Pregnancy Infancy
Nutrition
Growth and development occurring:
-Maternal plasma volume - expand near the end of the first trimester, with a
total increase in volume of 50% by 30 to 34 weeks of gestation. Red blood cell
production is stimulated with a total increase in red blood cell mass of
approximately 33%. Hematocrit levels decline until the end of the second
across the trimester, by which time red blood cell synthesis is synchronized with plasma
volume increase. Cardiac output increases approximately 30% to 50% during
pregnancy. Elevated cardiac output occurs in response to increased tissue
Lifespan
demands for oxygen and is accompanied by an increase in stroke volume. The
size of the heart increases by approximately 12%, probably because of the
increased blood volume and cardiac output.
-The kidneys increase slightly in both length and weight during pregnancy;
and the ureters elongate, widen, and become more curved. Changes along the
gastrointestinal tract support the increased demand for nutrients during
pregnancy. Elongation in gastrointestinal transit time occurs largely in the
third trimester of pregnancy and is not accompanied by a change in gastric
emptying time.
-The basal metabolic rate rises by the fourth month of gestation and is
usually increased by 15% to 20% by term.
Energy requirements & physical activity:
-The average recommended daily allowance (RDA) of calories for women of
childbearing age is 2,200. An additional 300 calories, or a total caloric intake
of 2,500 calories, is recommended to meet the increased needs of pregnancy.
-Exercise helps prevent excessive weight gain, promotes faster delivery, and
hastens recovery. Exercise may also help reduce the risk of GDM (60) and can
be a helpful adjunct to therapies directed at controlling blood glucose.
- Pregnant women- 30 or more minutes daily of moderate-intensity physical
activity. Those to be avoided include sports with a high potential for contact,
activities with a high risk of falling, vigorous racquet sports with a risk of
abdominal trauma, scuba diving, and any exercise in the supine position after
the first trimester. Women who continue a regular exercise program must be
sure to maintain adequate energy, nutrient, and fluid intake throughout
pregnancy, along with adequate weight gain.
Specific nutrient requirements:
-The recommended balance of energy sources during pregnancy is the same
as for nonpregnant women: 10% to 35% as protein, 45% to 65% as
carbohydrate, and 20% to 35% of kcal as fat
PROTEIN-During pregnancy, whole body protein turnover increases, and
substantial amounts of protein are accumulated by the growth of the fetus,
uterus, blood volume, placenta, amniotic fluid, and maternal skeletal muscle.
Considering protein deposition over the last two trimesters, the
recommended dietary allowance (RDA) increases by 25 g/day.
CARBOHYDRATES: The fetus uses glucose as its major energy source. The
transfer of glucose from mother to fetus is estimated at 17 to 26 g/day. By the
end of pregnancy, all this glucose is thought to be used by the fetal brain. The
estimated average requirement (EAR) for carbohydrate increases from 100
g/day to 135 g/day, which translates to an RDA for carbohydrate for
pregnant women of 175 g/day.
FATS: adequate intake (AI) values for essential fatty acids during pregnancy
are based on median intakes among pregnant women in the United States: 13
g/day for linoleic acid and 1.4 g/day for -linolenic acid.
Important foods:
- Whole fruits — like apples, berries, oranges, mango, and bananas;
Veggies — like broccoli, sweet potatoes, beets, okra, spinach, peppers,
and jicama; Whole grains — like brown rice, oatmeal, whole-wheat
bread; Proteins — like lean meats and chicken, eggs, seafood, beans
and lentils, nuts and seeds, and tofu; Low-fat or fat-free dairy — like
milk, yogurt, cheese, lactose-free dairy, and fortified soy beverages;
Oils — like olive oil, seafood, avocado, and nuts
Growth and development occurring:
-Birth weight doubles by 6 months, and triples by 12 months.
Height increases by 50% during the first year.
-By the end of the first year, the brain already reaches two thirds of
its adult size. Head circumference increases rapidly.
-Neuromuscular development begins
-Newborns have limited immunologic protection at birth due to
their inability to produce antibodies until about 2 months of age.
-Communicate through crying, cooing, and babbling.
Energy requirements & physical activity:
-high-protein, high calorie intake is necessary. Calorie allowances
can be gradually reduced during the first year from a level of 120
calories per kilogram of body weight at birth to approximately 100
calories per kilogram of body weight at the end of the first year.
-Exclusive breastfeeding for first 6 months as this is the best source
for an infant's energy and nutrition.
Specific nutrient requirements:
-Protein: 2.2 g per kilogram of body weight for first 2 months
-Fat: Linoleic acid, Docosahexaenoic acid (DHA) , and arachidonic
acid (ARA), are important for brain growth. Breast milk contains a
generous supply of all three of these fatty acids.
-Carbohydrates: Lactose appears to be the most easily digested of
the carbohydrates. Lactose also improves calcium absorption and
aids in nitrogen retention.
-Fluid: a newborn needs 150 to 200 ml/kg of water intake every 24
hours. This requirement can be supplied completely by
breastfeeding or formula feeding.
Important foods:
- Infant cereal is fortified with B vitamins and iron. It is supplied
as a precooked, fine dry powder to which expressed breast milk,
infant formula, or juice is added. Adding sugar to cereal is
unnecessary.
-Pureed fruits and vegetables: sweet potatoes, carrots, peas,
squash, bananas, pears, avocado, apples
-Proteins: Meat is usually introduced at 9 months of age
because this is the time an infant’s iron stores are beginning to
be depleted. Offer a variety of lean meats, eggs ( after 6 months)
-Fluids: Breast milk is the primary source of nutrition for
infants under one year. After that, whole cow's milk can be
introduced.
-Dairy: Yogurt and cheese (if there are no allergies) can also be
included in their diet for calcium and protein.
 EarlyChildhood
Growth and development occurring:
•During early childhood, growth and development are influenced by
genetic, environmental, behavioral, and dietary factors.
•Optimal nutrition is crucial for a child to achieve their genetic
potential.
•Complementary feeding becomes necessary after 6 months to meet
nutrient gaps, and signs of readiness for complementary feeding
include weight doubling, interest in food, and the ability to swallow.
•Feeding toddlers can be challenging due to developmental changes,
and growth rate decreases during this period.
•Self-feeding skills improve, muscle mass and bone density increase,
and language skills develop.
Energy requirements & physical activity:
•Energy needs in early childhood vary based on age, activity, and
metabolism.
•Protein, derived from high-biological-value sources, supports
skeletal and muscle tissue growth.
•Vitamins and minerals, especially vitamin A, riboflavin, thiamin,
and vitamin C, should be considered.
•Inadequate intake of calcium and iron may lead to nutrient
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deficiencies
Specific nutrient requirements:
∙ Protein: Necessary for tissue growth and repair, and can be found
in lean meats, poultry, fish, eggs, dairy products, legumes, and tofu.
∙ Carbohydrates: Serve as the primary energy source and can be
obtained from whole grains, fruits, vegetables, and legumes.
∙ Fats:Play a vital role in brain development and the absorption of
fat-soluble vitamins. Good sources of fats include avocados, nuts,
seeds, olive oil, and fatty fish.
∙ Vitamins and Minerals: Found in fruits, vegetables, lean meats,
fortified cereals, and legumes. Particular attention should be given to
getting enough iron, calcium, and vitamin C.
∙ Water: Proper hydration is crucial, so it's important to offer water
throughout the day.
Important foods:
∙ Fruits and Vegetables: Offer a diverse selection to ensure an
intake of essential vitamins, minerals, and dietary fiber.
∙ Whole Grains: Opt for whole wheat bread, brown rice, oats,
and quinoa instead of refined grains.
∙ Lean Proteins: Include lean meats, poultry, fish, eggs, dairy,
legumes, and tofu.
∙ Dairy Products: These are excellent sources of calcium and
protein; however, alternatives are available for those who are
lactose intolerant or follow a plant-based diet.
∙ Healthy Fats: Incorporate foods like avocados, nuts, seeds, and
olive oil into the diet.
∙ Water: Encourage regular consumption of water.
MiddleChildhood
Growth and development occurring:
- children annually grow 2 to 3 inches in height and gain about 5
pounds on average.
- a larger child eats more than a smaller one; an active child eats
more than a quiet one; and a happy, content child eats more than
an anxious one.
- School-age children maintain a relatively constant intake in
relation to their age group
- muscle strength, motor skills, and stamina increase
- increasing independence
Energy requirements & physical activity:
ACTIVITY:
- children require an energy intake of 1,600 to 2,600 kcal/day
depending on how active they are
- female children who have an active lifestyle usually require
1,800 to 2,200 kcal/day while those with a sedentary lifestyle
require 1,200 to 1,400 kcal
- male children with an active lifestyle usually require 2,000 to
2,600 kcal/day while those with a sedentary lifestyle require
around 1,200 to 1,600 kcal/day
- Ideally, parents should limit sedentary activities and encourage
at least one hour of daily physical activity to promote strong
skeletal, muscular, and cardiovascular development and instill in
their children the desire to be physically active throughout life.
- examples of physical activity that children can engage in may
include running, bicycle riding, and playing games such as
jumping rope, tug of war, and hopscotch
Specific nutrient requirements:
- calcium - maintains strong bones and teeth as they grow up
- fiber - promotes healthy bowel functions and helps prevent
constipation
- vitamin E - as a powerful antioxidant which helps protect cells
against damage caused by free radicals
- magnesium - important for muscle strength, supporting proper
sleep, regulating mood, improving concentration, and boosting
energy levels
potassium - helps maintain fluid balance in the body
- vitamin D - aids in the absorption of calcium which helps
maintain strong bones and teeth
Important foods:
- grain products: crackers, cereals, bread, pasta, rice
- vegetables: celery, broccoli, cauliflower, carrot, lettuce, peas
- fruits: apples, bananas, peaches, grapes, oranges, watermelon
- protein foods: eggs, cheese, peanut butter, fish, chicken
- dairy foods: milk, cheese, yogurt
TeenageYears
Growth and development occurring:
- puberty begins at the age of 12-13 for males and 10-11 for
females
- development of lean body mass (more apparent in men) and
fat stores (more apparent in women)
- males grow 8 inches taller and 6 inches for females
- males gain approximately 45 pounds and about 35 pounds
for females
Energy requirements & physical activity:
- an exceptionally active boy of 15 may need 3500 kcalories
or more a day just to maintain his weight
- girls' energy needs peaks sooner and decline earlier than
those of boy's. thus, an inactive girl of 15 whose growth is
nearly at standstill may need fewer than 1800 kcalories a
day if she is to avoid excessive weight gain
- the teenage girls then need to pay more attention to being
physically active and choosing nutrient-dense foods to meet
their nutrient needs without exceeding their energy needs
Specific nutrient requirements:
•Vitamin D - bone growth and development and also crucial
for calcium absorption.
•Iron requirements rise for females as they start to
menstruate and for males as their lean body mass develops.
•Calcium - for bone development and maintenance.
•Protein - for growth, tissue repair, and hormone
production
•Vitamin A - for vision, immune function, and skin health
Important foods:
-Lean Proteins: Chicken, fish, eggs, beans, and legumes
-Whole Grains: Whole wheat, brown rice, quinoa, and oats
-Dairy or Alternatives: Milk, yogurt, and cheese
-Fruits and Vegetables: Bok choy, collard greens, turnip
greens, kale, broccoli
-Healthy Fats: Olive oil, and fatty fish like salmon
 Adulthood
Growth and development occurring:
∙ By the time we reach early adulthood (20 to early 40s), physical
maturation is complete, although our height may increase slightly
and the weight and muscle mass change as a
∙ result of diet , exercise, pregnancy and lactation..
∙ In young adulthood, physical abilities are at their peak, including
muscle strength, reaction time, sensory abilities, and cardiac
functioning. Growth and strength in early adulthood, then slow
process of decline afterwards. Decline is affected by health and
lifestyles
∙ Early adulthood is a time of:
– establishing personal and economic independence
– Identity exploration, especially in love and work
– Instability; Self-focused
– Feeling in-between
Energy requirements & physical activity:
∙ Growth is no longer an energy-demanding factor in adulthood, and
BMR is relatively constant among population groups of a given age
and gender. Consequently, habitual physical activity and body
weight are the main determinants for the diversity in energy
requirements of adult populations with different lifestyles.
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∙ The diversity in body size, body composition and habitual physical
activity among adult populations with different geographic,
cultural and economic backgrounds does not allow a universal
application of energy requirements based on TEE measured with
DLW (or HRM) in groups with a specific lifestyle.
∙ For men of reference body size, the average allowance is 2,900
kcal/day; for women, it is 2,200 kcal. With light-to-moderate
activity, the coefficient of variation in energy requirements of adults
is approximately 20%
∙ Each week adults need 150 minutes of moderate-intensity physical
activity and 2 days of muscle strengthening activity
Specific nutrient requirements:
∙ Potassium - Adults should aim to consume 3,500-4,700 mg daily.
∙ Vitamin D - Recommended a supplement with a daily dose of 15 mg.
∙ Calcium - Adults need to get an average of 1,000 mg a day.
∙ Fiber - Women should get 25g of fiber and men should get 38g every
day.
∙ Iron - Men require 8 mg of iron a day, while women require 18 mg.
∙ Carbohydrates - Makes up 45%-65% of total daily calories.
∙ Protein - Anywhere from 10%-35% of their calories should come
from protein.
∙ Fat - Adults should limit total fat intake to 20%-35% of total energy,
while saturated fat should be less than 10% of daily calories.
Important foods:
-Whole grains such as whole-wheat breads and pastas, oatmeal, or
brown rice
-Plant-based proteins such as beans, peas, unsalted nuts, and seeds
-Vegetables such as kale, spinach, collards, squash, sweet potatoes,
and tomatoes
-Fruits such as oranges, apples, blueberries, avocados, and bananas
-Lean pork, poultry and fish such as halibut, tuna, and cod
-Fat-free milk or low-fat milk
Senior Years Summary
Growth and development occurring:
- Difficulty in chewing related to loss of teeth and periodontal disease What stages of life have high levels of
- Constipation is more prevalent and could be linked to reduced
peristalsis due to a decline in abdominal muscle tone, insufficient intake physical growth?
of fluids and fiber, a secondary response to drug therapy, or a decrease
in physical activity. - Infancy and Teenage Years
- Tremors, delayed reaction time, short-term memory issues, alterations
in personality, and depression can arise as a result of a reduction in the
number of brain cells or decreased blood flow to the brain.
Energy requirements & physical activity:
PHYSICAL ACTIVITY:
• Short-distance walking for at least 10 minutes and gradually increasing What stages of life have relatively low
the distance to a 30 to 60-minute walk at least five times a week.
ENERGY REQUIREMENTS: energy (calorie) requirements?
• 1,600 to 2,200 calories for women and 2,000 to 2,8000 calories for men, - Adulthood and Senior Years
according to level of activity.
• Protein - 1-1.25 kg/kg per day.
• Carbohydrate and Fiber - 25 or more grams (14 grams per 1000 calories).
• Fat - Dietary fat intake should be moderate
• Water and Beverages - 9 cups a day for women and 13 cups for men
• Vitamins and Minerals:
Vitamin D: Adults 51-70 years old - 15 micrograms daily; 71 years old and
older - 20 micrograms.
Vitamin B12: Adults 51 years and older - 2.4 micrograms daily
Iron - For postmenopausal women, high levels of iron are not needed. The What nutrients are consistently important
iron intake recommendation is at 8-10 mg per day.
Calcium: 1,000 mg of calcium for 51 to 70-year-old adults; 1,200 mg for 71-
across the lifespan?
year-olds and older. - Macronutrients namely carbohydrates,
protein, and fats, and micronutrients like
Specific nutrient requirements:
- Vitamin B12 – Deficiencies can result in various serious nerve-related calcium, iron, and potassium.
consequences
- Protein -- moderately high protein intake is necessary for maintaining
nitrogen balance and offsetting age-related lower energy intake.
Dietary Fiber -- Maintaining intestinal health and protecting against
heart disease and other metabolic conditions are recognized benefits
- Omega-3 -- Increased consumption of omega-3 fatty acids offers
enhanced protection against various cardiovascular events diabetes,
and cognitive decline.
What foods are consistently important
across the lifespan? (hint: MyPlate)
Important foods:
• Protein: Lower-calorie protein sources include lean tender meats, poultry, - Vegetables and Fruits
fish, boiled eggs, fat-free milk products, and legumes, which can help keep
weight at a healthy level. - Carbohydrate-rich foods like rice and
• Carbohydrate and Fiber: Whole grain breads, cereals, rice, and pasta;
Fruits and vegetables
bread.
• Calcium: Dairy products such as milk, cheese, and yogurt. Green leafy - Protein-rich foods such as meat and eggs.
vegetables such as broccoli, kale, cabbage, and spinach. Soya beans and
tofu. - Healthy fats like avocado
• Iron: Red meat, pulses (such as peas, beans, and lentils), oily fish such as
sardines, eggs, green vegetables, and breakfast cereals with added
vitamins
• Vitamin C: Fruit, especially citrus fruit, green vegetables, peppers,
tomatoes and potatoes
• Folic acid: Green vegetables, brown rice, bread, and cereals with added
vitamins.