Education Phase 3 Diet through life

1. Education Phase 3 Diet through life

2. Key stages in life • The key stages in life include: • Pregnancy; • Infancy; • Childhood; • Adolescence; • Adulthood; • Older adulthood.

3. Energy needs change through life • Energy requirements change through life and depend on many factors, such as: • age; • gender; • body size; • level of activity.

4. Pregnancy A varied diet, providing adequate amounts of energy and nutrients, is essential before and during pregnancy. Having a healthy body weight is important: -Being underweight can make it more difficult to become pregnant and make it more likely for the baby to have a low birth weight.  Babies with low birth weight have a higher risk of developing diseases in adulthood such as heart disease, high blood pressure or type 2 diabetes as compared to babies with normal birth weight. -Being overweightand obese increases the risk of complications in pregnancy and potentially affects the health of the child in later life. The risk of diabetes or high blood pressure during pregnancy is increased, and so are the risk of complications during labour and the risk of an emergency caesarean operation.

5. Early pregnancy: folate Folate (the natural form of folic acid found in foods) is needed for rapid cell division and growth in the foetus. This vitamin is important for the development of the neural tube, which develops into the central nervous system (this is the brain and the spinal cord). An adequate intake is essential to protect against neural tube defects including cleft palate, spina bifida and brain damage.  Foods that are good sources of folate are green leafy vegetables, oranges and folate fortified foods such as some breakfast cereals and breads. Women who are trying to become pregnant, or are pregnant, should take a supplement of folic acid as recommended by their member state guidelines. Women who have a higher risk of having a baby with a neural tube defect may be advised by their doctor to take higher dose folic acid supplements.

6. During pregnancy • During pregnancy, particularly in the last trimester, a woman’s nutritional needs increase to: • help the growth of breasts, uterus and placenta; • meet the needs of the growing foetus; • lay down stores of nutrients in the foetus, and in the mother for lactation. • On average pregnant women are advised to eat an extra 200 kcal per day in the third trimester only. But women who are underweight at the start pregnancy or stay as active as before getting pregnant may need more energy.

7. Lactation The process of producing breast milk and delivering it to the baby is called lactation. A mother who is breastfeeding requires extra energy and nutrients. There are also increased demands for nutrients, such as calcium, phosphorous, vitamin A and C. Breast milk provides all the energy and nutrients a baby needs for growth and maintenance during the first 4 to 6 months of life.

8. Breast milk Breast milk provides all the energy, nutrients and fluids that your baby needs in order to grow and develop healthily during the first six months of life. Breast milk provides special proteins, antibodies and white blood cells which help to protect the baby against infection. It also provides growth factors and hormones, important for the healthy growth and development of the baby. In the first three days after birth, the mother produces a special form of breast milk called colostrum. It contains less fat, more protein and more protective factors than the breast milk produced later.

9. Weaning At around 6 months of age, milk no longer fulfils all the baby’s need for energy and nutrients. The baby then must be given other foods in addition to breast milk or infant formula. This is called weaning. It is important that weaning is not delayed once a baby is six months because stores of essential nutrients such as iron, built up prior to birth, need to be replenished. Also delays in the introduction of new flavours and textures at this stage can make the introduction and acceptance of new foods more challenging. Foods used during the first stage of weaning include baby rice and mashed or pureed ripe fruit and vegetables. Cow’s milk should not be given to infants under 1 year of age as the main drink, because it does not provide adequate nutrients for the infant. Some EU countries may also recommend infants receive supplements from 6 months. CommNet project EarlyNutrition are investigating the long term effects of early nutrition. Learn more here: http://www.project-earlynutrition.eu/

10. Childhood Children have a higher energy requirement for their body size compared to adults and need foods that provide sufficient energy but are also rich in nutrients. Childhood is an important time for growth and development and children need a good supply of protein, and other nutrients including calcium, iron and vitamins A and D. Calcium is needed for healthy tooth development, and together with vitamin D, can help develop strong bones. Young children do not have large stomachs to cope with big meals. Therefore, to achieve the relatively high energy intake for their age, foods should be eaten as part of small and frequent meals. CommNet project NUTRIMENTHE looked at role that diet plays in the mental performance of children. Learn more here: http://www.nutrimenthe.eu/

11. Healthy weight in childhood • Children should be encouraged to remain a healthy weight with respect to their height. To help children maintain a healthy weight, they should be encouraged to: • Eat a healthy varied diet; • Take plenty of physical activity; • Limit the amount of foods, drinks and snacks high in calories. • A healthy family lifestyle can help in the weight management of children. CommNet project I Family is investigating the determinants of eating behaviour in European children, adolescents and their parents. Learn more here: http://commnet.eu/02_Network/History.kl

12. Dental hygiene Children should pay attention to dental hygiene and ways to prevent dental caries. If children choose to eat food and drinks high in sugar occasionally, this should be done at mealtimes and not in between meals. Brushing teeth twice a day with a fluoride toothpaste and regular dental visits are also important for dental hygiene.

13. Adolescence Adolescence is a period of rapid growth and development and is when puberty occurs. The demand for energy and most nutrients is relatively high. Boys need more protein and energy than girls for growth. For boys and girls, an average of 23cm is added to height and 20-26kg is added in weight. Before this growth spurt, boys and girls have an average of 15% body fat. During adolescence this increases to about 20% in girls and decreases to about 10% in boys.

14. Weight management in adolescence It is important to encourage an active lifestyle with a healthy, balanced diet during this time. This is because good habits practised now are likely to benefit their health for the rest of their lives.

15. Adolescence: Iron It is important to eat plenty of foods containing iron, especially girls, as during menstruation, the body loses some of its iron stores. Iron is important for carrying oxygen around the body. Many teenage girls do not get enough iron in their diet. Sources of iron include:- Red meat and liver;- Chicken, turkey, eggs, fish;- Wholegrain bread and breakfast cereals;- Dark green vegetables, pulses, dried fruit and nuts.

16. Adulthood Nutritional requirements do not change much between the ages of 19 to 50, except during pregnancy and lactation. A poor diet can lead to diseases such as obesity, cardiovascular diseases, cancer and diabetes.

17. A balanced diet for adults To reduce the risk of developing these diseases, it is important to: •eat a balanced diet; •eat plenty of fruit and vegetables; • drink alcohol in moderation; • stay active; • do not smoke.

18. Healthy weight for adults Adults should aim for a healthy body weight for their height and try to keep it at that level. The Body Mass Index (BMI) is a good indicator if a person is underweight, overweight or a healthy weight. To calculate BMI (kg/m2), divide weight (kg) by height (m) x height (m). Recommended BMI range Underweight less than 18.5 Normal 18.5 - less than 25 Overweight 25 - less than 30 Obese 30 - 40 Very obese over 40 Look at the statistics on overweight and obesity in the EU here: http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Overweight_and_obesity_-_BMI_statistics

19. Older adults • Requirements for energy gradually decrease after the age of 50 as activity level falls. • Older adults is the term usually refers to people over the age of 65. • Healthy ageing • To maintain good health, it is important that older adults: • -enjoy their food; • -keep active; • -have adequate nutrient intakes. • It is also important they keep hydrated by drinking plenty of fluid. Even minor dehydration can lead to health problems.

20. Older adults As we progress through adulthood, bone resorption (replacement of old bone tissue) takes place at a faster rate than bone formation. This leads to a gradual fall in bone mass as we age. In women, bone loss is accelerated following the menopause. Osteoporosis may occur when bones become weak, brittle and break easily. This can lead to fractures in the wrist, back and hip. Osteoporosis is a major problem in older adults, especially women.  Based on the WHO diagnostic criterion approximately 22 million women and 5.5 million men aged between 50-84 years are estimated to have osteoporosis in the EU (2010 figures)*. *Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden Arch Osteoporos 2013. Hernlund E, Svedbom A, Ivergard M, Compston J, et. al. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 2013 8:136

21. Older adults Older adults should have plenty of calcium intake from milk and dairy products, green leafy vegetables, beans, pulses, and products made from flour. As we age, our skin is less efficient at making vitamin D from sunlight and it is unlikely that the diet alone will provide adequate vitamin D, so some European health bodies recommend that older adults and other ‘at risk’ groups take a vitamin D supplement. CommNet project PERFORMANCE is investigating use of 3D printing as part of a personalised food supply chain for frail, older adults facing swallowing and/or masticating problems. Learn more here: http://www.performance-fp7.eu/ CommNet project NU-AGE is investigating new dietary strategies to address the specific needs of elderly population for an healthy ageing in Europe. Learn more here: http://www.nu-age.eu/