NUTRITION IN SPECIAL GROUPS. ATHLETES PREGNANT WOMEN INFANTS ELDERLY ALCOHOLICS

1. NUTRITIONIN SPECIALGROUPS.ATHLETESPREGNANT WOMENINFANTSELDERLYALCOHOLICS BY DR. NEBOH C.E.O

2. Nutrition is an important factor which must be considered in special groups of individuals with specific needs. These special groups of people require specific nutrients to be able to survive and function adequately. • These groups include: • Athletes • Pregnant women • Infants • Aged • Alcoholics. Dr. Neboh E.E. Nutrition in Special Groups

3. Dr. Neboh E.E. Nutrition in Special Groups

4. NUTRITION IN ATHLETES Dr. Neboh E.E. Nutrition in Special Groups

5. NUTRITION FOR ATHLETES A well-chosen diet offers many benefits to all athletes, irrespective of event, sex, age or level of competition • Optimal gains from the training programme • Enhanced recovery within and between workouts and events • Achievement and maintenance of an ideal body weight and physique • A reduced risk of injury and illness Dr. Neboh E.E. Nutrition in Special Groups

6. Confidence in being well-prepared for competition • Consistency in achieving high-level performances • Enjoyment of food and social eating occasions Dr. Neboh E.E. Nutrition in Special Groups

7. Despite these advantages, many athletes do not meet their nutrition goals. Common problems and challenges include • Poor knowledge of foods and drinks and inadequate cooking skills • Poor choices when shopping or dining out • Poor or outdated knowledge of sports nutrition • Inadequate finances • Busy lifestyle leading to inadequate time to obtain or consume appropriate foods • Poor availability of good food and drink choices • Frequent travel • Indiscriminate use of supplements and sports foods Dr. Neboh E.E. Nutrition in Special Groups

8. Carbohydrates for training • Carbohydrate provides an important, but relatively short-lived, supply of fuel for exercise that must be refilled each day from carbohydrate foods in the diet. Everyday eating and drinking plans for athletes need to provide enough carbohydrate to fuel their training programmes and to optimize the recovery of muscle glycogen stores between workouts. • General targets can be provided for carbohydrate needs, based on each individual’s size and the demands of their training programme Dr. Neboh E.E. Nutrition in Special Groups

9. Target for Carbohydrate intake. • Immediate recovery (within 0-4 hours) after fuel-depleting exercise: about 1 g per kg of body weight per hour, consumed at frequent intervals • Daily recovery from a moderate duration/low intensity training session: 5-7 g per kg BW per day • Recovery from moderate-heavy endurance training or fuelling up for a distance event: • 7-10 g per kg BW per day. Dr. Neboh E.E. Nutrition in Special Groups

10. Example of nutrient-rich Carbohydrate foods and meal combinations. • Breakfast cereal with milk • Fruit with flavoured yoghurt • Fruit smoothie or liquid meal supplement • Sandwich with meat and salad filling • Stir-fry with rice or noodles. Dr. Neboh E.E. Nutrition in Special Groups

11. Protein needs for training • Protein has been considered a key nutrient for sporting success by athletes of all eras and in all sports. Whereas ancient Olympians were reported to eat unusually large amounts of meat, today’s athletes are provided with a vast array of protein and amino acid supplements to increase their protein intakes. Protein plays an important role in the response to exercise. Dr. Neboh E.E. Nutrition in Special Groups

12. Amino acids from proteins form building blocks for the manufacture of new tissue including muscle, and the repair of old tissue. • They are also the building blocks for hormones and enzymes that regulate metabolism and other body functions. Protein provides a small source of fuel for the exercising muscle. Dr. Neboh E.E. Nutrition in Special Groups

13. Hydration (WATER). • A good hydration strategy is an essential part of every athlete’s preparation for competition. Limit dehydration during training and competition by drinking water or a sports drink. • Since the negative effects of dehydration on high intensity performance are greater in warm environments, upgrade drinking practices in these conditions to minimize the overall fluid deficit. Dr. Neboh E.E. Nutrition in Special Groups

14. This may mean drinking before and during longer athletic events such as distance running and walking, but may also include drinking between attempts in jumps and throws and between rounds where there is more than one event in a day. • Don't drink at rates that are greater than sweat losses so that you actually gain weight during the competition period. Sodium should probably be included in fluids • consumed during events lasting longer than 1-2 hours or by individuals during any event that stimulates heavy sodium loss (i.e., more than 3-4 grams of sodium). Dr. Neboh E.E. Nutrition in Special Groups

15. Vitamins, minerals and anti-oxidants for training and staying healthy • Strenuous bouts of prolonged exercise and heavy training, particularly aerobic exercise, all stress the body. Adequate intakes of energy, protein, iron, copper, manganese, magnesium, selenium, sodium, zinc, and vitamins A, C, E, B6 and B12 are particularly important to health and performance. • These nutrients, as well as others, are best when obtained from a varied diet based largely on nutrient-rich foods such as vegetables, fruits, beans, legumes, Dr. Neboh E.E. Nutrition in Special Groups

16. IRON-RICH EATING Consume moderate servings of red meats (well-absorbed iron) in 3-5 meals per week. Choose iron-fortified cereal products such as breakfast cereals. Combine plant and non-meat sources of iron (e.g. legumes, cereals, eggs, green leafy vegetables) with food factors that enhance iron absorption. These include vitamin C. Dr. Neboh E.E. Nutrition in Special Groups

17. IRON. Iron deficiency is the most common nutrient deficiency in the world. It may occur in athletes and can impair training and competitive performance. Iron deficiency is a cause of fatigue and reduced performance. Females are particularly at risk because of increased iron requirements due to menstrual blood losses matched against a smaller intake of food. Iron-rich eating will help to reduce this risk. • CALCIUM. Calcium is important for healthy bones. The best sources are dairy foods, including low fat varieties. Fortified soy foods may provide a useful substitute where athletes cannot consume dairy foods. • CREATINE. Creatine supplements can increase the amount of high-energy creatine phosphate stored in the muscles, and may improve performance in single or multiple sprints. It may also lead to a gain in muscle mass, which may be helpful for some athletes but harmful for others. Dr. Neboh E.E. Nutrition in Special Groups

18. CAFFEINE. A small amount of caffeine (1-3 mg/kg) can help performance in prolonged exercise and may also be helpful in exercise of shorter duration. Such moderate doses can be found in everyday amounts of coffee, cola drinks and some sports products (e.g. gels). • BUFFERING AGENTS. In very hard exercise, the muscles produce lactic acid. This is both good (giving energy to allow hard efforts) and bad (causing pain and interfering with muscle function). In the same way that excess stomach acidity can be neutralized by taking bicarbonate, so buffering agents (Bicarbonate supplements) taken before an event can counter the negative effects of lactic acid. Dr. Neboh E.E. Nutrition in Special Groups

19. NUTRITION IN PREGNANCY Dr. Neboh E.E. Nutrition in Special Groups

20. Nutritional Needs During Pregnancy • Your body goes through a great deal of hormonal, physiological, and physical changes during pregnancy. • The way you nourish your body during this process will affect your own health, as well as the health of your baby. Dr. Neboh E.E. Nutrition in Special Groups

21. During pregnancy your body has increased nutritional needs. Although the old adage "eating for two" isn't entirely correct, you do require more macronutrients (for example, calories, protein, and fluids) and micronutrients (for example, calcium, folate, and iron). Dr. Neboh E.E. Nutrition in Special Groups

22. In general, most women can meet these increased nutritional needs by choosing a diet that includes a variety of nutritious foods, including 8 to 10 glasses of water a day, and by taking a prenatal vitamin prescribed by their health care provider. • A simple way to ensure that you are getting all the nutrients that you and your baby need is by eating a variety of foods from each of the food groups every day. Dr. Neboh E.E. Nutrition in Special Groups

23. Each food group has something to offer your body. • Grains like cereal and pasta, for example, are good sources of energy. • Fruits and vegetables are packed with water-soluble and fat-soluble vitamins, as well as antioxidants and fiber. • The food group that includes meats, poultry, fish, eggs, tofu, and beans offers your body protein, B vitamins, folate, and iron. • Dairy products are the best source of calcium and vitamin D. Dr. Neboh E.E. Nutrition in Special Groups

24. Dr. Neboh E.E. Nutrition in Special Groups

25. NUTRITION IN INFANTS Dr. Neboh E.E. Nutrition in Special Groups

26. Infant Nutrition • Babies can be exclusively breast-fed for their first six months of life. • Breast milk is the optimal nutrient mix for infants. It’s full of good stuff like antibodies, antimicrobial factors, enzymes, and anti-inflammatory factors along with fatty acids (which promote optimal brain development). Dr. Neboh E.E. Nutrition in Special Groups

27. Breast is best for both mom and baby. • Breastfeeding keeps the baby developing and growing properly, helps infants fight off disease (such as gastrointestinal and respiratory infections) both now and in the future, and may even ensure that the baby grows up to prefer healthy food. • Because breastfeeding stimulates the release of beneficial hormones such as oxytocin and prolactin, it can help the mother lose weight and bond with her baby. • Breast milk is delivered in a biodegradable “organic package”, so mom doesn’t need to use as much plastic packaging (since humans easily absorb plastic-contained endocrine disruptors). • What you as a pregnant or nursing mother eat, your baby eats. Dr. Neboh E.E. Nutrition in Special Groups

28. Limit your alcohol, caffeine, etc. • Limit your toxin exposure. Eat organic when possible; scrub your fresh veggies/fruits; and avoid most seafood. Of course, breast milk will be especially healthy if mom eats nutritiously while she’s pregnant and breastfeeding. Dr. Neboh E.E. Nutrition in Special Groups

29. Fluids & hydration • The amount of fluid in breast milk or formula will usually be enough, so normally you shouldn’t need to supplement with water. • However, infants easily and quickly become dehydrated under certain conditions, such as if the infant has a fever or is vomiting a lot; or if  the climate is very hot. • Rehydration is also crucial if infants have diarrhea. (In this case, add a little sugar and salt to the water to make a simple electrolyte solution.) • Use urine colour as a guide: Dark yellow urine will signify dehydration. Clear urine signifies potential over-hydration. You want to see something somewhere in the middle. (Baby will undoubtedly oblige with a urine sample, probably at the most socially inconvenient time.) Dr. Neboh E.E. Nutrition in Special Groups

30. Food Allergy Reactions • A food allergy happens when the body reacts against harmless proteins found in foods. The reaction usually happens shortly after a food is eaten. Food allergy reactions can vary from mild to severe. Because there are many things that can be confused with food allergies, it is important for parents to know the difference. Dr. Neboh E.E. Nutrition in Special Groups

31. Symptoms of food allergy include: • Skin problems • Hives (red spots that look like mosquito bites) • Itchy skin rashes (eczema, also called atopic dermatitis) • Swelling • Breathing problems • Sneezing • Wheezing • Throat tightness • Stomach symptoms • Nausea • Vomiting • Diarrhea • Circulation symptoms • Pale skin • Light-headedness • Loss of consciousness Dr. Neboh E.E. Nutrition in Special Groups

32. Foods That Can Cause Food Allergies • Any food could cause a food allergy, but most food allergies are caused by the following: • Cow milk • Eggs • Peanuts • Soy • Wheat • Nuts from trees (such as walnuts, pistachios, pecans, cashews) • Fish (such as tuna, salmon, cod) • Shellfish (such as shrimp, lobster) • Peanuts, nuts, and seafood are the most common causes of severe reactions. Allergies also occur to other foods such as meats, fruits, vegetables, grains, and seeds such as sesame. Dr. Neboh E.E. Nutrition in Special Groups

33. Reactions That Are Not Allergy Food can cause many illnesses that are sometimes confused with food allergies. The following are not food allergies: • Food poisoning—Can cause diarrhea or vomiting, but is usually caused by bacteria in spoiled food or undercooked food. • Drug effects—Certain ingredients, such as caffeine in soda or candy, can make your child shaky or restless. • Skin irritation—Can often be caused by acids found in such foods as orange juice or tomato products. • Diarrhea—Can occur in small children from too much sugar, such as from fruit juices. Some food-related illnesses are called intolerance, or a food sensitivity, rather than an allergy because the immune system is not causing the problem. Lactose intolerance is an example of a food intolerance that is often confused with a food allergy. Lactose intolerance is when a person has trouble digesting milk sugar, called lactose, leading to stomachaches, bloating, and loose stools. Dr. Neboh E.E. Nutrition in Special Groups

34. Baby Bottles and Bisphenol A (BPA) • Many food and liquid containers, including baby bottles, are made of polycarbonate, or have a lining that contains the chemical bisphenol A (BPA). • BPA is used to harden plastics, keep bacteria from contaminating foods, and prevent cans from rusting. • There are concerns, though, over the possible harmful effects BPA may have on humans, particularly on infants and children. • Animal studies have shown effects on the endocrine functions in animals related to BPA exposure. Dr. Neboh E.E. Nutrition in Special Groups

35. Precautionary Measures to Reduce Babies’ Exposure to BPA • Avoid clear plastic baby bottles or containers with the recycling number 7 and the letters “PC” imprinted on them. Many contain BPA. • Consider using certified or identified BPA-free plastic bottles. • Use bottles made of opaque plastic. These bottles (made of polyethylene or polypropylene) do not contain BPA. You can also look for the recycle symbols with the number 2 or 5 in them. • Glass bottles can be an alternative, but be aware of the risk of injury to you or your baby if the bottle is dropped or broken. • Because heat may cause the release of BPA from plastic, consider the following: • Do not boil polycarbonate bottles • Do not heat polycarbonate bottles in the microwave • Do not wash polycarbonate bottles in the dishwasher Dr. Neboh E.E. Nutrition in Special Groups

36. NUTRITION IN THE ELDERLY Dr. Neboh E.E. Nutrition in Special Groups

37. Nutrition and Aging • For adults over 50, the benefits of healthy eating include increased mental acuteness, resistance to illness and disease, higher energy levels, faster recuperation times, and better management of chronic health problems. Dr. Neboh E.E. Nutrition in Special Groups

38. As we age, eating well can also be the key to a positive outlook and staying emotionally balanced. But healthy eating doesn’t have to be about dieting and sacrifice. Whatever your age, eating well should be all about fresh, colorful food, creativity in the kitchen, and eating with friends. • Adults over 50 can feel better immediately and stay healthy for the future by choosing healthy foods. A balanced diet and physical activity contribute to a higher quality of life and enhanced independence as you age. Dr. Neboh E.E. Nutrition in Special Groups

39. Food your body needs as you age • Fruit – Focus on whole fruits rather than juices for more fiber and vitamins and aim for 1½ to 2 servings or more each day. Break the apple and banana rut and go for color-rich pickings like berries or melons. • Veggies – Color is your credo in this category. Choose antioxidant-rich dark, leafy greens, such as kale, spinach, and broccoli as well as orange and yellow vegetables, such as carrots, squash, and yams. Try for 2 to 2½ cups of veggies every day. • Calcium – Maintaining bone health as you age depends on adequate calcium intake to prevent osteoporosis and bone fractures. Older adults need 1,200 mg of calcium a day through servings of milk, yogurt, or cheese. Non-dairy sources include tofu, broccoli, almonds, and kale. • Grains – Be smart with your carbs (carbohydrates) and choose whole grains over processed white flour for more nutrients and more fiber. If you’re not sure, look for pasta, breads, and cereals that list “whole” in the ingredient list. Older adults need 6-7 ounces of grains each day (one ounce is about 1 slice of whole grain bread). Dr. Neboh E.E. Nutrition in Special Groups

40. Protein – Adults over 50 without kidney disease or diabetes need about 1 to 1.5 grams per kilogram (2.2lbs) of bodyweight. This translates to 68 to 102g of high-quality protein per day for a person weighing 150 lbs. (0.5 g of protein per lb. of body weight is close enough). Try to divide your protein intake equally among meals. It’s important to vary your sources of protein instead of relying on red meat, including more fish, beans, peas, eggs, nuts, seeds, and low-fat milk and cheese in your diet. • Water – As we age, some of us are prone to dehydration because our bodies lose some of the ability to regulate fluid levels and our sense of thirst may not be as sharp. Post a note in your kitchen reminding you to sip water every hour and with meals to avoid urinary tract infections, constipation, and even confusion. • Vitamin B – After 50, your stomach produces less gastric acid making it difficult to absorb vitamin B-12—needed to help keep blood and nerves vital. Get the recommended daily intake (2.4 mcg) of B-12 from fortified foods or a vitamin supplement. • Vitamin D – We get most of our vitamin D intake—essential to absorbing calcium and boosting muscles—through sun exposure and certain foods (fatty fish, egg yolk, and fortified milk). With age, our skin is less efficient at synthesizing vitamin D, so consult your doctor about supplementing your diet with fortified foods or a multivitamin, especially if you’re obese or have limited sun exposure. Dr. Neboh E.E. Nutrition in Special Groups

41. Use Less Salt • Everyone requires a certain amount of salt, but too much can increase the risk of high blood pressure and heart disease. • Salt occurs naturally in many foods such as meat, eggs, milk and vegetables, but much of the salt in the Australian diet comes from the salt added to foods by manufacturers or when adding salt yourself. • Older adults should restrict their intake of high salt foods such as cured meats (including ham, corned beef, bacon and luncheon meats), snack foods (such as potato chips and savoury pastries) and sauces (such as soy sauce). Choose reduced salt varieties of foods when shopping, and flavour foods with herbs and spices instead of adding salt. Dr. Neboh E.E. Nutrition in Special Groups

42. Drink more water Water supports and provides many vital functions in body, including hydration, digestion and blood volume, however as you age you may not feel thirsty as often, even when your body needs fluid. Aim to drink at least six times a day, and more in warmer weather or if you’re exercising. Tea, coffee, mineral water, soda water and reduced fat milk can all count towards your fluid intake during the day, but water is always best! • Limit your intake of high fat foods Pies, pastries, fried and battered foods, and discretionary items such as chips and chocolate are all high in fat and should only be eaten very occasionally. Try fresh fruits with reduced fat yoghurt for sweetness and flavour, and choose wholegrain and/or oat-based options for crumbles or cakes. • Be careful with alcohol Alcohol does not provide any essential nutrients but it is full of kilojoules. which can add up. Dr. Neboh E.E. Nutrition in Special Groups

43. NUTRITION IN ALCOHOLICS Dr. Neboh E.E. Nutrition in Special Groups

44. Nutrition in Alcoholics Dr. Neboh E.E. Nutrition in Special Groups

45. Alcohol is a part of many social occasions, from family dinners to parties, to sporting events and nightcaps. • The problems associated with alcoholism are well known, but what about the impact of social drinking or a moderate intake of alcohol? • Does alcohol belong in our diet, or does the risk that it presents outweigh any benefits that may be derived from consuming it? Dr. Neboh E.E. Nutrition in Special Groups

46. Alcohol Metabolism • The body does not require alcohol. Instead, it is treated like a toxin that needs to be removed before it can cause damage to cells. • When an individual drinks alcohol, the body gives priority to metabolizing alcohol. • This means that other digestive processes are stopped while the alcohol is dealt with. • Most of the detoxification of alcohol occurs in the liver. This organ works hard to make alcohol safe. Dr. Neboh E.E. Nutrition in Special Groups

47. Good nutrition can help to improve your health and prevent diseases. • The essential nutrients that your body needs are carbohydrates, protein, fat, vitamins, minerals, and water. • The term "essential" means that if you remove one of these nutrients from your diet there will be a deficiency that causes health problems. • Alcohol would not fall under the category of essential nutrients because there is no problem or disease state that occurs if you do not consume it. • However, some argue that there are added health benefits from consuming alcohol and argue it should be added to our diets. Dr. Neboh E.E. Nutrition in Special Groups

48. Effects of Alcohol on the Body • Cirrhosis Alcohol causes inflammation of the liver, and chronic drinking can cause scarring of liver tissue that leads to cirrhosis, a potentially fatal condition where the liver is so scarred it can no longer function. The risk increases the longer you have been drinking. Dr. Neboh E.E. Nutrition in Special Groups

49. Dementia • Heavy drinking can affects areas of the brain and can lead to memory loss and some symptoms of dementia. This abuse of alcohol can cause alcohol dementia, which results in poor judgment and difficulty in decision-making. Dr. Neboh E.E. Nutrition in Special Groups

50. Depression • Alcohol abuse and depression are often associated. In some cases, people are depressed and turn to alcohol to self-medicate. However, a 2013 study showed that many people who drink heavily develop depression Dr. Neboh E.E. Nutrition in Special Groups