Lecture 1 of nutrition

Nutrition requirements during life cycle

1- Nutrition and infancy (0-12 months)

-The importance of nutrition to the infancy are
1- Promotion of normal growth and brain development.
2- Prevention of illness during the first years of life.
-Infancy is a period of rapid growth. (i.e. The development during infancy is
rapid than any other period in the life time of an individual).
-The growth and development is accompanied by a number of physiological
changes which include: -
1. Change in body size
-A healthy normal infant doubles its birth weight by six months and
- triples the birth weight by the end of one year.
-Similarly there is increase in body length of the infant from 50-55 cm at birth
to about 75 cm during the first year.
2. Change in body composition
Weight gain comprises of growth in muscles, organ tissue, skeletal tissue and
skeletal structure.
3-Changes in gastro intestinal system
- As the child grows the digestibility improves and by the end of first year the
child is able to digest all types of food.
4. Changes in excretory system
Kidneys reach their full functioning capacity by the end of first Year
5. Mental development
There is a rapid increase in the number of brain cells in the first 5- 6 months’
after birth.
6. Changes in circulatory system
The infants have a rapid heart rate of 120-140 per minute.
At birth the level of haemoglobin is 18-22 g/100ml which provides sufficient
reserve for expansion of blood volume and adequate oxygen carrying capacity
to the growing tissues during the first 4-6 months.
7. Feeding behaviour
Maturation of nervous system especially that which controls muscular
coordination brings about the change in feeding behaviour.
Nutritional requirements: -
For almost all infants six months or younger, breast milk is the best source
to fulfill nutritional requirements. An infant may require feedings eight to
twelve times a day or more in the beginning.
-After six months, infants can gradually begin to consume solid foods to help
meet nutrient needs.
Energy: -
- Equations are used to calculate the total energy expenditure and resulting
energy needs.
For example: - the equation for the first three months of life is
(89 x weight [kg] −100) + 175 kcal.
Recommended daily intake of energy:
Age group Energy allowance/day (kcal/kg/day)
Infancy:
0-6 months 115 kcal / kg / day
7-12 months 105 kcal / kg / day
Children:
1-3 years 100 kcal / kg / day
4-6 years 90 kcal / kg / day
-Macronutrients
The dietary recommendations for infants are based on the nutritional content
of human breast milk.
1-Carbohydrates make up about 45 to 65 percent of the caloric content in
breast milk, which amounts to a RDA of about 130 grams. Almost all of the
carbohydrate in human milk is lactose, which infants digest and tolerate well.
2-Protein makes up about 5 to 20 percent of the caloric content of breast
milk, which amounts to 13 grams per day.
3-Fat make up about 30 to 40 percent of the caloric content of breast milk.
A high- fat diet is necessary to encourage the development of neural pathways
in the brain and other parts of the body.
-Micronutrients: -
Almost all of the nutrients that infants require can be met if they consume
an adequate amount of breast milk.
There are a few exceptions: -
1-Human milk is low in vitamin D, which is needed for calcium absorption
and building bone. Therefore, breastfed children often need to take a vitamin
D supplement in the form of drops.
2-Breast milk is also low in vitamin K, which is required for blood clotting.
Babies are born with limited vitamin K, so supplementation may be needed
initially and some states require a vitamin K injection after birth.
3-Also, breast milk is not high in iron, but the iron in breast milk is well
absorbed by infants. After four to six months, however, an infant needs an
additional source of iron other than breast milk.
Fluids
-Infants have a high need for fluids, 1.5 milliliters per kilocalorie
-parents or other caregivers can meet an infant’s fluid needs with breast
milk or formula.
- (Breastfeeding provides the fuel a newborn need for rapid growth and
development. As a result, the WHO recommends that breastfeeding be done
exclusively for the first six months of an infant’s life).
2-Nutritional requirements during childhood: -
The Toddler Years (Ages Two to Three years)
-During this phase of human development, children are mobile and grow more
slowly than infants, but are much more active.
-Children learn how to eat on their own and begin to develop personal
preferences.
-Therefore, with the proper diet and guidance, toddlers can continue to grow
and develop at a healthy rate.
Nutritional requirements: -
1-Energy
-The energy requirements for ages two to three are about 1,000 to 1,400
calories a day. In general, a toddler needs to consume about 40 calories for
every inch of height.
-Toddlers require small, frequent, nutritious snacks and meals to satisfy
energy requirements.
-The amount of food a toddler needs from each food group depends on daily
calorie needs.
2-Macronutrients
-carbohydrate intake is about (113 to 163 grams for 1,000 daily calories).
-Toddlers’ needs increase to support their body and brain development.
Brightly colored unrefined carbohydrates, such as peas, orange slices,
tomatoes, and bananas are not only nutrient-dense; they also make a plate look
more appetizing and appealing to a young child.
-The RDA of protein is (13 to 50 grams for 1,000 daily calories).
-The RDA for fat for toddlers is (33 to 44 grams for 1,000 daily calories).
3-Micronutrients
As a child grows bigger, the demands for micronutrients increase. These needs
for vitamins and minerals can be met with a balanced diet, with a few
exceptions.
According to the American Academy of Pediatrics, toddlers and children of
all ages need 600 international units of vitamin D per day. Vitamin D-fortified
milk and cereals can help to meet this need. However, toddlers who do not get
enough of this micronutrient should receive a supplement.
Feeding Problems in the Toddler Years
High-Risk Choking Foods: -
-It is important to offer children foods that they can handle on their own and
that help them avoid choking and other hazards.
Examples include fresh fruits that have been sliced into pieces.
-nuts such as peanut, Popcorn should be avoided
Picky Eaters: -
-The parents of toddlers are likely to notice a sharp drop in their child’s
appetite. That means, the capacity of the child to take a small quantity of food.
Therefore, they should be provided with Nutrient dense food (less quantity
but the nutrient contents are high).
Food Jags: -
For weeks, toddlers may go on a food jag and eat one or two preferred foods—
and nothing else.
-To consider this problem include,
- children should not be forced to eat foods that they do not want.
- Rotating acceptable foods while continuing to offer diverse foods
Toddler Obesity
There are a number of reasons for this growing problem.
1-lack of time (parents have time may find it difficult to fit home-cooked
meals into a busy schedule and may turn to fast food.
2- A lack of access to fresh fruits and vegetables.
3-Sedentary lifestyle is more likely to be overweight or obese.
4- lack of breastfeeding support
To prevent or address toddler obesity parents and caregivers can do the
following
-Eat at the kitchen table instead of in front of a television to monitor what and
how `much a child eats.
- Offer a child healthy portions, i.e. an appropriate serving size.
- Plan time for physical activity, about sixty minutes or more per day
Iron-Deficiency Anemia
An infant who switches to solid foods, but does not eat enough iron-rich foods,
can develop iron-deficiency anemia.
Steps that parents and caregivers can take to prevent iron-deficiency
anemia,
- Adding more iron-rich foods to a child’s diet, including lean meats, fish,
poultry, eggs, legumes, and iron-enriched whole-grain breads and cereals
-Children may also be given a daily supplement,
3-Nutritional requirement during the childhood (4-8 years)
-From age’s four to eight, school-aged children grow consistently, but at a
slower rate than infants and toddlers.
-At this life stage, a healthy diet facilitates physical and mental development
and helps to maintain health and wellness.
-School-aged children experience steady, consistent growth, with an average
growth rate of (5–7 centimeters) in height and (2–3 kilograms) in weight per
year
Energy
-Children’s energy needs vary, depending on their growth and level of
physical activity.
-Energy requirements also vary according to gender. Girls ages four to eight
require 1,200 to 1,800 calories a day, while boys need 1,200 to 2,000 calories
daily, and, depending on their activity level,
- Children should be provided nutrient-dense food at meal- and snack time.
However, it is important not to overfeed children, as this can lead to childhood
obesity.
Macronutrients
-For carbohydrates, the RDA is 135–195 grams for 1,200 daily calories.
-Carbohydrates high in fiber should make up the bulk of intake.
-The RDA for protein is 10–30 percent of daily calories (30–90 grams for
1,200 daily calories). Children have a high need for protein to support muscle
growth and development.
-High levels of essential fatty acids are needed to support growth (although
not as high as in infancy and the toddler years). As a result, the RDA is (33–
47 grams for 1,200 daily calories).
-Children should get 17–25 grams of fiber per day.
Micronutrients
-Parents and caregivers should select a variety of foods from each food group
to ensure that nutritional requirements are met. Because children grow
rapidly, they require foods that are high in iron, such as lean meats, legumes,
fish, poultry, and iron-enriched cereals.
-Adequate fluoride is important to support strong teeth. One of the most
important micronutrient requirements during childhood is adequate calcium
and vitamin D intake. Both are needed to build dense bones and a strong
skeleton.
Factors can influence children’s eating habits and attitudes toward
Food: -
- Family environment, social trends, taste preferences, and messages in the
media all impact the emotions that children develop in relation to their diet.
4-Nutritional requirements for adolescence: -
Puberty is the beginning of adolescence. (9-13 years)
The onset of puberty brings a number of changes, including the development
of primary and secondary sex characteristics, growth spurts, an increase in
body fat, and an increase in bone and muscle development. All of these
changes must be supported with adequate intake and healthy food choices.
-Puberty is second to the prenatal period in terms of rapid growth as the long
bones stretch to their final, adult size.
Girls grow 2–8 inches (5–20 centimeters) taller, while boys grow 4–12 inches
(10–30 centimeters) taller. The second phase involves weight gain related to
the development of bone, muscle, and fat tissue.
Energy
The energy requirements for preteens differ according to gender, growth,
and activity level. For ages nine to thirteen, girls should consume about
1,400 to 2,200 calories per day and boys should consume 1,600 to 2,600
calories per day.
Macronutrients
For carbohydrates, the RDA is 158–228 grams for 1,400–1,600 daily calories.
Carbohydrates that are high in fiber should make up the bulk of intake.
-The RDA for protein is 35–105 grams for 1,400 daily calories for girls and
40–120 grams for 1,600 daily calories for boys).
-The RDA for fat is 39–54 grams for 1,400 daily calories for girls and 44–62
grams for 1,600 daily calories for boys, depending on caloric intake and
activity level.
Micronutrients
Key vitamins needed during puberty include vitamins D, K, and B12.
Adequate calcium intake is essential for building bone and preventing
osteoporosis later in life. Young females need more iron at the onset of
menstruation, while young males need additional iron for the development of
lean body mass. Almost all of these needs should be met with dietary choices,
not supplements
5-Nutritional requirements for young people ages: -14-18 years
- Older adolescents are more responsible for their dietary choices than
younger children, but parents and caregivers must make sure that teens
continue to meet their nutrient needs. It can be helpful to explain to young
people how healthy eating habits can support activities they enjoy.
Energy
-Adolescents have increased appetites due to increased nutritional
requirements.
Nutrient needs are greater in adolescence than at any other time in the life
cycle, except during pregnancy.
- The energy requirements for ages fourteen to eighteen are 1,800 to 2,400
calories for girls and 2,000 to 3,200 calories for boys, depending on activity
level.
Macronutrients
1- For carbohydrates, the RDA is 203–293 grams for 1,800 daily calories.
-Adolescents require more servings of grain than younger children, and should
eat whole grains, such as wheat, oats, barley, and brown rice.
2- The requirements of protein are increased to support growth in the
adolescent.
-The RDA is 45–135 grams for 1,800 daily calories.
-lean proteins, such as meat, poultry, fish, beans, nuts, and seeds are excellent
ways to meet those nutritional needs.
3-The RDA of fat is 50–70 grams for 1,800 daily calories, and the RDA for
fiber is 25–34 grams per day, depending on daily calories and activity level.
- It is essential for young athletes and other physically active teens to intake
enough fluids, because they are at a higher risk for becoming dehydrated.
Micronutrients
Micronutrient recommendations for adolescents are mostly the same as for
adults, though children this age need more of certain minerals to promote bone
growth (e.g., calcium and phosphorus, along with iron and zinc for girls).
Again, vitamins and minerals should be obtained from food first, with
supplementation for certain micronutrients only (such as iron).
-The most important micronutrients for adolescents are calcium, vitamin D,
vitamin A, and iron. Adequate calcium and vitamin D are essential for
building bone mass.
-The recommendation for calcium is 1,300 milligrams for both boys and girls.
Low fat milk and cheeses are excellent sources of calcium and help young
people avoid saturated fat and cholesterol. It can also be helpful for
adolescents to consume products fortified with calcium, such as breakfast
cereals and orange juice. Iron supports the growth of muscle and lean body
mass. Adolescent girls also need to ensure sufficient iron intake as they start
to menstruate. Girls ages twelve to eighteen require 15 milligrams of iron per
day. Increased amounts of vitamin C from orange juice and other sources can
aid in iron absorption