
 An increase of 50% above
nonpregnant needs‚ to
meet maternal and fetal
needs.
• Many women begin
pregnancy with diminished
iron stores.
 An iron supplement of 30
milligrams ferrous iron
daily during the second
and third trimesters is
recommended.
To facilitate iron absorption
from the supplement, iron
should be taken between
meals with vitamin C-rich
fruit juice or at bedtime.
© 2007 Thomson - Wadsworth
Nutritional Needs During
Pregnancy
• The DRI for calcium during
pregnancy is:
 1,300 milligrams for teens.
 1,000 milligrams for adults
over 18 years of age.
• Intestinal absorption of calcium
doubles early in pregnancy,
and the mineral is stored in the
mother’s bones.
• During the last trimester of
pregnancy when fetal skeletal
growth is maximum and teeth
are being formed
 The fetus draws
approximately 300
milligrams per day from the
maternal blood supply.
© 2007 Thomson - Wadsworth
Nutritional Needs During
Pregnancy
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for the
Future
• Low birthweight (LBW): a birthweight of
5½ lb (2,500 g) or less, used as a predictor of
poor health in the newborn and as a probable
indicator of poor nutrition status of the mother
during and/or before pregnancy.
 Normal birthweight for a full-term baby is
6½ to 8¾ lb (about 3,000 to 4,000 g).
• LBW infants are of two different types:
 Premature: they are born early.
 Growth failure in the uterus: they may or
may not be born early, but they are small.
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for the
Future
Practices to Avoid During Pregnancy
• Pica: the craving of nonfood items such as clay,
ice, and laundry starch. Pica does not appear to
be limited to any particular geographic area,
race, sex, culture, or social status.
• Low-carbohydrate or low-calorie diets that
cause ketosis.
• Smoking restricts blood supply to the fetus and
stunts growth.
 Smoking is responsible for 20-30% of all low-birth
weight deliveries in the United States.
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for the
Future
Practices to Avoid During Pregnancy
• Consumption of alcohol which adversely affects
fetal development.
 Birth defects, low birthweight and spontaneous
abortions occur more often in women who drink.
 Fetal Alcohol Syndrome (FAS): the cluster of
symptoms seen in an infant or child whose mother
consumed excess alcohol during pregnancy.
 Fetal alcohol effect (FAE): A lesser condition that
causes learning impairment and other more subtle
abnormalities in infants exposed to alcohol during
pregnancy.
• Avoid taking all drugs and herbal supplements
except for physician-advised medicine.
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for the
Future
Practices to Avoid During Pregnancy
• Avoid lead exposure:
 Avoid ceramic and leaded crystal ware.
• Reduce exposure to mercury:
 Avoid large ocean fish such as shark, swordfish, king
mackerel and tilefish.
 Pregnant women can safely eat 12 ounces of cooked
fish including canned fish, shellfish, and smaller ocean
or farm-raised fish.
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for
the Future
For most women, the
surest way to have a
healthy baby is to follow a
healthy lifestyle: Get early
prenatal care, eat a sellbalanced diet, exercise
regularly with your
doctor’s permission, and
avoid cigarettes, alcohol,
and other drugs.
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for the
Future
Common Nutrition-Related Problems
of Pregnancy
• Morning Sickness
• Constipation
• Pregnancy-induced hypertension (PIH):
high blood pressure that develops during the
second half of pregnancy.
• Preeclampsia: a condition characterized by
hypertension, fluid retention, and protein in
the urine.
• Eclampsia: a severe extension of
preeclampsia characterized by convulsions.
© 2007 Thomson - Wadsworth
Pregnancy: Nutrition for the
Future
• Gestational
diabetes: the
appearance of
abnormal glucose
tolerance during
pregnancy, with a
return to normal
following pregnancy.
© 2007 Thomson - Wadsworth
Not for Coffee Drinkers Only
• Caffeine: a type of
compound, called a
methylxanthine, found in
coffee beans, cola nuts,
cocoa beans, and tea leaves.
 A central nervous system
stimulant, caffeine’s
effects include:
• Increasing the heart
rate.
• Boosting urine
production.
• Raising the metabolic
rate.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Caffeine Dependence
• Caffeine dependence syndrome:
dependence on caffeine characterized by at
least three of the four following criteria:
 Withdrawal symptoms such as headache
and fatigue.
 Caffeine consumption despite knowledge
that it may be causing harm.
 Repeated, unsuccessful attempts to cut
back on caffeine.
 Tolerance to caffeine.
© 2007 Thomson - Wadsworth
Adolescent Pregnancy
• More than 700,000 teenagers become
pregnant in the United States each year.
 One out of every eight babies is born to a
teenager.
 More than a tenth of these mothers are
under age 15.
• Pregnancy places adolescent girls, who are
already at risk for nutrition problems, at even
greater risk because of the increased energy
and nutrient demands of pregnancy.
© 2007 Thomson - Wadsworth
Nutrition of the
Breastfeeding Mother
• Adequate nutrition of the mother makes a
highly significant contribution to successful
lactation.
• A nursing mother produces 30 ounces of milk
a day, on the average, with wide variations
possible.
• Current recommendations suggest that 400
calories to support this milk production come
from added food and that the rest come from
the stores of fat the mother’s body has
accumulated during pregnancy for this
purpose.
© 2007 Thomson - Wadsworth
Milk for the Infant:
Breastfeeding
• Breastfeeding has both emotional and physical
health advantages.
 Colostrum (co-LAHS-trum): a milklike secretion from
the breast, rich in protective factors, present during the
first day or so after delivery and before milk appears.
 Bifidus factor (BIFF-id-us): a factor in colostrum and
breast milk that favors the growth in the infant’s
intestinal tract of the “friendly” bacteria Lactobacillus
bifidus so that other, less desirable intestinal
inhabitants will not flourish.
 Lactoferrin (lak-toe-FERR-in): a factor in breast milk
that binds and helps absorb iron and keeps it from
supporting the growth of the infant’s intestinal bacteria.
© 2007 Thomson - Wadsworth
Milk for the Infant:
Breastfeeding
• Breast milk is tailor made
to meet the nutrient needs
of the young infant.
 With the exception of vitamin
D, its vitamin contents are
ample.
• The American Academy of
Pediatrics recommends
that infants receive breast
milk for the first twelve
months of life.
 Approximately 69% of
mothers initiate
breastfeeding.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Healthy Infants
Feeding Formula
• Infant formulas are
manufactured with the
approximate nutrient
composition of breast milk.
• The parents can see that
the baby is getting enough
milk during feedings.
• The mother can offer similar
closeness, warmth, and
stimulation during feedings
as the breastfeeding mother
does.
• Other family members can
get close to the baby and
develop a warm relationship
in feeding sessions.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Healthy Infants
Food for the Infant
• Solid foods may normally be
added to a baby’s diet when
the baby is between 4 and 6
months old, depending on
readiness. The following are
indicators of readiness:
 The infant is 6 months old.
 The infant is
developmentally ready.
• He or she can sit
upright with support
and can control head
movements.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Healthy Infants
Nutrition-Related Problems of Infancy
• Iron deficiency remains a prevalent
nutritional problem in infancy.
 It has declined in recent years in large part
because of the increasing use of ironfortified formulas.
• Food allergies are common and genetics is
probably the most significant factor affecting
an infant’s susceptibility to food allergies.
 At-risk infants can be identified by means of
careful skin testing and by a family history.
 To detect food allergies, new foods should
be introduced one at a time.
© 2007 Thomson - Wadsworth
Early and Middle Childhood
Growth and Nutrient Needs of Children
• After age one, a child’s growth rate slows, but
the body continues to change dramatically.
 At one, most babies have just learned to
stand and toddle.
 By two, they can take long strides with solid
confidence and are learning to run, jump,
and climb.
• The internal change that makes these new
accomplishments possible is the accumulation
of a larger mass and greater density of bone
and muscle tissue.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Early and Middle Childhood
• Make learning about nutrition fun.
• Read food labels together at the grocery store,
checking for the supply of…
 Vitamins
 Minerals
...the amounts of:
 Sugar
 Salt
 Fat
© 2007 Thomson - Wadsworth
Early and Middle Childhood
The most common nutrition-related
problems among U.S. children:
• Overweight and obesity
 Obese children are at risk for cardiovascular
disease, insulin resistance and type 2
diabetes, orthopedic problems, psychosocial
problems, and other serious health
problems.
• Iron-deficiency anemia
• High blood cholesterol
© 2007 Thomson - Wadsworth
Early and Middle Childhood
• Healthy Eating Index
(HEI): a summary
measure of the quality of
one’s diet.
• The HEI provides an
overall picture of how
well one’s diet conforms
to the nutrition
recommendations
contained in the Dietary
Guidelines for Americans
and the MyPyramid.
© 2007 Thomson - Wadsworth
Early and Middle Childhood
• The popularity of fast-food meals poses
a challenge to the nutritional quality of
children’s diets, because these meals
are typically high in:
 Fat
 Sodium
 Sugar
...and lacking in:
 Fruits
 Vegetables
© 2007 Thomson - Wadsworth
Teen Nutrition
• The dramatic changes in
body composition and
rate of growth give rise
to the term “adolescent
growth spurt.”
• Individual teenager’s
energy need is
influenced by body size,
activity levels, and
biologic factors affecting
growth.
© 2007 Thomson - Wadsworth
Teen Nutrition
• Most “adolescents” in the U.S. are
perceived to be healthy.
• Nutrition-related problems include:
 Overweight and obesity
 Undernutrition
 Iron-deficiency anemia
 Low calcium intakes
 High blood cholesterol
 Dental caries
 Eating disorders
© 2007 Thomson - Wadsworth
Nutrition in Later Life
• In 1900, 4% of
the U.S.
population were
more than 65
• In 2000, 12.4%
• In 2030, it is
expected to reach
20%
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Nutrition in Later Life
Aging and Nutrition Status
• Older people vary greatly in their
social, economic, and lifestyle
situations, functional capacity, and
physical conditions.
• Most older adults live at home, are
fully independent and have lives of
good quality.
• Some older people have problems
with activities of daily living (ADL)
including:
 Bathing.
 Dressing.
 Grooming.
 Transferring from bed to chair.
 Going to the bathroom.
 Feeding oneself.
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Nutrition in Later Life
© 2007 Thomson - Wadsworth
Nutrition in Later Life
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Nutrition in Later Life
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Nutrition in Later Life
• The federal Elderly Nutrition
Program (ENP) is intended
to improve older people’s
nutrition status.
• Its specific goals are to
provide the following:
 Low-cost, nutritious
meals.
 Opportunities for social
interaction.
 Nutrition education and
shopping assistance.
 Counseling and referral
to other social and
rehabilitation services.
 Transportation services.
• DETERMINE:
Disease
Eating poorly
Tooth loss or oral pain
Economic hardship
Reduced social contact
Involuntary weight loss
or gain
 Need of assistance with
self-care
 Elderly person older than
80 years






© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Meals for One
• Keep cupboards stocked with
healthy foods
• Keep healthful, ready-to-eat
snacks on hand
• Buy large bags of frozen veggies
• Keep whole-grain breads frozen
• Buy large packages of meat or
poultry on sale; freeze in portions
© 2007 Thomson - Wadsworth
Meals for One
• Buy produce in season:
Winter = oranges, grapefruits, sweet
potatoes, rutabagas, greens
Spring = asparagus, green beans,
sweet peas, rhubarb
Summer = berries, peaches, zucchini,
melons
Fall = apples, pears, acorn &
butternut squash
© 2007 Thomson - Wadsworth
Meals for One
• Cook several meals at a time
• Double a recipe & store extra in the
freezer
• Add freshly steamed veggies to frozen
entrees
• Choose frozen entrees with <10 g fat
per 300 calories & <800 mg
sodium/serving
• Pretend you are cooking for guests
© 2007 Thomson - Wadsworth
Addressing Overweight and
Obesity in Childhood
• Prevalence of childhood obesity
has tripled in the U.S.
• Associated with:
Type 2 diabetes
High blood lipids
High blood pressure
Gallbladder disease
Injury to joints
Emotional problems
© 2007 Thomson - Wadsworth
Influences on Obesity
• Increased calorie intakes
• Increased consumption of foods
away from home
• Excessive soft drink consumption
• Lack of positive role models
• Physical inactivity
• Fewer opportunities for activity
© 2007 Thomson - Wadsworth
Eating Habits
• Too few fruits & vegetables
• Too much fat & added sugars
• Large food portions
• Reliance on fast foods
© 2007 Thomson - Wadsworth
Impact of the Media
• Time with T.V. &
video games =
less exercise
• Advertisements
for food
• Lots of T.V. =
more sedentary
© 2007 Thomson - Wadsworth
Tips for Helping Instill Good
Eating Habits
• Set a good example
• Discourage eating while watching T.V.
or doing homework
• Eat meals together as a family
• Encourage eating only when
physiologically hungry
• Limit high-fat & high-sugar foods
• Include children in food preparation
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth