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Diet requirements for different client groups

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  1. Diet requirements for different client groups Sally Ison Senior Community Dietitian

  2. Learning Outcomes • Be aware that there is a range of different client groups • Identify different characteristics of different client groups • Knowledge of different components in different foods • Identify other factors that will affect their product choice

  3. Maternal Babies and toddlers Primary school children Adolescents Adults Older people Vegetarians Coeliac Diabetics Food intolerant Some Client Groups……..

  4. Nutrition through Life Cycle

  5. Pregnancy • Provide sufficient calories to support weight gain • Provide all essential nutrients • 400ug/day folic acid • Fibre 25 –35 g/day • Iron • Increase fluid intake

  6. Pregnancy • Lifestyle changes – alcohol, smoking, caffeine • Salt ‘to taste’ • Vitamin A • Vitamin D • Calcium

  7. Breast Feeding

  8. Formula Feeding • Some Mums choose not to or are unable to breast feed • Formula Milks • Using human milk as the nutritional standard, formula manufacturers follow a basic recipe that includes proteins, fats, carbohydrates, vitamins, minerals and water

  9. Formula Milk

  10. Child and Preadolescent Nutrition • Children continue to grow and develop physically, cognitively and emotionally during the middle childhood and preadolescent years • Children continue to develop eating and physical activity behaviors that affect their current and future states of health • Children’s families continue to exert the most influence over their eating and physical activity habits

  11. Child and Preadolescent Nutrition • External influences • Teachers • Coaches • Peers • Media • Independence

  12. Dietary Recommendations • Iron – inclusion of iron-rich foods including meats, fortified breakfast cereals, and dry beans (+ vitamin C for absorption) • Fibre – Age + 5 grams per day; may prevent adulthood disease; fresh fruit and veg; whole grain breads and cereals • Fat – Use high fat esp saturated fat sparingly; fat intakes <20% are not recommended for children; need calories, EFA, FSV

  13. Dietary Recommendations • Calcium – 800mg 4-8 yrs; 1300mg 9-18 yrs; bone formation; prevention of osteoporosis; low-fat dairy products • Fluids – esp. during exercise • Soft drinks – increased consumption with age; overweight children

  14. Products

  15. Adolescents • Biological, psychosocial and cognitive changes affect nutritional status • Rapid growth increases nutrient needs • Desire for independence may cause adoption of health-compromising eating behaviours

  16. Adolescents • Common belief that the adolescent diet is nutritionally inadequate – is this true? • Getting taller! • Getting heavier! • Energy surplus + Reduced Activity • Micronutrient deficiency?

  17. Adults • Early = 21-39 yrs • Midlife = 40-59 yrs • Old age = 60+ yrs • Need to develop beneficial nutritional and lifestyle choices to support physical and mental health and well-being in old age

  18. Adults • Growth and maturation are complete by early adulthood • Focus now on maintaining physical status, strength and avoidance of excessive weight gain • Reduce fat intake to 30% or less; limit saturated fats to less than 10%; limit cholesterol to 300 mg daily

  19. Adults • 5 or more serving of vegetables and fruits per day • Maintain moderate protein intake • Balance food intake and physical activity to maintain normal weight • Limit salt intake less than 6 grams

  20. Adults • Limit alcohol intake less than 2-3 units per day for women; 3-4 for men with 2-3 alcohol free days in the week • Maintain adequate calcium • Avoid taking vitamin and mineral supplements in excess of RDA

  21. Elderly • Main age related body changes: • Decrease in muscle mass • Slower uptake of vitamin A • Decline in immune function • Reduced skin synthesis of vitamin D • Decreased vitamin B6 utilisation • Decreased absorption of certain vitamins and minerals • Recommendations for specific nutrients change with age

  22. Elderly • Some nutrients are of particular importance in older adults: e.g: fibre, protein, saturated fat, vitamin D, vitamin B12, vitamin A, Iron, vitamin E, folate, calcium, magnesium and zinc

  23. Vegetarian and Vegans • In general vegetarians have a well balanced diet • Lower mortality from some chronic diseases • Vegetarians are more likely to be ‘health conscious’ and alter other aspects of their diet and lifestyle

  24. Coeliac • Coeliac’s Disease is a reaction to gluten, which causes damage to the lining of the small intestine, thereby reducing an individual’s ability to absorb enough nutrients for their needs. Gluten is found in wheat and some other cereals • 250,000 diagnosed with coeliac disease in UK • 500,000 undiagnosed in UK

  25. Coeliac • The Gluten Free Food and Drink Directory ("The Food List")

  26. Diabetics • Diabetes mellitus is a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot use it properly • Type 1 diabetes develops if the body is unable to produce any insulin • Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work effectively

  27. Diabetics • The diet for people with diabetes is a balanced healthy diet, the same kind that is recommended for the rest of the population • low in fat, sugar and salt • plenty of fruit and vegetables • meals based on starchy foods, such as bread, potatoes, cereals, pasta and rice

  28. Food intolerance • Food allergy and food intolerance are both types of food sensitivity • Food intolerance doesn’t involve the immune system and is generally not life-threatening. But if someone eats a food they are intolerant to, this could make them feel ill or affect their long-term health • Essential to examine the label on any pre-packed food

  29. Peanuts nuts such as almonds, hazelnuts, walnuts, Brazil nuts, cashews, pecans, pistachios and macadamia nuts Eggs Milk Crustaceans (including prawns, crabs and lobsters) Fish sesame seeds cereals containing gluten (including wheat, rye, barley and oats) soya celery mustard sulphur dioxide and sulphites (preservatives used in some foods and drinks) at levels above 10mg per kg or per litre Labeling Rules

  30. Components of food in human diet • Carbohydrates • Proteins • Fats • Minerals • Vitamins • Water • Roughage

  31. Important Note You should target your product to a particular client group bearing in mind their specific dietary requirements

  32. Carbohydrates • C= carbo   H2O = hydrate • Basic formula (CH2O)n • All carbohydrates are converted to glucose and absorbed into the blood • Glucose - vital fuel: n = 6  C6 H12 O6

  33. Carbohydrates • Chemically carbohydrates are defined by the number of saccharide units in their structure • Monosaccharides • Disaccharides • Oligosaccharides • Polysaccharides

  34. Dietary Carbohydrates • Originate from plants – CO2 + H2O – Photosynthesis • Living animals have carbohydrates but this dissipates rapidly on death • Not all carbohydrates are digestible • 1 gram of carbohydrate = 4 kcal • Starches and sugars are main sources of dietary carbohydrate

  35. Dietary sugars • Intrinsic sugars: those present within intact cells e.g. Sugars in fruit • Non-milk extrinsic sugars: present in a free and readily absorbable state e.g. sucrose

  36. Requirement and intake • Total carbohydrate should provide 50% energy • Non-milk extrinsic sugars should not exceed 11% energy intake • Starches, intrinsic and milk sugars should contribute to 39% energy intake

  37. Sources of dietary Carbohydrates Starches Intrinsic Sugars Milk Sugars NMES

  38. Restriction of Carbohydrate intake • Atkins Diet • Low carbohydrate • Ketongenesis • GI diet • The glycaemic effect of 50g of a particular food in relation to 50g glucose • Encourages low GI foods

  39. Protein • Protein = amino acid+amino acid+amino acid+amino acid… • Made of 20 different amino acids bonded together in different sequences to form many SPECIFIC proteins • Twenty amino acids are important in nutrition

  40. Amino Acid • Side chain of an amino acid determines its properties (R group) • The carbon to which the carboxyl is attached is the alpha-carbon • Amino acids have 4 different groups around the alpha carbon resulting in optically active L or D isomers or enantiomers

  41. Amino Acid • L-forms – proteins and biological systems • D-forms – bacteria (not mammals) • D-forms slowly absorbed in digestion • Amino acids can be positively or negatively charged according to the pH of the environment • The polarity of the amino acid indicates how the amino acid will be incorporated into proteins

  42. Classification of amino acids • Essential amino acid • One that the body is unable to make or can only make in inadequate quantities • Need to be consumed from the diet • 8-10 essential amino acids • Nonessential amino acid • One that the body can make in large enough quantities • Made from essential amino acids • Not necessary to consume these in the diet • 10-12 nonessential amino acids

  43. H H O OH H N C C H Side chain (R) Central carbon Acid group Amino group Structure of amino acid • Different side chains make different amino acids

  44. Essential (10) Phenylalanine Valine Threonine Tryptophan Isoleucine Methionine Histidine Arginine Leucine Lysine Nonessential (10) Alanine Asparagine Aspartic acid Cysteine Glutaminc acid Gluatmine Glycine Proline Serine Tyrosine Amino Acids • Conditionally essential (3) • Cysteine • Glutamine • Tyrosine