Food for healthy living

1. Food for healthy living Chapter 12

2. Learning Objectives • Plan menus that are appropriate and nutrient rich for children and adolescents and older adults • Identify issues specific to menu planning for aging adults • Identify nutrition recommendations for pregnancy, breastfeeding • Discuss nutrition recommendations for toddler/preschool, school age, adolescence • Identify health issues of older adults and provide nutrition recommendations

3. Nutrition For Pregnancy • Choose My Plate • Increased Protein • + 25 grams/day (3 oz protein) • RDA- 71 grams/day • Folate • 600 synthetic mcg/day • DNA, reduce neural tube defects • Pre-natal vitamin

4. Nutrition For Pregnancy • Iron • 27 mg/day • Increased blood volume, baby’s iron stores • High in pre-natal • Iron deficiency anemia….supplement • Calcium • 1000-1300 mg/day (4 cups a day) • Last trimester- 300 mg/day transferred to baby • Low in pre-natal

5. Basic Nutrition Guidelines • Prenatal vitamin-mineral supplement • 1st trimester • 2-4 pound weight gain, ↑ nutrients • 2nd and 3rd trimester • 1 pound a week weight gain, + 300 calories • Moderate caffeine, sugar substitutes • Adequate fluids- RDI- 3.0 L/day • Limit mercury containing fish • 12 oz fish a week or less, variety

6. Alcohol • No safe known level • #1 preventable birth defect • Lifelong affects, cognitively and physically • Fetal Alcohol Syndrome

7. Appropriate Weight Gain • 25-35 pounds (healthy body weight) • Helps prevent low-birth weight (less than 5 ½ pounds) • Poor growth/immune system • Delivery complications • Undeveloped lungs • Helps prevent excess weight gain • Gestational diabetes, hypertension, other pregnancy complications; childhood obesity • Comfort for the mother!

8. Nutrition Needs of Breastfeeding Mom • + 500 calories/day or more • + 25 grams protein or more (RDA- 71 grams) • 8-12 cups of fluids – RDA 3.8 L/day • Continue pre-natal supplement • Choose My Plate • Limit caffeine, alcohol

9. Breastmilk • Colostrum • First few days, antibodies, anti-infective, probiotics • Mature Milk • High in essential fats, probiotics, enzymes • Minimal digestion • Changes in composition to meet growth needs

10. Breastmilk Points of Interest • Many health benefits • Produced based on demand • Proper latching on important • Small stools, rarely constipates, no smell • Minimal “spitting up” • Food flavors transfer from foods mom eats to milk • History of food allergies, eliminate protein from moms diet

11. Formula • Supports normal growth and development • Formula contains • lactose/sucrose (CHO) • casein, whey (PRO) • vegetable oils (FAT) • Vitamins-mineral fortified, high iron • More symptoms of intolerance • Spitting up, gassy, protein intolerance, constipation

12. Formula Types • Standard • Essential fatty acid enhanced • Modified for gassy babies • Organic • Lactose-Free • Follow-up (6-12 months) • Soy-protein • Hypoallergenic- Protein Sensitivity • Preemie • Medical

13. Formula Tips • Easier to overfeed • Mix according to instructions • Too dilute- poor nutrition • Too concentrated- GI problems • Food Safety – GI problems • Discard unfed formula • Refrigerate diluted formula 24 hours • Clean nipples/bottle- dishwasher OK • Safe water

14. Feeding Children 14

15. 4-6 Months • Introduce solids • Developmental feeding milestones • Mature GI tract •  protrusion reflex • Head-neck control • Interest in food • Iron-fortified rice cereal • Then vegetables-fruits • Wait several days to introduce new food • Diarrhea, vomit, rash, wheezing, very fussy, wait

16. 6-12 months • Mashed, soft foods to small chunks • Introduce foods according to ability • Pincer grasp • Hand to mouth movement • Imitates chewing motion • Holds eating utensils • Holds bottle, cup • Eating is part of motor skill development • Caution with foods that could cause choking (nickel sized)

17. Adequate Nutrition • Growth Curves • Problem if growth deviates off usual curve • Hemoglobin (iron deficiency anemia) • Normal Development

18. Fig. 14.1

19. 1-5 years • Food Provides • Nutrients • Decision making, motor skill development • My Plate Balance • Model good eating patterns • Provide healthy choices • Smaller portions • 1 Tblsp. year portions • Establishment of eating behaviors, food preferences • Dental Caries • No bottles in bed

20. Best Time to Teach Nutrition • Pre-school and grade school years • Love to cook, help with food • 3 yo- wrap, pour, mix, shake, spread • 4 yo- roll, juice, mash, peel • 5 yo- measure, grind, grate, cut • Less peer influence

21. 5-10 Years • Continued slow growth • 10 y.o.- 1800 calories/day • Regular meals and snacks • 5-7 eating times/day • Breakfast, snacks, < sweetened beverages • Concerns • Obesity • High blood cholesterol (>170 mg/dl), hypertension, high blood sugars

22. Adolescents • Rapid growth triggered by hormones • Girls 10-11 y.o., fat increases, 35 pounds, 6” • Boys 12-14 y.o., muscle increases, 45 pounds, 8” • Calories up to 4000-5000/day during growth spurts • Iron, calcium, vitamin D, protein

23. Nutrition Issues • Peer influenced eating • Eating disorders • Obesity • Iron deficiency anemia • Low calcium intake- girls • Vegetarianism • Sports nutrition • Adequate calories to support growth and activity • +500-1500 calories/day

24. Meeting the Needs of Children Best choices • Use primarily basic whole foods • Serve roasted, grilled or poached foods • Serve fruits whole or cut for more nutrients and fiber • 100% juice rather than sweetened fruit drinks • Serve plenty of vegetables

25. Meeting the Needs of Children Best choices • Dips and sauces appeal to kids • Nutrient-dense beverages with each meal • Healthful side dishes • Low-fat milk or equivalent dairy products at meals and snacks • Brown rice and other whole grains; whole-wheat breadcrumbs • Serve cookies and snacks with healthful ingredients

26. Meeting the Needs of Children Tips for chefs • Offer variety to appeal to different ages • Serve small bites and hand-held food items • Use child-sized utensils and plates • Minimize choking hazards • Be aware of common allergens such as peanuts • Serve familiar foods and use flavors children know • Serve appropriate portions

27. Meeting the Needs of Children Tips for chefs • Use healthful cooking techniques • Introduce new options in familiar ways • Serve colorful, nutrient-rich foods for eye appeal • Put produce on every plate • Add variety by offering half portions from the regular menu • For sandwiches, offer low-fat meats, poultry or reduced-fat cold cuts

28. Feeding Aging Adults 28

29. Sensory Losses • Taste • Smell • Vision • Thirst

30. Most Significant Nutrient Concerns with Aging… • Unintentional Weight Loss • Loss of Lean Body Mass • Low vitamin D • Dehydration • Malnutrition • Depression • Food Insecurity • More than 80% of 65 or older have at least one chronic condition affected by nutrition and/or food choices

31. Weight Loss • Middle age- weight gain; peak weight- 75 yo, weight loss- after 75 • Difficulty regaining weight • Loss of functional ability • 25-30 calories/kg body weight

32. Strategies: Calories Avoid unnecessary dietary restrictions Encourage use of nutrientdense foods Use more frequent meals plus supplements or snacks

33. Strategies: Calories Use foods that are well liked frequently Provide double portions of favorite foods Add calories by using sauces, gravies, toppings, and fats Emphasize calorie containing liquids to meet fluid needs

34. Sarcopenia • Loss of lean body mass • Affects physical function, strength, overall health, quality of life, activities of daily living • Adequate Calories • Adequate Protein • 1.2 grams/kg • Animal sources, supplements • 25 grams at a time (snacks and meals) • 3-5 times a day • Resistance Exercise

36. Dietary Protein/Calorie Supplements • Liquid supplements • 13+ grams • Protein powders • 25 grams a scoop • Smoothies • Food intake is often ↓ by use of these supplements, but overall nutritional intake is improved • Considered a “supplement” not meal replacement

37. Dehydration • Affects • constipation, blood pressure, dementia (confusion), muscle function • 8-11 cups of fluids a day • Ideas to increase intake: • Availability, pitchers, variety of fluids, flavors

38. Live to Be 100 • http://ngm.nationalgeographic.com/ngm/0511/sights_n_sounds/index.html • Mediterranean Type Diet • Home-grown foods, fruits, vegetables, olive oil, fish, whole grains, drink tea-coffee-red wine, few processed or refined foods • Maintain healthy weight • Reduced calories and exercise • Social Networks • Family, friends, • Spiritual life, “sabboth” • Reason for living-purpose • Rural living

39. Meeting the Needs of Aging Adults Key nutrition points • Nutrient-dense foods meet nutritional requirements in fewer calories • Liberal diets recommended for those in long-term care. Promoting enjoyment of food and enhancing quality of life are important goals. Overly restrictive diets may reduce food intake and cause unintended weight loss, with devastating health effects • Chewing and swallowing problems may require altering the consistency of a food and/or liquid to make it safe and easier to swallow- small, bite size pieces, soft • Appetite often small

40. Meeting the Needs of Aging Adults • The immune system often compromised with age. Follow best practices in food sanitation and safety. Avoid serving risky foods such as raw oysters or uncooked eggs

41. Meeting the Needs of Aging Adults Tips for chefs • Expect questions about food intolerances, dietary restrictions, food preparation techniques and ingredients. Train servers to communicate specific needs to the kitchen staff • Eating “early” and low-budget dining are common requests. Small portions, economical offerings, and early dining options can add a new group of regular patrons, and they will have finished eating by the prime dining time • Older customers have smaller appetites and ask for smaller portions or take leftover food for another meal