1.
NUTRITION THROUGHOUT THE
LIFE CYCLE
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2.
Importance of preconceptional
nutrition
• Optimal preconceptional nutrition
lowers risk of birth defects.
• The embryo is particularly vulnerable
during the first few weeks when
organs are formed.
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3.
Importance of preconceptional
nutrition
• Required levels of Vitamins and amino acids
are needed for DNA synthesis, especially
folate, vitamin B12 and B6, are needed.
• Excess retinol intake, on the other hand,
increases the risk for heart and other organ
defects.
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4.
Nutrition before conception
Some deficiency related problems develop very
early in pregnancy:
• Adequate folate (400 μg daily) before
conception can reduce the risks
• Neural tube defects:
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5.
Nutrition before conception
A healthy diet before conception includes
• Avoiding teratogens: substances that cause
birth defects
• Avoiding alcohol and illegal drugs
• Avoiding other possible hazards: Smoking,
caffeine
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6.
Nutrition before conception
A healthy diet and appropriate levels of
physical activity before conception:
• Promotes optimal body weight
• Reduces the risk of developing nutrition-
related disorders during pregnancy, such as
gestational diabetes
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7.
Nutrition Before Conception
A man’s nutrition before conception
• Adequate nutrition keeps the immune
system strong and promotes fertility (Sperm
number and motility (ability to move)
• Fertility can be reduced by alcohol
consumption, certain prescription, and
illegal drugs.
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8.
Nutrition during pregnancy
A full term pregnancy lasts 38 – 42 weeks:
• 1st trimester: conception to 13th week
• 2nd trimester: 14th to 27th week
• 3rd trimester: 28th to 40th week
Embryonic stage: ~ day 15 to the 8th week
• After the 3rd month, the developing baby is called a
fetus.
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9.
Nutrition during Pregnancy
1st trimester
• Zygote (fertilized egg) gets implanted in the
wall of the uterus
• Development of organs, limb buds, facial
features, placenta begins (adequate
nutrients required)
• Embryos are extremely vulnerable to
teratogens during this time
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10.
Critical Period of Development
During the first trimester, malnutrition in
the mother can cause irreversible damage
to the developing embryo.
• Heart damage
• Neural tube defects
• Incomplete development of limbs, eyes,
and ears
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11.
Nutrition During Pregnancy
2nd trimester
• Continued development of organ systems
• Growth from ~ 3 inches to over a foot long
by the end of the 2nd trimester
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12.
Nutrition During Pregnancy
3rd trimester
• Time of intense growth and maturation
• Fetus gains ¾ of it’s weight in this time
• Brain growth is also extensive
• Lungs become fully mature
• A balanced, adequate diet for the mother continues
to be critical
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13.
Nutrient source for fetus
• Nutrients are provided by chorionic fluid
first, later via placenta.
• During the first weeks the embryo gets all
nutrients from fluids secreted by the
chorion into the chorionic sac which
envelops the embryo.
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14.
Nutrient source for fetus
• Glucose, amino acids, vitamins and other
essential compounds are absorbed by the
embryo’s yolk sac, by both passive and active
transport mechanisms
• Towards the end of the first trimester the
placenta takes over the maternal-fetal
exchange of nutrients, fluids and gases.
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15.
Meeting fetal nutrient needs
• Maternal diet and nutrient stores
together provide for fetal needs.
• Pregnancy increases the requirement for
nearly all nutrients; folate and iron
needs increase dramatically.
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16.
Meeting fetal nutrient needs
• Maternal stores (especially iron and B12) are
important to cover some of the additional
nutrient needs of pregnancy.
• Lack of sufficient energy, protein and
micronutrients can interfere with fetal brain
and other organ development.
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17.
Meeting fetal nutrient needs
• Regardless of pre-pregnancy weight, all
pregnant women need to gain some weight
during pregnancy. The average
recommended weight gain is between 11-
16 kg.
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18.
Nutrition During Pregnancy
• Weight gain during pregnancy:
• Pattern of weight gain is important:
–1st trimester: 1.5 to3 kg.
–2nd-3rd trimesters: average 0.5kg. per week
–Typically 11-16kg.
• Too much weight gain is also risky
• Women should not diet during pregnancy: this
may deprive the fetus of critical nutrients
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19.
Macronutrients
Energy
• 2nd and 3rd trimesters: additional 350-450
kcal/day
• Nutrient-dense foods to obtain sufficient
nutrients
• Safe and physician-approved program of
regular moderate physical activity
Proteins and Carbohydrates
• 1.1 gm/kg body wt/day of protein
• 175 grams/day minimum of carbohydrates
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20.
Macronutrients
Fat
• The percentage of calories obtained from fat
should not change during pregnancy.
• Limit saturated fat, avoid trans fats
• Fat is required by the newborn for
temperature regulation and as an energy
source
• Omega-3 polyunsaturated fatty acid
docosahexaenoic acid (DHA) is critical for
embryo’s neurologic and eye development
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21.
Micronutrients
The micronutrients that are most critical during
pregnancy include
• Folate
• Vitamin B12
• Vitamin A
• Vitamin C
• Vitamin D
Assignment: Check out for functions of each
during pregnancy.
• Calcium
• Zinc
• Iron
• Sodium
• Iodine
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22.
Neural Tube Defect
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23.
Nutrition-Related Concerns
Nutrition-related problems during pregnancy
can include:
• Morning sickness
• Cravings, pica and food aversions
• Heartburn
• Constipation and hemorrhoids
• Gestational diabetes
• High blood pressure – causing nutrient
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24.
Fluids Intake During Pregnancy
The need for fluids increases to 3 liters per
day for:
• Increase in the mother’s blood volume
• Regulating body temperature
• Production of amniotic fluid to protect and
cushion the fetus
• Combat fluid retention and constipation
• Prevent urinary tract infections
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25.
Nutrition during Breast feeding
Lactation: production of breast milk
Prolactin: hormone responsible for the synthesis
of milk
• Produced toward the end of pregnancy
• Suppressed by estrogen and progesterone until
childbirth
Colostrum: first milk produced; rich in proteins,
antibodies, vitamins, minerals
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26.
Breastfeeding
• Milk production requires 700 – 800 kcal/day
• Lactating women should consume an extra
330- 400 kcal/day above their own needs
• Allow for gradually weight loss (0.5–2
kg/mo)
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27.
Breastfeeding
• Increased need for protein, certain vitamins
and minerals (folate, iron, calcium), fluid
• Multivitamin: not substitute for proper
nutrition
• BENEFITS OF BREAST FEEDING
• OBSTACLES TO BREAST FEEDING
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28.
Nutrition during Infancy
Optimal nutrition is critical in the first year:
• The baby’s organs are developing
• The nervous system continues to develop
• Babies typically grow 10 inches in length and
triple their weight in the 1st year
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29.
Infants Nutrition
• The most appropriate food for an infant is
human milk.
• Infants require 93-120 Kcal/kg/day, the
highest requirements of the lifecycle, and
must nurse several times a day to meet
these needs.
• They require 86-103 ml/kg/day of fluid;
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30.
Infants:
Appropriate infant food
• At birth, low secretion of digestive enzymes
makes digesting solids foods or cow’s milk
difficult.
• Low renal capacity means high protein
intake can cause renal overload and induce
osmotic diuresis and water loss.
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31.
Infants:
Appropriate infant food
• After 4-6 months an infant’s kidneys will
mature enough to handle the high solute
loads caused by solid foods.
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32.
Infant Nutrition
• Infants double their birth weight by 4-6
months of age and triple it by I year
• The length increase by 50% in the 1st year and
double by 4 years
• Stomach capacity increases from 10-20ml at
birth to 200ml by I year enabling infants to
consume more food.
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33.
Infant Nutrition
Nutrition-related concerns for infants include
• Allergies
• Colic
• Failure to thrive
• Anemia
• Dehydration
• Nursing bottle syndrome
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34.
Important nutrients
• Zinc
• Vitamin A
• Iron
• Energy
• Protein
• Carbohydrates
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35.
Childhood and Adolescence
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36.
Toddlers
Age 12 to 36 months
• Rapid growth rate of infancy begins to slow
• Gain 5.5 to 7.5 inches, average 9-11 pounds
• Higher energy expended for increased activity
levels
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37.
Toddlers
Macronutrients:
• 30%-40% of total kcal from fat
• 1.1 grams of protein per kg body weight
• 130 grams carbohydrates per day
• 14 grams fiber per 1,000 kcal/day
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38.
Toddlers
Micronutrients:
• Ensure adequate intake of the micronutrients
including: Vitamins A, C, E, calcium, iron, zinc,
potassium
• Until age 2 or beyond, drink whole milk for
calcium
• Iron deficient anemia is the most common
nutrient deficiency in young children
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39.
Toddlers
Fluid needs:
• 1.3 liters per day
• Supplements:
• Toddlers may need supplements, especially for
fluoride
• Supplement should not exceed 100% Daily
Value for any nutrient per dose
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40.
Toddlers
Nutritious Food Choices:
• Innate ability to match intake with needs
• Nutritious variety encourages a healthy diet
• Food should not be forced on a child
• Frequent small meals for small stomach
• Developmentally appropriate foods
• Small portions, limited healthy alternatives
• Role modeling is important
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41.
Preschoolers
Age 3 to 5 years
• Growth rate continues to slow
• Will gain 3–4 inches, 5–6 pounds per year
• Reduced appetite
• Chew most foods adequately
• Use a cup, spoon, and fork with relative ease
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42.
Preschoolers
Macronutrients:
• Total fat intake should gradually be 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
• 14 grams fiber per 1,000 kcal
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43.
Preschoolers
Micronutrients:
• Adequate fruits and vegetables in the diet continues
to be a concern
• Fiber and potassium: priority nutrients lacking in the
diets of low-income preschoolers
• Concerns: vitamins A, C, E, calcium, iron, zinc
• AI of calcium increases for toddlers
• RDAs for iron and zinc also increase
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44.
Preschoolers
Fluid:
• 1.7 liters per day
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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45.
Preschoolers
Nutritious Food Choices:
• Parents can teach preschoolers about healthy
food choices
• Some foods will “give them energy”
• Some foods “help us grow healthy and strong”
• Some foods are used as occasional treats
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46.
Preschoolers
Nutrition-Related Concerns:
• Iron deficiency anemia
• Constipation
• Dental caries
• Childhood food insecurity
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47.
School-Aged Children
Age 6 to 13 years
• Growth is slow and steady, 2-3 inches/year
• Children begin to make their own food choices
• Activity levels vary
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48.
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
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49.
School-Aged Children
Micronutrients:
• The need for most micronutrients increases
slightly through age 8
• Micronutrient needs rise sharply as children
approach puberty
• Calcium and iron are still very important
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50.
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
• Water should be encouraged during physical
activities to maintain hydration
• Water remains the beverage of choice
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51.
School-Aged Children
Nutritious Food Choices:
• Peer pressure can influence food choices
• School lunches should be based on the RDA
for this age group
• A variety of foods
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52.
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 favor of other beverages
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53.
Adolescents
Age 14 to 18 years
• Emotions and behaviors often unpredictable
• Puberty: secondary sexual characteristics
develop, capacity for reproduction
• Growth spurts begins at age 10-11 for girls, 12-
13 for boys
• Expect an average 20-25% increase in height
• Weight and body composition also change
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54.
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%-60% of kcal from carbohydrates
• 0.85 gram protein / kg body weight
• 26-38 grams of fiber per day
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55.
Adolescents
Micronutrients:
• Calcium intakes must be sufficient for
achieving peak bone density: 1300 mg/day
• Iron needs are relatively high: 11 mg/day for
boys, 15 mg/day for girls
• Vitamin A is critical for supporting rapid
growth and development
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56.
Adolescents
Fluid:
• The need to maintain fluid intake is increased
by higher activity levels
• Boys: 3.3 liters/day
• Girls: 2.3 liters/day
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57.
Adolescents
• Nutritious Food Choices:
• Peer influences and fast-paced lifestyle can
lead adolescents to choose fast foods
• Parents can act as role models and make
healthy food choices available
• Encourage fruits, vegetables, milk
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58.
Adolescents
Nutrition Related Concerns:
• Adequate dietary calcium to maximize bone
calcium uptake and bone mineral density
• Disordered eating and eating disorders can
begin in these years (anorexia nervosa;
bulimia etc. )
• Acne and diet
• Cigarette smoking, alcohol, and illegal drugs
can have an impact on nutrition
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59.
Nutrition in adulthood
Age 18 to 65 years
• Early adult hood (18 to 30 yrs)
• Middle adulthood (30 to 65yrs)
• There’s less physical activity in adulthood and
nutrition needs decrease to a maintenance level
except for iron in women.
• After 21, energy needed for metabolism slowly
decreases with age
• Iron requirement in women decrease after
menopause
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60.
Nutrition in adulthood
Nutrition related health problems:
• Obesity
• Hypertension
• Atherosclerosis
• Family planning methods may increase
nutrient needs in women (e.g. the IUD) may
lead to blood loss – increased iron needs
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61.
NUTRITION IN THE ELDERLY
• Age 65 and above
Nutritional well being is influenced by:
• Person’s general health
• Established food habits
• Ability to obtain and prepare food
• Financial situation
• Level of physical activity
• Emotional state
• Mental health
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62.
NUTRITION IN THE ELDERLY
• Nutrition concerns
• Constipation – decreased GI motility and
physical activity
• Iron deficiency anemia
• Pernicious anemia
• Dental problems
• Other chronic diseases
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63.
Requirements of the elderly:
– ↑Vitamin D for bone strength
– ↓ Energy (not active)
– ↓ Iron (females) d/2 menopause.
– ↑ Vitamin to prevent diseases.
– ↑ Proteins for body tissue repair.
• Reasons
– ↓ lean body mass.
– ↓ Metabolic rates
– ↓ Physical activity
– Age related bone degeneration.
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64.
As people age there are Physiological;
psychological and economic changes that affect
nutrition:
• Physiological changes: body functions slow
with age & ability of the body to reduce worn
out tissues is reduced. Dentition is common
among other challenges, if nutrition has been
chronic immune system is compromised.
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65.
• Psychological changes: Loneliness ; feelings of
unworthy, / loss of self-esteem, grief, physical
disabilities that come in old age can destroy
the social life can lead to depression, diminish
ones appetite and ability to shop or cook.
• Economic changes: Decreased income affects
ones quality of life and adds worries in paying
bills… one may select less than healthy diet on
the basis of cost rather than nutrients
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