Diet through life. Extension. Learning objectives. To recognise the different key stages in life. To understand why different amounts of energy and nutrients are required through life. To describe the needs of different life stages to maintain health. Energy needs change through life.
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Energy requirements change through life and depend on many factors, such as:
The amount of nutrients needed to keep the body healthy is also different for each person.
The key stages in life include:
It is important to maintain good health through life.
A varied diet, providing adequate amounts of energy and nutrients, is essential both before a woman becomes pregnant (conception) and during pregnancy.
The mother’s diet can influence the health of the baby.
Being a healthy body weight is important before pregnancy.
Being underweight can make it more difficult to conceive. It can also make it more likely that the baby will have a low birth weight, leading to a greater risk of ill health.
Being overweight increases the risk of complications, such as high blood pressure and diabetes during pregnancy.
Folate (the natural form of folic acid found in foods) is needed for rapid cell division and growth in the foetus that takes place during pregnancy.
It has been shown to reduce the chance of neural tube defects, such as spina bifida, in the unborn baby.
Foods that are good sources of folate are green leafy vegetables, oranges, bread and fortified breakfast cereals.
Women who are trying to become pregnant, or who are pregnant, should take a 400 microgram (μg) supplement of folic acid every day from the time they stop using contraception until at least the 12th week of pregnancy. This is because it is difficult to achieve the extra folate needed through diet alone.
All women of child-bearing age are also advised to consume adequate amounts of folate. This is particularly important because it may take time for a woman to realise that she is pregnant.
During pregnancy, a woman’s nutritional needs increase to:
During the first six months of pregnancy, most women do not need to eat more food than normal. The body becomes more efficient at absorbing and using nutrients from food.
The Estimated Average Requirement (EAR) increases during the last three months of pregnancy by an average of 800kJ per day.
Gaining too much weight during pregnancy can raise the mother’s blood pressure and increase her risk of being overweight or having diabetes.
On average, if a woman eats to satisfy her appetite, her weight will usually increase by about 3.5kg in the first 20 weeks, then 0.5kg a week until the end of pregnancy.
The total weight gain will be about 12.5kg.
A normal pregnancy is between 37 and 41 weeks.
On average, new-born babies weigh around 3.3kg. Boys are approximately 300g heavier than girls.
The process of producing breast milk is called lactation.
Breast milk provides all the energy and nutrients a baby needs for growth and maintenance during the first 4 to 6 months of life.
In the first three days after birth, the mother produces a special form of breast milk called colostrum. It contains less fat, more protein and more protective factors than the breast milk produced later.
A mother who is breast feeding requires extra energy and nutrients. Some of this requirement is supplied through extra stores laid down during pregnancy, in addition to the diet.
The extra EAR for energy during lactation is 1900kJ per day during the first month, and later depends on how long breast feeding is continued. There are also increased demand for nutrients, such as calcium, phosphorous, vitamin A and C.
On average, 100g of breast milk provides:
● 289kJ energy
● 1.3g protein
● 4.1g fat
● 7.2g carbohydrate
● 34mg calcium
Breast milk provides special proteins, antibodies and white blood cells, which help to protect the baby against infection.
It also provides growth factors and hormones, important for the healthy growth and development of the baby.
If a mother does not wish to breast feed her baby, or finds it difficult, she can use an infant formula (also known as ‘baby milk’) from a bottle with a teat. Infant formulas do not provide any of the factors that help prevent infections.
It is important to note that once a mother has started to bottle feed her baby, it is difficult to change to breast feeding.
The Department of Health recommends exclusive breast feeding for the first 6 months of life.
After 4 to 6 months of age, milk no longer fulfils all the baby’s needs for energy and nutrients. The baby must be given other foods in addition to breast milk or infant formula. This process is called weaning.
Weaning before this age is not recommended, as the intestines and kidneys may not be able to process the food.
Different foods can be used during weaning, but they must be semi-fluid and soft, since the baby has no teeth and cannot chew, e.g. rice, puréedvegetables and fruit and mashed potatoes.
It is recommended that infants under 6 months should not be given wheat or other cereals that contain the protein gluten. This is to avoid a possible allergic reaction to gluten, called coeliac disease.
Eggs should be cooked until both the white and yolk are solid. Raw eggs and foods that contain raw or partially cooked eggs should be avoided due to the risk of food poisoning from Salmonella.
After the age of 6 months, infants receiving breast milk as their main drink or receiving less than 500ml of infant formula each day, should be given supplements of vitamins A, C, and D in the form of liquid drops.
Between the age of 1 to 5 years, vitamins A and D supplements should be given unless the baby receives adequate intake and exposure to sunlight.
Cow’s milk should not be given to infants under 1 year of age as the main drink because it does not provide adequate nutrients for the infant.
The energy requirements of children increase rapidly because they grow quickly and become more active. This means they have a high energy requirement for their size.
Young children do not have large stomachs to cope with big meals. Therefore, to achieve the relatively high energy intake for their age, foods should be eaten as part of small and frequent meals.
Children should be encouraged to remain a healthy weight with respect to their height. A healthy family lifestyle can help in the weight management of children.
A good supply of protein, calcium, iron, vitamin A and D, as part of a healthy, balanced diet, is essential.
Calcium is needed for healthy tooth development, and together with vitamin D, help develop strong bones.
Children should pay attention to dental hygiene and ways to prevent dental caries.
If children choose to consume food and drinks high in sugar occasionally, this should be done at mealtimes and not in between meals.
Brushing teeth twice a day with a fluoride toothpaste and using dental floss will help maintain healthy teeth. Regular dental visits are also important.
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Adolescence is a period of rapid growth and development and is when puberty occurs.
The demand for energy and most nutrients are relatively high. Boys need more protein and energy than girls due to their later growth spurt.
A growth spurt begins around 10 years of age in girls and 12 years in boys. In both sexes, an average of 23 cm is added to height and 20 to 26kg in weight. Before adolescence, both girls and boys have an average of 18% body fat, during adolescence, this increases to around 28% in girls and decreases to around 15% in boys.
Adolescents should have plenty of energy in their diet for rapid growth. However, some adolescents tend to eat more than they need and become overweight.
It is important to encourage an active lifestyle with a healthy, balanced diet during this time, because good habits practised now are likely to benefit their health for the rest of their lives.
After menstruation begins, girls need more iron than boys to replace losses.
It is recommended that teenage girls and women require 14.8 mg of iron each day, while adolescent boys only need 11.3mg of iron per day, but this reduces to 8.7 mg of iron daily for men aged 19 or above.
Some women have very high iron requirements because they have large menstrual losses.
Nutritional requirements do not change much between the ages of 19 to 50, except during pregnancy and lactation.
On average, UK adults are having too much saturated fat and salt from food, and not enough fruit and vegetables.
A poor diet can lead to diseases such as obesity, cardiovascular diseases, cancer and diabetes.
To reduce the risk of developing these diseases, it is important to:
Adults should aim for a healthy body weight for their height and try to keep it at that level.
The Body Mass Index (BMI) is a good indicator if a person is underweight, overweight or a healthy weight. To calculate BMI (kg/m2), divide weight (kg) by height (m) x height (m).
Recommended BMI range
Underweight less than 18.5
Normal 18.5 - less than 25
Overweight 25 - less than 30
Obese 30 - 40
Very obese over 40
Requirements for energy gradually decrease after the age of 50 as activity level falls.
Older adults is the term usually refer to people over the age of 65.
Older people may eat less for different reasons,
To maintain good health, it is important that older adults:
Older adults should adopt a healthy, balanced diet to maintain health.
It is also important they keep hydrated by drinking plenty of fluid. Even minor dehydration may lead to health problems.
After menopause (when menstruation stops), women lose bone strength at an increased rate. Having a great peak bone mass (PBM) in early adulthood helps adults to start from a higher point from which bones will be lost during the ageing process.
As people age, osteoporosis may occur when bones become weak, brittle and break easily. This may lead to fractures in the wrist, back and hip.
Osteoporosis is a major problem in older people, especially women.
Older adults should have plenty of calcium intake from milk and dairy products, green leafy vegetables, beans, pulses, and products made from white and brown flour, which are fortified with calcium in the UK.
They should also remain active and have adequate vitamin D from foods such as oily fish, cod liver oil and margarine, or through the action of sunlight on the skin.
Everyone over 65 years of age is recommended to take supplements of vitamin D.