PREGNANCY AND LACTATION
Vitamin C (extra 10 mg/day)
• Recommended increase to meet the demands of
pregnancy varies from one nutrient to another
a) To meet normal requirements of the mother
b) To meet the nutrient needs of the growing
fetus and other maternal tissues
c) For building reserves in preparation for
delivery and lactation
PRDI Recommended Nutrient Intake during
Pregnancy
RATIONALE FOR INCREASING SPECIFIC NUTRIENT
REQUIREMENT
1. Energy (+ energy is required)
- Growth of the fetus, placenta and maternal
tissues and their maintenance
- Increase in BMR; better utilization of dietary
protein and good pregnancy outcome
- The addition of 300 kcal/day during the second
and third trimesters of pregnancy is
recommended; this amounts to the total of
56,100 kcal
2. Protein (+ by an average of 8g/day)
- Meet the needs of developing maternal tissues,
support the growth of the fetus and placenta
- Protect the pregnancy course and outcome
against risk associated with low protein intakes
3. Vitamin A (800 µg RE/day)
- essential for the health of the epithelial tissues
including the skin and the membranes that like
glandless duets and passages of the
gastrointestinal, urinary and respiratory tracts
- the RNI of 800 µg RE/day for the pregnantwoman
also accounts for the vitamin A storage in the
fetal tissue
4.
- to maintain the integrity of fetal membranes and
tissue structure
5. Thiamin, riboflavin, and niacin
- important during pregnancy particularly with
reference to carbohydrate, protein and lipid
metabolism
6. Folate (600 µg DFE daily / +200 µg/day)
- additional 200 µg/day is based on folacin role in
promoting normal fetal growth (DNA synthesis)
and in erythrocyte maturation, and preventing
neural tube defects.
7. Calcium (+ allowance of 50 mg; total of 800 mg)
- to promote adequate mineralization of fetal
skeleton and deciduous teeth of the fetus.
8. Iron (higher than what can be provided by usual
diet alone, thus supplementation is
recommended)
- Allow for build-up of iron stores
- Allow for the expansion of the red cell mass, and
- Provide the needs of the fetus and the placenta
9. Iodine (+ allowance of 50 µg/day
- not to compromise the development of the fetus
- iodine deficiency in pregnancy has been known
to result in cases of cretinism.
Other Minerals and Vitamins
• Zinc: minimal increase during 1st trimester (0.6
mg/day); increase more than twice of the non-
pregnant woman (4.5 mg/day) during 3rd
trimester to provide the needs for maternal and
embryonic or fetal tissue growth.
• Vitamin B6 (1.9 mg/day): take care of the fetal,
placental and maternal needs and its
bioavailability in food.
• Water and electrolytes:
- Water -an additional 300ml/day is recommended
because of the expanding extracellular fluids, the
needs of the fetus and the amniotic fluid.
- Sodium: the increase in extracellular fluids calls
for an increase in body sodium, sodium
restriction should not be a routine; sodium
restriction stresses the renin-angiotensin
aldosterone mechanism in order to maintain
homeostasis; the additional need in pregnancy is
69 mg/day.
- JA
 NUTRITIONAL REQUIREMENTS (LACTATION) c) safe – are hygienically stored and prepared, and
Energy/Nutrient PDRI 2015 fed with clean hands using clean utensils and not
Energy, Kcal +500 bottles and teats
Protein, g +27 d) properly fed – are given consistent with a child’s
Vitamin A, RE +400 signals of appetite and satiety, and that meal
Vitamin C, mg +35 frequency and feeding are suitable for age.
Thiamin, mg +0.2
Riboflavin, mg +0.6 DBW, IDEAL HEIGHT & TER COMPUTATION
Niacin, NE +4
𝑫𝑩𝑾 = (𝒂𝒈𝒆 𝒊𝒏 𝒚𝒆𝒂𝒓𝒔 𝒙 𝟐) + 𝟖
Folate, ug +150 Example: 8 years old
Calcium, mg 750 DBW = (8 x 2) + 8
Iron, mg +2 DBW = (16) + 8
Iodine, ug +100 𝑫𝑩𝑾 = 𝟐𝟒
𝑰𝒅𝒆𝒂𝒍 𝑯𝒆𝒊𝒈𝒉𝒕 = (𝒂𝒈𝒆 𝒊𝒏 𝒚𝒆𝒂𝒓𝒔 𝒙 𝟓) + 𝟖𝟎
RATIONALE FOR SPECIFIC NUTRIENT Example: 8 years old
REQUIREMENTS DURING LACTATION Ideal Height = (8 x 5) + 80
• Calories: for production of milk in adequate Ideal Height = (40) + 80
amounts, to supply the energy content of the 𝑰𝒅𝒆𝒂𝒍 𝑯𝒆𝒊𝒈𝒉𝒕 = 𝟏𝟐𝟎
𝑻𝑬𝑹 = 𝟏𝟎𝟎𝟎 + (𝟏𝟎𝟎 𝒙 𝒂𝒈𝒆 𝒊𝒏 𝒚𝒆𝒂𝒓𝒔)
milk secreted, the mother's own energy needs
Example: 8 years old
• Protein: necessary for the production and TER = 1000 + (100 x 8)
increased secretion of milk TER = 1000 + (800)
• Calcium: necessary to replenish and avoid 𝑻𝑬𝑹 = 𝟏𝟖𝟎𝟎)
depletion of the mother's calcium stores
• Iron: does not increase above that for pregnancy; 1-3 years old 105 kcal
only a small amount of iron transferred to human 4-6 years old 90 kcal
milk, and this is well utilized by the infant 7-9 years old 75 kcal
• Iodine: to increase milk flow 10-12 years old Girls: 65 kcal; Boys: 55 kcal
• Vitamin A: small storage of Vitamin A at birth and
human milk becomes the main source of both NUTRITIONAL REQUIREMENTS (LACTATION)
Vitamin A and carotenoids Energy/Nutrient 1-3 years 4-6 years
Energy, Kcal 1070 1410
• Thiamine: thiamin deficiency may cause infantile
Protein, g 28 38
beri-beri among breast-fed infants.
Vitamin A, RE 400 400
• Riboflavin: human milk provides the infant with
Vitamin C, mg 30 30
a high level of this nutrient
Thiamin, mg 0.5 0.6
INFANCY, PRESCHOOL, SCHOOL AGE Riboflavin, mg 0.5 0.6
Niacin, NE 6 7
• 6 months – infant’s need for energy and Folate, ug 160 200
nutrients starts to exceed what is provided by Calcium, mg 500 550
breast milk, thus complementary foods are Iron, mg 8 9
necessary to meet those needs Iodine, ug 90 90

Complementary foods should be: NUTRIENT REQUIREMENT FOR PRESCHOOL

a) timely – are introduced when the need for
energy and nutrients exceeds what can be
provided through exclusive breastfeeding
b) adequate – provide sufficient energy, protein
and micronutrients to meet a growing child’s
nutritional needs
• Energy - energy requirements for individual
children are determined by Resting Energy
Expenditure (REE), rate of growth, and activity;
daily intakes of 150 to 250 kcal/kg/day of body
weight have been recommended

- JA
• Protein - for maintenance of tissue, for changes • The RENI for Filipinos classified school children
in body composition, and for synthesis of new into two groups: the 7-9 years old and the 10-12
tissue years old. The older group is called pre-
→ Protein intake must be based on: adolescents.
a) the adequacy of growth rate • Their dietary allowances are grouped according
b) the quality of protein to sex
c) combinations of foods that provide
complementary amino acids when NUTRIENT REQUIREMENT FOR SCHOOL CHILDREN
consumed together • Energy - determined by age, basal metabolism
d) the adequacy of the intake of vitamins, and activity; Allowances for school children
minerals, and energy decline gradually to approximately 80-90 kcal/kg
• Calcium - essential for bone growth and for the 7-9 age group and 70-80 kcal/kg for the
mineralization; More than 98% of body calcium is 10-12 age group; need for energy and nutrients
bone; Lactose increases absorption, binders such are the same for boys and girls 7-9 years, at age
as phytic acid and oxalic acid reduce absorption, 10-13 years boys have higher needs
and the level of dietary protein affects the • Protein - cover the requirements for periods of
urinary excretion of calcium; As levels of protein rapid growth; minimum of 8% of the total energy
intake increase levels of urinary calcium increase; requirement is necessary since children are
Recommendations are set at 800 mg/day, since susceptible to recurrent infections; higher
growing children may need 2-4x as much calcium amounts of high biological value protein
per unit of body weight as adults require • Vitamins and minerals - The most important
• Zinc - For normal protein synthesis & growth minerals that may be limiting at this age are
• Iron - Iron deficiency is the most common calcium and iron
nutritional deficiency; It may result from → Calcium: for continued mineralization of
inadequate iron intake, impaired absorption, a bone and prevention of osteoporosis
large hemorrhage, or repeated small blood → Iron: for growth and development &
losses. prevention of anemia
→ IDA causes delayed mental and physical → Physicians do not recommend routine
development and decreased resistance to vitamin and mineral supplementation for
infection. healthy children except for fluoride
• Vitamin A - For maintenance of normal vision; supplementation in areas not fluoridated
Promotes the differentiation of the epithelial
cells of the body’s skin and linings of all tissues ADOLESCENTS, ADULTS, OLDER ADULTS
from invasive microorganisms and other harmful
NUTRIENT REQUIREMENT FOR ADOLESCENTS
particles; Promotes growth; Promotes immunity
by maintaining the integrity of the epithelial Energy
tissues; Influences the expression of over 300
genes - Energy needs of adolescents are influenced by a)
activity level, b) basal metabolic rate, c) increased
NUTRITION IN SCHOOL CHILDREN requirements to support pubertal growth and
development
Energy/Nutrient 7-9 years 10-12 years
- Basal metabolic rate (BMR) is closely associated
Energy, Kcal 1600 2140
with the amount of lean body mass of individuals.
Protein, g 43 54
Vitamin A (ug) 400 400 PDRI Table for Energy
Vitamin A (mg) 35 45
Calcium, mg 700 1000 Age group Male Female
Iron, mg 11 13 10-12 2060 kcal 1980 kcal
Iodine, ug 120 120 13-15 2700 kcal 2170 kcal
16-18 3010 kcal 2280 kcal

- JA
Protein PDRI Table for Energy

- for maintenance of existing lean body mass, plus Age group Fiber
allowances for the amount required to accrue 10-12 15-17
additional lean body mass during the adolescent 13-15 18-20
growth spurt. 16-18 21-23
- developmental age will be more accurate than
Fat
absolute recommendations based on
chronological age. - requires dietary fat and essential fatty acids for
- Protein requirements are highest for females at normal growth and development
10 to 12years and for males at 16 to 18 years, - Current recommendations suggest that children
when growth is at its peak. over the age of 2 years consume no more than
25–35% of calories from fat, with no more than
PDRI Table for Energy
10% of calories derived from saturated fat.
Age group Male Female - National dietary guidelines also suggest that
10-12 43 46 adolescents consume no more than 300 mg of
13-15 62 57 dietary cholesterol per day. The DRIs recommend
16-18 72 61 specific intake of linoleic and alpha-linolenic acid
to support optimal growth and development
Carbohydrates Vitamins and Minerals
- provide the body’s primary source of dietary • Calcium - main constituent of bone mass;
energy Additionally, calcium needs and absorption rates
- The recommended intake of carbohydrate are higher during adolescence than any other
among teens is 130 g/day or 45–65% of daily time except infancy
energy needs. → Female adolescents have the greatest
- Sweeteners & added sugars provide capability to absorb calcium at about the
approximately 21% of energy intake by teens time of menarche, with calcium absorption
- In a study conducted in US, males consumed 35 rates decreasing from then on.
tsp and female teens consumed 26 tsp of added → Calcium absorption rates in males peak
sugar per day. during early adolescence, a few years later
- Soft drinks, candy, baked goods, and sweetened than in females
beverages are major sources of added → Young adolescents retain up to four times as
sweeteners in the diets of adolescents much calcium as young adults.
Dietary Fiber PDRI Table for Calcium
- important for normal bowel function and may Age group Male Female
play a role in the prevention of chronic diseases 10-12 1000 mg 1000 mg
such as certain cancers, coronary artery disease, 13-15 1000 mg 1000 mg
and type 2 diabetes mellitus. 16-18 1000 mg 1000
- Adequate fiber intake is also thought to reduce
serum cholesterol levels, moderate blood sugar - Adolescent females consume 849 mg calcium per
levels, and reduce the risk of obesity. day, while adolescent males consume 1186 mg
- During adolescence, fiber intake among males calcium each day.
increases slightly with age, while it decreases - Calcium consumption drops as age increases;
with age among females. however, males consume greater amounts of
calcium at all ages females.
- Calcium intakes among adolescents are highly
correlated with energy intakes.

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- Females who restrict calories in an effort to PDRI Table for Folate
control their weight are at particularly high risk
for inadequate calcium intakes. Age group Male Female
10-12 300 (µgDFE) 300 (µgDFE)
• Iron - The rapid rate of linear growth, the
13-15 400 (µgDFE) 400 (µgDFE)
increase in blood volume, and the onset of
16-18 400 (µgDFE) 400 (µgDFE)
menarche during adolescence increase a teen’s
need for iron. - Folate in the form of folic acid is twice as
bioavailable as other forms of folate; For this
PDRI Table for Iron
reason, dietary folate equivalents (DFEs) are used
Age group Male Female in the DRIs.
10-12 12 20 - One microgram of folic acid is equivalent to
13-15 19 28 approximately 2 DFEs, while 1 microgram of
16-18 24 28 other forms of folate is approximately equivalent
to 1 DFE.
- Folic acid is the form of folate added to fortified
- Requirements cannot be met by usual diet alone. cereals, breads, and other refined grain products.
Intake of iron-rich and iron-fortified foods and - Severe folate deficiency results in the
the use of supplements are recommended, if development of megaloblastic anemia, which is
necessary rare among adolescents.
- The two types of dietary iron are heme iron, - Red blood cell & serum folate levels drop during
which is found in animal products, and nonheme adolescence as sexual maturation proceeds,
iron, which is found in both animal and plant- suggesting that increased folate needs during
based foods. growth and development are not being met
- Heme iron is highly bioavailable, while nonheme - Poor folate status among adolescent females also
iron is much less so. More than 80% of the iron presents an issue related to reproduction.
consumed is in the form of nonheme iron. - Studies show that adequate intakes of folate
prior to pregnancy can reduce the incidence of
• Vitamin D - fat-soluble vitamin that facilitates spina bifida and selected other congenital
intestinal absorption of calcium and phosphorus anomalies and may reduce the risk of Down
that is required to maintain adequate serum syndrome among offspring.
levels of these minerals.
- The American Academy of Pediatrics (AAP) has
• Vitamin C - Vitamin C is involved in the synthesis
recommended that all adolescents who do not of collagen and other connective tissues.
consume at least 400 IU ( 10ug) of vitamin D per
day through dietary sources receive a PDRI Table for Vitamin C
supplement of 400 IU per day.
Age group Male Female
PDRI Table for Vitamin D 10-12 45 mg 45 mg
13-15 60 mg 55 mg
Age group Male Female 16-18 70 mg 60 mg
10-12 5 ug 5 ug
13-15 5 ug 5 ug - Vitamin C intakes are generally adequate within
16-18 5 ug 5 ug the adolescent population.
- Mean intakes are estimated at 97 mg/day among
Folate - Folate is an integral part of DNA, RNA, and males and 75 mg/day among females
protein synthesis. Thus, adolescents have increased - Vitamin C acts as an antioxidant. Smoking
requirements for folate during puberty. increases the need for this antioxidant within the
body because it consumes vitamin C in oxidative
reactions

- JA
- Consequently, smoking results in reduced serum
levels of vitamin C.
- Recommended levels of vitamin C intake are
higher among smokers.
TER Table
Kcal / kg IBW
Age group Male Female
10-12 65 kcal 55 mg
13-15 55 kcal 45 mg
16-19 45 mg 40 mg
Total Protein Requirement
• 10-12 yrs old = 1.5 g of CHON per kg bodyweight
• 13-19 yrs old = 1.2 g of CHON per kg bodyweight
ADULTS
Estimating Energy Needs
Energy needs are based on an individual’s basic
metabolic rate (BMR), the thermic effect of food
(TEF), and activity thermogenesis (which includes
energy expended through exercise and non-exercise
activity such as fidgeting).
1. The largest component of daily energy
expenditure, 60–75% for most adults, is the
involuntary process of internal chemical activities
that maintain the body.
2. Additional energy is required for the digestion,
absorption, and metabolism of food–referred to
as the thermic effect of food (TEF). TEF is lower in
some obese individuals, suggesting that more
efficient digestion and absorption of food may be
a factor in obesity.
3. The most variable component of energy
expenditure is activity thermogenesis which
accounts for 20-40% of total energy expenditure.
Approximately 15 calories per pound per day are
needed to maintain weight. Cutting to 13 calories/lb
per day can result in weight loss and increasing to 17
calories/lb per day can produce weight gain.
Energy Adjustment for Weight Change
A pound of body weight is the equivalent of
approximately 3500 calories. To lose1 lb a week, an
adult would need to create a negative calorie balance
of 500 calories daily. These 500 calories can be
generated from a combination of decreased calorie
intake and increased physical activity.
The Food guide pyramid for Filipinos recommend to
drink at least 8 glasses per day and Pinggang Pinoy
recommend to include 1-2 glasses of water every
meal.
Alcoholic Beverages
Alcohol is a popular beverage with significant social
and cultural significance, but it is also a psychoactive
drug with potential for abuse.
Moderate alcohol intake is a recognized contributor
to heart health, but alcohol also increases the risk of
oral, esophageal, liver, and colorectal cancers, and
breast cancer in women.
France and Italy have the highest levels (3-5 drinks per
day for men and 2-3 drinks per day for women), while
Canada (7 per week for men and women) and the
United Kingdom (1-2 per day for men and for women)
have the most stringent guidelines.
A drink contains roughly 13–15 grams of alcohol or
0.5 oz of ethanol.
Water Intake Recommendations
The Food and Nutrition Board defines the adult
adequate intake (AI) level for water based on median
total water intake (from fluids and food)
Men and women need to drink each day is
approximately 12 cups and 9 cups, respectively, of
water and other beverages
Effects of Caffeine Intake on Water Need
Caffeine is a stimulant that relaxes the esophageal
sphincter (leads to acid reflux), has a laxative effect,
and temporarily increases urine production at high
doses.
COMPUTATION
𝑪𝑩𝑾 = (𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 − 𝑰𝑩𝑾) 𝒙 𝟐𝟓% + 𝑰𝑩𝑾
Example: ABW=90 kg; IBW=75 kg
𝐶𝐵𝑊 = (90 − 76) 𝑥 0.25 + 75
𝐶𝐵𝑊 = 79 kg
- JA
NUTRIENT REQUIREMENT FOR OLDER ADULTS
Energy
- Elderly people require less energy than young
adults because of a reduced basal metabolic rate
- energy requirements decrease due to loss of fat-
free mass. As a consequence, resting energy
expenditure is found to be lower in elderly
individuals than in young adults.
- Older people should be encouraged to meet their
energy requirement through a healthy diet.
Protein
- Is necessary for building up muscles, and to
replenish vital body fluids, and wear and tear of
the body. It is also required for the metabolic
processes of the body in the form of enzymes and
hormones.
- Older persons are vulnerable to protein energy
malnutrition associated with a progressive
decline in body protein manifested by declining
fat-free mass.
- The reduction in fat-free mass is attributed
mainly to the loss of skeletal muscle and is
associated with reduced muscle strength as well
as predisposition to many metabolic disorders.
Fat
- Fat is a concentrated source of energy. It makes
food palatable and help in the absorption of fat-
soluble vitamins such as A, D, E, and carotene.
- Fats and oils are concentrated sources of energy.
- According to the World Health Organization
except for in cases of overweight or obesity,
there is no need to restrict fat intake beyond 30
energy % for sedentary and 35 energy % for
active older persons.
- The role of dietary fat does not seem to change
with age; high saturated fat and trans fatty acid
intake continues to be a risk factor for chronic
disease. Consumption of saturated fat should be
minimized and should not exceed 8 energy %.
Carbohydrate
- are energy-giving nutrients, and the body needs
carbohydrates because it cannot make it for itself
from other nutrients.
- Carbohydrates are energy-yielding substances.
- Senses of taste and smell are less sharp among
older people, which interfere with the appetite
for many foods.
- During old age, loss of teeth makes it difficult to
chew food properly. Elderly people tend to
consume more carbohydrate-rich food, which
require minimum chewing, are easily digested,
need minimum cooking time, stand maximum
storage, and are cheaper than protein-rich food
- A slow increase of dietary fiber allows the
intestinal system to adapt to the additional
bacterial substrate.
Fiber
- Apart from digestible carbohydrates such as
cereals and sugar, several foods contain
nondigestible carbohydrates in the form of
cellulose, gums, pectin.
- Dietary fiber contributes to the bulk of stools,
and helps relieve constipation and lower blood
cholesterol level, especially among elderly
people.
- Consumption of 25-30g of fiber daily is
considered to be beneficial
Calcium and Vitamin D
- Maintains good bone health, therefore, it is
advisable to increase the intake of calcium-rich
food such as milk and milk products
- If elderly people are confined indoors and are not
exposed to sunshine, they should be given
vitamin D supplements.
Calcium
- An explosion of calcium fortified foods and
supplements presents the possibility of adverse
effects of excess calcium (reported at 4000 mg
per day). These include high blood calcium levels,
kidney damage, and calcium deposits in soft
tissues and outside the bone matrix, such as bone
spurs on the spine.
- High calcium intake may interfere with zinc, iron,
and magnesium absorption, and it may result in
elevated urinary excretion of calcium, leading to
new kidney stones in individuals with a history of
kidney stones.
- JA
Vitamin D
- Age-associated metabolic changes affect vitamin
D status, independent of dietary intake, primarily
due to a four-fold decrease in the following
ability of aged skin to synthesize vitamin D.
- Older adults use more medications that may
interfere with vitamin D metabolism.
Iron
- Women’s iron needs decrease after menopause,
and older men and women eat more iron than
the RDA of 8 mg .
- Iron is stored more readily in the old than in the
young. Excess iron contributes to oxidative
stress, increasing the need for antioxidants to
deal with oxidant overload. Fortunately, vitamin
C intake increases iron absorption and serves as
an antioxidant.
Vitamin A, E and C
- They are protective antioxidants.
- Liberal intake of food rich in beta–carotene is
advocated due their antioxidant properties.
Vitamin A
- Older adults were more likely to overdose on
vitamin A than to be deficient in the nutrient,
Plasma levels and liver stores of vitamin A
increase with age. This may be due to increased
absorption but is more likely due to decreased
clearance of vitamin A metabolites (retinyl
esters) from the blood.
- Kidney disease further elevates serum vitamin A
levels because retinol-binding protein, another
vitamin A metabolite, can no longer be cleared
from blood. Thus older adults are more
vulnerable to vitamin A toxicity and possible liver
damage than younger individuals are.
- Vitamin A’s plant precursor, beta-carotene, will
not damage the liver, although supplements used
as antioxidants to prevent cardiovascular disease
have been linked to higher all-cause mortality.
Excess dietary beta-carotene, because it is water-
soluble, may give old skin a yellow-orange tint,
but it will not lead to hair loss, dry skin, nausea,
irritability, blurred vision, or weakness
Vitamin E
- It is a problematic nutrient because dietary
intake is well below the recommended 15 mg or
15 IU alpha-tocopherol equivalent.
- plays a special role in the health of older adults
due to its antioxidant functions, such as hindering
development of cataracts.
- is associated with enhanced immune function
and cognitive status, although not with reduced
cardiovascular disease risk.
- At higher doses, vitamin E may increase all-cause
mortality and is linked to longer blood-clotting
times and increased bleeding. Aspirin, anti-
coagulants, and fish-oil supplements also
increase blood-clotting time and are
incompatible with high vitamin E intake
Folate
- are found in green leafy vegetables, pork, liver,
pulses, groundnuts, and oilseeds is associated
with a diminished risk of vascular disease.
Magnesium
- is needed for bone and tooth formation, nerve
activity, glucose utilization, and synthesis of fat
and proteins.
- Magnesium deficiency can result not only from
low intake but also from malabsorption due to
gastrointestinal disorders, chronic alcoholism,
and diabetes. Signs of deficiency include
personality changes (irritability, aggressiveness),
vertigo, muscle spasms, weakness, and seizures.
- Drugs used by older adults, such as magnesium
hydroxide or citrate laxatives, may lead to
magnesium overdose. Signs of magnesium
toxicity are diarrhea, dehydration, and impaired
nerve activity. Food sources including milk, yeast
breads, coffee, ready-to-eat cereals, beef, and
potatoes do not result in toxicity
Phytochemical
- can lower the risk of major health problems such
as cancer and heart disease. Hence, consumption
of food rich in phytochemicals should be
encouraged.
- Many degenerative age-related diseases
aggravate the tendency toward dehydration in
older persons.
- JA
Water

- Proportion of water in total body weight Such nutritional risk factors include:
decreases with age, resulting in a smaller water
a) Lack of appetite resulting from illness
reservoir and leaving a smaller safety margin for
b) loss of taste or smell, or depression
maintaining hydration. The DRIs for water are
c) Diseases or bacterial overgrowths in the gastro-
constant after age 19.
intestinal tract that prevent absorption
- Drinking 6 or more glasses of fluid per day
d) Poor diet due to food insecurity
prevents dehydration (and subsequent
e) loss of function, dieting, or disinterest in food
confusion, weakness, and altered drug
f) Avoidance of specific food groups such as meats,
metabolism) in individuals whose thirst
milk, or vegetables
mechanism has grown less sensitive.
g) Contact with substances that affect absorption or
Dietary Supplements metabolism: smoke, alcohol, drugs

- Recovery from illness and trauma is definitely COMPUTATION

aided by supplemental formulas, including
vitamins, minerals, and energy nutrients such as TCR
50-59 years old Reduce TCR by 10%
protein and fatty acids.
60-69 years old Reduce TCR by 20%
- “Multivitamin/mineral supplement use may
>= 70 years old Reduce TCR by 25%
prevent cancer in individuals with poor or
TPR = 1.5 g CHON/kg IBW
suboptimal nutritional status.
- Multivitamin/ mineral supplements conferred no
benefit in preventing cardiovascular disease or
cataract, and may prevent advanced age-related
macular degeneration only in high-risk
individuals.
- Discussions about supplements are based on the
assumption that whole foods are the ideal source
of nutrients, and supplements boost marginal
diets.
- Sometimes it turns out that, as is the case with
vitamins A, E, and beta-carotene, the pill form of
a nutrient is harmful while the food form
promotes health.
- Furthermore, the interactions among nutrients
and the composition of plants and animals
making up our food supply are much too complex
to replicate in supplements. However, vitamin
B12 and folic acid are two nutrients better
absorbed in a synthetic form than in their
protein-bound food form—but this becomes
important only when normal metabolic
processes fail.
- It is possible for older adults to live well without
dietary supplements. Some age-associated
circumstances make an individual vulnerable to
malnutrition and more likely to benefit from
dietary supplements.

- JA