NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS
NUTRITION
ADOLESCENCE
DURING
penile development and the appearance of pubic hair
among males.
Adolescence – is a transition period of human
development that occurs between childhood and
adulthood. It is usually defined as the period of life
between 11 and 21 years of age. It is a time of profound
physical, emotional, and cognitive changes during which
a child develops into an adult. Physical, psychosocial, and
cognitive maturity are largely accomplished during this
life stage Girls go through this period earlier than boys.
Nutritional Changes in Times of Change

The physical, psychosocial, and cognitive changes
associated with adolescence have direct effects on
nutritional status. The dramatic physical growth and
development experienced by adolescents, which
matches and can even exceed the rate of growth
experienced during infancy, significantly increases
their needs for energy, protein, vitamins, and
minerals.
Changes in Weight, Body Composition and Skeletal
Mass


Puberty


Early adolescence encompasses the occurrence of
puberty, the physical transformation of a child into a
young adult. The biological changes that occur during
puberty include sexual maturation, increases in height
and weight, accumulation of skeletal mass, and
changes in body composition.
Sexual Maturation Rating (SMR), also known as
Tanner Stages, is a scale of secondary sexual
characteristics that allows health professionals to
assess the degree of pubertal maturation among
adolescents, regardless of chronological age. SMR is
based on breast development and the appearance of
pubic hair among females, and on testicular and

As much as 50 percent of ideal adult body weight is
gained during adolescence. Among females, peak
weight gain follows the linear growth spurt by 3–6
months. During the peak velocity of weight change,
which occurs at an average age of 12.5 years, girls
will gain approximately 18.3 lb (8.3 kg) per year.
Weight gain slows around the time of menarche, but
will continue into late adolescence. Adolescent
females may gain as much as 14 lb (6.3 kg) during the
latter half of adolescence. Peak accumulation of
muscle mass occurs around or just after the onset of
menses.
Among males, peak weight gain coincides with the
timing of peak linear growth and peak muscle mass
accumulation. During peak weight gain, adolescent
males gain an average of 20 lb (9 kg) per year. Body
fat decreases in males during adolescence, resulting
in an average of approximately 12 percent by the end
of puberty.
Almost half of adult peak bone mass is accrued during
adolescence. By age 18, more than 90 percent of adult
skeletal mass has been formed, thus adolescence is a
critical time for osteoporosis prevention.
Psychosocial and Cognitive Development

During this stage of biological changes, young
adolescents experience the development of body
image and an increased awareness of sexuality are
central psychosocial tasks during this period of life.
The dramatic changes in body shape, size, and
composition can cause a great deal of ambivalence
among adolescents, often leading to the development
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS
of poor body image and sometimes leading to
disordered eating if not addressed by family or health
care professionals.
Health and Nutrition During Adolescence

Eating patterns and behaviors of adolescents are
influenced by many factors in addition to peer
attitudes and behaviors, including parental modeling,
food
availability,
food
preferences,
cost,
convenience, personal and cultural beliefs, mass
media, and body image. Teens report that food
preferences, accessibility of foods, cost, busy
schedules, and social support from family and friends
are key factors in their food choices.
Unhealthy Food Choices

Adolescents lead busy lives. Many are involved in
extracurricular sports or academic activities, others
are employed, and many must care for younger
children in a family for part of the day. These
activities, combined with the increased need for social
contact and approval, and increasing academic
demands as they proceed through school, leave little
time for adolescents to sit down to eat a meal.
Snacking, skipping meals, and eating foods that
are cheap and quick, such as vending machine
snacks and fast foods, are commonplace behaviors
among adolescents who report a lack of time as a
major barrier to healthy eating.
Physical Activity


Physical activity is defined as any bodily movement
produced by skeletal muscles, which results in energy
expenditure.
This definition is distinguished from exercise, which
is a subset of physical activity that is planned,
structured, and repetitive and is done to improve or
maintain physical fitness. Physical fitness is a set of
attributes that are either health- or skill-related.
DIETARY REQUIREMENTS, INTAKES AND
ADEQUACY among ADOLESCENTS
 Calorie Allowance
 The reference 44-kg boy between 13 and 15 years
old needs 310 kcal more than what the girl of the
same weight and age does. This is due to higher
energy expenditure brought about by intense
physical activity. As a consequence, thiamine,
riboflavin, and niacin allowances are also increased.
Around 0.5 mg/1,000 calories is the set allowance
for thiamine and riboflavin and 6.6 niacin
equivalent for every 1,000 kcal.
 Protein Allowance
 The protein needs are high among teenagers because
of the accelerated growth and development. Protein
allowances for adolescents aged 13 to 15 years is
59 grams for both boys and girls. However, for
those aged 16 to 19 years, protein allowance for the
reference 55-kg boy increases to 65 grams while
that of a reference 48-kg girl remains the same.
 Vitamin Allowances
 Allowance Vitamin A is the same for all levels.
Vitamin C allowance is constantly higher among
boys than among girls aged 16 to 19 years.
Compared to their female counterparts, the older
male adolescent have higher recommended
allowance for Vitamin A, thiamine, riboflavin,
niacin and Vitamin C.
 Mineral Allowances
 The recommended calcium allowance of the 13 to
15 age group is higher (700 mg) compared to the
16 to 19 age group (600 mg). This difference
reflects the spurt of bone development between the
ages of 13 and 15 and the plateau by ages 16-19.
Growth acceleration during sexual maturation
period increases iron requirements primarily for
hemoglobin production.
 More iodine should be supplied in the diet in the
form of iodized salt to compensate for the increased
thyroid activity associated with growth.
HEALTH AND NUTRITIONAL
CONDITIONING AMONG ADOLESCENTS
 Overweight and Obesity
 The increase in the prevalence of overweight and
obesity among adolescents has nearly doubled
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS
during the past two decades. Exact reasons for this
increase have not been identified. Environmental
factors, or interactions between genetic and
environmental factors, are the most likely causes
of dramatic rise in overweight and obesity.
Inadequate levels of physical activity and
consuming diets high in total calories and
added sugars and fats are behavioral risk factors
common among a significant proportion of
adolescents. These environmental factors increase
the risk of developing obesity if an adolescent is
genetically predisposed to obesity.
 Substance Use
 The use of substances such as tobacco, alcohol,
and recreational drugs can affect the nutritional
status of adolescents. Recent data on the effects of
substance use on eating behaviors have focused
exclusively on the risk for disordered eating
behaviors, particularly on bulimia nervosa and
binge-eating disorder. Disordered eating is seen
more frequently among females who report
smoking cigarettes, drinking alcohol, and using
inhalants. It is believed that substance use may
result in depleted stores of vitamins and
minerals, including thiamin, vitamin C, and iron.
Chronic ingestion of alcohol and drug use can
result in a reduced appetite, leading to low
dietary intakes of protein, energy, vitamins A and
C, thiamin, calcium, iron, and fiber.
 Iron-Deficiency Anemia
 Iron-deficiency anemia is the most common
nutritional deficiency noted among children and
adolescents. Several risk factors associated with
its development among adolescents, including
rapid growth, inadequate dietary intake of ironrich foods or foods high in vitamin C, vegan diets,
calorie-restricted
diets,
meal
skipping,
participation in strenuous or endurance sports, and
heavy menstrual bleeding.
 The effects of iron-deficiency anemia include
delayed or impaired growth and development,
fatigue, increased susceptibility to infection
secondary to depressed immune system
function, reductions in physical performance and
endurance, and increased susceptibility to lead
poisoning.
 Hypertension and Hyperlipidemia
 Blood pressure can be high, normal, or low, but over
time and with age, blood pressure rises. The walls of

large arteries become more rigid and the small blood
vessels become narrower. Because of these changes,
the heart has to generate a greater force to keep blood
flowing around the body. This leads to an increase in
blood pressure. Hypertension is defined as blood
pressure that is consistently higher than 140/90 mm Hg
(systolic, diastolic, or both blood pressures).
Risk factors for hypertension among adolescents
include a family history of hypertension, high dietary
intake of sodium, overweight or obesity,
hyperlipidemia, inactive lifestyle, and tobacco use.
Adolescents who display one or more of these risk
factors should be routinely screened for hypertension.
Key Points:
1. Rapid rates of physical growth and development
experienced by adolescents significantly increase
their needs for energy, protein, vitamins, and
minerals.
2. Body composition changes dramatically during
puberty, with the percentage of body fat increasing
among females but decreasing among males.
3. Adolescents will not fully develop abstract
reasoning and critical thinking skills until late in
adolescence or early adulthood; therefore,
nutrition education messages should be simple and
concrete, and should relate to activities common in
their current everyday lives.
4. Risk factors for iron deficiency anemia, the most
common nutrition deficiency among adolescents,
include rapid growth, low dietary iron intake, meal
skipping, dieting, athletic participation, and heavy
menstrual bleeding.
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS
NUTRITION DURING ADULTHOOD
Adulthood

Is the period of life when one has attained full
growth and maturity (between 21 and 50 years of
age).
 Adulthood marks a long period between the active
growth and development phases of infancy,
childhood, and adolescence and the older adult
phases where a concern is sustaining physical and
mental capacity. Adulthood is subdivided into the
following segments: early adulthood (twenties),
midlife (forties) and later adulthood (early sixties).
 Early Adulthood: The twenties generally involve
becoming independent, leaving the parental home,
finishing formal schooling, entering regular
employment and starting a career, developing
relationships, and choosing a partner. Planning,
buying, and preparing food are newly developing
skills for many. The thirties could be characterized by
increasing responsibilities to and for others, including
having children, providing for and caring for family,
building a career, and involvement in community and
civic affairs. There may be renewed interest in
nutrition at this time “for the kids’ sake.”
 Midlife: The forties are a period of active family
responsibilities (that may include nurturing children
and teenagers and, for some, building new
relationships and blending families), as well as
expanding work and professional roles. Managing
schedules and meals becomes a challenge.
Sociologists say that this is a time of reviewing life’s
accomplishments and beginning to recognize one’s
mortality.
 The phase around the fifties is referred to as the
sandwich generation. Many, especially women,
are multigenerational caregivers who juggle the
roles of caring for children and aging parents
while maintaining a career. Work and career
continue to be priorities for most adults. In the
fifties, health concerns frequently are added to the
picture. Dealing with a chronic disease or
managing identified risk factors to prevent
diseases is an added responsibility.
 Later Adulthood: By their early sixties, many adults
are making the transition to retirement, have more
leisure time, and are able to give greater attention to
physical activity and nutrition. While many are
“empty-nesters,” significant numbers have children
living at home and/ or have responsibilities as
guardians and caretakers of grandchildren, parents, or
others. Food choices and lifestyle factors may take on
added significance for those who are dealing with a
chronic disease.
PHYSIOLOGICAL CHANGES DURING THE
ADULT YEARS
 Bone
 Bone shape is modified in response to
physiological influences and mechanical forces.
The ongoing process of bone remodeling
preserves bone strength and mineral (calcium and
phosphorus) homeostasis. Around age 40, men
and women begin to gradually lose bone mass.
The risk of developing osteopenia (low bone
mineral density) and osteoporosis (weak, porous
bones with high risk for fracture) depends on the
peak bone mass achieved in the late twenties.
 Adiposity
 Positive energy balance typical between ages 20
and 64 results in weight gain and storage of
excess energy in adipose tissues. Storage begins
with hypertrophy of subcutaneous fat cells, then
shifts to deposits in the central and intraabdominal space (visceral fat) and other tissues
such as heart, blood vessels, liver, and muscle
(ectopic fat). Obesity and visceral fat are strongly
related to development of inflammation and
metabolic disturbances, which are connected to
insulin resistance, diabetes, gallbladder disease,
hypertension, stroke, and coronary artery disease.
 Gut Microbiome
 The composition of gut microbiota (formerly
called gut flora) determines the balance between
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS

beneficial and harmful actions in the gut lumen.
Healthy gut microbiota functions to activate and
support the immune system, protect against
opportunistic pathogens, digest food to release
nutrients and energy from diet, ferment
nondigestible carbohydrates, synthesize vitamins
(K, B12, biotin, carnitine), stimulate renewal of
cells of intestinal lining, control colonic motility
and transit time, and provide regulatory signals
through the gut–brain axis.

FEEDING THE ADULT
To stay healthy, the following guidelines must be
observed by adult men and women:
1. Eat a variety of foods.
2. Maintain the ideal weight (18.5 to 24.9 kg/m2)

3. Avoid too much fat, saturated fat and cholesterol.
4. Eat foods with adequate starch and fiber.
5. Avoid too much sugar.
6. Avoid too much sodium.
7. Drink alcohol moderately
Key Points:
1. Individual choices as well as external factors
strongly influence the course of health and
wellness for adults.
2. There are significant disparities in the incidence
and prevalence of disease across population
groups. Social and economic disadvantage, along
with other factors, are important determinants of
nutritional and health outcomes.
3. Beginning early in the adult years, bone mass
begins to decline, and there is an increase in body
fat that is associated with increased risk of
chronic diseases.
4. Various eating patterns can be healthful, provided
energy intake is not excessive, recommended
amounts of nutrients are consumed over time, and
nutrients are balanced to support their
interdependent functions.
NUTRITION DURING ELDERHOOD
Elderhood

Refers to the period of being past middle age.
Aging is a natural phenomenon. It reflects the
physiological changes that the body undergoes
over the course of a lifetime. Many of the changes
may lead to a decline in resilience, however,
aging is not all loss or decline. Rather, healthy
aging is associated with continuing psychosocial,
personal, moral, cognitive, and spiritual
development.
Aging is a heterogeneous process. Everyone
ages differently. Genetics, lifestyle, and disease
processes all affect the way people age. Although
older adults are more vulnerable to disease
because of biological changes that occur over
time, aging is not synonymous with disease.
Aging is an ongoing process; however, there is no
single way of defining old age.
Old has been defined chronologically,
biologically, psychologically, and socially.
Definition of old age is important for political,
economic, and medical reasons. Chronological
age is being used most frequently, but one 80year-old individual may be playing tennis while
another may be in a wheelchair.
Dietary Requirements, Intakes and Adequacy
among the Elderly
 Calorie Allowances
 A reduction of calories is recommended because of
reduced basal metabolism and physical activity.
Statistics have shown by age 60, the average adult
accumulates about 7 extra kilograms. The
recommended decrease in calorie intake is as
follows:
45-55 years
55-65 years
After 65 years

=
=
=
7.5% decrease
7.5% decrease
10% decrease
Protein Allowance
 An allowance of 1.1g/kg body weight is required.
This is necessary for the prevention of wasting and
susceptibility to disease and infection. Older
persons who have poor dietary habits or illnesses
may benefit from an increased intake.
 Vitamin and Mineral Allowances
 Calcium, iron, Vitamin A, and Vitamin C are
important minerals and vitamins commonly found
lacking in the diet for the aged because of low intake
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS
of meat, milk, green leafy vegetables, and fruits.
The B-complex vitamins may be in adequate
amounts if enriched cereals and breads are
consumed. Vitamin and mineral supplements may
be taken to further augment the intake in these
nutrients.
 Water and Fiber Allowances
 About 6 to 8 glasses should be consumed daily. The
kidneys can function efficiently in eliminating
waste solids if there are sufficient fluids. Also, water
stimulates peristalsis, combating constipation.








Physiological Changes during the Elder Years
Lean Body Mass (LBM) and Fat
Of all physiologic changes that occur during aging,
the biggest effect on nutritional status and physical
resilience is due to the shifts in the musculoskeletal
system. On average, there is a decline in fat-free or
lean body mass of 2–3 percent per decade from age
30–70, even when weight is stable. This leads to the
loss of up to 15 percent of muscle mass
(sarcopenia).
Taste and Smell
Although there is some argument about the extent to
which aging affects the sense of taste, there is
general agreement that taste and smell senses are
generally robust until age 60, when they start
declining. Women retain their sense of smell better
than men do. Other than aging, conditions leading
to impaired olfaction include congestion, upper
respiratory tract infections, stroke, epilepsy,
medications, and current smoking
Chewing and Swallowing
Poor dietary habits are a modifiable risk factor that
can contribute to caries and potential tooth loss. Oral
health depends on several organ systems working
together: gastrointestinal secretions (saliva), the
skeletal system (teeth and jaw), mucous
membranes, muscles (tongue, jaw), taste buds, and
olfactory nerves for smelling and tasting.
Disturbances in oral health and tooth loss are
associated with, but not necessarily caused by,
aging.
Appetite and thirst
Hunger and satiety cues are weaker in older than in
younger adults. Elderly people don’t seem to notice
thirst as clearly as younger people do. Dehydration
occurs more quickly after fluid deprivation and that
rehydration is less effective because of lower thirst,
sensation and reduced renal water-conservation
capacity.
Feeding the Elderly
How to live longer:
1. Avoid red meat and substitute fish whenever
possible in the diet.
2. Eat vegetables rich in beta-carotene (broccoli,
spinach, carrots, sprouts, and cantaloupes). They are
proven to reduce the risk of cancer.
3. Eat vegetables more frequently than red meats and
dairy products.
4. Adhere to a low-fat, low-calorie diet.
5. Avoid preserved foods, especially those preserved
with nitrates.
6. Cut smoked meats out of diet.
7. Take vitamin supplements daily.
8. Do not smoke.
9. Drink hard water.
10. Avoid all fats and oils.
11. Avoid all sugars.
12. Severely limit salts.
13. Severely limit cholesterol.
14. Avoid alcohol, black tea, and caffeinated drinks.
15. Freely use whole-grain products.
16. Freely use tubers and legumes.
17. Drink plenty of water.
18. Eat a good breakfast daily.
Key Points:
1. Functional ability (the demonstrated ability to
carry out activities of daily living) is more
important than chronological age in assessing the
health status of older adults.
2. Good nutrition, good health habits, environment,
access to health care, and genetics contribute to
human life expectancy, which is still significantly
shorter than the potential human life span.
Theories of aging, such as wear-and-tear theories,
help to explore which factors contribute most to a
longer, disease-free life.
3. While adults in general consume more than
enough calories and protein, clusters of older
adults may be lacking in adequate dietary protein
and energy.
4. The thirst mechanism of older adults is not as
sensitive as that of younger adults, placing them
at higher risk of dehydration.
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS
LABEL READING
Deciphering the Nutrition Facts Label
Why is a healthy diet important?
o
o
o
o
o
Better school performance
Developmental growth
Helps manage weight and prevents overweight
and obesity
Reduces the risk of chronic disease
Reduces the risk of early mortality
Nutrition Facts Label

that
particular
serving of food
Ex: cup or ounce
Percent Daily Value (%DV)



Shows how a food fits into a daily diet
Based on 2000 calorie diet
Interpreting Percent Daily value
o 5% IS LOW
o 20% is HIGH
Highs and Lows
Get enough of these nutrients: Dietary fiber, Vitamin A,
Vitamin C, Calcium, Iron
Limit these nutrients: Fat, cholesterol, sodium
How many calories would you consume if you eat the
whole package? ► 500 calories
How many grams of fat? ►24 grams
Portion vs Serving
Portion
Serving
 Amount of a food
 A unit of measure
item you eat at one
listed on a food
time
product’s
nutrition
facts
 Amount served in a
panel
restaurant
 It tells the amount
 Amount offered in
of calories and
packaged foods
other nutrients in
 Amount you choose
to put on your plate
Interpreting the Label
Which nutrients have high values? ►Fat, sodium, and
calcium
Which nutrients have a low value? ►Vitamin A, Vitamin
C & Iron
What nutrient is this food lacking? ►Dietary Fiber
Ingredients List
NUTRITION ACROSS THE LIFE SPAN
NCM 105 – NUTRITION AND DIET
THERAPY
BSN – N2 | PROF. ALMARIO | 1ST SEM, MIDTERMS



Ingredients are listed in order from most to least
Avoid added sugars
What about this ingredient list makes this food
appear to be a healthy choice? A: “Whole wheat”
as a first ingredient