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Week 12

Nutrition GSCI 1045 (George Brown College)

Introduction to Module 12: Nutrition Through the Lifecycle

Nutrition Through the Life Cycle

In previous modules, we have seen the importance of choosing the right foods to get the
nutrients we need.
In this module we'll look at what particular things are needed at each stage of the life cycle
for a healthy life. It's no secret that nutrition plays a very critical role in every stage of life.
Good nutrition not only supports health and wellness from before conception through
pregnancy, birth, and early childhood but it also lays the groundwork for how we will eat
later in life.
Following guidelines set out by Canada's Food Guide through all stages of life will help
ensure that we live well into older age.
This module we'll look at the key nutritional needs during the various stages of life.
Specifically, we'll look at nutrition during these stages: preconception, pregnancy, infancy,
childhood, adolescence, adulthood and the elderly.
Things to do this module:
o Review contents of module pages, watch the videos and complete the activities
o Read Chapter 12: Nutrition through the Life Cycle: From Pregnancy to the Toddler Years
in the Essentials of Nutrition textbook.
o Read Chapter 13: Nutrition through the Life Cycle: From Childhood to the Elderly Years
in the Essentials of Nutrition textbook.
o Complete the Module 12 Practice Test to check your understanding of key concepts.
Nutrition and the Major Life Stages
Major Life Stages and Nutrition
o As the human body changes over time, the food and nutrients required also change.
o No matter what age we are, we all need the basic nutrients that we have discussed
throughout our modules.
o Specifically, we need the essential amino acids, carbohydrates, essential fatty acids, and
twenty-eight vitamins and minerals to keep us healthy.
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o What changes throughout the lifespan is the amounts of these nutrients needed.
o The stages of the human life cycle we will discuss are preconception, pregnancy, infancy,
childhood, adolescence, adulthood, and aging population.

Preconception
While it is important to follow a healthy diet at every stage of life, it is especially important
for those considering pregnancy to ensure that both partners are healthy. Let's take a look
at what each partner should consider.

Factors to Consider for Women

o A healthy diet and lifestyle is important for those considering pregnancy.
o Eating a well-balanced diet according to Canada's Food Guide and keeping active
through exercise will aid in maintaining a healthy weight.
o Being overweight or obese can be associated with fertility problems as well as a higher
rate of complications during pregnancy.
o The best advice is to always consult with a health professional especially concerning any
health issues
Polycystic Ovarian Syndrome (PCOS) is common cause of infertility. It can be related to
family history, but there is a relationship to obesity. Weight loss may regulate the menstrual
cycles and improve chances of fertility.
Disordered reproductive cycling (menstrual cycling) can be caused by illness, ovarian or
uterine disease, some medications, stress, smoking, drug use or excessive exercise.
To improve fertility the Mayo Clinic has this advice on what to avoid:
o Don't smoke - smoking ages the ovaries and depletes eggs prematurely.
o Limit alcohol - heavy drinking is associated with ovulation disorders
o Curb caffeine - reproductive experts recommend limiting caffeine to less than 200-300
milligrams (1 and a half cups) a day when trying to conceive.
o Be wary of vigorous physical activity-maintain a healthy weight and limit vigorous
activity to less than 5 hours a week.
o Avoid exposure to toxins in the environment and workplace
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Things to do:
o Eat a healthy diet according to Canada's Food Guide
o Maintain a healthy weight through proper diet and exercise
o Take a daily prenatal multivitamin with folic acid (.4 mg recommended to prevent neural
tube defects like spina bifida) and iron (16 to 20 mg of iron to prevent fatigue,
premature delivery and low birth weight (source Healthy Canadians, Health Canada).
o According to EatRight Ontario "Women who are pregnant should not take a vitamin A
supplement, and should limit their consumption of liver, because of its high vitamin A
content.
o Too much vitamin A can cause birth defects."
o Eat a diet rich in antioxidant nutrients.
Factors to Consider for Men
o The male reproductive system is vulnerable to the adverse effects of poor nutrition and
obesity is strongly correlated with lower sperm quality and quantity.
o Diseases like diabetes may result in erectile dysfunction and effects on ejaculation that
could affect reproductive function.
o Similar to the recommendations for women, men should consider stopping smoking,
limiting alcohol, maintaining a healthy weight, exercise in moderation, and avoiding
exposure to toxins to increase their fertility.
o Following a well-balanced diet according to Canada's Food guide is important.
o For men concerned about fertility consideration should be given to a diet with
micronutrients and antioxidants including folic acid, selenium, zinc, and vitamins C and
E, as these have been linked to improved sperm quality. (source: Today's Dietitian).

Pregnancy Nutrient Requirements

Pregnant woman

Nutrient Requirements During Pregnancy

According to Canada's Food Guide for pregnant women, women should:
o Eat according to Canada's Food Guide.
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o Take a daily multivitamin that has 600 mg of folic acid and 16 to 20 mg of iron.
o Include an extra 2 to 3 Food Guide Servings each day, for example a fruit and yogurt for
a snack.
o Be active every day as part of a healthy pregnancy. Talk to your health care provider
before increasing your activity level.
Iron
o When a woman is pregnant, the amount of blood in her body increases to almost twice
her normal amount. Because of this, a pregnant woman needs more iron.
o The body uses iron to produce red blood cells and to support the growth of the baby.
o When there is a deficiency of iron, it can lead to iron deficient anemia and severe iron
deficiency will affect the infant.
o The Recommended Dietary Allowance (RDA) for pregnant women is 27 mg per day.
o Vitamin C aids in iron absorption but taking calcium or food rich in polyphenols at the
same time as iron may hinder absorption.
Calcium
o The Calcium RDI’s for pregnant women is the same as for adults as absorption is
increased (1000mg/d).
o There may be some exceptions where there is a need to increase intake or take a
supplement.
Zinc
o Zinc is required for DNA, RNA and protein synthesis.
o With increased supplementation, there is a possible link to abnormalities in fetus;
therefore, the recommendation is to follow the RDA of 11mg per day.
Protein
o Health Canada RDA = 71g/d for 2nd half of pregnancy

Vitamins

o Vitamin C - Requirements for vitamin C increase because it improves iron absorption

and is important for synthesis of collagen
o Vitamin D - Essential for Calcium absorption
o Folic acid - Prevent spina bifida-600mg folic acid
o Vitamin B12 - Required to generate active form of folate
o Thiamine and Riboflavin - Increased requirements in third trimester as energy
requirements increase
o Vitamin A - Excessive amounts can be harmful.

Avoid
o Pregnant and breastfeeding women should avoid these higher risk foods
(source: Healthy Canadians, Health Canada)
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o Raw fish - especially shellfish, oysters and clams

o Undercooked meat, poultry, seafood
o Hot dogs and deli meats (for example, non-dried deli-meats, pâté, refrigerated smoked
seafood and fish)
o Raw or lightly cooked eggs (homemade Caesar vinaigrette, runny eggs)
o Unpasteurized milk products - soft and semi-soft cheeses like brie or Camembert
o Unpasteurized juices - unpasteurized apple cider
o Raw sprouts - especially alfalfa sprouts
o For a good resource see The Sensible Guide to a Healthy Pregnancy from Health Canada. It
contains information on lifestyle choices and a ten-month pregnancy calendar that
includes facts, useful information and tips.
Low Birth Weight (LBW)
o Babies born full term weighing less than 5.5 lb. are at increased risk of infection,
learning disabilities, impaired physical development, increased risk of heart disease,
diabetes later in life and respiratory issues as well as death in first year of life.
o The World Health Organization (WHO) estimates that 30 million births worldwide
can be classified as low birth weight and in developing countries it is as high as 30%.
o Low birth weight is greater in disadvantaged populations; for example, where
women have low socio-economic status, poor health and nutrition or are living in
abusive situations.
o But mothers who smoke, drink or take drugs also risk having low birth weight babies.
What factors affect birth weight?
o Smoking
o Alcohol consumption
o Age of mother
o Weight of mother
o Nutrition status of mother
EER During Pregnancy
Remember that the Estimated Energy Requirement changes throughout the pregnancy.
Note the addition of the Pregnancy Energy Deposition.
Estimated Energy Requirement (kcal/day) = Non-pregnant EER + Pregnancy Energy
Deposition
o 1st trimester EER = Non-pregnant EER + 0
o 2nd trimester EER = Non-pregnant EER + 340
o 3rd trimester EER = Non-pregnant EER + 452
Advice
o Alcohol - avoid when conceiving and throughout pregnancy
o Smoking - don’t do it
o Caffeine - limit to ~ 200 mg/d Caffeine crosses into the baby’s blood.
o Check the caffeine content!
o Tim Horton’s vs Starbuck’s coffee
o Fish - 2 portions of oil-rich fish or 600mg DHA/day
o Food Safety/Food Hygiene - be wary of unpasteurized cheeses, mercury rich fish, cross
contamination of high risk foods.

Infancy and Nutrition

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o From the time of birth up to one year optimal nutrition is extremely important as early
nutrition can affect nutrition throughout life.
o Nutrition at this stage is shaped by physiological and developmental processes.
o It is a time for the development of attitudes and behaviors toward food that can shape
long-term health.
o In the first year weight increases by 300% and height increases by 50-75%.
o Rapid growth means that energy and nutrient requirements are high.
o Growth rates for boys and girls are similar over the first 5 years.
o Energy from food intake requirement is high and fat reduced and fibre rich foods are
inappropriate.
o It is not necessary to add sugars or salt to the baby's diet.
Nutrient Requirements during infancy:
o Carbohydrate and protein - necessary for growth
o Fibre - sufficient but not excessive!
o Fat - sufficient for energy requirements
o Fluids
Vitamins and Minerals
o Wide variety of foods required to ensure good intake of all nutrients
o Zinc deficiency can impair growth
o Excessive amounts of Sodium (Na) can be harmful
o Iron important as stores used up by six months
o Vitamin D important for Calcium metabolism and bone development
o Vitamin C required for absorption of nonheme iron.

Read an interesting study about diet habits “Childhood diet habits set in infancy”:
http://mobile.nytimes.com/2014/09/02/health/childhood-diet-habits-set-in-infancy-studies-suggest.html

Breastfeeding and Weaning

Exclusive breastfeeding is best until 4-6 months. According to Health Canada, "Breastfeeding
is the normal and unequalled method of feeding infants. Health Canada promotes
breastfeeding - exclusively for the first six months and sustained for up to two years or
longer with appropriate complementary feeding - for the nutrition, immunologic protection,
growth, and development of infants and toddlers."
o Breast milk helps the baby grow and develop.
o It contains all of the protein, carbohydrate, fat, vitamins and minerals required.
o Breast milk is easier to digest compared to formula and it contains antibodies that help
prevent disease.
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o The first milk produced after birth, called Colostrum, helps protect the baby from the
growth of harmful bacteria and is even more important for premature babies.
o Solid foods should not be introduced before 4 months.
o The Department of Health recommends: ‘At about 4-6 months a baby can easily be
moved onto a mixed diet’.
o Iron rich rice based cereals introduced as iron stores are depleted.
o Fruits and veg introduced next.

When to introduce new foods to infants cheat sheet Today’s Parent:

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http://www.todaysparent.com/baby/baby-feeding-cheat-sheet/
See more recommendations from Healthy Canadians
Website http://healthycanadians.gc.ca/healthy-living-vie-saine/infant-care-soins-
bebe/nutrition-alimentation-eng.php

Nutrition for School Children

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o As we move from stage to stage in the human life cycle, the requirements for nutrients
change.
o During high growth periods like childhood, the caloric intake changes relative to body
size to ensure physical and mental development.
o Physically there is much growth but also emotionally and psychologically.
o This is a period where a child's attitudes about food are formed and influenced by family
and peers.
o During this period caregivers should serve as role models to reinforce good food choices
and habits.
o The energy needs of children vary, depending on their gender, their growth and level of
physical activity.
In the chart below you can see that active girls ages four to nine require 1,400 to 1,850
calories a day, while active boys need 1,650 to 2,000 calories daily. Notice also that the
figures show activity levels.
Estimated Energy Requirements (EER) - Canada's Food Guide
Males (Calories per day) ------------------------- Females (Calories per day)
Low Low
Sedentary Active Sedentary Active
Age Active Active
Level Level Level Level
Level Level
Source: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-
base/1_1_1-eng.php
2-3 y 1100 1350 1500 1100 1250 1400
4-5 y 1250 1450 1650 1200 1350 1500
6-7 y 1400 1600 1800 1300 1500 1700
8-9 y 1500 1750 2000 1400 1600 1850
10-11
1700 2000 2300 1500 1800 2050
y
o Recommended intakes of macronutrients and most micronutrients during these ages
are higher relative to body size, compared to adulthood.
o What this means is that children need nutrient-dense food for meals and snacks.
o However, caution must be taken to not overfeed children because this can lead to
childhood obesity.

Canada's Food Guide Recommendations for Children

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Canada's Food Guide Children

Number of Servings
Age in Years 2-3 4-8 9-13
Sex Girls and Boys
Vegetables and Fruit 4 5 6
Grain Products 3 4 6
Milk and Alternatives 2 2 3-4
Meat and Alternatives 1 1 1-2
The Importance of Breakfast
A balance breakfast gives children an advantage in school when it comes to learning. Studies
show that children who eat a healthy breakfast have both higher energy levels and better
learning ability when compared to students who do not eat breakfast.
See Eat Right Ontario's guide to a balance breakfast below
"A balanced breakfast includes foods from at least three of the four food groups in Eating
Well with Canada’s Food Guide:
o Vegetables and Fruit like bananas, frozen blueberries, dried apricots, cucumber, canned
peaches and spinach.
o Grain Products like whole grain cereals, whole wheat tortillas, whole grain roti, oatmeal,
brown rice and naan.
o Milk and Alternatives like plain yogurt, skim milk cheese, soy beverage and low fat
cottage cheese.
o Meat and Alternatives like eggs, tofu, chicken breast, almonds, pumpkin seeds and
peanut butter."
Overall Recommendations:
o Young children need to eat frequent small meals-Energy foods are important, choose
nutrient-dense foods for children
o Serve protein rich foods
o Serve colorful foods rich in nutrients- colorful fruits and vegetables
o Look for foods rich in Vitamin D, Vitamin C and calcium
o Avoid added sugar and salt (i.e., sugary pops, juices)
Tricks for Picky Eaters

Children can be picky eaters, to entice them to eat healthy:

o Choose bright and beautiful foods.
o Select a wide variety of foods.
o Hide fruits and veggies in sauces and dips.
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o Get them in the kitchen to participate.

o Take them to the grocery store or market to involve them.
o Make or choose healthy finger foods so they can sample small portions.
Kid Friendly Recipes
For some kid friendly recipes see:
Cooking with Amber at https://www.youtube.com/watch?v=ss1OCWoYmrc
Nourishing Meals – Green smoothie http://www.nourishingmeals.com/2010/03/how-to-
make-green-smoothie-uncooking.html
Jessica Seinfeld https://www.youtube.com/watch?v=cGU4_8e3eqQ

Adolescence and Nutrition

Adolescence is a period between 9 and 18. It is a period of rapid growth and increased
nutrition needs. During this period adolescents are more independent eaters, many times
they are out with friends eating. They are more likely to be influenced by their peers, but
they are also influenced by societal pressures to appear a certain way, thin, perfect, or
muscular. Food choices during this period are very important because eating patterns
developed can be followed throughout life.

See Health Canada's Estimated Energy Requirement (EER) for adolescents

Males (Calories per day) ---------------Females (Calories per day)
Sedentary Low Active Active Sedentary Low Active Active
Age
Level Level Level Level Level Level

8-9 y 1500 1750 2000 1400 1600 1850

10-11 y 1700 2000 2300 1500 1800 2050
12-13 y 1900 2250 2600 1700 2000 2250
14-16 y 2300 2700 3100 1750 2100 2350
17-18 y 2450 2900 3300 1750 2100 2400

But are Canadians adolescents meeting their nutrient intake? Are they exceeding their
EER?
According to a study by Health Canada
o 3 in 10 adolescents have energy intakes that exceed their energy needs.
o The saturated fat intakes of Canadian adolescents could be further decreased.
o Many adolescents have inadequate intakes of magnesium, vitamin A, vitamin D, calcium
and phosphorous.
o For nutrients with an Adequate Intake (AI), there is concern that Canadian adolescents
may not be meeting their needs for potassium and fibre - although the interpretation of
the adequacy of nutrients with an AI is limited.
o Canadian adolescents' sodium intakes are associated with an increased risk of adverse
health effects.
From this information we can see that we have to be concerned with adolescents exceeding
their daily caloric intake and also not meeting their nutritional needs.
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Note the health Implications of a poor diet--childhood obesity, chronic disease, poor bone
development, iron deficiency, allergies, eating disorders, dental problems and alcohol
abuse.

Adolescents should:

o Follow Canada's Food Guide for EER and caloric intake.

o Eat a variety of foods.
o Ensure they are getting enough vitamin A, vitamin D, calcium and phosphorus.
o Eat 3-4 servings of low fat milk or milk alternatives, low fat yogurt or fortified soy
beverage each day.
o Choose whole grain foods.
o Include vegetables and fruit with meals.
o Watch overconsumption of protein.
o Prepare meals with less fat, limit deep fried foods; include fish and meat alternatives like
beans, lentils and tofu.
o Choose unsaturated fats and limit saturated and trans fats- eat nuts and seeds and limit
junk foods.
o Reduce consumption of sugar and salt.
o Girls should make sure they are eating iron rich foods.
o Be active- 60 minutes of moderate-to-vigorous intensity physical activity per day.
o 2 times per week focus on enhancing and maintaining muscle strength, flexibility and
bone health.

Adult Nutrition

o Getting the required nutrients is important at any age but as an adult what you eat will
determine the state of your health in later years.
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o Following Canada's Food Guide will aid in maintaining good health. To ensure good
health follow 'preventive nutrition.'
o Preventive nutrition is following dietary practices that reduce disease and promote
health and well-being; for example, choosing unrefined carbohydrates over refined
carbohydrates, avoiding saturated and trans fats, consuming foods high in antioxidants,
like colorful fruits and vegetables to reduce the risk of cancer and eating foods rich in
Omega 3 fatty acids such as oily fish, including salmon, mackerel, tuna, herring, cod, and
halibut and monounsaturated fats in plant oils, such as avocados, peanuts, and pecans
to help prevent coronary artery disease.
Review Canada Food Guide recommendations below:
Recommended Number of Food Guide Servings per Day
Adults
Age in Years 19-50 years
Sex Females Males
Vegetables and Fruit 7-8 8-10
Grain Products 6-7 8
Milk and Alternatives 2 2
Meat and Alternatives 2 3
Canada's Food Guide Estimated Energy Requirement (EER) for adults.
Males (Calories per day) ---------------Females (Calories per day)
Low Low
Sedentary Active Sedentary Active
Age Active Active
Level Level Level Level
Level Level
Source: Canada's Food Guide
19-30
2500 2700 3000 1900 2100 2350
y
31-50
2350 2600 2900 1800 2000 2250
y

Recommendations

o Follow food guidelines

o Consume nutrient dense foods
o Eat 1 green and 1 orange vegetable everyday
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o Eat a diet low in or no saturated fats and trans fats

o Eat a diet rich in fruits, vegetables, nuts, seeds, legumes
o Choose good quality protein including all amino acids
o Do not smoke, and minimal to no alcohol consumption
o Maintain a healthy body weight
o Be active -2-3 hours/week of moderate physical activity
o Use weight training to strengthen bones and muscles.

Elderly Population

According to the World Health Organization's 2012 report our aging population will create
social transformation in the years to come.
Look at the key findings of their report:
o The number of people today aged 60 and over has doubled since 1980.
o The number of people aged 80 years will almost quadruple to 395 million between now
and 2050.
o Within the next five years, the number of adults aged 65 and over will outnumber
children under the age of 5.
o By 2050, these older adults will outnumber all children under the age of 14.
o The majority of older people live in low- or middle-income countries. By, 2050, this
number will have increased to 80%.(source: WHO)
o As we have seen, most people die of diseases such as heart disease, cancer and diabetes
and as we have also seen nutritional factors can play a role in the prevention of these
diseases.
o With an increased number of aging people there will be a burden on the health care
system, so paying attention to the factors that influence nutritional frailty will be
important. Let's look at some of those factors.
Factors that Influence Nutritional Frailty:
o Poor diet intake
o Weight loss
o Disease
o Inactivity sarcopenia, bone loss
o Immune disorders
o Medication.
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o Poor dental health

o Declining absorption in stomach due to reduced HCl
o Reduced saliva flow (cotton mouth)
o Dysphagia
o Environment (i.e., eating alone vs. in a public setting with friends)
o Overconsumption of tea and/or coffee
o Dehydration.
Elderly Nutritional Issues and Needs

o As you can see from the chart here, there is a vicious circle for the elderly concerning
poor appetite.
o A decreased appetite leads to poor food intake, poor nutritional status
and undernutrition.
o Undernutrition leads to increased morbidity.

What are the nutritional needs for the elderly?

If you look at Canada's Food Guide, you will see that energy requirements (calories) are
decreased.
Estimated Energy Requirements (EER) - Canada's Food Guide
Males (Calories per day) ------------------------- Females (Calories per day)
Low
Sedentary Low Active Active Sedentary Active
Age Active
Level Level Level Level Level
Level
Source: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-base/1_1_1-
eng.php
51-70 y 2150 2350 2650 1650 1850 2100
71+y 2000 2200 2500 1550 1750 2000

But although there is a decreased caloric intake for the aging population, there is also an
increased need for calcium (particularly for women), Vitamin D, folate, Vitamin B12, Vitamin
B6, fibre and protein.
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What Ways are There to Improve Health in the Elderly?

o Encourage frequent snack consumption
o Eat in groups
o Select energy and nutrient dense foods
o Provide a variety of familiar foods
o Enhance food’s flavor with appropriate seasonings
o Reduce coffee/tea consumption if excessive
o Drink plenty of fluids
o Encourage weight bearing exercise and resistance training
o Activity-2-3 hours of moderate exercise per week

Overall, good nutrition throughout the life cycle will reduce chronic disease, improve bone
and joint health and mobility, increase immune function and protect against infection,
improve brain function and cognitive performance, increase longevity and improve overall
quality of life.