1
FOOD FOR HEALTHY
LIVING
Chapter 12
Learning Objectives
2
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Plan menus that are appropriate and nutrient rich for
children and adolescents and older adults
Identify issues specific to menu planning for aging adults
Identify nutrition recommendations for pregnancy,
breastfeeding
Discuss nutrition recommendations for toddler/preschool,
school age, adolescence
Identify health issues of older adults and provide nutrition
recommendations
Nutrition For Pregnancy
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Choose My Plate
Increased Protein
+
25 grams/day (3 oz protein)
 RDA- 71 grams/day
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Folate
 600
synthetic mcg/day
 DNA, reduce neural tube defects
 Pre-natal vitamin
Nutrition For Pregnancy
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Iron
 27
mg/day
 Increased blood volume, baby’s iron stores
 High in pre-natal
 Iron deficiency anemia….supplement
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Calcium
 1000-1300
mg/day (4 cups a day)
 Last trimester- 300 mg/day transferred to baby
 Low in pre-natal
Basic Nutrition Guidelines
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Prenatal vitamin-mineral supplement
1st trimester
 2-4
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2nd and 3rd trimester
1
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pound weight gain, ↑ nutrients
pound a week weight gain, + 300 calories
Moderate caffeine, sugar substitutes
Adequate fluids- RDI- 3.0 L/day
Limit mercury containing fish
 12
oz fish a week or less, variety
Alcohol
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No safe known level
#1 preventable birth defect
Lifelong affects, cognitively and physically
Fetal Alcohol Syndrome
Appropriate Weight Gain
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25-35 pounds (healthy body weight)
Helps prevent low-birth weight (less than 5 ½ pounds)
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Poor growth/immune system
Delivery complications
Undeveloped lungs
Helps prevent excess weight gain
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Gestational diabetes, hypertension, other pregnancy
complications; childhood obesity
Comfort for the mother!
Nutrition Needs of Breastfeeding
Mom
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+ 500 calories/day or more
+ 25 grams protein or more (RDA- 71 grams)
8-12 cups of fluids – RDA 3.8 L/day
Continue pre-natal supplement
Choose My Plate
Limit caffeine, alcohol
Breastmilk
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Colostrum
 First
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few days, antibodies, anti-infective, probiotics
Mature Milk
 High
in essential fats, probiotics, enzymes
 Minimal digestion
 Changes in composition to meet growth needs
Breastmilk Points of Interest
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Many health benefits
Produced based on demand
Proper latching on important
Small stools, rarely constipates, no smell
Minimal “spitting up”
Food flavors transfer from foods mom eats to
milk
History of food allergies, eliminate protein from
moms diet
Formula
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Supports normal growth and development
Formula contains
lactose/sucrose (CHO)
 casein, whey (PRO)
 vegetable oils (FAT)
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Vitamins-mineral fortified, high iron
More symptoms of intolerance

Spitting up, gassy, protein intolerance, constipation
Formula Types
 Standard
 Essential
fatty acid enhanced
 Modified for gassy babies
 Organic
 Lactose-Free
 Follow-up
(6-12 months)
 Soy-protein
 Hypoallergenic- Protein Sensitivity
 Preemie
 Medical
Formula Tips
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Easier to overfeed
Mix according to instructions
 Too
dilute- poor nutrition
 Too concentrated- GI problems
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Food Safety – GI problems
 Discard
unfed formula
 Refrigerate diluted formula 24 hours
 Clean nipples/bottle- dishwasher OK
 Safe water
Feeding Children
14
4-6 Months
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Introduce solids
Developmental feeding milestones
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Mature GI tract
 protrusion reflex
Head-neck control
Interest in food
Iron-fortified rice cereal
Then vegetables-fruits
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Wait several days to introduce new food
Diarrhea, vomit, rash, wheezing, very fussy, wait
6-12 months
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Mashed, soft foods to small chunks
Introduce foods according to ability
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Pincer grasp
Hand to mouth movement
Imitates chewing motion
Holds eating utensils
Holds bottle, cup
Eating is part of motor skill development
Caution with foods that could cause choking (nickel sized)
Adequate Nutrition
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Growth Curves
 Problem
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if growth deviates off usual curve
Hemoglobin (iron deficiency anemia)
Normal Development
Fig. 14.1
1-5 years
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Food Provides
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My Plate Balance
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Nutrients
Decision making, motor skill development
Model good eating patterns
Provide healthy choices
Smaller portions
 1 Tblsp. year portions
Establishment of eating behaviors, food preferences
Dental Caries
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No bottles in bed
Best Time to Teach Nutrition
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Pre-school and grade school years
Love to cook, help with food
3
yo- wrap, pour, mix, shake, spread
 4 yo- roll, juice, mash, peel
 5 yo- measure, grind, grate, cut
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Less peer influence
5-10 Years
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Continued slow growth
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10 y.o.- 1800 calories/day
Regular meals and snacks
 5-7
eating times/day
 Breakfast, snacks, < sweetened beverages
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Concerns
 Obesity
 High
blood cholesterol (>170 mg/dl), hypertension, high blood
sugars
Adolescents
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Rapid growth triggered by hormones
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Girls 10-11 y.o., fat increases, 35 pounds, 6”
Boys 12-14 y.o., muscle increases, 45 pounds, 8”
Calories up to 4000-5000/day during growth spurts
Iron, calcium, vitamin D, protein
Nutrition Issues
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Peer influenced eating
Eating disorders
Obesity
Iron deficiency anemia
Low calcium intake- girls
Vegetarianism
Sports nutrition
 Adequate
calories to support growth and activity
 +500-1500 calories/day
Meeting the Needs of Children
24
Best choices
 Use primarily basic whole foods
 Serve roasted, grilled or poached foods
 Serve fruits whole or cut for more nutrients and
fiber
 100% juice rather than sweetened fruit drinks
 Serve plenty of vegetables
Meeting the Needs of Children
25
Best choices
 Dips and sauces appeal to kids
 Nutrient-dense beverages with each meal
 Healthful side dishes
 Low-fat milk or equivalent dairy products at meals
and snacks
 Brown rice and other whole grains; whole-wheat
breadcrumbs
 Serve cookies and snacks with healthful ingredients
Meeting the Needs of Children
26
Tips for chefs
 Offer variety to appeal to different ages
 Serve small bites and hand-held food items
 Use child-sized utensils and plates
 Minimize choking hazards
 Be aware of common allergens such as peanuts
 Serve familiar foods and use flavors children know
 Serve appropriate portions
Meeting the Needs of Children
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Tips for chefs
 Use healthful cooking techniques
 Introduce new options in familiar ways
 Serve colorful, nutrient-rich foods for eye appeal
 Put produce on every plate
 Add variety by offering half portions from the
regular menu
 For sandwiches, offer low-fat meats, poultry or
reduced-fat cold cuts
Feeding Aging Adults
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Sensory Losses
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Taste
Smell
Vision
Thirst
Most Significant Nutrient Concerns
with Aging…
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Unintentional Weight Loss
Loss of Lean Body Mass
Low vitamin D
Dehydration
Malnutrition
Depression
Food Insecurity
More than 80% of 65 or older have at least one
chronic condition affected by nutrition and/or food
choices
Weight Loss
Middle age- weight gain; peak weight- 75 yo,
weight loss- after 75
 Difficulty regaining weight
 Loss of functional ability
 25-30 calories/kg body weight
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Strategies: Calories
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Avoid unnecessary dietary
restrictions
Encourage use of
foods
Use more frequent meals plus
supplements or snacks
nutrient dense
Strategies: Calories
Use foods that are well liked
frequently
 Provide double portions of
favorite foods
 Add calories by using sauces,
gravies, toppings, and fats
 Emphasize calorie containing
liquids to meet fluid needs
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Sarcopenia
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Loss of lean body mass
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Adequate Calories
Adequate Protein
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Affects physical function, strength, overall health, quality of life,
activities of daily living
1.2 grams/kg
Animal sources, supplements
25 grams at a time (snacks and meals)
 3-5 times a day
Resistance Exercise
Dietary Protein/Calorie
Supplements
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Liquid supplements
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Protein powders
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13+ grams
25 grams a scoop
Smoothies
Food intake is often ↓ by use of these supplements, but
overall nutritional intake is improved
Considered a “supplement” not meal replacement
Dehydration
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Affects
 constipation,
blood pressure, dementia (confusion),
muscle function
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8-11 cups of fluids a day
Ideas to increase intake:
 Availability,
pitchers, variety of fluids, flavors
Live to Be 100
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http://ngm.nationalgeographic.com/ngm/0511/sights_n_soun
ds/index.html
Mediterranean Type Diet
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Maintain healthy weight
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Reduced calories and exercise
Social Networks
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Home-grown foods, fruits, vegetables, olive oil, fish, whole grains,
drink tea-coffee-red wine, few processed or refined foods
Family, friends,
Spiritual life, “sabboth”
Reason for living-purpose
Rural living
Meeting the Needs of Aging Adults
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Key nutrition points
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Nutrient-dense foods meet nutritional requirements in
fewer calories
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Liberal diets recommended for those in long-term care.
Promoting enjoyment of food and enhancing quality of life
are important goals. Overly restrictive diets may reduce
food intake and cause unintended weight loss, with
devastating health effects
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Chewing and swallowing problems may require altering
the consistency of a food and/or liquid to make it safe
and easier to swallow- small, bite size pieces, soft
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Appetite often small
Meeting the Needs of Aging Adults
40
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The immune system often compromised with age.
Follow best practices in food sanitation and safety.
Avoid serving risky foods such as raw oysters or
uncooked eggs
Meeting the Needs of Aging Adults
41
Tips for chefs
 Expect questions about food intolerances, dietary
restrictions, food preparation techniques and
ingredients. Train servers to communicate specific needs
to the kitchen staff
 Eating “early” and low-budget dining are common
requests. Small portions, economical offerings, and
early dining options can add a new group of regular
patrons, and they will have finished eating by the prime
dining time
 Older customers have smaller appetites and ask for
smaller portions or take leftover food for another meal