1. © Cengage Learning 2016 Personal Nutrition, 9e Boyle | Long The Life Cycle: Conception through the Later Years 12

2. © Cengage Learning 2016 12.1Describe nutrient needs during pregnancy and lactation. 12.2Identify benefits of breastfeeding. 12.3Describe how growth affects nutrient needs of children. 12.4Discuss nutrition-related problems of adolescents. 12.5Describe how aging affects nutrient needs. Chapter Objectives

3. © Cengage Learning 2016 12.6Recognize components of successful aging. 12.7Describe the incidence of childhood obesity and environmental factors that influence its development. Chapter Objectives

4. © Cengage Learning 2016 Prescription for good health –Avoid excess alcohol –Do not smoke –Maintain a healthy weight –Exercise regularly –Get regular sleep –Eat nutritious, regular meals Introduction

5. © Cengage Learning 2016 The developing fetus obtains nutrients via the placenta –Dependent upon the mother’s nutrient stores Malnutrition in the prenatal and early postnatal periods affects –Mental and physical development 12.1 Pregnancy: Nutrition for the Future

6. © Cengage Learning 2016 Nutritional risk factors in pregnancy -Age 15 or under -Unwanted pregnancy -Many pregnancies close -History of poor pregnancy outcome -Poverty -Lack of access to health care -Low education level -Inadequate diet due dieting 12.1 Pregnancy: Nutrition for the Future

7. © Cengage Learning 2016 Nutritional risk factors in pregnancy (cont’d.) -Iron-deficiency anemia early in pregnancy -Cigarette smoking -Alcohol or drug abuse -Chronic disease requiring special diet Underweight or overweight -Insufficient or excessive weight gain in pregnancy -Carrying twins or triplets 12.1 Pregnancy: Nutrition for the Future

8. © Cengage Learning 2016 Ideal characteristics for a pregnant woman –Starts pregnancy at a healthy weight with adequate nutritional stores –Has firmly established habits of eating a balanced and varied diet Nutritional needs of pregnant women –Nutrient needs are higher during pregnancy and lactation than at any other time in their adult life –Refer to Figure 12-2 12.1 Pregnancy: Nutrition for the Future

9. © Cengage Learning 2016 Nutritional needs of pregnant women (cont’d.) –Energy needs Additional 340 calories during the second trimester Additional 450 calories per day during the third trimester Best met by the routine intake of a variety of foods –Nutrients of particular concern Protein, folate, iron, zinc, and calcium as well as vitamins known to be toxic in excess amounts 12.1 Pregnancy: Nutrition for the Future

10. © Cengage Learning 2016 A Food Guide for Pregnant and Lactating Women

11. © Cengage Learning 2016 Nutritional needs of pregnant women (cont’d.) –Folate supplements reduce the recurrence of neural tube defects –The fetus draws on its mother’s iron stores –The fetus extracts 300 milligrams of calcium per day from the maternal blood supply in the third trimester –A diet that has high nutrient density provides needed nutrition without excessive energy 12.1 Pregnancy: Nutrition for the Future

12. © Cengage Learning 2016 Maternal weight gain –Normal weight gain and adequate nutrition Support the health of the mother and the development of the fetus –A low-birthweight (LBW) infant is at risk for physical and mental defects 12.1 Pregnancy: Nutrition for the Future

13. © Cengage Learning 2016 An Example of the Pregnant Woman’s Weight Gain

14. © Cengage Learning 2016 Practices to avoid –Consumption of nonfood substances Pica: craving for and ingestion of nonfood items –Low-carbohydrate or low-calorie diets –Smoking –Alcohol consumption Fetal alcohol syndrome (FAS) –Drugs and herbal products –Environmental contaminants 12.1 Pregnancy: Nutrition for the Future

15. © Cengage Learning 2016 Common nutrition-related problems of pregnancy –Morning sickness Small frequent meals are recommended –Constipation Eat a high-fiber diet and engage in regular exercise –Hypertension in pregnancy Pregnancy-induced hypertension (PIH) Preeclampsia and eclampsia 12.1 Pregnancy: Nutrition for the Future

16. © Cengage Learning 2016 Common nutrition-related problems of pregnancy (cont’d.) –Risk factors for gestational diabetes Obesity First degree relative with diabetes Member of an ethnic or racial group with a high prevalence of diabetes Previously delivered a baby weighing >9 pounds Personal history of gestational diabetes 12.1 Pregnancy: Nutrition for the Future

17. © Cengage Learning 2016 Adolescent pregnancy –Pregnant adolescents require early intervention and special care throughout pregnancy –Risks for pregnant teens Higher rates of pregnancy-induced hypertension, iron-deficiency anemia, premature birth, stillbirths, low-birthweight infants, and prolonged labor 12.1 Pregnancy: Nutrition for the Future

18. © Cengage Learning 2016 Nutrition of the breastfeeding mother –400 calories per day is needed to support milk production Energy comes from fat stores and added food –A nursing mother can continue lactation with gradual weight loss (1 pound per week) An energy deficit that is too large will inhibit lactation 12.1 Pregnancy: Nutrition for the Future

19. © Cengage Learning 2016 Growth rate of an infant –Birthweight is doubled during the first 4 to 6 months –Birthweight is tripled by the end of the first year Milk for the infant: breastfeeding –Colostrum is produced the first 2 or 3 days of lactation Contains antibodies and white cells from the mother’s blood 12.2 Healthy Infants

20. © Cengage Learning 2016 Milk for the infant: breastfeeding (cont’d.) –Both colostrum and breast milk contain the bifidus factor that favors growth of “friendly” probiotic bacteria –Breast milk includes lactoferrin and other factors that protect the infant against infection –The American Academy of Pediatrics recommends Breastfeeding exclusively the first 6 months Breastfeeding with complementary foods for at least 12 months 12.2 Healthy Infants

21. © Cengage Learning 2016 Baby-Friendly Hospitals: 10 Steps to Successful Breastfeeding

22. © Cengage Learning 2016 Contraindications to breastfeeding: the mother should not breastfeed if she –Has a communicable disease –Is taking a medication that is secreted in breast milk and is know to affect the infant –Is using drugs of abuse –Is undergoing radiation treatments or chemotherapy 12.2 Healthy Infants

23. © Cengage Learning 2016 Feeding formula –Infant formulas approximate the composition of breast milk Do not offer immunologic protection –Shift to infant formula when weaning an infant Cow’s milk is not recommended during the first year of life –Variations are available for infants with special needs, e.g., allergies to milk protein or lactose intolerance 12.2 Healthy Infants

24. © Cengage Learning 2016 Supplements for the infant –Vitamin D supplement is prescribed for breastfed infants –Supplementary fluoride should not be given during the first 6 months The pediatrician may prescribe fluoride from 6 months to 3 years of age if the water supply is deficient 12.2 Healthy Infants

25. © Cengage Learning 2016 Food for the infant –Based on body weight, infants need more than twice as much as adults for many of the nutrients –Factors affecting the addition of foods to a baby’s diet The baby's nutrient needs The baby's physical readiness to handle different forms of foods The need to detect and control allergic reactions. 12.2 Healthy Infants

26. © Cengage Learning 2016 Nutrients for an Infant and an Adult Compared on the Basis of Body Weight

27. © Cengage Learning 2016 First Foods for the Infant

28. © Cengage Learning 2016 Meal Plan for a One-Year-Old

29. © Cengage Learning 2016 Nutrition-related problems of infancy –Iron deficiency American Academy of Pediatrics recommends that infants be fed breast milk or iron-fortified formula for the first year of life, with appropriate foods added (see Table 12-4) –Food allergies Genetics impacts susceptibility to food allergies Breast milk is best for infants allergic to cow’s milk protein Introduce new foods one at a time 12.2 Healthy Infants

30. © Cengage Learning 2016 Critical time in human development—a child –Grows 2 to 3 inches taller and adds 5 pounds each year from age 1 to adolescence –Develops fine motor skills –Becomes increasingly independent –Learns appropriate ways to express themselves 12.3 Early and Middle Childhood

31. © Cengage Learning 2016 Growth and nutrient needs of children –A child’s energy requirements vary by Basal metabolic rate Activity patterns Rates of growth –MyPlate food guide recommends a balance among Dairy products Meats and meat alternates Fruits, vegetables, and grains 12.3 Early and Middle Childhood

32. © Cengage Learning 2016 Serving Up MyPlate: A Yummy Curriculum Level 1

33. © Cengage Learning 2016 Serving Up MyPlate: A Yummy Curriculum Level 1 Insert bottom part of Figure 12-4

34. © Cengage Learning 2016 Strategies to Foster Healthful Eating Habits and Happy Mealtimes

35. © Cengage Learning 2016 Other factors that influence childhood nutrition –Children encounter foods prepared and served by outsiders in preschool/grade school –Children need to be encouraged to try new healthful foods in all food groups –Allowing a child to choose his/her own snack from two or three options Can promote greater acceptance of a variety of foods 12.3 Early and Middle Childhood

36. © Cengage Learning 2016 Nutrition-related problems of childhood –The Healthy Eating Index (HEI): a tool that measures how well people’s diets meet the Dietary Guidelines Recent results: diet quality of most children and adolescents aged 2 to 17 is less than optimal –Recommendations Increase consumption of vegetables Replace refined grains with whole grains Decrease the amount of sodium and empty calories from solid fats and sugar 12.3 Early and Middle Childhood

37. © Cengage Learning 2016 Consumption of Sugar-Sweetened Beverages versus Milk

38. © Cengage Learning 2016 Nutrition-related problems of childhood (cont’d.) –Iron-deficiency anemia Nine percent of children aged 1 to 5 years have iron deficiency Iron is found in foods from animal sources, some plant foods, and foods that are iron-enriched or fortified –High blood cholesterol Ages 1+: eat no more than 30 percent of total calories from fat; less than 10 percent saturated fat 12.3 Early and Middle Childhood

39. © Cengage Learning 2016 Nutrient needs of adolescents –“The adolescent growth spurt” requires adequate intakes of energy and nutrients –Individual energy needs vary by Body size Activity levels Biological factors affecting growth 12.4 The Importance of Teen Nutrition

40. © Cengage Learning 2016 Nutrition-related problems of adolescents –Undernutrition Adolescents at higher risk: are in low-income families, have run away from home, or abuse alcohol or other drugs –Iron-deficiency anemia Females are at greater risk –Low calcium intakes Replacement of milk with soft drinks adds to the risk of osteoporosis in later life 12.4 The Importance of Teen Nutrition

41. © Cengage Learning 2016 Nutrition-related problems of adolescents (cont’d.) –High blood cholesterol Risk factors: family history of coronary heart disease; diets high in total fat and saturated fat, hypertension; low activity levels; and smoking –Dental caries Children in low-income families have higher risk –Eating disorders Common eating disorders: anorexia nervosa and bulimia nervosa 12.4 The Importance of Teen Nutrition

42. © Cengage Learning 2016 Life expectancy in the U.S. is 78 years Good nutrition can support healthy aging Disease can shorten people’s lives –Poor nutrition practices make diseases more likely to occur 12.5 Nutrition in Later Life

43. © Cengage Learning 2016 Demographic trends and aging –In 2000: people aged 65+ → 12.4 percent of population –By 2040: number of people aged 85+ is expected to triple from 5.7 million in 2011 to 14.1 million Improved life expectancy has resulted from better prenatal and postnatal care and more effective means of combating disease in older adults 12.5 Nutrition in Later Life

44. © Cengage Learning 2016 The Aging of the Population

45. © Cengage Learning 2016 Healthy adults –Many of the leading causes of death for adults aged 65+ are directly influenced by nutrition- related factors –Physical activity and a healthy diet can help control heart disease risk factors of: High saturated fat intake Overweight Sedentary lifestyle 12.5 Nutrition in Later Life

46. © Cengage Learning 2016 Recommendations for Reducing the Risk of Chronic Diseases

47. © Cengage Learning 2016 Nutritional needs and intakes –Calorie needs decline with age due to lower BMR and decreased physical activity –Nutrient-dense foods selections are advised –Health benefits can result with up to 2½ hours a week of moderate-intensity physical activity –Certain nutrient needs increase with aging Refer to Table 12-8 12.5 Nutrition in Later Life

48. © Cengage Learning 2016 MyPlate for Older Adults

49. © Cengage Learning 2016 A Healthy Eating Report Card for Adults Age 45 and Older

50. © Cengage Learning 2016 Nutrition-related problems of older adults –Changes in biological function between the ages of 30 and 70 Cardiac output: ↓ 30 percent Maximum heart rate: ↓ 25 percent Vital capacity: ↓ 40 percent Maximum O2 uptake: ↓ 60 percent Muscle mass: ↓ 30 percent Hand grip, flexibility: ↓ 30 percent 12.5 Nutrition in Later Life

51. © Cengage Learning 2016 Changes in biological function between the ages of 30 and 70 (cont’d.) –Bone mineralization: ↓ 20–30 percent –Renal function: ↓ 40 percent –Taste and smell: ↓ 90 percent –Basal metabolic rate: ↓ 15 percent 12.5 Nutrition in Later Life

52. © Cengage Learning 2016 Chronic conditions in older persons –Hypertension (72 percent) –Diagnosed arthritis (51 percent) –All types of heart disease (31 percent) –Any cancer (24 percent) –Diabetes (20 percent) 12.5 Nutrition in Later Life

53. © Cengage Learning 2016 Common Causes of Disability in Older Persons

54. © Cengage Learning 2016 Factors that contribute to malnutrition in older adults –Disease; multiple medications –Tooth loss or oral pain; eating poorly –Economic hardship –Reduced social contact –Involuntary weight loss or gain –Need of assistance with self-care –Advanced age (older than 80 years) 12.5 Nutrition in Later Life

55. © Cengage Learning 2016 Sources of nutritional assistance –Supplemental Nutrition Assistance Program (SNAP) –Local food banks –The Older Americans Act (OAA) Nutrition Services Congregate Nutrition Services: Home-Delivered Nutrition Services –Factors affecting nutritional status Physiological 12.5 Nutrition in Later Life

56. © Cengage Learning 2016 Factors affecting nutritional status of older adults –Physiological –Socioeconomic –Psychological –Environmental 12.5 Nutrition in Later Life

57. © Cengage Learning 2016 Tips for buying and preparing foods –Keep cupboards and refrigerator stocked with nutritious selections –Keep fresh fruits or vegetables and other items on hand for snacking –Buy large bags of frozen vegetables –Keep an assortment of whole-grain breads in the freezer –Divide large meat packages into single servings and freeze separately The Savvy Diner: Meals for One

58. © Cengage Learning 2016 Tips for buying and preparing foods (cont’d.) –Buy fruits and vegetables in season –Simplify cooking and clean-up –Downsize your meal –Recruit friends and neighbors for a cooking club –Double a favorite recipe; freeze extra –Choose healthful frozen entrees The Savvy Diner: Meals for One

59. © Cengage Learning 2016 A healthy and engaged lifestyle during early life can support an individual as s/he approaches older age –Goal is to arrive at maturity with as healthy a mind and body as possible “Life advantages” –Genetic potential for extended longevity –A continued desire for new knowledge and new experiences 12.6 Looking Ahead and Aging Wisely

60. © Cengage Learning 2016 “Life advantages” (cont’d.) –Socialization, intimacy, and family integrity –Adhering to a healthy diet –Avoiding substance abuse –Acceptable living arrangements –Financial independence –Access to health care 12.6 Looking Ahead and Aging Wisely

61. © Cengage Learning 2016 The Aging Well Pyramid

62. © Cengage Learning 2016 Helping children learn good eating habits –Parents can set good examples –Discourage children from eating while doing other things, e.g., watching television –Eat meals together as a family –Encourage children to “listen to their bodies” and eat only when hungry –Limit consumption of high-fat or high-sugar foods –Include children in preparation of meals 12.7 Spotlight: Addressing Weight Problems in Children and Adolescents