NUTRITION AND DIETETICS:
Chapter 12: NUTRITION IN THE LIFE CYCLE
Pregnancy
✓ Also called gestation, is the period from
conception to birth and for human beings last
from 38-42 weeks.
✓ Is unique in that at no other time in life does the
well-being of an individual depends so much on
the well-being of another.
✓ The time of greatest nutritional vulnerability is
possibly before a woman even suspects she is
pregnant and certainly before the first prenatal
appointment.
✓ Therefore, the health of the mother before and
during the pregnancy has profound effects on the
status of her infant in the womb and at birth.
Therefore, efforts are directed to the mother to
ensure a safe and successful delivery and that her
infant will be born well.
Three Stages of Pregnancy
Stage 1: Implantation
is the period in which the fertilized ovum
implants itself in the (endometrial lining)
uterus and begins development. This usually
occurs during the first two weeks of
conception.
Hormones
The main function of the endometrial lining is during
a woman's reproductive years. This inner lining of the
uterus begins to thicken to prepare for an embryo to
implant, or for pregnancy to occur. If pregnancy occurs,
the lining helps to maintain the pregnancy. If pregnancy
does not occur, the lining sheds (you get your period),
and the process begins again for the following cycle
(Critchley et al., 2022).
✓ Implantation bleeding typically occurs within
days of conception, when the embryo (or
blastocyst) attaches to the uterine lining. Some
people mistake it for their regular period
because it can look similar and occur near the
time, you’d expect your normal cycle.
Here’s a closer look at a general timeline of ovulation,
fertilization, and implantation based on a regular 28-
day cycle:
• Day 1 - First day of menstrual period.
• Days 14 - Ovulation occurs 14 days before
your next menstruation.
• Days 14 to 15 - Fertilization occurs 0 to 1 day
after ovulation (typically within hours of
ovulation).
• Days 20 to 24 - Implantation happens about 6
to 7 days after fertilization, and implantation
bleeding may occur for a few days.
Abbreviations: DPO- Days Past Ovulation
TTC – Trying To Conceive
Stage 2: Organogenesis
Organogenesis – the embryo undergoes differentiation
or rapid cell division that occurs from 2 to 8 weeks after
conception.
 This is called Critical Period.
 Critical period is an interval of time during
which cells of a tissue or organ are genetically
programmed to multiply.
 Malnutrition that occurs at this stage may
affect organ development that may not be
reversed by subsequent refeeding.
Stage 3: Growth
Growth – the remaining 7 months that is
characterized primarily by growth in the
number of cells and size of the organs until it
can support extra-uterine life. Nourishing of
the fetus becomes the role of the placenta.
✓ One of the most interesting special functions of
the placenta is the production of hormones to
regulate the activities of pregnancy. Some
hormones are present only in the pregnancy while
others are normally present have altered rates of
secretion due to pregnancy
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✓ Human placental lactogen (HPL) and human
growth hormone (HGH) has antagonistic effects
to insulin by continuing to feed glucose into the
blood stream from the breakdown of glycogen.
Progesterone
✓ Its chief function is to cause a relaxation of the
smooth muscles of the uterus so that it can expand
as the fetus grows but it also has a relaxing effect
on their smooth muscles in the body. Relaxation
of the muscles of the GI reduces motility in the
gut, allowing more time for the nutrients to be
absorbed.
Functions:
❑ Development of the uterine endometrium-
essential for the early nutrition of the embryo.
❑ Contributes to the development of the ovum
prior to implantation.
❑ Prepares the breast for lactation.
Estrogen
✓ for the promotion of growth and control of the
function of the uterus; for the alteration of the
structure of mucopolysaccharides in connective
tissues which makes the tissue more flexible and
therefore assist in dilating the uterus at birth,
however, it also increases the affinity of become
puffy and changes in cardiovascular dynamics
causing extracellular fluid to accumulate in the
feet and legs.
Functions: Enlargement of the uterus, breast, and the
female external genetalia and relaxes various pelvic
ligaments for easier birth.
Summary of Physiological changes associated with
pregnancy
 Blood volume and red blood cell mass increase
 Hormones promote growth and changes in
breast tissues
 Uterus expands
 Heart rate increases by 20%
 Curvature of spine increases
 Fat stores increase
 Gastrointestinal motility slows
 Common Nutrition Concerns
 Nausea and vomiting
 Heartburn
 Constipation
 Edema
 Leg cramps
 Rapid weight gain or loss
 Anemia
 Gestational Diabetes Mellitus
During pregnancy, the placenta secretes:
1. Human Chorionic Gonadotrophin (HCG)
▪ Causes positive results in pregnancy test.
▪ Prevents the degeneration of the Corpus
Luteum. Corpus Luteum forms after the
ovaries release an egg and lasts just long
enough to help the uterus support a developing
fetus.
▪ Stimulates the growth of the CL.
✓ CL increases secretion of both estrogen and
progesterone. It also prevents menstruation.
▪ Stimulates the interstitial cells of the fetal
testes to secrete testosterone.
2. Human Chorionic Somatomammotrophin (HCS)
▪ Starts to secrete from the 5th week.
▪ Increases in HCS secretion is proportional to
the weight of the placenta (uterus).
▪ Functions: development of the breast, growth
hormone effect enhanced, decrease maternal
insulin sensitivity, promotes release of FFA
from maternal stores – alternative source of
energy for her metabolism.
Fertilization of the Ovum
✓ Takes place in the fallopian tube.
✓ Distally, the last 2 cm remains spasmatically
contracted – under the influence of estrogen for 3
days after ovulation.
✓ Smooth muscle relaxed under the influence of
progesterone – secreted by corpus luteum.
✓ This allows the embryo to enter into the uterus.
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Maternal Weight Gain
✓ All women need to gain weight during pregnancy
for fetal growth and maternal health.
✓ Maternal weight gain during pregnancy is closely
related to the birth weight of the infant that is a
strong predictor of the health future development
of the infant.
✓ Women should have a normal BMI when they
become pregnant and that they should gain
weight during their pregnancy within a fairly
narrow range, based on their age, race, or
ethnicity and various other factors that may affect
the pregnancy outcomes.
✓ A woman should gain 0.9-1.8 kg (2-4 lbs) by the
end of the first trimester and approximately 0.45
(1 lb) a week hereafter.
✓ Underweight women (BMI <18.5) have a high
risk of having a low birth weight infant, pre-term
infant, and higher infant mortality rates. They
need to gain weight prior to conception and gain
extra pounds during pregnancy. Overweight
women (BMI 25-29) are at high risk of
complications of pregnancy such as hypertension,
gestational diabetes, and postpartum infections
Prenatal Vitamins
✓ Prenatal vitamins are supplements made for
pregnant women to give their bodies the vitamins
and minerals needed for a healthy pregnancy.
Folate
✓ It can prevent birth defects that affect the baby’s
brain and spinal cord. Neural tube defects
develop early in pregnancy, before many women
know they’re pregnant; half of all pregnancies are
unplanned. This is why doctors recommend that
any woman who could get pregnant take 400
micrograms (mcg) of folic acid daily, starting
before conception and continuing for the first 12
weeks of pregnancy.
Foods that have folic acid include: Green leafy
vegetables, Nuts, Beans, Citrus fruits
Iodine
✓ is critical for a woman’s healthy thyroid function
during pregnancy. Iodine deficiency can cause:
Miscarriage, Stillbirth, Stunted physical growth,
Severe mental disability, Deafness
Calcium and Iron
Calcium- It can help prevent you from losing your
bone density as the baby uses calcium for its own bone
growth.
Iron - helps the body make more blood red cells. These
blood cells carry oxygen to the baby that it needs to
develop.
Vitamin D and Omega 3
Vitamin D- to help absorb calcium.
Omega 3 - These fats, which include DHA
(docosahexaenoic acid) and EPA (eicosapentaenoic
acid), come only from food sources such as fatty fish
and nuts. Studies show omega-3s can lower risk of
preterm birth and of having a baby with low birth
weight.
Why is Nutritional Needs Increased During Pregnancy?
✓ To meet the nutritional requirement of the mother,
nutritional needs of the growing fetus and other
maternal tissues, and building reserves in
preparation for the delivery and lactation
✓ Caloric increase arises from several factors:
growth of fetus, growth of the placenta, normal
increase in maternal body size, additional work of
carrying the growing infant, and steady slow rise
in basal metabolism.
✓ Protein should be increased in order to meet the
need of the developing maternal tissues and to
support the growth of fetus;
✓ Calcium increased by 5 gms for skeletal
framework of the growing fetus and for teeth
formation;
✓ Iron for building blood supply and reserve during
child birth;
✓ Vitamin A for epithelial cells during organ
formation and bone and tooth development;
✓ Iodine for metabolic processes during pregnancy
causing strain of the thyroid gland;
✓ Vitamin C for maintenance of the integrity of fetal
membrane (30 mg)
✓ Thiamine, riboflavin, and niacin are equally
important during pregnancy particularly with
reference to their relationship to caloric intake.
Energy
✓ The two factors that determine energy
requirement are the mother’s usual physical
activity and the increase in metabolic rate to
support the work required for growth of the fetus
and the accessory tissues.
❑ Additional 300 kcal/day in the TER.
Protein
✓ this nutrient is essential as it forms the structural
basis for all new cells and tissues in the mother
and fetus.
❑ The Philippine RENI is given at additional 8 g
protein/day throughout pregnancy.
Fats
✓ the additional uterine, placental, and fetal growth,
together with the increased maternal blood
volume and mammary gland development raises
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the Essential Fatty Acids requirements by 15%
energy in the maternal diet, adding up to a total of
at lease 4.5% energy EFA.
Diet Related Complications of Pregnancy
Pregnancy-Induced Hypertension
1. Pre-eclampsia – hypertension with proteinuria
and/or edema developing after the 20th week of
gestation.
2. Eclampsia – convulsions or coma; usually
both when associated with hypertension,
proteinuria, edema; occurs after the 20th week
of gestation.
Foods to Avoid
• soft cheeses
• undercooked or raw meat, fish and seafood
• pre-prepared or unwashed fruits and vegetables
• undercooked or raw eggs
• unpasteurised milk
• alcohol
Foods to Limit
• caffeine
• liver
Lactation and Human Milk
✓ Breast milk is produced by the mammary
alveolar cells of the breast after childbirth. The
mammary gland is a highly evolved skin gland,
and its rudiments (undeveloped or immature part)
are first seen during the 6th week in utero (in
uterus or pregnancy).
✓ Mammogenesis, or breast development, begins
during puberty with increased breast size due
mainly to estrogen and lobuloalveolar
development facilitated predominantly by
progesterone. During pregnancy, with the support
of these hormones and others including prolactin
and placental lactogen, breast glandular tissue
further differentiates, and the alveolar epithelium
proliferates and then becomes secretory (Furman
& Schanler, 2012).
✓ In prepubertal girls, estrogens play a prominent
role in the initial development of the duct system
of the breast. Then as puberty approaches,
estrogens, acting on a base of growth hormone
and insulin-like growth factor activity, stimulate
further development of both the mammary ducts
and the fatty tissue that surrounds them (Fig. 3.1).
✓ During pregnancy, the high levels of progesterone
and the secretion of prolactin by the anterior
pituitary starting in the second month stimulate
further development of the duct system, as well
as development of the secretory alveoli. Even in
nonpregnant women, the effects of progesterone
during the last half of the normal menstrual cycle
can often be felt in the breasts. During pregnancy,
actual milk production, which is stimulated by
prolactin, is inhibited by the estrogenic and
progesterone-rich hormonal environment.
✓ After birth, the inhibitory effects of estrogens
and progesterone are removed, and prolactin
becomes the dominant hormone involved in the
promotion of milk production. For the first few
days after birth, the mammary glands produce
colostrum, a secretion closely resembling milk
except that it lacks the high-fat concentration of
normal milk, which begins to be produced in
increasing amounts late in the first post-partum
week.
Breast Development
Lactation
✓ Is the period of milk production by the mammary
glands.
✓ The two main hormones responsible for milk
production are prolactin and oxytocin
❑ Colostrum – the first milk that is thick, yellowish
fluid that comes on the second to the
fifth day after delivery. It contains antibodies and
immune cells.
1. The preparation for lactation starts during
adolescence when hormonal changes bring about
the development and increase in size of the breast,
areola, and nipple.
2. The two main hormones responsible for milk
production are:
a. prolactin – initiates milk production
b. oxytocin – oxytocin reflex is sometimes called “milk
ejection reflex”. It makes the milk that is already in the
breast flow for the current feed.
Composition of Human Milk
There are over 200 recognized constituents in breast
milk:
✓ Proteins
✓ Carbohydrates
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✓ Fats B – best for baby
✓ Vitamins R – reduces the incidence of allergies, asthma, eczema
✓ Minerals E – economical – no waste
Enzymes important in infant digestion A – antibodies – increase immunity to some infections
❑ Amylase (starches) S – stool is inoffensive – not constipated
❑ Lipases (fats) T – temperature is always ideal
❑ Proteases (proteins) F – freshmilk – never goes off
Protective Factors of Human Milk E – emotional bonding - affection
Immunoglobulins E – easy – once established
• Proteins synthesized by the immune system, D – digestible/ digested easity within 2-3 hours
included all known antibodies. I – immediately available
• sIgA (Secretory Immunoglobulin A) – protects N – nutritionally optimum
infant against food allergies and microbial G – gastroenteritis greatly reduce
antigens. Special Problems
• The principal Ig in human milk: sIgA Common Reasons of Failure of Lactation
• Colostrum has 17x more sIgA than mature 1. Conditions that mothers with newborns may
milk have, which ALLOWS breastfeeding include:
Lactoferrin • Diabetes mellitus
• Inhibits the growth of iron dependent bacteria • Multiple sclerosis
• Protects against certain GI infections in • Systemic lupus
breastfed infants • Hypertension
Lysozyme • Hepatitis C without co-infection
• helps protect nursing babies from infection • Crohn’s Disease
Bifidus Factor • Ulcerative Colitis
• growth factor for bifidobacteria.(important • Hyperlipoproteinemia
bacteria in the human gut) • Cystic Fibrosis
Immune cells • Kidney Transplant
• Lymphocytes – synthesizer IgA antibody • Benign breast cysts
• Macrophages – phagocytosis: killing bacteria • Fibrocystic disease
and production of lysosome and lactoferrin • Galactosemia
• Leukocytes – phagocytosis and microbial • Phenylketonuria
killing 2. Cases when breastfeeding is UNALLOWED are:
Hormones in Breast Milk – there are 16 different • Breast cancer detected during
types of hormones in breastmilk. pregnancy
✓ Advantages of Breastfeeding • HIV
✓ Breastfeeding done together with exercise can help • Active tuberculosis
in weight loss. • Illicit drug use
✓ Human milk is nutritionally superior to other kinds • Chemotherapy
of milk. • Mothers addicted to alcohol, illicit
✓ Breastmilk is bacteriologically safe. drugs, and smoking.
✓ Breastmilk is always fresh and at the right
3. Poor maternal attitude
temperature for the baby.
4. Inadequate milk supply
✓ It contains immune cells and antibodies that will
5. Lack of information and support
give natural immunity for the baby.
✓ It is the least allergenic of any infant food. Nutrition During Infancy
Growth and Maturation
✓ It is inexpensive compared to commercial milks.
✓ Breastfeeding is convenient (e.g., traveling). Growth – refers to the Maturation – is the
✓ It promotes closer mother-baby ties or contact. increase in size due to process of becoming mature;
✓ Babies are least likely to be overfed with increase in the number of the emergence of individual
cells. and behavioral
breastfeeding. characteristics through
✓ Breastfeeding promotes good tooth and jaw growth processes over time.
development.
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Patterns of Growth and Maturation:
Birth weight – double at 5 months and triple at one
year
Birth Length – increase by 9-10 inches during the first
year
Brain size – 25% of its adult weight at birth double its
size by six months and will reach 90% of its adult size
by age 4 years.
Digestive system – at birth is capable of digesting only
protein, simple carbohydrates, and emulsified fats.
After some months, the production of digestive
enzymes will be more fully developed to enable him to
digest other starches and fats.
Characteristics of the Normal Full Term Infant
✓ Total body fat increases rapidly during the first 9
months of life, after which the rate tapers off till the
end of childhood.
✓ The newborn infant has a functional but
physiologically immature kidney that gradually
increases in size and capacity to concentrate.
✓ The stomach capacity of infants increases from 20-
30 ml at birth to 200 ml by one year of age.
✓ Fat absorption varies. Human milk is well absorbed
as well as the fat combinations in commercially
prepared infant formulas.
✓ The bile-stimulated lipase in human milk
hydrolyzes triglycerides into fatty acids and
glycerol.
✓ The enzymes that digest disaccharides reach adult
levels by 28-32 weeks of gestation.
Milk for Infants
Breastmilk – is the best food for infants.
Formula – commercial formulas are made from heat –
treated not fat milk are designed to provide the
necessary nutrients in a well-absorbed form and to
approximate closely the composition of human milk.
Unmodified Cow’s Milk – not recommended during
the first year of life because of its tough, hard curd is
difficult for the infant to digest and lesser amount of fat
is absorbed compared with human milk.
Three Types of Feeding
1. exclusively breastfeeding
2. replacement feeding receiving no breast milk
3. mixed feeding with breast milk and
replacement feeding.
Semi-Solid Foods in the Infant's Diet
After six months, breast-feeding should be continued up
to one year of age. After months, solids should be
introduced:
1. Cereals (lugaw, oatmeal, or boiled rice),
fruits (banana, papaya, mango, and
avocado), and vegetables (leafy greens
and yellow vegetables) are introduced
first.
2. Hard cooked eggs and cooked dried
beans such as munggo and peanuts
follow this at 7 months.
3. At 8 months, fish, liver, meat, and poultry
is added.
Food Choices for Infants
The Sequence in Which New Food is introduced
Cereals and grains (rice, oatmeal, etc.)
Vegetables (strained cooked vegetables)
Meat and other high protein foods (strained meat, liver,
eggs)
Fruits (mashed ripe bananas, papaya, strained cooked
fruits)
Dairy Products (small amounts of cottage cheese)
Nutritional Problems
Obesity – defined as weight above the 95th percentile
in relation to height, sex, and body build.
Baby Bottle Tooth Decay
Colic – this condition is defined as severe abdominal
pain in infants.
Low Birth Weight Infants
Term Infant – one who is born between the 37th and
42nd week of gestation
Preterm or premature infant – one who is born
before the 37th week of gestation.
Post term infant – one who is born after 42 weeks of
gestation.
Low Birth Weight (LBW)- an infant weighing less
than 2500 g (5 ½ lb).
Very Low Birth Weight Infant (VLBW) – an infant
weighing less than 1,500 g (3 ½ lbs).
Extremely Low Birth Weight Infant - an infant who
weighing less than 1000 g (2 ¼ lb).
Small for gestational age (SGA) – an infant whose
birth weight is less than the 10th percentile of the
standard weight for that gestational age.
Appropriate for gestational age (AGA) – an infant
who has a birth weight between the 10th to the 90th
percentiles on the intrauterine growth chart.
Large for gestational age (LGA) – an infant whose
birth weight is above the 90th percentile on the
intrauterine growth chart.
Nutrition in Preschool
Milestones in Growth and Development
The Toddler Stage
✓ Toddler is the transition period between the
infancy and childhood, extending from about 1-3
years of age.
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Growth and Development
✓ Weight gain of about 2.5 to 5 kg and height of
about 7.5 cm per year
✓ Requires less food, not as hungry as during
infancy
✓ Psychomotor skills (mind is directed to muscle
action) improve.
✓ Progress from eating with his fingers and hands
to using utensils to eat.
✓ Movements are initially clumsy and awkward but
slowly become more coordinated; has tendency
to turn the spoon over enroute from a dish to
mouth.
✓ Both time and practice are necessary to improve
skills.
✓ When tired or hurried, may temporarily revert to
earing with fingers and sloppiness may increase.
Nutritional Requirements
1-2 Years old – provide simple finger foods; teach
them how to wash hands before eating. Avoid choking
hazards. Cut up food in small pieces and foods easy to
swallow. Monitor that the child chews well before
putting more food in the mouth. Place small servings
on the plate and start teaching how to handle small
spoons. Introduce one new food at a time. Do not force
the child to eat.
2-3 years old- continue with the introduction of new
taste/look, i.e, color and shape are appetizing. Provide
variety and observe right kind and amount per food
pyramid. Make mealtimes enjoyable. No nuts or sticky
foods that could stay in the throat. Avoid using food as
bribe.
3-5 years old – bring your child in food shopping.
Include his suggestions in meal- planning, but guide
selections using items in the food pyramid. At this time,
he may also be attending nursery school where the
teachers also teach them right food choices and proper
feeding.
Nutrition in School Age
Physiological Changes and Catch-up Growth
✓ The school years (the age range of 6 to 10 years)
are often considered to be uneventful period of
growth and development, since the school child
continues to grow and develop without any
dramatic changes although each year brings
unique changes as children mature.
Food Requirement of the School Child
The food requirement of the school can be met by
providing:
Adequate amounts of body- building, regulating and
energy-giving foods in each meal
Every food eaten must carry some protein, minerals,
and vitamins and calories to meet the large requirement
for continued growth and increased activity.
Nutritious snack
Well planned home packed lunches or school lunches
should furnish at least 1/3 of the child’s daily food
requirements.
Pleasant experiences with food that will help in
forming good food habits.
Nutrition during childhood to adulthood
Adolescence
Adolescence is a transition stage in the life cycle,
linking childhood to adulthood. Adolescents are often
labeled as “difficult to manage” and as having “poor
food habits”.
Several specific biological changes occur during
adolescence namely:
The growth rate increases Height and weight
during early adolescents. increase.
Body composition (the Sexual maturity is
proportion of various achieved.
tissues in the body)
changes.
There are several important nutritional implications
related to the adolescent growth process:
✓ More food is needed to support growth at this
time of life
✓ Girls need to increase their food intake at an
earlier age than boys
✓ Boys need more food than girls (when they begin
the growth spurt) since boys gain substantially
more lean body mass.
✓ Compared to females, males continue to need
more food to maintain their large lean body mass
✓ Nutrient needs may correlate with an adolescent’s
stage of sexual maturation, being greatest before
menarche in females and when secondary sexual
characteristics appear in males. With the onset of
menses, girls need to increase intake of iron.
Note:
Menarche – the time when the first menstrual cycle
occur
Peak height velocity – the single year during which the
increase in height is greatest
Puberty – period of capability of reproduction
Older Adulthood
✓ Older adults are usually described as being
individuals 60 to 65 years of age and older. The
nutritional status of older persons in influenced
by the process of aging. Aging begins at the
moment of conception; however, decreased
renewal of cells and tissues does not become
obvious for many years.
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The following should be observed to promote ease of
✓ Although the precise role of nutrition plays in the digestion, good rest and enjoyment of meals:
aging process has not been determined, certainly,
nutrition influences the development and course Eat a good breakfast to start the day right.
of many chronic and degenerative diseases that Eat four or five light meals instead of three heavy
meals.
often accompany old age. One motivation for
Eat leisurely in pleasant surroundings
eating prudently throughout life is increasing the
Include essential foods first like meat, fish, poultry,
chance of being able to enjoy “old age” in a state
vegetables and fruits and rice. Sweets should be taken
of good health. There is no guarantee that disease in moderate amounts.
will not strike but even if it does, sensible eating Eat the heaviest meal at noon rather than at night if
helps a person feel as well as possible under the sleeping is difficult.
circumstances. Fats may retard digestion. If there is discomfort, avoid
fatty foods.
The following nutrients should be taken into
Avoid coffee late in the day if insomnia is a problem.
consideration during elderly:
Drink hot milk before going to bed.
Energy – the demand for calories is decreased because Effect of Good Nutrition among the Aged
of reduced basal metabolic rate and physical activity. A Good nutrition contributes to:
decrease of 7.5% in caloric intake is recommended Feeling better Looking better
after the age of 45 years. Moving and thinking Living longer and more
Protein – the protein allowance of 1.1 gm/KgDBW is better productively.
maintained at this period. Protein is necessary for the
prevention of tissue wasting and susceptibility to
disease and infection.
Calcium – the allowance for calcium is the same as that
for young adults. Calcium requirement is maintained to
prevent the occurrence of condition known as
“osteoporosis” characterized by increased porosity of
the bones, especially among women.
Iron – the iron allowance for women at the age of 50
and above drops to as low as 7.0 mg/day, a decrease of
more than 50% from the previous reproductive years.
At this period, menopause takes place, marking the
permanent cessation of menstruation, thus the need for
iron decreases. The iron allowance for men remains the
same.
Vitamins – the allowance for vitamin A and ascorbic
acid (vitamin C) remains the same. Vitamin C
facilitates absorption of calcium and iron, together with
vitamin E that retards cellular aging. The B-complex
vitamins are needed in the same proportion because it
counteracts the poor appetite commonly found among
the aged and helps regulate the muscle tone of the
gastrointestinal tract.
Water and fiber – about 6 to 8 glasses of fluid is
essential for the older persons as it is for the younger
individuals. Water stimulates peristalsis thus aids in
combatting constipation.