Download Nutrition metabolism throughout the life cycle Pregnancy and

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Beta carotene-fat soluble
Lecture 10- 14 November 2013
This lecture is based largely on Chapter 7, 12, 14,
15,16 in Understanding Normal and Clinical
Nutrition by Rolfes et al.
Lecture 10- 14 November 2013
Outline
Water
-role in metabolism
-role in metabolic regulation
Outline of lecture 10
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Infancy
Early Childhood
Adolescence
Adulthood
More Detailed Comments
Water
-role in metabolism
-carries nutrients and waste products
throughout the body
-maintains structure of large molecules like
proteins and glycogen
Water
-role in metabolism
-participates in metabolic reactions- eg
hydrolysis (eg protein catabolism), or
product of metabolism (metabolic
sink)(eg when hydrogen joins with
oxygen as part of electron
transport chain processes)
-solvent (provides medium for reactions)
-regulation of body temperature
-maintains blood volume
Water
-class exercise
-explain each role in metabolic regulation
Break
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
foetal growth and development
-folate supplementation
-prevent neural tube defects
-one month before conceptionwhy?
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
foetal growth and development
folate supplementation
-0.8 to 4 mg supplements
-if have had previous neural
tube baby then 4 mg
supplements may be
recommended - require
a prescription as high
folate intake may mask
pernicious anemia of a
vitamin B12 deficiency
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
critical periods
-maternal anemia during critical
growth period of placental growth
alters pattern of blood vessel
growth which may affect
cardiovascular health of infant
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
critical periods
-infant beta cell development-poor
maternal nutrition during critical
period of beta cell development (12
weeks gestation to 5 months post
delivery) may cause diabetes
particularly if person eats in
overabundance in later life
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
weight prior to conception-underweight
mother
-underweight mother leads to greater
chance of a low birthweight infant
especially if mother is unable to gain
sufficient weight during the
pregnancy
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
weight prior to conception-underweight
mother
-as well rates of preterm births and
infant deaths are higher for
underweight women
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
weight prior to conception-overweight
mother
overweight mother leads to greater
chance of her experiencing
gestational diabetes, hypertension
and post-partum infections and of
having a stillborn and/or other
labour and delivery complications
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
weight prior to conception-overweight
mother
-as well infants tend to be larger and
have greater risk of poor
health(including neural tube
defects) and death than do normal
weight infants
-never try to lose weight during
pregnancy- lose appropriately preconception or post-delivery
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
weight gain during pregnancy
underweight
correct weight
overweight
obese
28-40 lbs
25-35 lbs
15-25 lbs
15 lbs minimum
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during pregnancy
energy
add 100 kcal per day trimester 1
add 300 kcal per trimesters 2 and 3
pregnant teenagers, underweight and
physically active women may
require more
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
fig 14-10
Fig. 14-10, p. 489
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
carbohydate- ideally 250 or more
grams per day and no less
than 100 grams per day
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
protein
add 5 grams per day trimester 1
add 20 grams per day trimester 2
add 25 grams per day trimester 3
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
protein
most people have enough protein
to begin with in their diet to
meet these protein
requirements
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
protein
do NOT use high protein
supplements during
pregnancy-chance of low
birthweights, pre-term births
and still borns
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
essential fatty acids
linoleic and alpha-linolenic- brain
growth and development,
visual acuity
fish oil supplements are not
recommended -possibility of toxins
and effect on pregnancy is not known
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
energy and nutrient needs during
pregnancy
nutrient needs
-folate, B12, iron and zinc as well as
vitamin D and calcium require
particular attention
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
common nutrition related concerns of
pregnancy
-nausea, constipation,
haemorrhoids, heartburn,
food cravings and aversions,
non food-cravings (pica)
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
malnutrition and pregnancy
-malnutrition can lead to reduced
fertility for males and females
-malnutrition prior to pregnancyprevent placenta from
developing properly with
subsequent potential for
physical and cognitive
abnormalities on the part
of the infant
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
infants birthweight
-low- premature-can catch up -have
easier time catching up in
growth development if their
post-delivery nutrition is good
-less than gestational age- have
tougher time catching up in
growth development even if
their post-delivery nutrition is
good
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
mothers age
-adolescence- immaturity may lead
to poor food choices with
subsequent foetal risk
-weight gain of 35
lbs for normal
weight female
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Pregnancy
practices incompatible with pregnancy
alcohol and herbal supplements and
nutraceuticals
Break
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation
Lactation
Nutrition during lactation
mother's nutrient needs
energy
additional 450 kcal per day consumedrest comes from fat stores built up
during pregnancy
figure 14-10
Fig. 14-10, p. 489
Nutrition metabolism throughout the life cycle
Infancy
energy and nutrient needs
energy
infants require about 100 kcal/kg/day
protein
inadequate-consequences
too much-stress kidneys and liver
figure 15-2
Fig. 15-2, p. 517
Nutrition metabolism throughout the life cycle
Infancy
breast milk
lactose improves calcium
absorption
omega 3 fatty acids
figure 15-3
Fig. 15-3, p. 518
Nutrition metabolism throughout the life cycle
Infancy
infant formula
nothing beats breast milk
soya formulas-avoids allergy issue found
with some non-soya
formulas
- good for lactose intolerance
as there is no lactose in soya
formulas
avoid goats milk-low in folate
table 15-2
figure 15-4
Table 15-2, p. 519
Fig. 15-4, p. 521
Nutrition metabolism throughout the life cycle
Infancy
special needs of pre-term infants
poor absorption of calcium and lipid,
fat soluble vitamins, calcium, iron
and zinc due to immature gut
solution-pre-term breast milk
eg higher protein
concentration than
full term breast
milk
Nutrition metabolism throughout the life cycle
Infancy
introducing cow's milk
not until 12 months of age
poor iron content and it may cause
intestinal bleeding
cows milk is higher in calcium and
lower in vitamin C-thus inhibiting
iron absorption
type 1 diabetes issue-this is
controversial
Nutrition metabolism throughout the life cycle
Infancy
introducing solid foods
no earlier than 6 months
6-12 months
if not before end of first year there
may be delayed growth
Nutrition metabolism throughout the life cycle
Infancy
introducing solid foods
6-12 months
iron fortified cereals, meat or meat
alternatives such as legumes
-serve with vitamin C to
improve iron absorption
-vitamin C rich foods
include citrus fruit juices
and chopped berries
Nutrition metabolism throughout the life cycle
Infancy
introducing solid foods
at one year-2-3.5 cups of milk
maximum to avoid displacement of
iron rich foods plus give iron
fortified cereals, fruits and
vegetables to meet iron
requirements
primary food in first 12 months ideally
is breast milk
Nutrition metabolism throughout the life cycle
Early Childhood
energy and nutrient needs
energy
1 year 1000 kcal/day
3 years-1300 kcal/day
10 years-2000 kcal/day
Nutrition metabolism throughout the life cycle
Early Childhood
energy and nutrient needs
nutrient needs
protein-needs dictated by needs to
maintain nitrogen balance, protein
quality and added needs of growth
vitamins and minerals-met by 6
principles of dietary
planning(adequacy, moderation,
balance, variety, energy control
and avoiding empty kcal foods)
Nutrition metabolism throughout the life cycle
Early Childhood
hunger and malnutrition in children
glucose and iron are critical to brain
functioning and subsequently to the
child's behaviour
adverse reactions to foods
must meet nutrient needs of child
childhood obesity
excess energy intake relative to energy
expenditure
Nutrition metabolism throughout the life cycle
Early Childhood
mealtimes at home
-6 principles of good dietary planning
nutrition at school
-pack lunches
Nutrition metabolism throughout the life cycle
Adolescence
energy and nutrient needs
energy-2000-4000 kcal/day
activity levels
males need more than females
Nutrition metabolism throughout the life cycle
Adolescence
nutrients
vitamin D and calcium
iron
chronic diseases
atherosclerosis
type 2 diabetes
hypertension
Nutrition metabolism throughout the life cycle
Adulthood
as we age in adulthood we reduce our
metabolic rate- therefore need to
reduce caloric intake while
meeting the 6 principles of
good dietary
planning that adequately
address changing nutrient
intake requirements
Nutrition metabolism throughout the life cycle
Adulthood
water- avoid dehydration-mobility and
desire to consume water are issues
here
protein- 0.8 g/kg/day
carbohydrate- increased fibre to offset
constipation- also need more fluid
Nutrition metabolism throughout the life cycle
Adulthood
vitamin B12, vitamin D, calcium as well as
iron are among the nutrients of primary
concern
vitamin B12 -bacterial overgrowth-in
stomach results in vitamin B12
consumption by bacteria
vitamin D and calcium -a concern due to
reduced dairy intake as we
age as well as the risk of
osteoporosis
Nutrition metabolism throughout the life cycle
Adulthood
vitamin B12, vitamin D, calcium as well as
iron are among the nutrients of primary
concern
iron- deficiency risk if low food energy
intakes-mobility and desire to
consume food are issues here
Nutrition metabolism throughout the life cycle
Adulthood
nutrient-brain relationships-table 16-2
Table 16-2, p. 574