ANGELES UNIVERSITY FOUNDATION

Angeles City
COLLEGE OF NURSING

Module 4:​ ​Nutrition on Life Stages

MODULE OVERVIEW:

Life Cycle Nutrition involves the study of special nutritional needs,

physiology, and health concerns of pregnant and lactating women, infants,
children, adolescents, and older adults. As you age, your body's dietary needs will
change. These changes will continue throughout all life stages with the
requirements for calories, protein, vitamins and minerals adjusting as we grow
older. A healthy diet is made up of a balance and variety of different foods, which
provides all of the nutrients required by the body. At certain stages through life
individual requirements for energy and nutrients are different.

In this module, you will learn nursing care management specific to stages of
growth and development nutrition, with any of the following life stages. (1) Diet
during Pregnancy and Lactation; (2) Nutrition during Infancy; (3) Nutrition for
Pre-Schoolers; (4) Nutrition for Schoolers; (5) Nutrition for Adolescents; (6)
Nutrition during Early and Middle-Aged Adulthood; (7) Nutrition during Senior
Years
The discussion of the nutrition on life stages will focused on usual
conditions/concerns during Pregnancy & their Management; different types and
techniques in formula feeding; Common problems of Infants/babies; preschoolers;
schoolers, adolescents, early and middle-aged adulthood and senior years.
You will spend eight hours in this module. Below are the details of the
content and the estimated time of completion.
 Part of the module Estimated time allotment

Pre-Discussion activity 20 minutes

Discussion on:

1. Viewing activity 5 minutes

2. Video conferencing 1 180 minutes
3. Discussion board 50 minutes
4. Video conferencing 2 180 minutes
5. Viewing activity 5 minutes

Summary and conclusion 10 minutes

Assessment activities 30 minutes

Multiple choice (30 items)

TOTAL NO. OF HOURS 8 hours

MODULE LEARNING OUTCOMES:

Pursuant to the Commission on Higher Education (CHED) Memorandum Order

No. 15, the required policies, standards and guidelines in the nursing program
parallels this module’s aim to satisfactorily meet the following learning outcomes:

● LO2 Assess with the client one’s nutritional health status

● LO3 Formulate with the client a plan of care to address the dietary health
needs, problems and issues
● LO4 Implement safe and quality interventions with the client to address the
dietary health needs, problems and health issues
 ● LO4 Provide dietary health education using selected planning models
● LO5 Evaluate with the client their health and nutritional status

PRE-DISCUSSION ACTIVITY: (UNGRADED)

You will answer a pretest to check your level of knowledge prior to

discussion using poll feature via Myclass. These are sample questions which are
contents in the module itself. It will determine what the students’ needs to learn
during the discussion.

DISCUSSION:
1. Viewing of videos:​ Nutrition Throughout the Lifecycle
https://youtu.be/-SgH-w1smAI​ (3.34). To set the discussion, you should
take note of the needed nutrients for specific age group.

2. VIDEO CONFERENCING 1:

Your Professor will lead a discussion on the nursing care management

specific to stages of growth and development nutrition, with any of the
following life stages. (1) Diet during Pregnancy and Lactation; (2)
Nutrition during Infancy; (3) Nutrition for Pre-Schoolers; (4) Nutrition for
Schoolers;

Learning objectives:

At the end of the discussion, the learner will be able to:

1. Identify the nutritional considerations throughout the life cycle

2. Discuss effect of inadequate nutrition during the growing years
3. Modify the normal diet to meet the needs in each life cycle.
4. Identify the role of proper nutrition in assessing growth and development
through various stages of life.
Nutrition During Pregnancy

Good Nutrition is a must for both the mother to be and her child during pregnancy
as nutrients and calories must be supplied for the increase in breast and uterine
tissue, blood volume, placenta and embryo in addition to the pregnant woman’s
normal nutritional requirement.

Effects of Nutrition during Pregnancy

With an OPTIMUM NUTRITION With a FAULTY NUTRITION there

the pregnant woman is:
a. Growth retardation in the
a. Feels better
fetus
b. Is better able to maintain a
b. Low birth weight
healthy status
c. Slow development of the
c. Has more chances of
child
bearing a healthy infant

Caloric Requirement: The daily caloric intake should not be reduced below 36
cal/kg of pregnant weight. Or an equivalent of 300 total caloric intake is needed
during pregnancy.

Special Nutritional Requirements:

A. Vitamins
i. A and E- an increase of 25 % is needed to maintain healthy eyes, skin
and bones
ii. D- normal requirement must be increased by 50 to 100 % to facilitate
and maximize Calcium and Phosphorous absorption for the skeletal
development of both mother and baby
iii. K- maintenance of 70 to 140μcg intake for normal clotting ability of blood
iv. B- B12, B6,
 v. C- an increase of 33 % is needed for wound healing and increased
resistance
vi. FOLATE and vitamin B12
vii. THIAMINE, RIBOFLAVIN, and NIACIN

B. Minerals

i. Calcium and Phosphorous- an increase of 400 mg each is needed for

bone and teeth development
ii. Magnesium- a 50% increase must be met for healthy bones, muscles
and blood tissue
iii. Iron- an increase from 18 mg to 30-60 mg is needed to meet increase in
hemoglobin level supplying the maternal tissue, placenta and fetus
iv. Zinc- 33 % increase is simple for the:
a. Release of Vitamin A from the liver
b. Metabolism of the pituitary, adrenals, ovaries and testes
c. Development of the skeleton, nervous system and brain of the
growing fetus
d. Growth and enzymatic action
v. Iodine- an increase of 15 % is needed to prevent maternal
goiter

USUAL CONCERNS DURING PREGNANCY

1. Nausea/ Morning Sickness
● Usually during the first trimester but can occur all throughout the pregnancy
term
● Due to increased production of gastric acids or to emotional factors, or
hormonal (HCG)
Management:

▪ Dry crackers

▪ Small frequent feedings

▪ Eliminate some fat in diet

 ▪ Avoid too much liquid at mealtimes
2. Weight Gain
● A total of 11 kg or 24 lbs is desirable (3-11-11 lbs)

3. PIH/ Pre-eclampsia
● Triad Symptoms:
a. high blood pressure
b. albuminuria
c. edema
4. Nutritional Anemia
● Common forms
i. Fe deficiency Anemia (microcytic)
ii. Folic Acid Deficiency Anemia (macrocytic)

5. Alcohol, Smoking, Drugs

● Alcohol- drinking when excessive, can affect fetus and cause transient
respiratory depression and fetal withdrawal syndrome
● Smoking- causes vasoconstriction leading to low birth weight babies
● Drugs- are teratogenic and therefore are contraindicated during pregnancy
unless prescribed by the doctor
a. Steroids

b. Iodine- contained in many over-the-counter cough suppressants

c. Vitamin K

d. Aspirin

e. Phenobarbital

f. Streptomycin

g. Tetracycline

h. Cocaine
6. Constipation and Flatulence
Causes:
a. Displacement of stomach and intestine by enlarged fetus
b. Increase in progesterone which inhibits gastric motility

Management:

▪ Avoid fried, fatty foods

▪ Sips of milk at frequent intervals

▪ Slow, frequent meals

▪ Take antacids

7. Leg Cramps
Causes:
a. Low Ca and high phosphorous levels
b. Fatigue and muscle tenseness
c. Increase pressure

Management:

▪ Increase Ca intake

▪ Press knee of affected leg and dorsiflex foot

▪ Take rest periods with legs elevated

▪ Wear warm and comfortable clothing

DURING LACTATION
Lactation- period during which the mother nurses her baby resulting to a relative
increase in caloric needs
● 1 oz of milk yields 20 calories
 On the average, an estimated additional caloric requirement of 500 cal/ day
is needed by the lactating mother. At the end of the nursing period, caloric intake
must be reduced to avoid gaining unwanted weight.

DIETS FOR PREGNANCY AND LACTATION​:

● Designed to meet the increased nutrient needs due to normal physiologic
changes
● More milk or frequent use of dilis or calcium rich greenly leafy vegetables
or alternative dairy products like yoghurt will improve the calcium content
of diets
● Iron supplementation is highly recommended
● Emphasis on foods high in calcium dried and fresh dilis, dried and fresh
alamang, dried fish, shellfish and crustaceans, fresh fishes; milk, cheese,
ice cream, soybeans, mongo and other dried beans and leafy vegetables
● Foods rich in iron are prescribed: liver and glandular organs(except
tripe), egg yolk, shellfishes, dried dilis and alamang, leafy vegetables,
soybeans, dried banana flower
● Adolescent pregnant girls require a diet higher in calories, protein,
vitamins and minerals to meet both the needs of the developing fetus and
their growth
 NUTRITION DURING INFANCY

GUIDING PRINCIPLES IMPLICATIONS

1. Significant Person- Mother 1. Maximize opportunity to feed infant
personality during breastfeeding/
bottlefeeding
2. Psychosocial Development – Trust vs. 2. Meet his basic needs for:
Mistrust a. warmth and comfort
b. love and security
c. sensory stimulation
d. sucking
e. food
3. Psychosexual Development Oral Stage 3. Meet his basic needs for sucking and
● Pleasure gained from putting Food
things in mouth
● If not satisfied, fixation at this
stage may occur
4. Usually reacts to Parent’s Emotions
4. Do not force food nor present it in a
5. Experiences most rapid growth period tense manner. Relax and enjoy
● At 6 months infant’s weight mealtime with the infant
double 5. Meet infant’s Nutritional and Caloric
● At 1 year weight increases by needs
three times

Milk – basis of infant’s diet as it is highly nutritious, easily digested and a complete food.
Methods of Feeding:
a. Breastfeeding
b. Bottlefeeding
c. Mixed feeding

A. Breastfeeding – An adequately fed newborn will breastfeed 8 to 12 times, wet

atleast six diapers and have at least three loose stools each day in the first
week of life. Normal growth, regular elimination patterns, and a satisfied
demeanor are the best indicators that a baby is getting enough to eat.
Importance:
 1. Economical
2. Nutritionally adequate
3. Sanitary
4. Saves time
5. Provides temporary immunity
6. Sterile and easy to digest
7. Bonding
8. Hastens period of involution
9. Allergic manifestations are less likely to appear

Contraindications:
1. Mastitis and other infections
2. Emotional or mental stress
3. Insufficient supply of milk
4. When another pregnancy follows
5. With delicate or inverted nipples
6. Smokers
7. Contraceptive pills

B. Bottle feeding – women may decide not to breastfeed or to breastfeed only

briefly. Their infants need infant formulas designed to provide adequate
nutrition.
Indications:
1. When breastfeeding is contraindicated
2. Mothers employed outside the home
3. Breast milk production is inadequate
4. Sickly mother
5. Inborn errors of metabolism wherein babies lack necessary
enzymes to digest or utilize milk
6. Personal reasons
Important Points to Consider when Bottle feeding:
● Provide love and attention
● Cuddle and keep baby warm and comfortable
● Burp to release gas in the stomach
● Give milk at same temperature consistently
● Do not prop the bottle
 Types of Infant Formula
1. Standard Infant Formulas – uses cow’s milk as base. The manufacturers first
remove the milk fat and replace it with vegetable oils. It is fortified with all the
essential vitamins and minerals according to guidelines established by
American Academy of Pediatrics and enforced by the Food and Drug
Administration.

2. Soy Based Formulas – soy is the source of protein. They contain more protein
than formulas based n cow’s milk. They are lactose-free and iron-fortified. Corn
syrup and sucrose are the carbohydrate source.

3. Special Formulas – these are available for infants who are allergic to both
cow’s milk and soy protein, those who are premature, and those who have rare
defects in metabolic pathways.

C. Mixed Feeding – combination of breast and bottlefeeding

● The bottle is used to replace one or more breast feedings
● Helpful during weaning stage as it allows the breast to dry up
gradually

Two types of Mixed Feeding:

1. Complemental Feeding - used when mother’s milk is insufficient for the infant’s
needs
2. Supplemental Feeding – used when mother is away from home for periods
longer than feeding intervals

Introduction of Solid Foods into the Infant’s Diet

Weaning-​ means to detach the affection of one from something long followed or
desired. Usually begun at around 5 to 6 prepare infant for weaning.

Pointers to Consider in Weaning:

1. Vitamin drops are usually started with a 10-day old neonate.
2. Fruit juices follow shortly thereafter.
 3. The age at which new foods are introduced is highly variable.
4. Semi-solid foods are usually given at 4-6 months.
5. At 6 months, mother’s milk can no longer supply sufficient energy to the growing
infant.
6. Introduce one new food every 4-5 days.

Developmental Readiness for Solid Food

1. Absence of extrusion reflex
2. The infant can purposely bring her hand to her mouth
3. The baby is able to control her head and neck while sitting with minimal support

Common Problems of infants:

1. Diarrhea
Management:
a. dilute milk formula
b. eliminate fruit juices, solid foods, sugar and vitamin preparations
c. provide rice water or “AM”

2. Vomiting
Management:
a. reduce number of feedings
b. acidify milk
c. burp infant in between and after every feeding

3. Constipation
Management:
a. change sugar in formula
b. emphasize fruits and vegetable in diet

4. Allergy
Management:
a. give goat’s milk and meat-base formula as substitute
b. exclude animal CHON

5. Colic
Management:
a. changing the formula may bring about some improvement
 b. helps get rid of the air
c. drink warm water

6. Early Childhood Caries

Management:
a. Avoid putting a baby to bed with bottle

7. Iron Deficiency Anemia: Milk Anemia

Management:
a. If bottle fed, give infant formula fortified with iron
b. To older infants, give iron-rich foods.

8. Failure to Thrive
Management
a. Babies need a high fat diet to support normal growth and brain
development.
b. Nutrition education for caregivers
c. Maintenance of food records by the caregiver
d. Frequent weight checks of the infant
e. Social service intervention for the family

NUTRITION DURING THE TODDLER STAGE

GUIDING PRINCIPLES IMPLICATIONS

1. Significant Person-Parents 1. Feeding of toddler should be done
and enjoyed by both parents together
2. Pyschological Development: Autonomy or alternately.
vs. Shame and Doubt. Dawdless and 2. Allow graded independence
does things in Ritualistic Manner 3. Avoid fussing-over him and let him
thinking by being independent and enjoy his meal.
powerful. 4. Do not offer too much snacks and
make him sit on the table during
3. Common Problem-Physiologic Anorexia meals: serve as MODELS

● Toddlers usually show less demand for

food.

NUTRITION DURING PRESCHOOLER

GUIDING PRINCIPLES IMPLICATIONS

1. Psychological Development: Initiative 1. Allow child to take part in household
vs. Guilt chores including meal preparation of
2. Loves to initiate adult roles he shows interests or volunteers to do
● Food likes and dislikes stage to develop this with you.
at this and often continue throughout 2. Be good models. Have good habits
their lives and be claim and relaxed about the
3. Very keen on taste, flavor, texture and child.
temperature of food. 3. Introduce food as appealing/attractive
4. Thumb sucking. as possible.
4. Satisfy child’s need for food.

Common Feeding Problems:

a. ​Eating too little

Management:
 a. Go slow in adding new foods
b. Serve less than he will eat
b. ​Eating too much
Management:
a. Refrain from serving “rich foods”
c. ​Gagging
Management:
a. Encourage self-feeding
b. Place him in a bright, well ventilated and clean eating place together
with other children
d. ​Dawding
Management:
a. Have him regularly checked by pediatrician and avoid fussing over him.
b. Let him enjoy eating.

e. ​Food aversion
Management:
a. Give fruits and substitutes of vegetables or of the food he particularly
dislikes to eat.
b. Offer food in appealing forms like flavored milk dessert, “leche plan,”
etc.

f. ​Feeding between meals

Management:
a. Limit intake of empty calories
b. Establish a routine for the child
 NUTRITION FOR THE SCHOOLER

GUIDING PRINCIPLES IMPLICATIONS

1. Psychological Development –Industry 1. Allow child to assist in marketing and
vs. Inferiority preparation of a new food.
2. Attention is focused on environment 2. Sometimes develop fondness for food
rather than their stomach products seen on TV commercials
3. Actively growing especially girls at and appetite for food favorites of
puberty stage. movie idol.
3. Meet nutritional and caloric needs of
schooler

Common Feeding Problems:

a. Inadequate Meals
b. Poor Appetite
c. Sweet tooth

3. Video conferencing 2:

Your Professor will lead a discussion on the nursing care management specific to
stages of growth and development nutrition, with any of the following life stages. (1)
Nutrition for Adolescents; (2) Nutrition during Early and Middle-Aged Adulthood; (3)
Nutrition during Senior Years
Learning objectives:
At the end of the discussion, the learner will be able to:
1. Identify the nutritional considerations throughout the life cycle
2. Discuss effect of inadequate nutrition during the growing years
3. Modify the normal diet to meet the needs in each life cycle.
4. Identify the role of proper nutrition in assessing growth and development through
various stages of life.

Providing Nutritional needs is a challenge to health professionals, because of:

1. Accelerated growth and development
•It is 1 of the fastest growth periods of a person’s life
•ADOLESCENCE GAIN 20% OF ADULTS HEIGHT AND 50% OF
ADULTS WEIGHT
• Girls: 10-13 y/0 = 3 inches/year
• Boys: 13-16 y/0 = 4 inches/year
2. Changes in lifestyle, including food habits
• Involvement in social and physical activities
3. Emotional problems associated with increase personal and academic
responsibilities
4. Problems with some teenagers that demands special nutritional needs
a. (smoking, drug-addiction, alcoholic beverage drinking, pregnancy
and eating disorders)

GUIDING PRINCIPLES IMPLICATIONS

Psychological Development –​Identity vs.
Role Confusion
- Imitators not of adults but of “PEERS” o Check food clothes for nutrient
- Starts to be conscious with their body content
image
o Be tactful as they may resent being
- With a natural desire for independence told what to do
o Close supervision and be patient
o Develop strong and trusting
relationship

- With enormous appetite o Higher caloric requirements for boys

IMPLICATIONS:
1. Check food clothes(labels) for nutrient content
2. Be tactful as they may resent being told what to do.
3. Close supervision and be patient.
4. Develop strong and trusting relationship
5. Increase caloric requirement for boys
6. Eating habits are seriously affected by busy schedules, sports, social
activities and no adult will prepare nutritious food

Special Nutritional Needs

1. Calories
Energy needs of boys and girls

10-12 y/o 13-15 y/o 16-19 y/o

Male 2090Kcal 2340 Kcal 2580 Kcal

Female 1910 Kcal 2010 Kcal 2020 Kcal

*rapid growth and high energy expenditure

Higher energy expenditure brought about by intense physical activity
2. Carbohydrates: should supply 50 to 60 percent of total Calories
needed/day

3. Protein:​ for accelerated growth and development

 ● Early stage: 60 grams/day for both female and male
● Late stage: Male 69grams/day; Female 56 grams/day
● High quality CHONs or complete CHONs: poultry, eggs, dairy products, meat
and fish
● Contains adequate amount of essential amino acids

4. Vitamins:
3a. Vitamin B1 (Thiamin) – increase of 0.5mg/1000cal.
needed for carbohydrate metabolism, maintain good appetite, good
muscle tone especially of the gastrointestinal tract, normal functioning of nerves.
( food sources: lean pork, pork liver, and other glandular organ of pork and some
sea food)
Food sources: pork, nuts, whole grain, cereals and legumes

3b. Vitamin B2 (Riboflavin) – increase of 0.5mg/1000cal.

Essential for protein, fat and carbohydrate metabolism and maintain normal
vision.

needed for RBC/ antibody production, cell respiration and growth

Food sources: milk, lean meat, fish, grains

3c. Vitamin B3 (Niacin) – increase of 6.6 niacin equivalents/1000 calories,
proper blood circulation, energy metabolism (acts as hydrogen and electron
acceptor), fatty acid synthesis and protein synthesis and catabolism (food
sources: protein sources, animal sources, legumes, nuts green vegetables)
Food sources: Meat, poultry, fish, beans, peanuts, grains
3d. Pantothenic Acid (B5​)-for CHO, CHON and fats metabolism, cholesterol
metabolism and hormone production
Food Sources: (whole grains, rice, wheat, broccoli, avocados
3e. Pyridoxine (B6)- ​essential for healthy nervous system and release of
glycogen for energy from the liver
Food Sources (wheat, grain, vegetables, nuts)
3f. ​Biotin(B7)​-for good hair and nail growth, and metabolism of CHO, CHON,
fats
Food Sources (beans, chocolate, egg yolk, fish, breads
 3h. Folic Acid (B9​)-coenzyme with vitamin B12 (RBC production and DNA
synthesis)

sources: green leafy veggies like asparagus, spinach, turnip greens, romaine
lettuce, dried and fresh beans, oranges, pineapples, bananas, pasta, cereals
3i. Cobalamin(B12)- ​essential for healthy nervous system, blood formation, cell
metabolism, DNA synthesis and energy production
Food sources (fish, meat, liver, shellfish, poultry eggs, milk and milk products)
3j. Vitamin A​: maintains integrity of epithelial tissues, constituent of the visual
purple in the retina, needed for normal night vision, needed for bone and skeletal
growth,
Food sources: Liver, egg yolk, whole milk, green or orange vegetable,
fruits
3k. Vitamin C –needed for accelerated growth and development, healing of
bones and fracture, megaloblastic anemia, body resistance against infection, and
improves absorption of iron

Food sources: citrus fruits, tomatoes, broccoli, cabbage

Vitamin A: maintains integrity of epithelial tissues, (sources: liver, egg yolk, milk,
cream, butter and cheese, anchovies, mussel or clamp and fish liver oil)
Vitamin C: (Ascorbic Acid): improves absorption of iron (tropical fruit, raw leafy
vegetables and tomatoes)

Minerals

1. Calcium–​ many teenagers are not meeting their need for calcium 3 cups/day
Calcium: 700mg/day both male and females. Late adolescence increase intake
to meet peak bone density before age 24 y/o
● Mineralization of bones:​ prime physiologic function during adolescence.
● Food sources: YMCASID

2. Iron: ​carrier of oxygen needed for cellular respiration, carry carbon dioxide
away from the lungs to the cell.
 Boys:​ 10-18y/o: 13-20mg
Girls​: 10-18 y/o:19-21mg (menstrual losses amount to about 2mg/day)
● Food sources: liver, meat, dark green vegetables, egg yolk

3. Iodine​: increased thyroid activity associated with growth

● regulates rate of basal metabolism, promotes growth and temperature, and
protein catabolic effect.
● Food sources: Iodized salt, seafoods, seaweeds

NUTRITIONAL PROBLEMS AND CONCERNS OF TEENS

The female adolescent who gets too conscious with her body shape and
figure, becomes a prey of false advertisement, food fads and fallacies or bad
practices of some peers on how to stay slim.
About 3% of young women between 18-30 years old and smaller percentage of
men have anorexia nervosa and bulimia nervosa.

1. Anorexia Nervosa:
● Anorexia​: without appetite, ​Nervosa:​ of nervous origin
● An eating disorder characterized as refusal to maintain minimally normal
body weight through self-imposed starvation
● Disturbed perception of body weight and shape
● They do not see themselves as underweight and continue to restrict their
food intake often in a RITUALISTIC MANNER (Binge eating/Bulimic
episodes, feeling out of control when eating, Increase consumption of food
will lead to increase in exercise, intensive study and work)
● The psychopathologic presentation dictates the need for psychiatric
intervention
● Life threatening
● Characterized by a feeling of panic after only a small weight gain
● an eating d/o characterized by excessive food restriction,
● irrational fear of gaining wt. and
● a distorted body self-perception
● they starve themselves and exercise obsessively till they become
extremely thin
● they set a maximum weight,
● expert in counting calories
● ​EFFECTS:​ hair loss, hypotension
● amenorrhea brain damage and
● even death
 2. Bulimia Nervosa: recurring episodes of binge eating combined with morbid fear
of becoming fat
● Bulimia means great hunger
● Binge-purge syndrome
● Binge eating: (eating excessively) feeling out of control when
eating, resulting to increase consumption of excessive amount of
food
● Secretive binge-eating: general not over eating in front of others.
● Purging: (induced-vomiting) the response to bingeing
● Non purging: use laxative or diuretics, inappropriate compensatory
behavior like fasting, diet pills, and excessive exercise
● Physiologic dimension: frequent weight fluctuation from alternate
bingeing, fasting
and Russell’s Sign (Calluses on the knuckles due to repeated self-
induced vomiting over long period)
*purchases syrup of ipecac
EFFECTS: ​not life-threatening but may cause electrolyte imbalance, dental caries,
malnutrition, DHN
- needs close supervision and limits eating to mealtime
3. Bulimarexia
an eating d/o marked by alternation between abnormal craving for and
aversion to food
manifested by episodes of excessive food intake followed by periods of
fasting and self-induced vomiting/ diarrhea

TREATMENT for Eating Disorder

a. Never restrict food intake to below the amount suggested for adequacy by the
food guide pyramid.
b. Small frequent feeding
People often do not eat frequently meals because of time constraints, but
eating can be incorporated into other activities, such as snacking while
studying. Person who eats frequently never gets so hungry as to allow hunger
to dictate food choices

c. Allow reasonable time to achieve weight goal. (reasonable loss of excess fat
can be achieved at the rate of about 1 percent of body weight per week)
d. Establish a weight-maintenance support group with people who share
common interest
 e. Counseling

4. Many teenagers are not meeting their needs for calcium

● Drinking soft drinks in place of milk causes teenagers to have
inadequate calcium intake

5. Iron- deficiency anemia

● Girls – after they start menstruating
● Boys – growth spurt

6. Nutrition and Acne

● 80% of teens experience Acne
● Although it is believed that eating nuts, chocolate and pizza can make
acne worse, scientific studies have failed to show a strong link between
any dietary factor and acne
4. OBESITY:
Obesity: If BMI is 30-39.9
Causes
a. Eating more foods and snacks away from home
b. Genetic (if both parents are obese 80%chances of being obese)
c. Sedentary lifestyle
d. Use of food for emotional comfort

TREATMENT FOR OBESITY:

⚫ Children should not be dieting but guidance should be provided as to

healthier eating patterns
⚫ Realistic energy intake:

⚫ To lose 1 pound per week, cut 500kcal/day

⚫ Eat less food at each meal: The goal is to eat enough food for energy,
nutrients and pleasure but not more.
⚫ Balancing carbohydrates, fats and protein

⚫ Meal spacing: Three meals per day is the standard but if you have 2
additional meals it must be of small content.
⚫ EAT REGULARLY
 ⚫ Adequate water

⚫ Physical activity

NUTRITION DURING EARLY AND MIDDLE AGE ADULTHOOD

I.INTRODUCTION: ​Period of life when one has attained full growth and maturity
It pertains to years from 20’s to 50’s
o Early adulthood: 20-30’s
o Middle adulthood: 30-50’s
This period is characterized by excitement and exploration with high dreams
and energy.
COMMON PROBLEMS REGARDING NUTRITION:
A1. Young Adult:
A. ​Weight Control

Nutritional Management focuses on MAINTENANCE OF DESIRABLE BODY

WEIGHT
A1. Nutritional requirement for Young Adult:
Activities:

Transition from one stage to another

Separate from their family
Focus on personal and career roles
Faces reproductive decision

RDA: 2200 Kcal daily for WOMEN

2900 Kcal for MEN: lean body mass

Maintain Ca and Fe intake (especially for women who are dieting)

A2. Middle Adulthood
● Continuation of family demands and career involvement
● Older children move to college or have their own families
● Cell loss rather than replication occurs

▪ Kcal declines as lean mass is lost and replaced by body fats that is less
metabolically active
▪ CHALLENGE: ​Meet the same nutrient needed with reduced Kcal intake

▪ A decrease of 3% is suggested for each decade because the resting metabolic

rate declines brought about by loss of lean body mass

II. Common Problems regarding nutrition

Nutritional Management focuses on MAINTENANCE OF DESIRABLE BODY
WEIGHT
1. Obesity ​introduces the following problems:
BMI=

a. DM
● Decrease metabolism
● Decrease sensitivity of the body to insulin
● Low production of insulin in the body due to decrease activity of the
pancreas
● Management​: balance between diet, medication and exercise
 b. HPN
● Increase blood pressure due to increase levels of blood cholesterol
and triglyceride
● Loss elasticity of blood vessels (atherosclerosis, arteriosclerosis)
● Management​: modifying dietary intake, weight loss, decreasing alcohol
intake and increasing physical activity

c. Risk for Surgery= due to deterioration of organs in the body

Examples: Heart surgery, Cholelithiasis, DM foot, gangrene
-Adipose tissues have lesser blood vessels= poor wound healing

d. Generally shorter life span- ​due to d/o like DM, HPN, CV diseases, renal etc.
e. ​Reduced self-esteem​-for many years, investigators have searched for
psychopathological cause of obesity but failed.
The result of studies: our culture’s extreme stigma against fatness extracts a
tremendous toll on obese people.

2. Osteoporosis- a common age-related metabolic bone disease in which there is

general reduction in skeletal bone mass and an increase susceptibility to
fractures.
● Age related loss begins in the 4​th​ decade
● Preventive measures –to prevent bone loss
● High calcium and Vitamin D diet
● Regular weight bearing exercise – running and walking- for 30 mins/day 3
or more times per week

3. Cancer
The American Cancer Society has gathered evidences that diet and
cancer are related. Here are the recommended foods to fend off cancer
a. Carotene (a form of Vitamin A present in pumpkin, dark green leafy veg,
carrots, sweet potatoes, tomatoes, citrus fruits) lowers the risk of cancer of
the larynx and esophagus.
b. Cabbage, broccoli, brussel sprouts and cauliflower reduce the risk of GI
and Respiratory tract cancer.
c. Fruits, vegetables and whole grain cereals (oatmeal, bran and wheat) may
help lower the risk of colorectal cancer.
 d. Foods high in fats, salt, or nitrite-cured foods (ham, fish and sausage)
should be eaten in moderation.
e. Milk may help ward off colon cancer.
f. Some cruciferous vegetables such as cabbage, cauliflower, broccoli,
brussel sprouts, mustard and collard greens, turnip and raddish have an
anticancer effect.
Cruciferae group
g. Moderate amount of alcoholic beverages.

NUTRITION DURING SENIOR YEARS

DEFINITION OF TERMS:
a. Gerontology: ​Study of phenomena with old age
b. Geriatrics: ​treatment of accompanying disease among elderly
c. Senescence​: Period of old age, referred to as elderly or senior citizen
Ages 60’s, 70’s, 80’s and above
This period of senescence is characterized by disturbed regulatory and
functional mechanisms in the body.

1. Gastrointestinal
▪ Decrease threshold to taste: (marginal deficiency of ZINC)
▪ Decrease gastric motility (constipation)
▪ Diminished secretion of gastric juices
▪ Poor absorption of nutrients (need for optimum nutrient intake)

2. Circulatory
▪ Loss of elasticity of BV

▪ Increase in BP especially Systolic BP

▪ Slow blood flow to different organs especially through the kidneys,

coronary artery, GI tract and brain
 ▪ Decrease myocardial ability to use oxygen

3. Excretory
▪ Decrease amount of functioning nephrons and slow rate of excretion of
waste (decrease GFR and increase circulating BUN)
▪ Decrease ability to concentrate urine (needs more water to concentrate
urine)

4. Endocrine:
▪ Alteration in the secretion, circulating levels, metabolism and
biological activity of hormones
▪ Reduction in secretion of thyroxine and pituitary hormone

▪ (decrease cellular metabolism and ability to withstand

stress)
▪ Reduce sensitivity to insulin (prone to DM)

▪ Decrease production of estrogen and testosterone.

5. Nervous:
▪ Decrease conduction of nerve impulses and sensory sensitivity
▪ (slow reflexes and reaction. Prone to accidents like fall,
burn etc)
▪ Prone to memory problem/ loss

6. Respiratory:
▪ Loss of pulmonary functional tissues and weakening of respiratory
muscles (reduce respiratory reserve for major illnesses and decrease
maximum breathing capacity)
▪ Ciliary activity and phagocytes in the lungs becomes less effective
(prone to respiratory infection, Pneumonia)
7. Muscular:
 ▪ Diminished muscle coordination

▪ Decrease number of bulk in muscle fibers (decrease muscle strength,

stooped posture and stiffened joints)
8. Reproductive:
▪ ​ trophy of corpus luteum (decrease production of estrogen and
A
progesterone; menopausal period)
9. Skeletal:
▪ Increase bone resorption (Brittle bones so they are more to having
fracture due to fall)
▪ Degeneration of articular cartilage

COMMON CHRONIC DISEASE:

1. Osteoporosis:

increase susceptibility to fracture

Decrease bone mass among women starting 35 years old and postmenopausal
Management:

​Provide 1,500mg of Ca or 1 quart of milk

For those having intake of Ca supplement they need to increase intake of
fluids to prevent renal calculi
2. Arthritis:

joint disorder that involves inflammation of one or more joints

Caused by degeneration, trauma, infection, age

Management:

-Avoid becoming overweight

-Take aspirins/Doctor’s order
- Pain relievers but take with precaution among individuals with liver and kidney
problems
 - Warm compress
-Bandage

3. Cancer​: prolonged exposure to carcinogenic

4. DM: ​Pancreas becomes less sensitive

5. HPN: ​decrease elasticity of BV

NUTRITIONAL ALLOWANCES:

Geriatric nutrition is concerned mainly with conservation of good health and prevention
of chronic degenerative diseases.

a. ENERGY: Demand for calories is decrease because of decrease BMR

and physical activities
b. CARBOHYDRATES ANF FATS:
▪ 50-60% of total Kcal must come from CHO primarily in form of starch
rather than sugar
▪ 20-25% from Fats (Polyunsaturated Fats)
▪ Sucrose and saturated fats increases triglyceride and cholesterol levels
▪ Poly- corn oil and sunflower oil – to increase HDL – transport
cholesterol from tissue to liver for excretion
c. PROTEIN: Maintained to 1.1 g/kg of body weight
▪ Since CHON is not stored in the body they must be provided in daily
diet
▪ CHON in essential in prevention of progressive tissue wasting and
susceptibility to disease and infection

d. VITAMINS AND MINERALS

▪ Vitamin B12, Ca, Fe and zinc have impaired GI bioavailability during
aging so they must be increased in the diet of elderly
● Vitamin B12: normal blood formation
● Food sources: meat and liver (Cobalamin)
● Calcium: to prevent bone loss
● Iron: important component of hemoglobin
● Zinc: improves taste acuity
o Deficiency in zinc alters sensitivity or taste perception
 o Increase ability to taste bitter and sour
o Decrease ability to taste sweet and salty (excessive use of
sugar and salt that can lead to DM, HPN and kidney
problems)
● Food sources: Eggs, leafy vegetables, meat
● Vitamin C: facilitates absorption of Fe
● Vitamin D: decrease among elderly due to liver injury, antibiotic
therapy, poor intestinal absorption and inadequate exposure to
sunlight
● Food sources: Fortified milk, fish oil, cereals

PROBLEMS RELATED TO INADEQUATE INTAKE OF VITAMINS AND MINERALS:

1. Osteoporosis (decrease calcium intake)
2. Anemia: Multiple Deficiencies of the following:
Fe: important component of hemoglobin
Vitamin. B6: catalyzed synthesis of heme portion of Hemoglobin
molecules
Vitamin. E: affects stability of RBC
Vitamin. B12 and folacin: Normal Blood Formation
Vitamin .C: Increase absorption of Fe
 4. Viewing activity: ​Watch this video related to effect of inadequate nutrition during
growing years.​ ​https://youtu.be/4WgkZXKSO-E​ ​(4.25)

5. Discussion board:​ You will be tasked to write a reflection about a statement

posted in the Discussion tab

1. What are the needed nutrient content for the diet of the specific age group?
2. Discuss the effects of inadequate nutrition during the growing years?

Your response shall be posted on November 13, 2020, until 5pm

Summary and conclusion:

Your Professor discussed the usual conditions/concerns during pregnancy &

their management; the different types and techniques in formula feeding; the common
problems of Infants/babies; preschoolers; schoolers, adolescents, early and
middle-aged adulthood and senior years.

The learner gained knowledge on the nutritional considerations throughout the life
cycle. Discussed the effect of inadequate nutrition during the growing years. Modified
the normal diet to meet the needs in each life cycle. Identified the role of proper nutrition
in assessing growth and development through various stages of life.

Assessment activities: (30 minutes)

Quiz: Multiple choice: (30 items exam)

Recommended Readings/Viewings:
Caudal, Maria Lourdes (2019). Basic Nutrition and Diet Therapy 2​nd​ Edition, C and E
Publishing
Dudek, Susan G. (2018). Nutrition Essentials for Nursing Practice, 8​th​ Edition.
Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins
Nutrition Throughout the Lifecycle: Retrieved on July 21, 2020 from
https://youtu.be/-SgH-w1smAI
Effect of inadequate nutrition during growing years: Retrieved on July 21, 2020 from
https://youtu.be/4WgkZXKSO-E

EVALUATION:

References:
Caudal, Maria Lourdes (2019). Basic Nutrition and Diet Therapy 2​nd​ Edition, C and E
Publishing
Dudek, Susan G. (2018). Nutrition Essentials for Nursing Practice, 8​th​ Edition.
Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins
Nutrition Throughout the Lifecycle: Retrieved on July 21, 2020 from
https://youtu.be/-SgH-w1smAI
Effect of inadequate nutrition during growing years: Retrieved on July 21, 2020 from
https://youtu.be/4WgkZXKSO-E

Prepared by:

Karen D. Sembrano, RN, MN

Peer reviewed by:

Myron L. Roque, RN, MN
Rhocette M. Sn Agustin, RN, MN

Reviewed and evaluated by:

Jennie C. Junio, RN, MAN

Brenda B. Policarpio RN, RM, MN
Level II Coordinators

Approved by:

Zenaida S. Fernandez, RN, Ph. D.

Dean