NUTRITION ACROSS LIFESPAN
> Pregnancy and Lactation
- To ensure optimum nutrition before, during and after pregnancy and during lactation, the woman’s
nutritional requirement should be meet.
- For Filipinos, the average weight gain is 24 lbs. (Caudal, ML, 2018)
- With a total weight gain of 28 lbs. for the tissues (fetus, uterus, placenta, etc.)
- 1st trimester: 3-5 lbs.
- Then 1 lb./ wk
- Pregnancy weight gain calculator provides a recommended weight gain schedule on a week-by-week
basis based on pre pregnancy bodyweight.
- According to Caudal, ML (2018), a gain of 1.5 lb. to 3.0 lbs. during the first trimester and a gain of 0.8 lb.
per week during the remainder of the pregnancy is a guideline.
- The pattern of weight gain is more than the total amount gained.
- A sudden gain in weight may indicate water retention and possible onset of pre-eclampsia.
Recommended Weight Gain during Pregnancy
Pre-Pregnancy Weight (BMI)
Underweight
<18.5
Healthy weight
18.5 – 24.9
Overweight
25.0-29.9
Obese
≥ 30
Recommended Weight Gain (lbs.)
28-40
25-35
15-25
15
Weight Gain Patterns
Underweight
Normal
Overweight

-
-
1st Trimester
Thereafter
1st Trimester
Thereafter
1st Trimester
Thereafter
5 lbs
1 lb per week
3 ½ lbs
1 lb per week
2 lbs
2/3 lb per week
Maternal weight:
1. Underweight
a. High risk of having a low birth weight infants
b. Higher rates of preterm deaths and infant deaths
Weight gain less than 500 gm/ 0.5 kg per month during the first trimester and 250 gm during the
second trimester can lead to the delivery of LBW infant or premature infants and babies with brain
and nerve damage.
Abortions may also occur
2. Overweight and Obesity
a. Higher risk for complications like hypertension, gestational diabetes, and postpartum
infections.
b. Complications of labor and delivery
c. Large newborns increase the likelihood of a difficult labor and delivery, birth trauma and
cesarean section.
d. May double the risk of neural tube defects.
Rapid weight gain or loss:
a. Excessive weight gain during pregnancy is defined as an increase of 3 kg or more per month in second
and third trimesters.
b. Excessive weight gain of 3 kgs or more per month in the second and third trimester: eclampsia
- 2/3 of the protein should be animal origin of the highest biologic value (HBV) such as meat, eggs,
cheese, milk, poultry and fish.
- Decrease carbohydrates intake will lead to retardation of growth of fetus (175 -210 g of CHO)
- Unless she is very active, the calories are increased only from 10 to 20%.
- On the average, an increase of 500 calories during the second half of pregnancy is recommended.
●Protein Allowance
- FAO/ WHO recommends an additional 9g per day for the latter part of pregnancy- Filipino adult woman:
14 g/ day- Filipino adolescent: 59 g plus 14 g = 73 g/day
Reasons for additional protein:
1. To provide for storage of nitrogen
2. To protect the mother against many complications during pregnancy
3. for the growth of woman’s uterus, placenta and associated tissues
4. To meet the needs for fetal growth and repair
5. for the growth of mammary tissues
6. for the hormonal preparation for lactation
●Calcium
- increased 0.5 to 0.9
- If the diet of the pregnant woman is inadequate in calcium, she will have to sacrifice the calcium of her
bones in favor of the developing fetus.
●Iron
- At least 700 to 1000 mg of Fe must be absorbed and utilized by the mother
●Iodine
- Inadequate intake of iodine may result in goiter in the mother or the child
- can be met by the regular use of iodized salt in blood
✸ PREECLAMPSIA/ECLAMPSIA
- is one of the leading causes of maternal death throughout the world.
- The WHO currently recommends calcium supplementation for the prevention of pre eclampsia and
eclampsia in areas where calcium intake is low
■ VITAMIN/MINERAL ALLOWANCES
a. Vitamin K
- Deficiency in this vitamin may cause miscarriage.
b. Vitamin B6 or pyridoxine
- Greater during pregnancy, and have much value in preventing nausea and vomiting associated with child
bearing
c. Vitamin A
- It is for vision, cell growth, and strong immune system
d. Folate is needed for cell division, red cell production, and growth of fetus and placenta. If lacking, babies
may be born with defects in the spinal cord.
e. Essential fatty acids like DHA for nerve and brain development
f. Iodine
- Deficiency in this mineral may lead to goiter, miscarriage, stillbirth, or congenital defects. Iodized salt and
seafood are rich in iodine.
g. Iron is needed for blood formation and brain development. Deficiency causes anemia or lack of red
blood cells
h. Zinc is for normal growth and brain development; also enhances immune system. If mother is deficient,
fetus may not grow properly or have malformations. Baby may also be born prematurely.
i. Calcium is needed for formation of bones and teeth. A pregnant woman needs additional calcium during
pregnancy
j. Vitamin D helps the body absorb calcium and phosphorus for development of bones and teeth.
k. Phosphorous works alongside calcium. If you are suffering from leg cramps, you might be lacking in this
mineral
l. Vitamin B breaks down amino acids, carbohydrates, and lipids. Deficiency causes insomnia, confusion,
nervousness, depression, and irritability.
m. Vitamin C boosts the immune system and helps the body absorb iron and folic acid.
- Examples per meal, to be combined with rice, vegetables and fruits: 1 pc fried egg with ½ pc daing na
bisugo, 1pc galunggong paksiw, 1 slice breaded pork, ½cup toasted dilis, 2 paksiw na bangus.
COMPLICATIONS AND DIETARY MODIFICATIONS
Salt intake is restricted for edema.
●Anemia
- Inclusion of ascorbic acid rich foods in the same meal containing rich sources of iron
●Diabetes
- Rigid control of maternal blood glucose concentration
- More prone to develop pre-eclampsia, pyelonephritis, polyhydramnios, higher risk of dying in the utero
or at birth.
●Constipation
- Lots of fruits and vegetables, fluid and regular exercise
●Rapid weight loss or gain
- The popular concept of “eating for two” is not valid for well-nourished mother as this may lead to
overweight and toxemia.
- Excessive maternal alcohol ingestion is linked to FAS.
- Its major features are CNS disorders, mental retardation, growth deficiencies, and facial deformities.
●Caffeine
- Caffeine crosses the placenta very rapidly
- The fetus can metabolize alcohol for a limited extent but not caffeine
- As parity increase, tendency toward lower nutrient intake also increases.
- Gestation in close interval depletes the maternal reserves of nutrients.
LACTATION
- The FNRI recommends an increase by 1000 calories above the normal requirement for an average
production of 850 ml of milk.
- Protein: additional of 20.2 gm of protein (20gm)
●Calcium/ Phosphorus/ Vitamin D
- Calcium: 1.0 g for daily good milk production
- Calcium and phosphorous: increased
- Vitamin D: same, 400 IU
●Iron
- A good allowance of iron in the mother’s diet during lactation does not convey additional iron to the
infant.
- Iron rich foods are essential for mother’s own health, while supplements are included early in the infant’s
diet
●Vitamin
- Increase demand for Vitamin A, Niacin, Riboflavin, thiamine, and Ascorbic acid
●Fluids
- Intake of 8 glasses or more
a. Mother’s milk is the best food for the baby.
b. It is easily digested, economical, has the right temperature and is free from harmful bacteria.
c. For the first 3 to 4 days, it contains a substance called colostrum.
d. Colostrum has high protein content, acts as a laxative and contains antibodies which help resist
infection.
e. Meat and vegetable group (tahong, tulya, malunggay,milk, and fruit juices)
●Galactogogues
- Milk stimulating hormone
- A food or drug that promotes or increases the flow of a mother's milk
Water should not be drunk beyond the level of natural thirst because it suppresses milk secretion through
its action on the pituitary hormone that regulates milk production.
Malnutrition/ illnesses like anemia and beri-beri can lessen the quality and quantity of milk flow.
> INFANCY
●DIET:
a. Breastfeeding: meets nutrient needs of early months
b. Bottle feeding: Iron-fortified formula
●WEIGHT GAIN
- A steady weight gain of 150 to 240 gm/ week that slows down toward the end of the first year to about
120 g/ week is considered as the proper weight gain (doubled birth weight at the 6 months and tripled at
the end of the year).
- Baby length increases by about 25.4 cm or 50%more at the end of the first year
●CALORIES
- At birth baby requires about 350 to 500 calories
- 120 cal/ kg BW from 2nd to 7th month
- 100 cal/ kg BW 7th to 12th month
1. 4 to 6 months solid food can be introduced
2. Decrease of the tongue extrusion reflex allows the infant to take food from spoon
3. 6 to 8 months: a good time to introduce new flavors
4. Plain, smooth and strained
5. Avoid acidic juices like orange and tomato
6. Continue to offer new and different vegetables even if the baby do not like it for the first time
7. Do not offer hard biscuits due to choking risk
8. The average requirement for growth in the first year is 50 calories per pound of expected weight, 2/3 of
these calories supplied by the milk and 1/3 by the additional carbohydrates.
●PROTEIN
- 1.5 to 2.5 g of protein/ kg BW from 0 to 6 months of age
- 1.5 to 2 g/ kg BW from 6 to 12 months
●FAT
- About 3 to 5% of fat is included when no specific amount is stipulated.
- If fat is restricted larger amount of protein or sugar or both is required for energy sources.
●CARBOHYDRATES
- 1 oz per 10 oz of milk is prescribed
- 1/3 of the CHO should be derived from the milk mixture and the remainder is added in the form of sugar
or starch
●MINERALS AND VITAMINS
- All vitamins and minerals are required proportionately.
- If the diet of a nursing mother is nutritionally adequate, the vitamins necessary for the infant will be
contained in the milk with the exception of Vitamin D and possibly ascorbic acid.
●Vitamin B6 (Pyridoxine)
- Deficiency may result in a syndrome characterized primarily by convulsions
- Vitamin A and all Vitamin B fractions are needed for optimum growth.
●WATER- The requirement for water varies from 10 to 15% of BW, or 1 and ½ oz to 2 ½ oz per lb BW.
●Start any new food with ½ tsp on the first day and addas the baby takes to the new taste.
●Never start two new foods at the same time.
●Supplementary foods
a. 2nd month- liquids
b. 4th month – cereal or scraped fruits and vegetables
c. 5th – full pureed diet
d. 7th finely chopped foods
e. 9th month – tender foods or coarsely chopped foods
COMMON DISORDERS:
●DIARRHEA
- Rice water suffices for mild diarrhea but in case of dehydration, parenteral and/ or oral fluids should be
given.
- Food can be given as early as 8 hours after the beginning of rehydration
●VOMITING
- Fluid replacement
- Reduce no. of feedings, acidifying milk, burp infant after every feeding
●ALLERGY
- Eczema is the most common sign of allergy before 9 months of age.
●CONSTIPATION
- Moderately restrict milk intake
- Increase fruit, vegetable and fluid intake
- Change sugar in the formula to laxative brown sugar (½ tsp plus 30 ml water at the beginning or end of a
feed 3 to 4 times a day until there is a soft poo)
- Check reconstitution of milk formula
●COLIC
- Changing the formula
●BABY BOTTLE TOOTH DECAY
- Use soft wash cloth to cleanse gums and move onto use soft infant toothbrush
> CHILDHOOD
- The won’t-eat era should not alarm the patients.
- The energy need of the pre-school child is determined by his age, activity and metabolism.
●Protein: 1.5 to 2 g/kg BW is required
●Vitamins and minerals: All are essential for normal growth and development
●Fluids: 4 to 6 glasses/ 1000 to 1,500 ml
●Feeding problems:
- Child is eating too little
- Go slow in adding new foods, start the meal with liked food
- Serve less
- Prepare simple dishes
●Child is eating too much
- Refrain from serving rich foods like cakes, pastries, pies, ice cream
●Child is dawdling during mealtime:
- Regular check up by pediatrician
- Avoid fussing
- let the child enjoy eating
●Child is gagging especially when fed coarse foods
- Encourage self-feeding
- Well-ventilated, bright clean eating place
- Colorful, eye-catching utensils
●Child has aversion towards some foods
- Give fruits as substitute for vegetables
- Mix vegetables with familiar foods- Give milk through other foods
●Child has allergies
- Monitor nutrient intake
- Make food substitutions
●Choking risks
- Children should be supervised when eating so they are not running or jumping while eating or putting
large quantities in their mouth
●Lead hazards
- Children with sub adequate intakes of iron, calcium, and zinc often absorb lead more readily because of
the lack of competition for absorption that occurs with normal intake of these minerals (Tucker &
Dauffenbach, 2012).
> SCHOOL-AGE
●Calories
- Allowances decline to about 80 to 90 kcal/kg for children 7 to 9 years old and 70 to 80 kcal/ kg for children
aged 10 to 12 years old
●Protein
- Approximately 37 g of protein is recommended daily for children 7 to 9 years old and 43 to 48 g for
children aged 10 to 12 years
●Vitamins and minerals
- As most girls start to menstruate at the age of 11or 12, iron allowance should consider the 1.4 mg/day
-Ascorbic acid allowance at 55 mg for children 7 to9 years old and 65 to 70 for children 10 to 12 yearsold
●Growing children needs 2 to 4 times as much as calcium (500 to 1000mg)
●120 mcg of iodine
●Feeding the school child
a. Psychological factors
b. School environment
c. Food preferences
●Feeding problems
a. Inadequate meals- Provide good breakfast
b. Poor appetite- O er nutritious snacksc. Sweet tooth- Hungry growing bodies recognizes the needfor
extra calories- give sweets as rewards or pasalubong
> ADOLESCENCE
- Because of the rapid growth and development during teenage years, adolescents have greater needs for
certain nutrients.
- Adolescent boys need more energy foods because of an increase in physical activities than adolescent
girls.
●CALORIES
- The energy requirement of adolescents aged 13-15years is 2700 kcal for 48.5 kg boys while 2170 kcal for
46 kg girls.
- For adolescents aged 16-18 years, it is 3010 kcal for59 kg boys while 2280 kcal for 51.5 kg girls.
●The need for body building foods is also high among teenagers because of accelerated growth and
development.
●Protein- The protein need of adolescents (13 -15 years) is 62grams per day for boys and 57 grams per
day for girls.
- For adolescents aged 16-18 years, it is 73 grams per day for boys while 61 grams for girls is needed;
●Teenagers have higher requirements for calcium as the adolescence period is a vital time for bone
development. Teenagers need extra calcium to store up an optimal amount of bone (peak bone mass).
●Building bone mass through a balanced diet, including adequate calcium may delay the onset or limit
chances of developing osteoporosis later in life.
●Calcium requirement for an adolescent boy or girl (13-18 years) is 1000 mg per day
●Iron
- The recommendation for iron is 19 mg/ day for teenage boys (13-15 years) while it is 28 mg/day for
teenage girls (13-15 years).
- Iron requirements of teenage girls cannot be met by usual diet alone. Intake of iron-rich andiron-fortified
foods and the use of supplements are recommended, if necessary
Possible Nutrition Problems
1. Low intake of Calcium, Vitamin A and C
2. Low intake of iron in girls
3. Anemia
4. Obesity or overweight
5. Skin problems
6. Nutritional deficiencies related to:
a. psychological factors – food aversions and emotional problems
b. fear of overweight or crash diets
c. food diets
d. poor choice of snack foods
e. Irregular eating pattern
f. additional stress of pregnancy
> ADULTHOOD
●Feeding the Adult
To stay healthy, the following must be observed and followed:
1. Eat variety of foods.
2. Maintain ideal weight.
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. If you drink alcohol, do so in moderation.
> ELDERLY
●Food Needs of the Aging and the Aged
1. Calories
- A reduction of calories is recommended because of reduced basal metabolism and physical activity.
2. Proteins
- An allowance of 1.1 gm/ kg body
3. Vitamins and Minerals- Calcium, Iron, Vitamin A, C and the B complex vitamins.
4. Water and Fiber
- About 6 to 8 glasses should be consumed daily. Common Problems among the Elderly
1. Difficulty in chewing due to loss of teeth and not getting used to dentures.
Solutions:
a. chop meat or flake fish
b. slice or chop vegetables into small bite-sized pieces foreasy chewing.
2. Lack of appetite
Solutions:
a. do light exercises like walking and gardening to improve appetite and the body fit.
b. eat in pleasant surroundings to make your meal enjoyable.
c. make the food attractive by varying color, shape and size.
3. Unwanted weight and due to lack of physical activity and/ or to overeating
Solutions:
a. exercise regularly
b. eat on the lean part of the meat or fish. Avoid the fatty portion.
c. take in only moderate amounts of energy food. Steam, boil, or broil foods. Avoid rich sauces, salad
dressings, and pastries or cake with heavy icings.
4. Anxiety, confusion, insecurity or loneliness
Solutions
:a. start the day right with a good breakfast
b. Have a hobby.
c. keep up with a group. Join a club and participate in community activities.
5. Poor digestion leading to constipation, gas pain, or diarrhea
Solutions:
a. include fruits and vegetables in your daily meals to prevent constipation.
b. have a 4 light meals. Eat the heaviest meal at noon.
c. drink 6 to 8 glasses of water and fruit juices every day.
d. help digestion and keep normal flow of body fluids.
e. if having diarrhea, take simple foods like tea, crackers, broth of boiled banana and camote, “lugaw.” or
toast. Avoid fibrous fruits and vegetables
6. Poor absorption leading to anemia and other vitamin deficiencies
Solution:
a. iron-rich foods like liver, lean meat, egg yolk, saluyot,kulitis, himbabap and seaweeds will protect you
from anemia.
b. Vitamin C- rich foods like papaya, mango and dalanghita will help absorb iron and speed up healing
c. take in foods like milk, milk products, dilis, alamang and other leafy vegetables. These food contain
calcium neededfor strong bones. Exposure to sunlight helps maintain the bone structure.
7. Difficulty in Sleeping
Solutions:
a. drink warm milk just before going to bed to assure a restful night
b. Avoid tea or coffee late in the day, if any of these affect your sleep.