DNT 200 NUTRITION FOR HEALTH SCIENCES

1. DNT 200NUTRITION FOR HEALTH SCIENCES NUTRITION THROUGH THE LIFE CYCLE PART 2

2. NUTRITION THROUGH THE LIFE CYCLE The four stages of man are infancy, childhood, adolescence, and obsolescence Bruce Barton (1886 - 1967) American writer, congressman

3. NUTRITION THROUGH THE LIFE CYCLE

4. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood • Growth and nutrient needs • Appetite fluctuates greatly • Will adjust their energy intakes at successive meals • Can be highly variable from meal to meal but is consistent on a day to day basis • Overweight children may not adjust their intakes appropriately -- may eat in response to external clues • Child will need and demand much more food during periods of rapid growth • Steady growth during childhood is reflected in gradually increasing needs for all nutrients

5. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Before adolescence, children accumulate stores of nutrients • During adolescent growth spurt, their nutrient stores cannot keep pace with demands for rapid growth • Draw upon stores accumulated earlier -- especially calcium • To provide all needed nutrients, a variety of foods from each food group is recommended • Parents are challenged to foster development of healthy eating habits in child

6. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Every meal is important in a child’s life • Concentrated sweets must be limited in the child’s diet if needed nutrients are to be supplied -- if permitted, tooth decay and/or obesity may result • In US children and adolescents, iron deficiency anemia is the most prevalent nutritional deficiency • Is decreasing because of • Increased breast feeding and increased use of iron fortified formula • WIC -- provides iron-rich foods during infancy

7. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Encourage iron-rich foods • Drink milk only to ensure adequate calcium and riboflavin intakes • After age 2, change to low fat milks and use Calories for other foods • Lean meats • Fish • Poultry • Eggs • Legumes

8. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Nutrient deficiencies and behavior • Iron deficiency • Usually diagnosed only after deficiency has progressed to anemia • Child’s brain is highly sensitive to lowered iron concentrations, long before blood effects appear • Shortening of attention span • Reduction in overall intellectual performance • Irritability • Aggressiveness • Disagreeability • Withdrawal

9. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children & teenagers • Early and middle childhood (con’t) • Lead poisoning • Can cause iron deficiency anemia -- and iron deficiency anemia impairs the body’s defenses against lead absorption • Anemia brought on by lead poisoning may be mistaken for simple iron deficiency • Mild lead toxicity has non-specific effects -- diarrhea, irritability, fatigue, reduced ability of blood to carry oxygen • With higher levels, signs become more pronounced -- yet still difficult to pinpoint to a cause • Learning disabilities develop • Behavior problems manifest

10. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Lead poisoning • Even greater levels can cause • Irreversible nerve damage • Paralysis • Mental retardation • Death • Prevention • Prevent hand-to-mouth ingestion in contaminated environments -- keep small children from putting dirty or old painted objects in their mouths • Make sure children consume nutritious foods consistently

11. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children & teenagers • Early and middle childhood (con’t) • Hunger and behavior • Children who eat a nutritious breakfast function better than their peers who do not • By late morning, discomfort from hunger may become distracting even if a child has eaten breakfast • Average child up to the age of 10 or so needs to eat every four to six hours to maintain sufficient blood glucose to support the activity of the brain and nervous system -- child’s liver can only store about 4 hours worth of glycogen

12. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children & teenagers • Early and middle childhood (con’t) • Food allergies • Incidence • Highest in first several years of life • Declines with age • About 5% of young children are diagnosed with food allergies • Often are inherited

13. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Food allergies • Occurs when a whole food protein or other large molecule enters the system without being further digested • Body’s immune system reacts as it does to an antigen -- produces antibodies, histamines, or other defensive agents • Allergies are diagnosed from examining antibody production, not from evaluation of symptoms only

14. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Food allergies • Identifying foods that cause an immediate reaction is easy • Symptoms correlate closely with the timing of eating the food • Allergic reactions to foods usually begin within minutes to a few hours after eating them • Foods that cause delayed reactions are more difficult

15. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Food allergies • Most cases are relatively mild -- most common symptoms • Swelling or itching of lips, mouth, and or throat followed by • Nausea, vomiting, diarrhea • Itching, hives, eczema and skin redness • Some people experience sneezing, runny nose, shortness of breath or other breathing difficulties

16. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Food allergies • Anaphylaxis is a rare but potentially fatal condition in which several parts of the body experience a food allergy reaction at the same time • Symptoms may progress rapidly • Severe itching • Hives • Sweating • Swelling of the throat • Breathing difficulties • Lowered blood pressure • Unconsciousness • Death

17. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t)

18. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Food allergies • Once an allergy has been diagnosed, the only proven therapy is to avoid the offending food -- the prescription for a severe reaction is an injection of epinephrine (adrenaline) • Children with allergies need all their nutrients, just as other children do

19. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Food allergies • Foods most often associated with allergies • Nuts* • Eggs • Milk • Soybeans • Wheat • Peanuts* • Chicken • Fish* • Shellfish* • Mollusks (oysters, clams, snails, squid, octopi, etc.) *Are often outgrown

20. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Hyperactivity and diet -- no behavior problems originate with diet other than the general misery caused by malnutrition

21. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Caffeine and other stimulants • Excess caffeine consumption can cause • Sleeplessness • Restlessness • Irregular heartbeats • Caffeine found in • Cola beverages -- the effect of two 12 ounce beverages in a child is equivalent to eight cups of coffee in an adult • Chocolate bars • Medication -- caffeine found in some • Cold remedies • Diuretics • Pain relievers • Pharmacologically active dose is 200mg

22. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Childhood obesity • Increased dramatically over last three decades • Diet and physical activity responsible • Influenced by television (and video games) • Requires no energy beyond basal metabolism • Replaces vigorous activities • Encourages snacking • Promotes sedentary lifestyle

23. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Childhood obesity • Problems • Potential for becoming obese adults • Social, economic & medical ramifications • Growth • Typically grow taller than peers but stop growing at shorter height • Develop greater bone and muscle mass -- both fat and lean weight (appear stocky even when they loose excess fat) • Have a faster metabolic rate

24. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Childhood obesity • Problems • Physical health • Display a blood lipid profile indicative that atherosclerosis is beginning to develop • Tend to have high blood pressure • Increased risk for developing diabetes • Increased risk for developing respiratory diseases (e.g. asthma)

25. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Childhood obesity • Problems • Psychological development • Are often victims of prejudice • Poor self-image • Sense of failure • Passive approach to life

26. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Childhood obesity • Prevention and treatment • Should be prevented or treatment begun early • Integrated approach is recommended • Diet -- initial goal is to reduce the rate of weight gain • Physical activity • Psychological support -- parental involvement encouraged • Behavioral changes -- focus on how to eat

27. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t)

28. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Mealtimes with children • Are a parent’s chance to influence food choices • Aims • Avoid obesity • Encourage physical activity on a daily basis • Vegetables • Children frequently dislike and refuse them • Do like raw vegetables over cooked ones-- offer them slightly undercooked, colorful, warm (not hot) and mild • If they prepare (measure, stir, decorate, cut, or arrange) them, they may be motivated to tray and taste them

29. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Mealtimes with children • Snacks • Should provide foods as nutritious as meal times (can be even mealtime foods served individually over time) • Should be easy to prepare and readily available to children • Sick days • On a short term basis, no reason to worry about loss of appetite -- as children recover, so will their appetite • Encourage plenty of fluids

30. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Nutrition at school • National school lunch program • Include specified numbers of servings of milk, protein-rich food (meat, poultry, fish, cheese, eggs, legumes or peanut butter), vegetables, fruits, and grains • Should provide 1/3 of DRI for each nutrient • National school breakfast program • Available to about 40% of schools • Must contain • One serving of fluid milk • One serving of fruit or vegetable or full strength juice • Two servings of bread or bread alternate or two servings of meat alternate, or one of each

31. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • Early and middle childhood (con’t) • Television and vending machines • Many authorities concerned that televisioncommercials have a negative impact • Vending machines now available at schools • Children will choose nutritious snacks when offered side by side with sugary foods • When milk is available, soft drink use drops

32. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • The teen years • Growth and nutrient needs • Growth rate speeds up abruptly and dramatically with the onset of adolescence • Lasts about 2 years • Energy needs vary to a great extent, depending on • Intensity of the growth spurt • Body size • Physical activity • Boys have a greater energy need than girls • Experience a more intense growth spurt • Develop more lean body mass

33. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • The teen years (con’t) • Calcium • Calcium intakes decline as milk consumption decreases • Low calcium intakes of adolescents are caused, in part, by their choices to replace milk with soft drinks • Food choices and eating habits of teenagers • With increasing after-school, social, and job activities, irregular eating habits result • Adults become “gatekeeper” providing access to only nutritious, economical foods

34. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • The teen years (con’t) • Drugs, Alcohol, Tobacco, and Nutrition • Marijuana • Alters sense of taste • Enhances enjoyment of eating, especially of sweets • Prolonged use does not seem augment energy intake long enough to bring on weight gain • Cocaine • Users experience loss of appetite • Weight loss is a common side effect • Craving for drug replaces hunger • Rats, given unlimited access of cocaine, will choose drug over food until they die of starvation

35. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • The teen years (con’t) • Effects of addictive drugs • Money spent on drugs cannot be spent on food • During “high” times, interest in food is lost • Some drugs induce depression of appetite • Drug abusers’ lifestyles often lack regularity and routine that promote good eating habits • Hepatitis, common in drug abusers, causes taste changes and loss of appetite • AIDS is a risk • Treatments and medications may alter nutrition status • Illegal drug users often become ill with infectious diseases which increases needs for nutrients

36. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • The teen years (con’t) • Alcohol • Is an empty calorie beverage • Can displace needed nutrients from the diet • Can alter metabolism and absorption of nutrients received

37. NUTRITION THROUGH THE LIFE CYCLE Nutrition for children and teenagers • The teen years (con’t) • Cigarette smoking • Risk of lung cancer is greater for smokers who have lowest intakes of carotene (Vitamin A) • Smoking eases the feelings of hunger -- postpones energy and nutrient intake • Smokers tend to weigh less • Smokers tend to gain weight upon cessation • Smokers tend to have lower intakes of dietary fiber, Vitamin A, folate, and Vitamin C • Vitamin C requirements of smokers may be twice as high as non-smokers

38. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults

39. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Aging and Nutrition Percent U.S. Population Growth 1960 - 1990

40. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Life expectancy has doubled in the past century • Aging seems to be inevitable • Programmed into the genes at conception • Changing lifestyle habits (regular physical activity) can slow the process within the natural limits set by heredity

41. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Good nutrition can retard and ease the aging process • Appropriate energy intake helps prevent • Diabetes • Obesity • Related cardiovascular disease • Adequate intakes of essential nutrients prevents diseases such as scurvy, goiter, anemia, and the like

42. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Variety in food intake as well as ample intakes of certain vegetables may be protective against certain types of cancers • A high fat diet is thought to promote cancer • Fiber and certain plant foods may help protect against cancer • Less frequent use of vegetables is found in people with colon cancer, specifically cabbage, broccoli, and Brussels Sprouts • Stomach cancer correlates with low vegetable intake • Lung cancer incidents can be as much as 60-80 percent lower in people with high Vitamin A intakes than those with low intakes

43. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Appropriate fiber intakes help prevent malfunctions of the digestive tract such as constipation, diverticulosis, and possibly colon cancer • Moderate sodium and adequate intakes of potassium, calcium and other minerals help prevent hypertension, at least to people who are genetically predisposed to it • Adequate calcium intakes throughout life helps protect people against osteoporosis

44. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Oral health issues • Moderation in sugar helps prevent dental caries • 50% of those over 65 have some form of dental or periodontal disease • Medicare/Medicaid will not pay for dentures when treatment is pulling all the teeth • Dental or gum issues should be identified (are under-assessed)

45. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Oral health issues (con’t) • Poor oral hygiene can result in • Avoidable weight loss • Increase in fasting blood sugar • Pneumonia • Endocarditis • Post CVA -- assess denture fit due to changes in facial muscle tone

46. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Oral health issues (con’t) • Things to watch out for • Broken or loose teeth • Infected gums • Showing bright inflammation • Changes in color of tongue • Long-term build-up of plaque • Mouth pain • Sensitivity to foods (hot/cold) • Mouth sores/ulcers • Food pocketing in cheeks and under tongue • Check for denture fit -- poor fit contributes to not eating or chewing well • Be alert to client who suddenly no longer performs self oral care -- could be the first signs of depression

47. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Nutrition related concerns • Cataracts • Antioxidant nutrients (Vitamins C & E, Selenium) may help reduce oxidative stress (which plays a role in cataract development) • Overweight appears associated but its role is not identified • Osteoarthritis -- overweight can increase pain when weight-bearing joints are stressed and irritated by having to carry excess poundage • Rheumatoid arthritis -- possible link to diet through the immune system, the integrity of which depends on adequate nutrition

48. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Nutrient needs and nutrition status of older adults • Water • Dehydration is a risk • Elderly may not notice thirst • Elderly may not pay attention to thirst • Even mild stresses such as fever or hot climate may precipitate rapid dehydration in older adults • 6-8 glasses of water per day is recommended • Energy • Energy needs decline with advancing age • Lean body mass diminishes, lowering BMR • Physical activity is typically reduced • When energy intake decreases, people need to be sure the foods they eat are nutrient-dense

49. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Nutrient needs and nutrition status of older adults (con’t) • Protein -- needs area about the same as those of younger people • Carbohydrate • Abundant protein needed to spare protein • Complex carbohydrates supply fiber and essential vitamins and minerals • High fiber foods alleviate constipation • NOTE: High fiber foods can be low in protein and energy -- elderly people may need protein and energy • Fat -- limit • Cut kcalories • Retard development of cancer, atherosclerosis and other degenerative diseases

50. NUTRITION THROUGH THE LIFE CYCLE Nutrition For Older Adults • Nutrient needs and nutrition status of older adults (con’t) • Vitamins • Vitamin A • Is absorbed and stored more efficiently in the aging GI tract and liver, although processing within the body slows slightly • Current DRI makes no recommendation for lowered intakes