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Barbara, I would like to set up an appointment with you to discuss our MSEI grant application. I am thinking sometime next week, anyday after next monday would be good for me. Please let me know your schedule, I will arrange the meeting. Thanks, Lifang. Chapter 11.

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chapter 11

Barbara,

I would like to set up an appointment with you to discuss our MSEI grant application. I am thinking sometime next week, anyday after next monday would be good for me. Please let me know your schedule, I will arrange the meeting.

Thanks, Lifang

Chapter 11

The Life Cycle: Conception Through the Later Years

© 2007 Thomson - Wadsworth

ask yourself
Ask Yourself
  • The poor nutrition of a pregnant woman can impair the health of her grandchild, even after that child has grown up.
  • A woman needs twice as many calories per day in late pregnancy as she did before she was pregnant.
  • Even one alcoholic beverage, if taken at the wrong time during pregnancy, can damage the development of the nervous system in the unborn infant.
  • A woman who craves a food during pregnancy instinctively knows that she needs the nutrients in that food.
  • Substances in a mother’s milk can protect the infant against certain diseases to which the mother has been exposed.

© 2007 Thomson - Wadsworth

ask yourself1
Ask Yourself
  • If a child loses his or her appetite, the caretaker must insist that the child eat his or her meals anyway.
  • School lunches provide all of the nutrients children need in a day.
  • For older adults, age-related weight gain is inevitable.
  • Caffeine is fine for young adults, but older people may suffer anxiety attacks if they ingest too much caffeine.
  • Phytochemicals may increase a person’s risk

for developing certain types of cancers.

© 2007 Thomson - Wadsworth

nutrition for the life cycle
Nutrition for the Life Cycle
  • Nutritional needs change at each stage of the life cycle.
    • Pregnancy
    • Infancy
    • Early and middle childhood
    • Adolescence
    • Adulthood
    • Senior adulthood

© 2007 Thomson - Wadsworth

pregnancy
Pregnancy
  • The only way nutrients can reach the developing fetus is through the placenta, the special organ that grows inside the uterus to support new life.

The close association between the fetus’s and mother’s circulatory systems permits the mother’s bloodstream to deliver nutrients and oxygen and remove waste products

© 2007 Thomson - Wadsworth

pregnancy1
Pregnancy
  • Malnourished mothers are more likely to have infants who become ill, have birth defects and suffer retarded mental or physical development.
  • Malnutrition in the prenatal (prior to birth) and postnatal (after birth) periods also affects learning ability and behavior.

© 2007 Thomson - Wadsworth

pregnancy2
Pregnancy
  • Trimester: one-third of the normal duration of pregnancy.
    • First trimester is 0 to 13 weeks.
    • Second trimester is 13 to 26 weeks.
    • Third trimester is 26 to 40 weeks.

© 2007 Thomson - Wadsworth

nutritional needs during pregnancy
Nutritional Needs During Pregnancy
  • Nearly all nutrients are recommended in increased amounts during pregnancy and lactation.
  • An average increase of only about 17% of maintenance calories is recommended to support the metabolic demands of pregnancy and fetal development.
    • 2nd trimester - add 350 calories per day
    • 3rd trimester - add 450 calories per day
  • Nutrients deserving special attention during pregnancy include protein, folate, iron, zinc, and calcium, as well as vitamins known to be toxic in excess amounts.

© 2007 Thomson - Wadsworth

nutritional needs during pregnancy1
Nutritional Needs During Pregnancy
  • The recommended intake for protein is an additional 20 grams/day over nonpregnant requirements.
    • Many women already consume enough protein.
  • A pregnant woman’s recommended intake for folate is 50% greater.
    • Folate supplements given around the time of conception are known to reduce the recurrence of neural tube defects.
    • Women are advised to get recommended amounts of folate before becoming pregnant and during the first trimester.
    • As of 1999, all refined grains are fortified with folate.

© 2007 Thomson - Wadsworth

nutritional needs during pregnancy2
Nutritional Needs During Pregnancy
  • Neural tube defects: include any of a number of birth defects in the orderly formation of the neural tube during early gestation.
  • Both the brain and the spinal cord develop from the neural tube; defects result in various central nervous system disorders. The two main types are:
    • Spina bifida: incomplete closure of the bony casing around the spinal cord.
    • Anencephaly:a partially or completely missing brain.

© 2007 Thomson - Wadsworth

nutritional needs during pregnancy3
Nutritional Needs During Pregnancy
  • The recommended intake for iron during pregnancy is 27 milligrams per day.
    • An increase of 50% above nonpregnant needs‚ to meet maternal and fetal needs.
  • Many women begin pregnancy with diminished iron stores.
    • An iron supplement of 30 milligrams ferrous iron daily during the second and third trimesters is recommended.

To facilitate iron absorption from the supplement, iron should be taken between meals with vitamin C-rich fruit juice or at bedtime.

© 2007 Thomson - Wadsworth

nutritional needs during pregnancy4
Nutritional Needs During Pregnancy
  • The DRI for calcium during pregnancy is:
    • 1,300 milligrams for teens.
    • 1,000 milligrams for adults over 18 years of age.
  • Intestinal absorption of calcium doubles early in pregnancy, and the mineral is stored in the mother’s bones.
  • During the last trimester of pregnancy when fetal skeletal growth is maximum and teeth are being formed
    • The fetus draws approximately 300 milligrams per day from the maternal blood supply.

© 2007 Thomson - Wadsworth

nutritional needs during pregnancy5
Nutritional Needs During Pregnancy

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future
Pregnancy: Nutrition for the Future
  • Low birthweight (LBW): a birthweight of 5½ lb (2,500 g) or less, used as a predictor of poor health in the newborn and as a probable indicator of poor nutrition status of the mother during and/or before pregnancy.
    • Normal birthweight for a full-term baby is 6½ to 8¾ lb (about 3,000 to 4,000 g).
  • LBW infants are of two different types:
    • Premature: they are born early.
    • Growth failure in the uterus: they may or may not be born early, but they are small.

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future1
Pregnancy: Nutrition for the Future

Practices to Avoid During Pregnancy

  • Pica: the craving of nonfood items such as clay, ice, and laundry starch. Pica does not appear to be limited to any particular geographic area, race, sex, culture, or social status.
  • Low-carbohydrate or low-calorie diets that cause ketosis.
  • Smoking restricts blood supply to the fetus and stunts growth.
    • Smoking is responsible for 20-30% of all low-birth weight deliveries in the United States.

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future2
Pregnancy: Nutrition for the Future

Practices to Avoid During Pregnancy

  • Consumption of alcohol which adversely affects fetal development.
    • Birth defects, low birthweight and spontaneous abortions occur more often in women who drink.
    • Fetal Alcohol Syndrome (FAS): the cluster of symptoms seen in an infant or child whose mother consumed excess alcohol during pregnancy.
    • Fetal alcohol effect (FAE): A lesser condition that causes learning impairment and other more subtle abnormalities in infants exposed to alcohol during pregnancy.
  • Avoid taking all drugs and herbal supplements except for physician-advised medicine.

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future3
Pregnancy: Nutrition for the Future

Practices to Avoid During Pregnancy

  • Avoid lead exposure:
    • Avoid ceramic and leaded crystal ware.
  • Reduce exposure to mercury:
    • Avoid large ocean fish such as shark, swordfish, king mackerel and tilefish.
    • Pregnant women can safely eat 12 ounces of cooked fish including canned fish, shellfish, and smaller ocean or farm-raised fish.

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future4
Pregnancy: Nutrition for the Future

For most women, the surest way to have a healthy baby is to follow a healthy lifestyle: Get early prenatal care, eat a sell-balanced diet, exercise regularly with your doctor’s permission, and avoid cigarettes, alcohol, and other drugs.

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future5
Pregnancy: Nutrition for the Future

Common Nutrition-Related Problems of Pregnancy

  • Morning Sickness
  • Constipation
  • Pregnancy-induced hypertension (PIH): high blood pressure that develops during the second half of pregnancy.
  • Preeclampsia: a condition characterized by hypertension, fluid retention, and protein in the urine.
  • Eclampsia: a severe extension of preeclampsia characterized by convulsions.

© 2007 Thomson - Wadsworth

pregnancy nutrition for the future6
Pregnancy: Nutrition for the Future
  • Gestational diabetes:the appearance of abnormal glucose tolerance during pregnancy, with a return to normal following pregnancy.

© 2007 Thomson - Wadsworth

slide23
Not for Coffee Drinkers Only
  • Caffeine: a type of compound, called a methylxanthine, found in coffee beans, cola nuts, cocoa beans, and tea leaves.
    • A central nervous system stimulant, caffeine’s effects include:
      • Increasing the heart rate.
      • Boosting urine production.
      • Raising the metabolic rate.

© 2007 Thomson - Wadsworth

caffeine dependence
Caffeine Dependence
  • Caffeine dependence syndrome: dependence on caffeine characterized by at least three of the four following criteria:
    • Withdrawal symptoms such as headache and fatigue.
    • Caffeine consumption despite knowledge that it may be causing harm.
    • Repeated, unsuccessful attempts to cut back on caffeine.
    • Tolerance to caffeine.

© 2007 Thomson - Wadsworth

adolescent pregnancy
Adolescent Pregnancy
  • More than 700,000 teenagers become pregnant in the United States each year.
    • One out of every eight babies is born to a teenager.
    • More than a tenth of these mothers are under age 15.
  • Pregnancy places adolescent girls, who are already at risk for nutrition problems, at even greater risk because of the increased energy and nutrient demands of pregnancy.

© 2007 Thomson - Wadsworth

nutrition of the breastfeeding mother
Nutrition of the Breastfeeding Mother
  • Adequate nutrition of the mother makes a highly significant contribution to successful lactation.
  • A nursing mother produces 30 ounces of milk a day, on the average, with wide variations possible.
  • Current recommendations suggest that 400 calories to support this milk production come from added food and that the rest come from the stores of fat the mother’s body has accumulated during pregnancy for this purpose.

© 2007 Thomson - Wadsworth

milk for the infant breastfeeding
Milk for the Infant: Breastfeeding
  • Breastfeeding has both emotional and physical health advantages.
    • Colostrum (co-LAHS-trum): a milklike secretion from the breast, rich in protective factors, present during the first day or so after delivery and before milk appears.
    • Bifidus factor (BIFF-id-us): a factor in colostrum and breast milk that favors the growth in the infant’s intestinal tract of the “friendly” bacteria Lactobacillus bifidus so that other, less desirable intestinal inhabitants will not flourish.
    • Lactoferrin (lak-toe-FERR-in): a factor in breast milk that binds and helps absorb iron and keeps it from supporting the growth of the infant’s intestinal bacteria.

© 2007 Thomson - Wadsworth

milk for the infant breastfeeding1
Milk for the Infant: Breastfeeding
  • Breast milk is tailor made to meet the nutrient needs of the young infant.
    • With the exception of vitamin D, its vitamin contents are ample.
  • The American Academy of Pediatrics recommends that infants receive breast milk for the first twelve months of life.
    • Approximately 69% of mothers initiate breastfeeding.

© 2007 Thomson - Wadsworth

healthy infants
Healthy Infants

Feeding Formula

  • Infant formulas are manufactured with the approximate nutrient composition of breast milk.
  • The parents can see that the baby is getting enough milk during feedings.
  • The mother can offer similar closeness, warmth, and stimulation during feedings as the breastfeeding mother does.
  • Other family members can get close to the baby and develop a warm relationship in feeding sessions.

© 2007 Thomson - Wadsworth

healthy infants1
Healthy Infants

Food for the Infant

  • Solid foods may normally be added to a baby’s diet when the baby is between 4 and 6 months old, depending on readiness. The following are indicators of readiness:
    • The infant is 6 months old.
    • The infant is developmentally ready.
      • He or she can sit upright with support and can control head movements.

© 2007 Thomson - Wadsworth

healthy infants2
Healthy Infants

Nutrition-Related Problems of Infancy

  • Iron deficiency remains a prevalent nutritional problem in infancy.
    • It has declined in recent years in large part because of the increasing use of iron-fortified formulas.
  • Food allergies are common and genetics is probably the most significant factor affecting an infant’s susceptibility to food allergies.
    • At-risk infants can be identified by means of careful skin testing and by a family history.
    • To detect food allergies, new foods should be introduced one at a time.

© 2007 Thomson - Wadsworth

early and middle childhood
Early and Middle Childhood

Growth and Nutrient Needs of Children

  • After age one, a child’s growth rate slows, but the body continues to change dramatically.
    • At one, most babies have just learned to stand and toddle.
    • By two, they can take long strides with solid confidence and are learning to run, jump, and climb.
  • The internal change that makes these new accomplishments possible is the accumulation of a larger mass and greater density of bone and muscle tissue.

© 2007 Thomson - Wadsworth

early and middle childhood1
Early and Middle Childhood
  • Make learning about nutrition fun.
  • Read food labels together at the grocery store, checking for the supply of…
    • Vitamins
    • Minerals

...the amounts of:

    • Sugar
    • Salt
    • Fat

© 2007 Thomson - Wadsworth

early and middle childhood2
Early and Middle Childhood

The most common nutrition-related problems among U.S. children:

  • Overweight and obesity
    • Obese children are at risk for cardiovascular disease, insulin resistance and type 2 diabetes, orthopedic problems, psychosocial problems, and other serious health problems.
  • Iron-deficiency anemia
  • High blood cholesterol

© 2007 Thomson - Wadsworth

early and middle childhood3
Early and Middle Childhood
  • Healthy Eating Index (HEI): a summary measure of the quality of one’s diet.
  • The HEI provides an overall picture of how well one’s diet conforms to the nutrition recommendations contained in the Dietary Guidelines for Americans and the MyPyramid.

© 2007 Thomson - Wadsworth

early and middle childhood4
Early and Middle Childhood
  • The popularity of fast-food meals poses a challenge to the nutritional quality of children’s diets, because these meals are typically high in:
    • Fat
    • Sodium
    • Sugar

...and lacking in:

    • Fruits
    • Vegetables

© 2007 Thomson - Wadsworth

teen nutrition
Teen Nutrition
  • The dramatic changes in body composition and rate of growth give rise to the term “adolescent growth spurt.”
  • Individual teenager’s energy need is influenced by body size, activity levels, and biologic factors affecting growth.

© 2007 Thomson - Wadsworth

teen nutrition1
Teen Nutrition
  • Most “adolescents” in the U.S. are perceived to be healthy.
  • Nutrition-related problems include:
    • Overweight and obesity
    • Undernutrition
    • Iron-deficiency anemia
    • Low calcium intakes
    • High blood cholesterol
    • Dental caries
    • Eating disorders

© 2007 Thomson - Wadsworth

nutrition in later life
Nutrition in Later Life
  • In 1900, 4% of the U.S. population were more than 65
  • In 2000, 12.4%
  • In 2030, it is expected to reach 20%

© 2007 Thomson - Wadsworth

nutrition in later life1
Nutrition in Later Life

Aging and Nutrition Status

  • Older people vary greatly in their social, economic, and lifestyle situations, functional capacity, and physical conditions.
  • Most older adults live at home, are fully independent and have lives of good quality.
  • Some older people have problems with activities of daily living (ADL) including:
    • Bathing.
    • Dressing.
    • Grooming.
    • Transferring from bed to chair.
    • Going to the bathroom.
    • Feeding oneself.

© 2007 Thomson - Wadsworth

nutrition in later life2
Nutrition in Later Life

© 2007 Thomson - Wadsworth

nutrition in later life3
Nutrition in Later Life

© 2007 Thomson - Wadsworth

nutrition in later life4
Nutrition in Later Life

© 2007 Thomson - Wadsworth

nutrition in later life5
The federal Elderly Nutrition Program (ENP) is intended to improve older people’s nutrition status.

Its specific goals are to provide the following:

Low-cost, nutritious meals.

Opportunities for social interaction.

Nutrition education and shopping assistance.

Counseling and referral to other social and rehabilitation services.

Transportation services.

DETERMINE:

Disease

Eating poorly

Tooth loss or oral pain

Economic hardship

Reduced social contact

Involuntary weight loss or gain

Need of assistance with self-care

Elderly person older than 80 years

Nutrition in Later Life

© 2007 Thomson - Wadsworth

meals for one
Meals for One
  • Keep cupboards stocked with healthy foods
  • Keep healthful, ready-to-eat snacks on hand
  • Buy large bags of frozen veggies
  • Keep whole-grain breads frozen
  • Buy large packages of meat or poultry on sale; freeze in portions

© 2007 Thomson - Wadsworth

meals for one1
Meals for One
  • Buy produce in season:
    • Winter = oranges, grapefruits, sweet potatoes, rutabagas, greens
    • Spring = asparagus, green beans, sweet peas, rhubarb
    • Summer = berries, peaches, zucchini, melons
    • Fall = apples, pears, acorn & butternut squash

© 2007 Thomson - Wadsworth

meals for one2
Meals for One
  • Cook several meals at a time
  • Double a recipe & store extra in the freezer
  • Add freshly steamed veggies to frozen entrees
  • Choose frozen entrees with <10 g fat per 300 calories & <800 mg sodium/serving
  • Pretend you are cooking for guests

© 2007 Thomson - Wadsworth

addressing overweight and obesity in childhood
Addressing Overweight and Obesity in Childhood
  • Prevalence of childhood obesity has tripled in the U.S.
  • Associated with:
    • Type 2 diabetes
    • High blood lipids
    • High blood pressure
    • Gallbladder disease
    • Injury to joints
    • Emotional problems

© 2007 Thomson - Wadsworth

influences on obesity
Influences on Obesity
  • Increased calorie intakes
  • Increased consumption of foods away from home
  • Excessive soft drink consumption
  • Lack of positive role models
  • Physical inactivity
  • Fewer opportunities for activity

© 2007 Thomson - Wadsworth

eating habits
Eating Habits
  • Too few fruits & vegetables
  • Too much fat & added sugars
  • Large food portions
  • Reliance on fast foods

© 2007 Thomson - Wadsworth

impact of the media
Time with T.V. & video games = less exercise

Advertisements for food

Lots of T.V. = more sedentary

Impact of the Media

© 2007 Thomson - Wadsworth

tips for helping instill good eating habits
Tips for Helping Instill Good Eating Habits
  • Set a good example
  • Discourage eating while watching T.V. or doing homework
  • Eat meals together as a family
  • Encourage eating only when physiologically hungry
  • Limit high-fat & high-sugar foods
  • Include children in food preparation

© 2007 Thomson - Wadsworth