Toddler to Teens- Older Adult

1. Toddler to Teens- Older Adult

2. Objectives- Toddlers to Teens • State 3 nutrition related principles for feeding 1-5 year olds • Identify fluid needs for hydration during illness • State 3 nutrition related principles for 5-10 year olds • Identify 4 components to a weight management program for kids • Identify calories and nutrients needed by teens • Identify 4 nutrition related issues for teens. • State reasons to increase meals for kids

3. Objectives- Older Adults • Identify 7 most significant nutrition concerns with aging • Identify strategies to prevent weight loss • Define sarcopenia • Identify strategies to increase protein • List vitamin D needs • Identify 4 side effects of dehydration • State 2 most significant “red flags” for malnutrition

4. Objectives- Older Adult • Identify side effects of malnutrition • State the importance of “liberalizing” the diet for older adults • Describe ways to improve dietary intake and eating environment for older adults • List 6 lifestyle factors related to longevity

5. 1-5 years • Rate of growth slows • Add 200 calories per year • 2 yo ~1000 calories, 3 yo ~ 1200 calories • Appetite dependent of activity level and growth spurts • “picky eating”, “food jags”

6. 1-5 years • Food Provides • Nutrients • Decision making, motor skill development • My Plate Balance • Model good eating patterns • Provide healthy choices • Smaller portions • 1 Tblsp. year portions • Establishment of eating behaviors, food preferences • Dental Caries • No bottles in bed

7. Stool Concerns • Stooling • Stool consistency and frequency varies • DISCOMFORT • Diarrhea-Dehydration • Viral infection, formula contamination, antibiotics • Replace fluids • Oral hydration formulas • 2 oz of fluid per pound of body weight

8. Best Time to Teach Nutrition • Pre-school and grade school years • Love to cook, help with food • 3 yo- wrap, pour, mix, shake, spread • 4 yo- roll, juice, mash, peel • 5 yo- measure, grind, grate, cut • Less peer influence

9. 5-10 Years • Continued slow growth • 10 y.o.- 1800 calories/day • Regular meals and snacks • 5-7 eating times/day • Breakfast, snacks, < sweetened beverages • Concerns • Dental caries, iron deficiency anemia • Obesity • High blood cholesterol (>170 mg/dl), hypertension, high blood sugars

10. Obesity • BMI • 85th-95th percentile- at risk • > 95th percentile- obese • Healthy Diet • Portion control • Balance • Physical Activity • Self-Esteem • Family involvement

11. Adolescents • Rapid growth triggered by hormones • Girls 10-11 y.o., fat increases, 35 pounds, 6” • Boys 12-14 y.o., muscle increases, 45 pounds, 8” • Calories up to 4000-5000/day during growth spurts • Iron, calcium, vitamin D, protein

12. Nutrition Issues • Peer influenced eating • Eating disorders • Obesity • Iron deficiency anemia • Low calcium intake- girls • Vegetarianism • Sports nutrition • Adequate calories to support growth and activity • +500-1500 calories/day

13. Importance of Mealtime • Better….. • School performance, health, family relationships • Nutrition Intake • Adequate vegetables, fruit, low-fat dairy, grains, fewer soft drinks/empty calories • Social skills • Family time • Distraction-free • Enjoyable • Try to increase!

14. Older Adults • General decrease in all physiological functions • Wide variation physical and cognitive abilities • Great variations in nutritional needs, social, economic, lifestyle • Various levels of nutrition • Health improvement • Treatment • Support life

15. Sensory Losses • Taste • Smell • Vision • Thirst

16. Most Significant Nutrient Concerns with Aging… • Unintentional Weight Loss • Loss of Lean Body Mass • Low vitamin D • Dehydration • Malnutrition • Depression • Food Insecurity

17. Weight Loss • middle age- weight gain; peak weight- 75 yo, weight loss- after 75 • Difficulty regaining weight • Loss of functional ability • 25-30 calories/kg body weight

18. Strategies: Calories Avoid unnecessary dietary restrictions Encourage use of nutrientdense foods Use more frequent meals plus supplements or snacks

19. Strategies: Calories Use foods that are well liked frequently Provide double portions of favorite foods Add calories by using sauces, gravies, toppings, and fats Emphasize calorie containing liquids to meet fluid needs

20. Sarcopenia • Loss of lean body mass • Affects physical function, strength, overall health, quality of life, activities of daily living • Adequate Calories • Adequate Protein • 1.2 grams/kg • Animal sources, supplements • 25 grams at a time (snacks and meals) • 3-5 times a day • Resistance Exercise

22. 3 oz meat = 21 1 oz meat = 7 1 cup milk = 8 1 cup yogurt = 8 2 T. peanut butter = 7 1 egg white = 7 ½ oz. nuts/seeds = 7 ½ c. legumes/soy = 7 ½ cup grain = 3 1 slice bread = 3 ½ cup vegetables = 2 1 cup soy milk = 8 ¼-½ cup meat substitute = 7-14 Veggie Burger = 14 ½ oz. tofu = 18 Scoop of protein powder = 24 Protein Bars- 7-14 MyPlate- 76 grams Food Protein Sources (grams)

23. Dietary Protein/Calorie Supplements • Liquid supplements • 13+ grams • Protein powders • 25 grams a scoop • Smoothies • Food intake is often ↓ by use of these supplements, but overall nutritional intake is improved • Considered a “supplement” not meal replacement

24. Oral Supplements 100 kcal/1 oz 10 gm protein 6 gm/pkt 23 kcal/Tbl 330 kcal/1.5 oz 7 gm protein

25. Vitamin D • 2010 Dietary Guidelines • 600 IU up to 70, 800 IU after 70 • Common Supplementation- 1000 IU • Repletion Guidelines (based on lab tests) • 50,000 IU for 6 weeks • 1000 IU a day

26. Dehydration • Affects • constipation, blood pressure, dementia (confusion), muscle function • 8-11 cups of fluids a day • Ideas to increase intake: • Availability, pitchers, variety of fluids, flavors

27. Malnutrition Risk • DETERMINE • Disease • Eating Poorly • Tooth loss or mouth pain • Economic hardship • Reduce social contact • Multiple medications • Involuntary weight loss or gain • Need for assistance with self care • Elder at an advanced age

28. Malnutrition • Easier to prevent than to cure… • Side Effects • Poor immune system • Frequent illness • Increased risk for infection • Poor wound healing • Poor drug tolerance • Skin conditions • Depression, apathy • Weakness • Dehydration • Unnecessary or long hospital stays

29. Long-Term Care • Liberalize the diet • Quality of life issue • All issues covered…+ pressure ulcers

30. Pressure Ulcers, Decubitus Ulcers, Bed Sores • Pressure, poor nutrition • High calories and protein • Vitamin C • 500 mg a day • Zinc Sulfate • 220 mg for 14 days • Multivitamin-mineral • Hydration

31. Encourage Healthy, Regular Eating • Eat regular/routine, small, frequent meals • Easy-to-prepare foods • Flavorful, familiar foods • Treats • Good lighting cooking and eating areas • Limit alone eating in isolation • Physical activity • Community Resources if food insecure

32. Live to Be 100 • http://ngm.nationalgeographic.com/ngm/0511/sights_n_sounds/index.html • Mediterranean Type Diet • Home-grown foods, fruits, vegetables, olive oil, fish, whole grains, drink tea-coffee-red wine, few processed or refined foods • Maintain healthy weight • Reduced calories and exercise • Social Networks • Family, friends, • Spiritual life, “sabboth” • Reason for living-purpose • Rural living