Dietary needs throughout life

You will gain an understanding of: Babies Pre-school children Young children Adolescents Adults The elderly Vegetarians Pregnant women Lactating women

Maternal and infant nutrition Key points A healthy, varied diet that contains adequate amounts of all the nutrients needed by a mother and her growing foetus (including sufficient iron, calcium and folate) is essential for a healthy pregnancy. All women of child-bearing age who may become pregnant are advised to take daily supplements (400 micrograms) of folic acid, as this can help to reduce the risk of the baby suffering from a neural tube defect.  Pregnant women should avoid supplements containing vitamin A as well as food rich in vitamin e.g. liver or liver products. Pregnant women should ensure that their intake of alcohol and caffeine does not exceed current recommendations and minimise their risk of suffering from food poisoning (e.g. by strict use of good food hygiene practices and avoidance of ‘high risk’ foods).  Avoidance of shark, swordfish and marlin and the consumption of no more than 2 portions of oily fish per week is advised because of the levels of potential contaminants in these fish. Staying physically active during pregnancy is important to promote general health and well-being.

Pregnant women A women's nutritional needs change during pregnancy, because her diet must provide for the growth and development of the foetus. Sufficient nutrients are needed to aid the development of the foetus. Maintaining a healthy diet is essential to make the birth as good as possible. A pregnant women must ensure her diet contains sufficient energy, protein, iron, calcium, folic acid, and vitamins C and D. Folic acid in pregnancy prevents neural tube defects. Pregnant women should eat lots of fruit and vegetables- especially leafy green, high in folate, starchy carbohydrates, dairy, lean meat and fish, preparing food carefully is important. Intake of tuna should be limited because of mercury in it. Pregnant women are advised not to eat liver due to it causing birth defects. Soft cheeses should be avoided as they can lead to premature birth. Eggs should be well cooked.

Lactating women It is essential that the mothers diet is sufficient to enable her to produce milk for her baby. During pregnancy, fat reserves are laid down to provide some of the energy requirement needed for breast milk production. Current research suggests that 300 to 400 kcal per day extra is enough for fully breast feeding mothers. Additional requirements are needed for protein, calcium and phosphorus. The diet should be balanced in breast feeding, fluid is very important, so 8-12 glasses of water should be consumed. Caffeine and alcohol should be limited as this can pass through the breast milk.

Maternal nutrition What is meant by eating for two? Why should the women's overall nutrient intakes increase?

Infant nutrition Breast-feeding is the best method of feeding for babies. A varied diet is important whilst breast-feeding to ensure a sufficient intake of all nutrients needed by both the mother and the baby.  Breast-feeding mums are also advised to take supplements containing 10 mcg of vitamin D each day. By 6 months of age breast or formula milk will be insufficient to meet a baby’s nutrient needs and the process of weaning onto a solid diet should begin.   Non-wheat cereals, fruit, vegetables and potatoes are suitable first weaning foods. Salt should not be added to any foods for babies.  Between 6 and 9 months the amount and variety of foods should be increased to include meat, fish, eggs, all cereals and pulses. From the age of 6 months, infants receiving breast milk as their main drink should be given supplements of vitamins A, C and D. A varied diet containing adequate amounts of energy and nutrients is essential both before a woman becomes pregnant (conceives), during pregnancy and if she breast-feeds (lactation). The mother’s diet influences the health of the baby in the short-term and perhaps even in the long-term.

Breast feeding Research on the internet why breast milk is best for baby. What does it contain which is vital for the growing baby?

Pre-school children List the vital nutrients needed for toddlers and pre-school children: Why are they necessary?

Nutrient intakes Using food tables books, find out the RDA for the following, for a child aged 2-5 years: Protein Fat Calcium

Pre- school children (12 months- 4 years) Key points Encouraging pre-school children to eat a healthy, varied diet will provide all the nutrients they need for healthy growth and development and help to establish good eating habits for life. Young children who are growing and are usually very active have high energy and nutrient requirements in relation to their size.  A good supply of protein, calcium, iron and vitamins A and D are important during this time. Young children have small stomachs and may not be able to obtain all the energy and nutrients they need if their diet contains too much fibre.  Such diets can sometimes reduce the amount of minerals they can absorb, such as calcium and iron. By the time they are 5 years old, children should be eating family food and consuming a diet that corresponds with the eat well plate

School age children (4-10 years) School age children are growing fast and are also very active, therefore they have high energy and nutrient needs through a period of rapid growth. Between age 4-6, there is a greater need for protein, the requirement for vitamin C is the same as pre-school children. Sunlight is their major source of vitamin D. Between 7 and 10 years, there is a marked increase in energy and protein requirements, also requirements for other vitamins and minerals also increases. School aged children require a healthy balanced diet, rich in fruit and vegetables and starchy foods. Sugary foods should be limited. Children's weight gain should be gradual. Milk and dairy foods are essential for tooth and bone development. Salt intake should not exceed 3-5g a day.

Meal planning Plan a meal for a toddler: Dish chosen…………………………… Reasons for choice: 1 2 3 What nutrients are necessary in a toddlers diet? How does your chosen meal meet these requirements?

School children  A varied diet containing adequate energy and nutrients is essential for normal growth and development, which at times can be very rapid. • National survey data suggest that there has been a reduction in the percentage of energy derived from fat (with average intakes of total fat in line with recommendations for adults), with a corresponding increase in the proportion of energy derived from protein and carbohydrate. • A large proportion of children are inactive, spending less than one hour a day participating in activities of moderate intensity. BNF, 2009

Eating patterns of school children. Why do you think that obesity is on the increase in children? Why have children over recent years become inactive? Who is to blame?!!

Teenagers Key points • Growth and development are rapid during teenage years, and the demand for energy and most nutrients is relatively high. • National data shows that average intakes of fat among teenagers were close to the adult benchmark of 35% of food energy. • A proportion of teenagers had low intakes of some vitamins and minerals (e.g. vitamin A, riboflavin, iron and magnesium), with more girls aged 11-18 having low intakes compared to boys of a similar age. • Teenagers in Britain are largely inactive, with 46% of boys and 69% of girls aged 15-18 spending less than the recommended one hour a day participating in activities of moderate intensity. BNF 2009 Research further using text books, diets of teenagers.

Requirements of teenagers. Using food tables books, research the nutrient requirements and RDA’s for teenage girls and boys. Why is it that teenage girls requirement of iron is greater than boys? Why do boys need more calories in their diets?

Teenager eating habits and patterns Answer the following in full sentences: 1) Discuss the eating habits of teenagers. 2) Do you believe that teenagers are receiving the correct amount of nutrients on a daily basis? 3) What advice would you give to teenagers on healthy eating and dietary guidelines? 4) Do you think that teenagers should be following the Eat Well Plate and why?

Adults Key points • Nutritional requirements do not change much between the ages of 19–50 years, except during pregnancy and lactation, but energy requirements vary depending on age, gender and activity level of the individual. At the adult stage of life, nutrients are needed for energy requirements, to maintain and repair body tissue and for normal bodily functions. Adults are no longer growing. Requirements for vitamins and minerals and protein remain virtually unchanged compared with adolescents. Energy sources should be obtained from starchy foods. Adults should follow government guidelines.

Adult findings- BNF  On average, the diet of UK adults provides more than enough of most nutrients, although some groups of the population appear to have low intakes of some vitamins and minerals. • The percentage of energy derived from saturated fatty acids is higher than recommended (although fat intake is close to recommendations), and the average diet contains too little fibre and too much salt.

Nutrient requirements of the elderly. Using textbooks provided, research the dietary needs of the elderly (60+) 70-72 in textbook

Tasks Activity 3.3- page 68 Activity 3.5- page 70

Elderly Key points • Although energy requirements generally decrease as we get older, the general dietary guidelines still apply. • It is important for older people to keep physically active. • People aged 65 years and over should take a vitamin D supplement as well as regularly eating food sources (e.g. oily fish, cod liver oil and margarine). • National survey data have highlighted potential areas of change that could improve the nutrient intake of older people but it is important to take into account other factors which may affect older people’s dietary intakes (e.g. illness, poor dentition, drug-nutrient interactions). Activity 3.9- page 72

Other groups Vegetarian and Vegan Diets KEY POINTS • Between 3-7% of the UK population are vegetarian, with women more likely to be so than men • There are many interpretations of vegetarian diets; ranging from ‘semi’ vegetarian or Pesco- vegetarian to vegan and fruitarians. • Provided a vegetarian diet is well balanced, it should provide all of the nutrients needed by the body throughout life • Most vitamins can be provided by foods of plant origin, with the exception of vitamin B12. Dietary supplements and/or fortified foods are a source of this vitamin for individuals who do not eat foods of animal origin.

Continued.. Vegetarians can gain HBV proteins in their diet by eating dairy foods. Plant sources should be eaten together so they provide more protein, they are LBV proteins. Care needs to be taken to ensure protein and energy requirements are met, especially in adolescence as this is a period of rapid growth and development. Iron maybe lacking in a vegetarian diet, but supplements can be taken. Activity 3.10- page 72, 3.12- page 75

Meal planning Plan a meal for a vegetarian: Dish chosen…………………………… Reasons for choice: 1 2 3

Nutritional needs questions 1) What are the nutritional needs of babies? 2) What are the dietary needs/ foods of school age children? 3) Outline a suitable meal for a teenager explaining the nutrients in it and why it is suitable. 4) What are the nutritional requirements of the Elderly? How may they find it difficult to prepare a nutritious meal for themselves? 5) Plan a suitable meal for a vegan, explain why the foods you have included are suitable.