Nutrition Module: 3. Nutritional Requirements Throughout the Lifecycle
Session 3 Nutritional Requirements Throughout the Lifecycle
In the previous two sessions, you learnt about food, nutrition and nutrients likewise every bit the food sources of the dissimilar nutrients.
In this session yous will learn about the nutritional needs at different stages of the lifecycle. The nutrient requirements during the four principal stages of the human lifecycle vary considerably. What infants and children require is unlike from what adults and the elderly need. In addition, in that location might be specific nutrients which a pregnant women and lactating mothers need in higher amounts than adult men. Therefore, every bit a Wellness Extension Practitioner, this written report session will help you to give the appropriate messages to different population groups.
Learning Outcomes for Written report Session three
When you have studied this session, you should be able to:
3.1 Ascertain and utilise correctly all of the key words printed in
assuming. (SAQs 3.i and 3.4)
3.2 Describe the food needs of significant and breastfeeding mothers. (SAQs 3.one and 3.2)
iii.3 Describe the nutrient requirements during infancy and childhood. (SAQs 3.2 and iii.3)
3.iv Describe the nutritional requirements of adolescents and adults. (SAQ 3.four)
3.5 Draw the food needs of older people. (SAQ 3.three)
3.1 Why it is important to know nutritional requirements
You demand to know nutritional requirements of an private or group for two major reasons:
Prescriptive reasons: that is, to provide or dispense food supplies; for example:
- to procure food for national consumption
- to secure food for institutional consumption
- to run nutritional supplementation programmes.
Diagnostic reasons: mainly to identify whether a group or an individual is suffering from malnutrition of any kind; for example:
- to evaluate nutritional intervention programmes
- to make up one’s mind whether the nutrient available in the stock is adequate to feed the household or nation for a certain duration of time.
In order to estimate nutritional requirements of individuals or groups, nosotros need to consider the following factors:
- Physical activity — whether a person is engaged in heavy physical action
- The age and sex of the individual or group
- Body size and composition — what the general build is of a person or group
- Climate — whether a person or group is living in hot or cold climate
- Physiological states, such as pregnancy and lactation.
Based on these factors, nutritional requirements in the unlike segments of the population tin can exist classified into four groups. These correspond to dissimilar parts of the lifespan, namely (a) pregnancy and lactation, (b) infancy and babyhood (c) adolescence and adulthood, and (d) quondam age. Yous are now going to wait at each of these in turn.
3.2 Diet during pregnancy and lactation
An unborn child needs a healthy and well-nourished mother to abound properly. Therefore, a mother needs to gain weight during pregnancy to help nourish her growing baby. Women who practice not proceeds enough weight often accept babies that weigh too lilliputian (low nascence weight). A baby weighing less than 2.five kg has an increased chance of both physical and mental wellness problems. Information technology may also endure more from infection and malnutrition compared with babies of normal weight. The increased requirement of nutrients during pregnancy and lactation is shown in Box three.one.
Box 3.1 Increased nutrients required during pregnancy
Increased requirements: free energy, poly peptide, essential fatty acids, vitamin A, vitamin C, B vitamins (B1, B2, B3, B5, B6, B12, folate), calcium, phosphorus, iron, zinc, copper and iodine.
Women should gain at least 11 kg during pregnancy (Figure three.1). If the mother gains less than this, the baby’s chances of survival and health declines. If a mother is overweight, she still needs to proceeds for her baby’s health. She should non try to lose weight while she is significant.
3.2.1 Gaining weight in pregnancy
A pregnant female parent should gain weight smoothly and steadily. If weight proceeds occurs suddenly, she should meet a health professional.
- During the kickoff three months, she should await to gain a total of one–2 kg.
- During the last six months, she needs to proceeds almost 0.five kg each calendar week.
- If she has already gained 11 kg after six–seven months, she should continue to gain moderately until delivery.
The baby puts most of its weight during the terminal few months.
A 29 weeks pregnant adult female (that is 7 months and one week) has already gained 12 kilograms of weight. What would you lot advise her and why?
Even though the significant woman has gained 12 kg (the minimum required being xi kg), you should advise her to continue to gain weight little past piffling until her infant is born. This is because the unborn baby puts on nigh of its weight during the last months of pregnancy.
3.two.two Eating during pregnancy
Women’s nutrition during pregnancy and lactation should focus on the 3 micronutrients (vitamin A, iron and iodine) and extra energy intake/reduction of energy expenditure. Therefore the following are essential nutrition actions related to maternal nutrition:
- A pregnant or breastfeeding woman needs extra foods, especially those that are expert sources of iron.
- Pregnant women need at least one boosted meal (200 Kcal) per day during the pregnancy.
- A pregnant woman needs to cut downwardly her free energy expenditure. She should reduce her involvement in strenuous household tasks that lead to college free energy expenditure.
- Meaning women should eat iodised salt in their diet.
- Meaning women should take vitamin A rich foods (such as papaya, mango, tomato, carrot, and light-green leafy vegetable) and brute foods (such as fish and liver).
- In the malarious areas, pregnant women should sleep under an insecticide-treated bed net.
- Pregnant women during the third trimester of pregnancy should be de-wormed using mebendazole or albendazole (you will larn about the doses for this in Study Session 7 of this Module).
- Pregnant women need a well balanced diet containing mixture of foods. This should include every bit far as possible food from the different food groups (animal products, fruits, vegetables, cereals and legumes).
Call up, in that location is no need for high-priced foods! A pregnant or lactating woman can become extra foods past eating a piffling more than of ordinary meals. She should increase the amount of nourishment at ane or two meals, not every repast.
iii.2.iii Preventing anaemia in pregnancy
Some women experience weak and tired when pregnant. They may be anaemic, which in plow ways that they may take difficulty in pregnancy and childbirth. Common issues linked to the female parent’due south anaemia include:
- Babies will be built-in without three to six months iron supply
- Breastmilk may take insufficient fe.
A pregnant or breastfeeding female parent should have enough atomic number 26 to keep herself and her baby good for you. She should eat enough of iron-rich foods every day such as dried beans, legumes, dark green leafy vegetables, liver, kidney and heart.
A significant female parent should get for her first antenatal care visit at the latest past the fourth calendar month of her pregnancy. At the clinic, cheque her urine for excess saccharide and proteins, and her blood for malaria (if she is showing signs of infection).
You diagnose anaemia in the post-obit way:
Examine the lower eyelids, the inside of the lips and the palms which should exist bright pink; if there is anaemia, all of these will be pale whitish.
- Give the mother fe tablets or tablets with fe and folate to build strong blood
- Remind the mother to have the tablets after a main meal. She should not take iron tablets with tea, coffee or milk
- If the fe tablets upset the mother or crusade side effects, she should not stop taking iron, but consume more leafy vegetables.
iii.2.iv Pregnant women with special needs
Some pregnant women in your community volition be particularly vulnerable. As a Health Extension Practitioner it is important that you place the women who may demand extra help and support. Box three.ii gives examples of women who may need special help from y’all and outlines the kinds of service you tin can provide for them.
Box 3.2 Identifying and helping pregnant women who need special help
Meaning women who might need special aid
- Women from poor families, or who are unemployed
- Women who are widows/separated, and have no support
- Mothers who have given birth to many babies over a short fourth dimension
- Women who are ill from diseases like Tuberculosis (TB)
- Women who wait thin and depressed
- Mothers whose previous babies were minor and malnourished
- Women with a history of their babe or babies dying in their commencement year of life
- Mothers overburdened with work
- Mothers who are very worried, particularly first fourth dimension pregnancies.
he Health Extension Practitioner
- Visit the significant women often
- Encourage them to eat as skillful mixture of foods as they can beget (fruits, vegetables, animal source foods)
- Permit them exist the first ones to receive iron or food supplements, when available
- Assist them to become proper healthcare
- Encourage other members of the household to do some of the work and lessen the work burden on the adult female.
What are the effects of depression maternal fe level for the babe and mother in pregnancy?
The mother will have difficulty during childbirth and pregnancy. The baby of an anaemic mother volition not develop well and will have depression birth weight. The infant will then be hands afflicted by different infections.
Which parts of the body should you examine to notice out whether a pregnant adult female is anaemic or not?
You should examine the lower eyelids, inside of the lips and the palms of the hand. If there is anaemia, they will exist pale whitish; if there is no anaemia they will exist pink.
3.three Diet during lactation (breastfeeding)
If all babies are to exist healthy and grow well, they must be fed breastmilk. When a babe sucks at the nipple, this causes the milk to come into the breast and go along to period. Breastmilk is food produced by the female parent’s torso especially for the baby, and it contains all the nutrients (nourishment) a healthy baby needs.
A lactating woman needs at least two extra meals (550 Kcal) of whatsoever is available at domicile. In addition a dose of vitamin A (200,000IU) should be given once between delivery and half dozen weeks subsequently delivery. This volition enable the infant to get an adequate supply of vitamin A for the showtime six months. During the outset six months the best way of feeding the baby is for the female parent to breastfeed exclusively. Yous will learn more about this in Written report Session iv of this Module. Box 3.3 shows the nutrients required during lactation.
Box 3.3 Increased nutrients required during lactation
Increased requirements: vitamins A, C, E, all B vitamins, and sodium (applies only to individuals nether age 18).
In addition to extra meals and one high dose of vitamin A, a breastfeeding woman also needs:
- Iodised table salt in her diet
- At least one litre of water per day
- Vitamin A rich foods (such as papaya, mango, tomato, carrot and green leafy vegetables) and animate being foods (such every bit fish and liver).
You lot have learnt what pregnant and lactating women require to be good for you and well for themselves and their babies. At present you are going to look at the nutritional requirements of infants, children and adolescents.
3.4 Nutritional requirements in infancy, childhood and boyhood
The mutual characteristic of infancy, childhood and boyhood is that all these age groups are undergoing rapid growth and development. This in turn poses a heavy demand on their nutritional requirements. Small children and infants practice not have a well developed body nutrient store, and therefore are more vulnerable to infection. In addition they have a larger surface area compared to their trunk size. All these factors increase their basal metabolic charge per unit (BMR), resulting in an increased requirement for nutrients.
iii.iv.i Boyish growth spurt
Adolescents also undergo a very rapid growth during their puberty (called the
pubertal growth spurt). During the pubertal growth spurt, they increase rapidly both in weight and height. Therefore, they need a nutrient intake that is proportional with their rate of growth. The growth charge per unit is very loftier right later birth (infancy). Then the growth charge per unit slows down until the historic period of 12–fourteen years. At most 15–16 years (the pubertal catamenia) there is a sharp rise in growth charge per unit/velocity. Subsequently that, the growth rate slows down once more.
Requirements for macronutrients (proteins, carbohydrates and fats) and micronutrients are higher on a per kilogram basis during infancy and childhood than at any other developmental stage. These needs are influenced by the rapid prison cell division occurring during growth, which requires protein, energy and fat. Increased needs for these nutrients are reflected in daily requirements for these age groups, some of which are briefly discussed below.
3.iv.2 Increased demand for nutrients
While about adults require 25–30 calories per kg, a 4 kg infant requires more 100 kilocalories per kg (430 calories/day). Infants of iv to six months who weigh vi kg require roughly 82 kilocalories per kg (490 calories/day). Energy needs remain high through the early on formative years. Children of ane to three years require approximately 83 kilocalories per kg (990 calories/day). Energy requirements turn down thereafter and are based on weight, tiptop, and physical activeness.
As an energy source, breastmilk offers significant advantages over manufactured formula milk. Breastfeeding is associated with reduced risk for obesity, a broad range of allergies, hypertension, and type 1 diabetes. It is also linked with improved cognitive evolution; and with decreased incidence and severity of infections. Information technology is also less plush than formula feeding. The list below outlines the nutrients and other constituents of breastmilk:
- Water = 87–89%
- Vitamins (especially vitamin A)
- Fat = 3–5%
- Free energy = 60–70 kcal/100 ml
- Saccharide (lactose) = half dozen.9–7.ii%
- Mineral = 0.2%
- Protein = 0.viii–0.9%
College intakes of poly peptide and free energy for growth are recommended for adolescents. For nearly micronutrients, recommendations are the same as for adults. Exceptions are made for certain minerals needed for os growth (e.chiliad. calcium and phosphorus). Evidence is articulate that bone calcium accretion increases as a outcome of exercise rather than from increases in calcium intake. Since weight gain often begins during boyhood and immature adulthood, young people must institute healthy eating and lifestyle habits that reduce the risk for chronic disease after in life.
Infants and children need plenty of h2o to drinkable, particularly when ill, or exposed to farthermost temperatures.
Total water requirements (from beverages and foods) are also higher in infants and children than for adults. Children take a larger trunk surface expanse per unit of body weight and a reduced chapters for sweating when compared with adults, and therefore are at greater risk of morbidity and bloodshed from aridity. Parents may underestimate these fluid needs, especially if infants and children are experiencing fever, diarrhoea or exposure to very cold or very hot temperatures.
Essential fatty acids
Requirements for fatty acids or fats on a per kilogram footing are college in infants than adults (meet Box 3.4). Some fatty acids play a key role in the cardinal nervous system. However infants and children should not ingest large amounts of foods that contain predominantly fats, so it is of import to become the balance correct.
Box 3.four Increased nutrients required during infancy, childhood and boyhood
Infancy and babyhood
Increased requirements of energy, protein, essential fatty acids, calcium and phosphorus.
Increased requirements of energy, protein, calcium, phosphorus and zinc.
three.5 Nutritional requirements during adulthood
The nutritional needs in adults of 19–50 years of age differ slightly co-ordinate to gender. Males crave more than of vitamins C, K, B1, B2 and B3, and zinc. Females require more fe, compared with males of similar age.
Yous have already seen that pregnant women and lactating mothers have particular nutrient requirements that are necessary for their ain health equally well as the health of their baby.
3.6 Nutritional requirements during after years
Elderly people are specially vulnerable to nutritional problems due to age related changes in their body (impaired physiological and anatomical capacity). Box 3.5 overleaf sets out some of the problems an older person might experience which could impact on their nutrition.
Box three.5 Possible nutritional bug in old age
- Bug of procuring and preparing foods
- Psychosocial problems
- Digestion issues
- Nutrient absorption bug
- Renal changes
- Retentiveness loss (senile dementia), which may include forgetting to eat
- Sensory changes
- Physical problems like weakness, gouty arthritis and painful joints.
3.6.1 Specific nutrient requirements in sometime age
An elderly person requires less energy than a younger individual due to reductions in muscle mass and physical activity. Some daily requirements for elderly people differ from those of younger adults. For example, in order to reduce the take chances for historic period related bone loss and fracture, the requirement for vitamin D is increased from 200 IU/24-hour interval to 400 in individuals of 51–70 years of historic period and to 600 IU/day for those over 70 years of age. Suggested iron intakes reduce however from 18 mg per mean solar day in women aged 19–50 to eight mg/day after age fifty, due to better iron conservation and decreased losses in postmenopausal women compared with younger women.
Some elderly people have difficulty getting adequate nutrition because of age or disease related impairments in chewing, swallowing, digesting and absorbing nutrients. Their nutrient status may also be affected by decreased production of chemicals to assimilate nutrient (digestive enzymes), changes in the cells of the bowel surface and drug–food interactions. Some elderly people demonstrate selenium deficiency, a mineral important for allowed function. Impaired immune role affects susceptibility to infections and tumours (malignancies). Vitamin B6 helps to boost selenium levels, so a higher intake for people aged 51–70 is recommended.
Nutritional interventions should first emphasise good for you foods, with supplements playing a secondary part. Although modest supplementary doses of micronutrients tin both prevent deficiency and support immune functions, very high dose supplementation (example, high dose zinc) may have the opposite result and result in immune-suppression. Therefore, elderly people as well demand special attention with regard to nutritional care.
3.7 Nutritional requirements throughout the life bicycle: conclusion
Requirements for energy and micronutrients modify throughout the life cycle. Although inadequate intake of certain micronutrients is a business concern, problems also come from the dietary excesses of energy, saturated fat, cholesterol and eating refined carbohydrates, all of which are contributing to obesity and chronic disease in adult countries. Below is a summary of the number of meals required at different stages in the lifecycle that might help you in your work in your community.
Demand at least two and if possible more meals each 24-hour interval as they may not eat much at each meal. They need fewer calories than younger people, merely nigh the same corporeality of protein and other nutrients. Women who have stopped menstruating need less fe than childbearing women. Old people may need soft nutrient.
Need at least two mixed meals every day and some snacks. They tin get enough energy from few large meals and from beefy nutrient.
Need at to the lowest degree two mixed meals every day and some snacks. If they are pregnant or lactating they demand every bit almost as much nutrient as men, especially if they are also doing hard physical work. They need much more iron and folate than men especially when they are significant.
Demand at least two large mixed meals and some snacks each day. They can consume bulky food. Boys need a lot of calories. Girls need plenty of iron. Meaning adolescent girls are still growing so they need more food than pregnant women.
School aged children
Need at least ii to 3 mixed meals and some snacks each day.
Children ane–5 years old
Demand breastmilk until they are at to the lowest degree two years erstwhile. They need at least three mixed meals and 2 snacks each mean solar day. They cannot eat large bulky meals. It is especially important for the meals to exist clean and non to comprise parasites or microorganisms that could crusade diarrhoea or other infection.
Babies vi-12 months
Need breastmilk eight to x times or more than each twenty-four hours. They need small-scale meals, which are not bulky, three to five times a 24-hour interval.
Babies under half-dozen months old
Need only breastmilk at to the lowest degree viii to ten times each day.
Equally a Health Extension Practitioner, you can aid families in choosing foods that keeps energy intake inside reasonable bounds, while maximising intake of nutrient-rich foods, specially vegetables, fruits, legumes and whole grains.
Self-Assessment Questions (SAQs) for Study Session iii
Now that you have completed this study session, you can assess how well yous have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the adjacent Study Support Meeting. You tin can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.
SAQ three.one (tests Learning Outcomes 3.ane and 3.two)
A pregnant woman asks your communication most what to swallow because she is worried about having another low birth weight babe. What should you tell her?
When advising a meaning woman what to eat, you would commencement tell her that it is very of import to gain weight during her pregnancy (at to the lowest degree 11 kilograms). Then you need to advise her virtually eating foods that contain vitamin A, iron and iodine, and making sure she has plenty free energy. She needs to consume a well-balanced diet merely there is no need for expensive additional foods.
SAQ 3.ii (tests Learning Outcomes three.2 and 3.three)
Mrs X tells you she does non take enough milk for her baby. What questions would you want to inquire before deciding how best to help her?
If a mother tells you she does non accept plenty milk for her baby y’all would want to ask her if she is eating enough (more than she did before becoming a mother), and if she is eating a skillful mix of food. You would also want to inquire her if she is drinking enough. Finally y’all need to know if she received a dose of vitamin A shortly afterwards giving birth and if she is now eating nutrient containing high amounts of vitamin A.
SAQ 3.3 (tests Learning Outcomes 3.iii and 3.5)
Children and elderly people both need special nutritional care. However, the care they need is unlike. What are two of these differences?
At that place are many differences between the nutritional needs of children and elderly people but you lot might have chosen two of the following:
- Small-scale children accept a higher basal metabolic rate than older people and then need more nutrients
- Children have huge free energy requirements so demand more calories than older people
- Children need more than h2o because they are at greater hazard of dehydration
- Older people might have physical bug which make eating difficult
- Older people need more vitamin D.
SAQ iii.4 (tests Learning Outcomes 3.i and three.4)
A mother is worried considering her adolescent son is eating then much. Is she right to be and so worried? What are the reasons for your answer?
A mother whose adolescent son is eating a lot does not need to worry unless he is eating a lot of one type of food. Adolescents feel a growth spurt at the historic period of 15/16 so demand a large intake of all kinds of nutrients during this fourth dimension.
Compare and Contrast the Nutritional Needs of Infants and Adults