This document provides an overview of nutrition in the life cycle, covering several life stages. It begins with an introduction to maternal and child nutrition, discussing the relationship between nutrition and pregnancy outcomes, low birth weight, lactation, and women's nutrition between births. It then covers nutrition and child development from infancy through childhood and adolescence. Key topics for adolescents include growth, nutrient requirements, weight issues, and dietary sources of vitamins and minerals. The document also discusses interventions to address nutritional problems for mothers and children, including supplementation and breastfeeding. It concludes with a chapter on the nutritional concerns of the elderly, such as changes in nutrient requirements and food pyramid recommendations with aging.
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1.00 Nutrition in the life cycle.pptx
1. NUTRITION IN THE LIFE CYCLE
Credit Hours: 2
By : Kefyalew Taye (MPH Nutrition, Asst-prof,
PhD, Candidate)
2. COURSE CONTENTS
Chapter I: Introduction to maternal and child nutrition
– the intricate relationship
Nutrition and pregnancy outcomes
Low birth weight , prevalence determinants, and consequences
Nutrition during lactation
Nutrition care for women between births
Chapter II: Nutrition and child development
Introduction
Infant and young child feeding (IYCF) strategies
Nutrition during Childhood (2-9 years),
3. CHAPTER III: ADOLESCENT NUTRITION (10-19 YEARS)
Introduction
Nutrient requirements
Chapter IV: Direct interventions to address nutritional problems
of mothers and children
Nutrient supplementation
Breast feeding
Chapter V: Nutritional concerns of elderly
Aging and nutrition
Nutrient requirements
Nutrition related risk factors
Nutrition related health problems
Intervention strategies
5. WHY LIFE CYCLE APPROACH
Special nutrient requirement
Vulnerable to malnutrition
Far reaching effects
Lifecycle approach intervention have
there is a cumulative effect in the next generation
long term impacts on succeeding generations
8. ADOLESCENT NUTRITION
Adolescence :
period of transition between childhood and adulthood, ages 10-
19 (WHO) often referred to as puberty
Period of exploration and learning
Good time to establish proper health and nutrition practices and
behaviors
Expanding relationship and friendships
Influence lifestyles and behaviors
8
9. ….ADOLESCENT GROWTH…
Second highest rate of growth attained, second to the first
year of life
More than 20% of total growth in stature and up to 50% of
adult bone mass are achieved
Nutrient requirements are significantly increased above
those in the childhood years
Among girls, the "growth spurt" or peak growth velocity
occurs normally about 12-18 months before menarche at
some time between 10 to 14 years.
10. Growth in stature continues, however, for up to 7 years
after menarche
Maximal adult height in women may thus be attained as
early as 16 years or, particularly for populations with high
rates of under nutrition, as late as 23 years
The development of the birth canal is not fully completed
until about 2-3 years after growth on height has ceased
;whereas peak bone mass is not achieved until the age of
25 years.
The adult height finally attained may still differ as a result of
pre-existing childhood stunting
12. FINDING FROM DIFFERENT STUDY
RESULTS
1. Children of poor families were adopted to a wealthy
families and from the studies it was shown that :
Girls, who were stunted when adopted in infancy, were
also significantly shorter in adulthood than their peers
who were not stunted at the time of adoption
The improved early childhood growth in these adopted
girls hastened menarche considerably and shortened
the period of rapid premenarcheal growth.
13. ..CONT..STUDY FINDING
There remains little evidence that growth retardation
suffered in early childhood can be significantly caught up
in adolescence.
Stunted children are more likely than no stunted children
to become stunted adults, while they remain in the same
environment which gave rise to the stunting
14. 2. RESULTS FROM STUDIES IN INDIA, COHORTS OF DUTCH
HUNGER TIME , AND GUATEMALA:
Growth failure in early childhood manifested by stunting,
may be irreversible to a large extent
Early childhood stunting and its functional correlates can be
addressed together only if the environment in which the
young child grows is improved at that time; i.e., within the
first two years of life
Early childhood stunting among young girls was correlated
significantly with the birth weights and mortality risk of their
infants
15. ENERGY AND NUTRIENT NEEDS FOR MALE AND FEMALE
ADOLESCENTS
• After reaching the age of puberty male and
female slightly differ in their nutritional
needs
• The requirements of both could be increase if by
workloads as they start to work for their families
• Adolescent girls need special attention
– To ensure adequate nutrition for their own development
– Ensure adequate nutrient reserve for future pregnancy
and lactation.
16. Energy and protein requirements peak at 11-14 for
girls (2,200 Cal/d) and 15-18 for boys (2,500+
Cal/d).
Protein requirements of 0.8 –1.0 g/kg/d are met by
typical American teens (even vegetarians).
Fat: adult levels of 30% of calories should be
encouraged.
Calcium: 1,200-1,500 mg/d recommended (600-800
consumed)
Iron: prevalence of Fe-deficiency anemia 2-10%
Zinc: growth increases zinc requirements
17. MORE REASON TO PAY ATTENTION TO
ADOLESCENT NUTRITION
This second period for rapid growth could be window
of opportunity to compensate earlier growth failure.
More effort could be made to avoid further growth
failure during this stage which could pass to
adulthood which makes malnutrition to pass to next
generation.
18. WHAT CAN ADOLESCENTS GIRLS DO TO ENSURE THEIR
NUTRIENT NEEDS?
Eating a diet rich in dairy foods and leafy green
vegetables help to ensure calcium
Increase their consumption of iron-rich
foods, such as red meats, fish, poultry and
legumes, to meet iron needs
Early pregnancy is better avoided
Special care must be provided during adolescent
pregnancy
19. SPECIAL ADOLESCENT POPULATIONS
Pregnant: add 300 Cal/d, increases protein and calcium
requirements, needs of the mother compete with the needs of the
fetus
Athletes: may use protein powders unnecessarily. For females:
eating disorders, amenorrhea, & inadequate Ca intake all contribute
to osteoporosis risk.
Obese: associated with development of cardiovascular risk,
exercise and avoidance of empty calories are important, caloric
restriction increases chances of deficiencies, ketogenic diets may
reduce hunger.
Vegetarian: many teens decide to adopt alternative diets, focus on
what is eaten rather than what is avoided
Poverty: low socioeconomic status is correlated with risk for poor
diets
21. DIETARY SOURCES OF MINERALS NEEDED
BY ADOLESCENTS
Iron:
Organ meats, fish, green vegetables, nuts, iron-fortified cereals,
raisins.
Calcium:
Dairy products, green leafy vegetables, sardines, salmon
Zinc:
red meat, organ meats, oysters, crabmeat, beans, whole grains
Magnesium:
Whole seeds, nuts, legumes, grains
Fiber:
Peas, beans, whole grains, sweet potato, green leafy
vegetables
22. ADOLESCENT NUTRITION
Weight problems usually begin to occur in this period.
Drug and alcohol decisions are being made
Eating disorders increase in female teens
Can be as high as 4000 calories in males related to lean
body mass and activity level.
Much lower in females compared to males due to size
differences, higher body fat and decreased physical
activity.
23. ADOLESCENT NUTRITION
Important to emphasize physical activity especially to females
because they grow earlier, and fat cells grow in size (*and
number) at this age.
Both males and females teens in America are more
overweight and obese than in past generations. (Increase of
diabetes type II also.)
Body image issues and cultural pressures to be thin and sexy
are major contributing factors to food and behavior choices!
27. INTERVENTIONS FOR MATERNAL AND BIRTH
OUTCOMES
• Protein-energy supplementation to pregnant women
– Reduces risk of LBW, mostly among the undernourshed
women
• Iron/folic acid supplementations to pregnant women
– Help for prevention of IDA, increases hemoglobin
– Help prevent neural tube defects among fetuses
• Multiple micronutrient (MMN) versus iron/folic acid
– MMN is more beneficial for increasing birthweight
• Nutrition education and Iron/folic acid supplements
to adolescents before pregnancy
– Increase hemoglobin and reduces anemia
28. INTERVENTIONS FOR NEW-BORN BABIES,
INFANTS AND CHILDREN
Breast feeding support and promotion
Reduce morbidity and mortality
Increase in early initiation of breastfeeding
Adequate and timely introduction of complementary
feeding
No best package to apply
Have beneficial effects in trials than in large
scale
29. INTERVENTIONS FOR NEW-BORN BABIES,
INFANTS AND CHILDREN
Hygiene practices and interventions
Decrease diarrhea and dysentery
Hand-washing counseling reduce 30% diarrhea
Lack of evidence on impact of hygiene practices
on stunting or underweight
Deworming
Small evidence base, but probably improve
growth of children
30. INTERVENTIONS FOR NEW-BORN BABIES,
INFANTS AND CHILDREN
Micronutrient supplementation interventions
Vitamin A supplementation (6-59 months) reduce
mortality by 24%
Zinc supplementation reduces duration of acute
diarrhoea
Poor evidence regarding effect of zinc on
stunting
Fortifications of staple food by some
micronutrients are effective in reducing
deficiencies
Treatment of severe acute malnutrition (SAM)
Found to be effective in reducing mortalities
31. INDIRECT INTERVENTIONS
• Efforts that might influence underlying causes
• These are development efforts made to be more
“nutrition-sensitive”
– social protection to reduce household poverty
agricultural development to improve rural incomes and
household food security
– women’s empowerment
– wider health systems strengthening and
– water and sanitation measures
32. SOCIAL PROTECTION
• Policy instruments to address poverty and vulnerability
• Includes the following programs
– social assistance,
– social insurance and efforts at social inclusion
– subsidies and others
• Social protection programs of food security have different
sources for “entitlements” to
– Food
– Labor (public work)
– Trade (subsidies on food price, grain reserve managements)
– Transfers (supplementary feeding, school feeding programs, cash
transfers )
33. CASH TRANSFERS
• Main aim is to alleviate poverty
• Also contributes to wider range of development outcomes
• The benefits include
– Improved food consumption
– Improved child weight and height
– Reduction of risk of stunting by 7%
• However ,
– No evidence sustainability of the initial benefits
– Evidences are not conclusive about impact on malnutrition (wasting)
• cash transfer programs have positive impact on child
nutritional status
– More effective on stunting than on wasting
– More effective if targeted at younger children
34. AGRICULTURE
• Evidences on direct effect on nutrition is poor
• Interventions include
– Homestead gardening
– Promotion of crops for nutritional values
– Bio-fortification
• Review of evidences on impact of such intervention show
mixed results
– Child anthropometry
– Diet
– Iron and
– Vitamin A absorption
• Agricultural growth contributes
– Increased food production improves health and nutrition
– increased the income of the poor
– Reduces the risk of stunting , but not in India
35. WHAT IS NEXT
Make continuous effort to update yourself with new
evidences as scientific information in human
nutrition is very dynamic over time
37. WHAT IS AGING AND AGING PROCESS
• How Old is Older? People of older than sixty years are
older people
• Aging is not a disease: _If we live long enough change
in body composition, physical function, and
performance will occur in all of us
• Many of the change as well as health problem which
become more common in old age have long been
attributed to the normal aging process
38. AGING…
Life expectancy: the average number of year lived
by people in a given society
Longevity: long duration of life
Life span: the maximum number of years of life
attainable by a member of a species (for humans is
130 yrs)
39. CHRONOLOGICAL AGE AND BIOLOGICAL AGE
• Chronological age: the age of a persons in years
since birth
• Biological age: a decline in functions that occur in every
human being with time
• Some people look and function as so they were older and others
as they were younger at the same chronological age
• The difference can go up to 10 years and some of the reason
could be due to improved life long nutrition
40. THE EFFECT OF AGING ON NUTRITIONAL STATUS
Decrease in lean body weight
Loss of taste and smell
Oral Cavity Changes
Decrease in gastrointestinal function
Loss in visual and auditory function
Loss of bone mineral mass
Mental impairment
Decrease in heart and lung fitness
Decreased ability to metabolize drugs
High prevalence of chronic disease
Neuromuscular changes
Decrease in liver and kidney function
11/24/2023
41. NUTRIENT REQUIREMENT FOR OLDER AGE
1. Water Needs
– Total body water decreases with age
– Can dehydrate rapidly
– Many older people do not feel thirsty or notice mouth dryness
– It may be difficult to get a drink or get to the bathroom
– Those who have lost bladder control may be afraid to drink
too much water
42. Dehydration Can lead to:
urinary tract infection
pneumonia
pressure ulcers
Confusion
disorientation
43. REQUIREMENT…
2.Calories Needed
Less calorie needed
Physical activity decreases
Basal metabolic rate decreases
Due to decrease in lean body mass
44. 3. Protein requirement
High-quality protein needed because of reduced calorie diet
Important for supporting immune System
Helps prevent muscle wasting Problem of expense
45. 4.Vitamin D
• Need more to prevent bone loss
• Less vitamin D made by body
– Limited exposure to sunlight
– Reduced capacity of skin to make it and
– liver to activate it
• Older adults drink less milk
– Increased incidence of lactose
intolerance
46. 5.Calcium
Needed to prevent bone loss
Problem of low dairy intake
Solutions:
Calcium-fortified juices,
adding milk powder to foods
supplements
47. 6.Iron
• Need in women decreases after menopause
• Low food intake can lead to deficit
• Loss of iron through chronic blood loss due to disease or
medicines
• Reduced iron absorption to due low stomach acid and
antacid use
48. 48
A food pyramid for the elderly
Calcium, vitamin D, vitamin B12,
Wholemeal
Fruit 2 portions
Cereals and tubers
6 portions
Wholemeal
is better
Vegetables
3 portions
Milk, yogurt, cheese
3 portions
Sweets and fats in moderation
Fish meat legumes
2 portions
Water and liquids 8 glasses