NLC2 LE7 FINAL.pdf

NUTRITIONAL REQUIREMENTS ABEER M. ALJAADI MODIFIED BY DR.AWATIF ALMEHMADI Lecture 7 Nutritional Requirements Adulthood Chapter 16-17th : Nutrition Through the Life Cycle, 6e. Judith E. Brown Chapter 16 & 17 in Understanding Nutrition (15th Edition) Chapters 18,19, & 20 in Krause’s Food & The...

NUTRITIONAL REQUIREMENTS ABEER M. ALJAADI MODIFIED BY DR.AWATIF ALMEHMADI Lecture 7 Nutritional Requirements Adulthood Chapter 16-17th : Nutrition Through the Life Cycle, 6e. Judith E. Brown Chapter 16 & 17 in Understanding Nutrition (15th Edition) Chapters 18,19, & 20 in Krause’s Food & The Nutrition Care Process (14th Edition) FLUIDS/WATER - ADULTHOOD ¡ Fluid intake should be at least 1500 ml/d. ¡ The Food and Nutrition Board recommended 1 ml water per calorie of food ingested. ¡ Estimates using body weight vary by activity and age, with the average adult needing 30-40 ml/kg. ¡ Concerns in older adults – why? FLUID - ADULTHOOD ¡ To meet fluid needs while managing calories and contributing to nutrient needs, a plan for daily beverage selections could be: ¡ Choose water as the preferred beverage, 3–5 12-ounce containers. ¡ Limit unsweetened coffee or tea to 3–4 cups. ¡ Drink two 8-ounce glasses of low-fat milk. ¡ Drink a small (4-ounce) glass of 100 percent fruit juice, or choose fresh fruit. ¡ Avoid sugar-sweetened soda; if using diet soda, limit to one 12-ounce can. MICRONUTRIENTS VITAMINS - ADULTHOOD Folic Acid ¡ The evidence for folic acid in the prevention of neural tube defects is so strong that the Food Drug Administration mandated folic acid fortification of grains and grains products. ¡ May lower homocysteine levels; possible risk marker for atherothrombosis, Alzheimer’s disease, and Parkinson’s disease ¡ DRI: 400 mcg for adults aged ≥ 19 years VITAMINS - ADULTHOOD Vitamin E ¡ Also known as tocopherol. ¡ vitamin E plays a special role in the health of adults, especially older adults due to its antioxidant functions, such as hindering development of heart disease, prostate cancer and cataracts. ¡ DRI: 15 mg for adults aged ≥ 19 years ¡ Food source of vitamin E include sunflower seeds and oil, walnuts, olive oil, and avocado. BONE HEALTH - ADULTHOOD Calcium, vitamin D, and magnesium ¡ Calcium plus vitamin D and magnesium help to develop and maintain bone density, which delay osteoporosis and reduce risk of bone fractures. ¡ Adequate calcium is potential contributor to lowered risk of colon cancer. ¡ Milk as part of the Dietary Approaches to Stop hypertension diet (DASH) has been successfully used as part of blood pressure reduction intervention. ¡ Older adults: decreased absorption? ¡ Calcium DRI: ¡ 19- 50 y: 1000 mg/d ¡ > 50 y women & >70 y men: 1200 mg/d  BONE HEALTH - ADULTHOOD ¡ Adequate intake of vitamin D stimulates active transport of calcium in the small intestine and calcium reabsorption in kidney. ¡ Concerns for older adults: ¡ Age-related metabolic changes affect vitamin D status, independent of dietary intake, primarily due to decreased ability of the skin to synthesize previtamin D3 from its precursor, 7-dehydrocholesterol. ¡ Another reason that vitamin D is of concern for older adults is that commonly used medications interfere with vitamin D metabolism. Example include barbiturates, cholestyramine, phenytoin, and laxatives. ¡ DRI for vitamin D: ¡ 19- 70 y: 15 mcg/d; >70 y: 20 mcg/d BONE HEALTH - ADULTHOOD Magnesium ¡ Magnesium is needed for bone and tooth formation, nerve activity, glucose utilization, and synthesis of fat and proteins. ¡ Magnesium is needed for more than 300 enzyme systems. ¡ DRI: 400- 420 mg/d for adult males. ¡ DRI: 310 - 320 mg/d for adult females. MINERALS – ADULTHOOD Sodium ¡ Limit consumption of sodium to less than 2300 milligrams a day. Potassium ¡ Older adults: Hypokalemia from low K intakes esp. if using some diuretics ¡ Supplements might be needed for those on potassium-wasting diuretics – blood levels have to be carefully monitored IRON - ADULTHOOD ¡ Women DRI: ¡ 19-50 y: DRI =18 mg/d ¡ >50 y: 8 mg/d; Why the drop? ¡ For women, iron needs drop from 18 to 8 mg per day at menopause. ¡ Men DRI: 8 mg/d for ≥ 19 y. ZINC - ADULTHOOD ¡ In older adults, there is relationships among zinc deficiency and delay wound healing, decrease taste acuity and immune response. ¡ Zinc supplementation seems to be beneficial only when zinc status is depleted. ¡ DRI: 8 mg daily for female aged ≥ 19 y ¡ DRI: 11 mg daily for male aged ≥ 19 y VITAMIN B12 - ADULTHOOD ¡ Vitamin B12 blood levels decrease with age even in healthy adults. ¡ Despite adequate intake, an estimated 30% of older adults suffer from atrophic gastritis. ¡ In atrophic gastritis, a bacterial overgrowth in the stomach leads to inflammation, and decreased secretion of hydrochloric acid, pepsin, and intrinsic factor. ¡ Those 50 and older should eat foods fortified with the crystalline form of vitamin B12 such as in fortified cereals or supplements (2.4 mcg/d). TOTAL DIET APPROACH ¡ The total diet approach, adopted in the 2010 Dietary Guidelines for Americans, focuses on the overall pattern of your eating habits and nutrient intake over time, rather than obsessing over every single meal. Here's a breakdown with more details: Flexibility: It acknowledges that people's food choices naturally vary from day to day and across seasons. There's no expectation of perfection every single day. Variety is Key: The approach emphasizes selecting a variety of foods within each food group across different days. This ensures you get all the necessary nutrients your body needs in the long run. MyPlate as a Guide: The MyPlate resource from ChooseMyPlate.gov helps you determine your calorie needs and create personalized food plans. These plans specify how much of each food group (fruits, vegetables, grains, protein foods, and dairy) you should aim for to achieve nutrient adequacy based on your calorie level.  Focus on Nutrient Density: The total diet approach encourages choosing nutrient-dense options within each food group. This means prioritizing foods that pack a lot of nutrients for the number of calories they contain. For example, a grilled chicken breast is more nutrient-dense than a fried chicken patty. Portion Control Matters: MyPlate recommendations for portion sizes are generally smaller than what you might typically find in restaurants or pre-packaged meals. Following these portion sizes helps you manage your calorie intake and avoid overeating. Examples of Healthy Eating Styles: Research suggests several healthy eating styles that align with the total diet approach: DASH diet (rich in fruits, veggies, low-fat dairy, and low sodium) Mediterranean diet (emphasizes vegetables, fish, olive oil) Vegetarian diets (featuring fruits, veggies, and meat alternatives) USDA food plans offer both a typical American pattern with meat and a vegetarian option.  Caffeine and Coffee Intake Some argue that beverages like coffee, tea, or those containing caffeine shouldn't count towards fluid intake due to their perceived diuretic effects. Caffeine, at high doses, can temporarily increase urine production, but there's no solid evidence linking these beverages to dehydration. The Food and Nutrition Board stated that caffeine-containing beverages contribute to daily total water intake. Biological Effects of Caffeine: Stimulating Effects: Caffeine is renowned for its stimulating effects on the central nervous system. Anticarcinogenic: Some compounds in coffee have been linked to anticarcinogenic effects. Antimicrobial: Coffee may possess antimicrobial properties. Neuroprotective: Certain compounds in coffee might offer neuroprotective effects, potentially guarding against Parkinson's disease. Hypoglycemic: Coffee components may have hypoglycemic effects, beneficial for managing diabetes and preventing weight gain.  Safe Consumption Levels: Routine Consumption: Healthy adults typically consume naturally occurring caffeine in the range of 400–800 mg/day without harm. Positive Effects: This level of caffeine intake is associated with positive effects like those mentioned above. Concerns with Supplemented Products: However, the proliferation of caffeine-supplemented products raises concerns about safety at higher intake levels. Adverse Effects: Excessive caffeine intake can lead to increased heart rate, elevated blood pressure, headaches, and other adverse effects, which vary depending on individual sensitive  DIETARY SUPPLEMENTS AND FUNCTIONAL FOODS Types of Dietary Supplements: Dietary supplements encompass a wide range of products, including vitamins, minerals, amino acids, herbal and botanical supplements, enzymes, prebiotics, and probiotics. Indications for Vitamin and Mineral Supplements: There are circumstances where the use of vitamin and mineral supplements is warranted to ensure nutritional adequacy. Examples include pregnancy, certain illnesses, or when following low-calorie or nutrient-restricted diets. Prevalence of Supplement Use: National survey data suggest that a significant portion of the population takes vitamin and/or mineral supplements, with 44 percent of males and 53 percent of females doing so. Many individuals take these supplements on a daily basis. Age-Related Trends: The use of supplemental vitamins and minerals tends to increase gradually with age. For instance, during perimenopause, many women begin taking calcium or calcium with vitamin D supplements to mitigate bone loss risks.  Botanical and Herbal Supplements: Many adults use botanical and herbal supplements to address specific health concerns, either for treatment or prevention. However, research supporting the purported benefits of these supplements is often lacking. Examples of Herbal Supplements and Associated Research: Echinacea: Some evidence supports its use for upper respiratory infections. Ginger: Shown to be effective for nausea relief. St. John's Wort: Mixed results regarding its efficacy for depression, with concerns about interactions with other medications. Cinnamon: No conclusive evidence regarding its effects on diabetes or heart disease. Challenges in Research: Research on the health effects and safety of herbal and botanical supplements is challenging due to variations in growing conditions, extraction processes, manufacturing standards, and marketing claims. This variability makes it difficult to draw definitive conclusions about their efficacy and safety.  FUNCTIONAL FOODS Functional foods represent a category of products that blur the lines between conventional food, supplements, and therapeutic agents. These products offer physiological benefits beyond their basic nutritional value. Categories of Functional Foods: Functional foods cover various categories, as outlined in Table 16.7 Physiological Benefits: There is a growing body of evidence linking dietary choices and the biologically active components of food to various physiological effects. These effects include improvements in immune function, antioxidant and anti-inflammatory properties, and reductions in the risk of chronic diseases. Consumer Interest and Demand: Interest in managing health and enhancing performance has led to increased demand for functional foods. Examples include the use of ergogenic products to boost physical performance and the consumption of prebiotics and probiotics to support gut health. PHYSICAL ACTIVITY RECOMMENDATIONS National Recommendations for Physical Activity: National recommendations emphasize the importance of regular physical activity for overall health and well-being. These recommendations are designed to combat obesity and prevent various chronic diseases, including cardiovascular disease, diabetes, hypertension, osteoporosis, and colon and breast cancer. Primary and Secondary Prevention Strategies: Healthy eating and increased physical activity are considered primary and secondary prevention strategies for obesity and chronic diseases. They play vital roles in both individual health and population-level health promotion.  Benefits of Regular Physical Activity: Muscle Strength, Balance, and Endurance: Regular physical activity enhances muscle strength, improves balance, and boosts endurance. Cardiorespiratory Fitness: Engaging in physical activity improves cardiorespiratory fitness, promoting a healthy heart and lungs. Physical and Mental Health: Physical activity supports both physical and mental health, contributing to overall well-being. Cognitive Function: Regular exercise has been linked to improved cognitive function, including better memory and focus. Weight Management: Physical activity helps manage weight by burning calories and promoting fat loss. Reduced Disease Risk Factors: Regular physical activity reduces risk factors for various diseases, such as high blood cholesterol and blood pressure. Enhancing Quality of Life: Engaging in regular physical activity and achieving fitness levels enables adults to meet the physical demands of daily life, work, and leisure activities. It enhances overall quality of life by improving physical function and increasing vitality.  Amount of Physical Activity Needed: Research synthesis suggests that 2.5 hours of moderate to vigorous physical activity per week is sufficient to achieve positive health effects. Basic Recommendation: Achieving the recommended level of physical activity can be as simple as engaging in a brisk 30-minute walk five days a week. Alternatively, individuals can create personalized activity plans using resources like "Be Active Your Way." Challenges in Meeting Recommendations: Despite the known benefits of physical activity, many adults struggle to meet recommended guidelines. Recent surveys indicate that a significant portion of adults report no physical activity in the past month, while only about half meet the Physical Activity Guidelines. Certain segments of the adult population, such as younger adults, men, Non-Hispanic whites, and those with higher education levels, tend to engage in higher rates of physical activity compared to others.