9 - Nutrition for Special Population.pdf

Nutrition for Special Population Pregnancy & Lactation Infants, Childhood & Adolescent Older Adults Vegetarian Pregnancy & Lactation Nutrition During Pregnancy & Lactation ◼ During the first trimester the daily needs for the embryo & fetus are smaller...

Nutrition for Special Population Pregnancy & Lactation Infants, Childhood & Adolescent Older Adults Vegetarian Pregnancy & Lactation Nutrition During Pregnancy & Lactation ◼ During the first trimester the daily needs for the embryo & fetus are smaller than in the second & third trimester. ◼ Excessive exercise & inadequate energy intake may yield inadequate maternal weight gain impede fetal growth. Nutrition During Pregnancy & Lactation Guidelines for Weight Gain Pre-pregnancy BMI Weight Gain (kg) Low ( 26-29) 7 – 11.5 Obese (>29) >6 Source : Nutrition During Pregnancy, 1990 * Most of this weight gain occurs during the 2nd & 3rd trimesters Nutrition During Pregnancy & Lactation ◼ Energy – RDA for 2nd & 3rd trimesters – 300kcal/day more than pre-pregnancy. – However, current evidence suggests that the actual increase in need varies. – Weight gain – best indicator of adequate calorie intake. – Weight loss is not advised during pregnancy, even for obese women Nutrition During Pregnancy & Lactation Macronutrients – Protein ▪ RDA – 60g/day – Fats ▪ > 10% of daily calories. Micronutrients – Carbs – Increase B vitamins ▪ Complex carbs, fiber (Thiamin, riboflavin, niacin, rich diet pantothenic acids). – Higher Folate & iron intake. Nutrition During Pregnancy & Lactation Foods & Substances to Avoid – Avoid alcohol & moderate caffeine intake. – Alcohol – Fetal Alcohol Syndrome (FAS) ▪ Growth deficiency, small head, facial irregularities, mental retardation, CNS disorders – Other substance – tobacco, drugs Impotency [from www.metacafe.com].wmv Nutrition During Pregnancy & Lactation ◼ Substance Abuse – Miscarriage – Premature delivery – Low birth weight – Infant addiction – Infant mortality – Sudden Infant Death syndrome (SIDS) – Fetal growth retardation – Birth defects – FAS (Fetal Alcohol Spectrum Disorder) dontdrinkdrive.wmv  Nutrition During Pregnancy & Lactation ◼ Lactation – RDA – additional 500kcal & 12-15g of protein each day. – Recommended higher intake levels for minerals. – Fluids are also important for adequate milk production ▪ 2 liter/day. At least 1 cup of water each breast feeding tobacco, alcohol & – Avoid drugs Infancy, Childhood & Adolescence  Nutrition for Infants Energy RDA for infants 39% 55% 55% 30% 15% 6% Infant Adult Protein Fat Carbs  Nutrition for Infants Primary Functions of Energy Yielding Nutrients CARB PROTEIN (lactose) FAT Growth Energy Energy Enhances Nervous system absorption of Accumulation of calcium & fats stores phosphorus  Nutrition for Infants Important Micronutrients Vit D Vit K Fluoride Infants Vit B12 Iron basketball_fever.wmv  Nutrition for Childhood Energy & Protein RDA Age (year) Kcal/kg Protein g/kg 1-3 102 1.2 4-6 90 1.1 7 - 10 70 1.0  Nutrition for Childhood Food Guide Pyramid for Young Children (6 – 12 yr) Fats & sweets Eat Less Milk Group 2 serving Meats Group 2 serving Vegetables 3 servings Fruits 2 serving Bread, rice, pasta 6 or more serving Nutrition for Childhood Important Micronutrients Iron Zinc Childhood Vit E Vit D  Nutrition for Adolescence Energy & Protein RDA Age (year) Kcal/kg Protein g/kg Males 11 - 14 55 1.0 15 - 18 45 0.9 Females 11 - 14 47 1.0 15 - 18 40 0.8 Nutrition for Adolescence Important Micronutrients Iron Adolescence Vit A Calcium Older Adults Nutrition for Older Adults Age-related Physiological Changes Saliva production Digestive secretion Blood pressure Lactose secretion Body weight GI motility Bone loss Cardiac output Blood volume Kidney function Immune function Vitamin absorption Re s.m pg  Nutrition for Older Adults Age-related Changes & Nutrient Needs Change in Body Composition or Impact on Nutrient Requirement Physiologic Function Decreased muscle mass Decreased need for calories Decreased bone density Increased need for calcium, vit D Decreased immune function Increased need for vit B6, vit E, zinc Increased gastric pH Increased need for vit B12, folic acid, calcium, iron, zinc Decreased skin capacity for Increased need for vit D cholecalciferol synthesis Decreased calcium bioavailability Increased need for vit D  Nutrition for Older Adults Food Guide Pyramid for Older Adults Calcium, vit D, Vit B12 Fats, oils, sweets May be needed use sparingly Meat, yogurt & cheese 3 serving Meats, poultry, fish, eggs & nuts 2 or more Vegetables 3 or more Fruits 2 or more Bread, rice, pasta 6 or more serving Water 8 or more serving Nutrition for Older Adults Important Micronutrients Iron Magnesium Zinc Vit B6 Folate Older Adult Vit B12 Vit D Calcium Vegetarian  Nutrition for Vegetarian Types of Vegetarian ◼ Vegan – eats only foods of plant origin (fruits, vegetables, legumes, grains, seeds & nuts) ◼ Lacto-vegetarian – include dairy products ◼ Ovo-lacto-vegetarian – includes egg & dairy products ◼ Semi-vegetarian – consume white meat (fish & chicken) but do not eat red meat  Nutrition for Vegetarian Protein quantity & quality IIe Lys Met Trp ◼ Plant protein alone can provide enough of the Legumes essential & non-essential AA as long as sources of dietary protein are fairly varied & Grains energy intake is adequate to at least meet expenditure. IIe – Isoleusine; Lys – Lysine; Met – Methionine; Trp - Tryptophan  Nutrition for Vegetarian Vitamins & Minerals ◼ Vegetarian tend to eat more vit C & B complex. ◼ However, vit A & B12 are lacking in plant food. ◼ Vegans can obtain vit B12 – fortified breakfast cereals, fortified soy beverages, nutritional (brewer’s) yeast & vit supplements. ◼ Iron – fortified & whole grain cereals, dried beans, dark green vegetables, brewer’s yeast, dried fruits