Food for toddlers, young children, teenagers, adult and older people

Food for toddlers, young children, teenagers, adult and older people

Childhood From age 1 through the beginning of adolescence. Growth in childhood slower than infancy. Weight gain about 5 pounds and grow 2-3 inches annually. Three groups on the basis of age and development Toddlers (Age 1-3 years) Preschoolers (Age 4-5 years) School children (Age 6-10 years) Energy & Proteins RDAs for children Age (y) Kcal/kg Kcal/day Proteins g/kg Proteins g/day 1-3 102 1300 1.2 16 4-5 90 1800 1.1 24 6-10 70 2000 1.0 28 On average 1 year old child requires 1000-1300 Kcal/day. This energy requirement doubles by 10 years age.

What and How Much to Feed Your Toddler Toddlers need between 1,000 and 1,400 calories a day, depending on their age, size, and physical activity level (most are considered active). Nutrient needs include 16 grams of protein; 44 grams of fat; and 210 grams of carbohydrate. The toddler also needs 10 milligrams of iron a day. (potatoes, spinach, split peas, and strawberries). Milk should not exceed 24oz. per day to prevent reduced iron absorption. Feed a toddler who eats too much by using a small plate; cut food in small pieces to allow hand eating; serve low calorie foods; be sure he/she is eating fiber foods and exercising (both will reduce appetite).

Feeding the Toddler Self-feeding for one-year-old-finger-foods, variety, use of spoon, training cup Two-year old fine motor skills are improving, eat with spoon and fork, eat with other family members, but can be allowed to get up from table when they are finished due to short attention span Three-year old full set of primary teeth and can chew most foods, meat and tough foods should still be cut

Toddlers /Pre-School / School Age Children Children between 1-4 years have high energy and nutrient needs. Important nutrients include; Calcium and Vitamin D, Fibre, Iron and Fluoride (Should avoid high fat, high salt and high sugar food) From age 5, children should have a healthy balanced diet as per the Eatwell model

Fluoride and Your Child Fluoride has a positive effect on oral health by making teeth more resistant to decay. Fluoride can also prevent or even reverse tooth decay that has started.

Primary School Children Continually growing and developing physically, cognitively and emotionally Although family exert most influence, other external influences including; Teachers / Coaches, Friends, Media, Ethnic group / religion, Special requirements. Need for Independence Iron deficiency problematic include iron rich foods (Meats, fortified breakfast cereals (Vit. C to aid absorption) Constipation problematic fibre and fluids encouraged (Fruit and vegetables, wholegrain breads and cereals) Calcium requirements - bone formation prevention of osteoporosis

9 What foods encourage regular bowel movements? Fiber promotes regular bowel movements. (fresh/raw fruits and vegetables, legumes, whole grains) What foods should be avoided? Limit fried foods, sweets, carbonated drinks, white flour and all junk food Avoid ice cold drinks because they will slow the digestive process Constipation is a sign of chronic dehydration constipation slows the flow and use of essential nutrients by the body drink required amount of water each day

10 Nutritional Needs Recommended Macronutrient Proportions by age

Vitamins and minerals With cooperation of healthy child a well planned diet provide most nutrients except iron. RDA for iron during childhood (1-3 years) is 7 mg. RDA for iron during childhood (4-8 years) is 10 mg. Milk should be limited to 3-4 cups, diet rich in iron like lean meats, legumes, fish, poultry and cereals etc. A child diet may also be deficient in other micronutrients like zinc, vitamin D & E. Outside influences such as TV viewing, affect children preferences for low nutrient density foods. These result in illnesses, stunted growth, limited development and in case of vitamin A deficiency possibly permanent blindness.

Adolescence Adolescence is a period of rapid growth and development and is when puberty occurs. The demand for energy and most nutrients are relatively high. Boys need more protein and energy than girls for growth. Girls need more iron than boys to replace menstrual losses. It is important to encourage an active lifestyle with a healthy, balanced diet during this time. Need for calcium and Vitamin D to build bone density; Iron to prevent iron-deficiency anaemia; Zinc for essential mineral growth Watch intake of high salt, high sugar and fatty foods

Nutrient needs of adolescents Energy & Proteins RDAs Males Age (yrs) Kcal/kg Kcal/day Proteins g/kg Proteins gm/day 11-14 55 2500 1.0 45 15-18 45 3000 0.9 59 Females Age (yrs) Kcal/kg Kcal/day Proteins g/kg Proteins gm/day 11-14 47 2200 1.0 46 15-18 40 2200 0.9 44 Three nutrients of importance i.e. vitamin A, iron and calcium. Calcium 1300 mg/day, for iron is 11 mg/day (boys) and 15 mg/day (girls).

A healthy diet is important for teenagers A growth spurt usually begins around the age of 10 in girls, and 12 in boys, adding an average of 23cm to height and 20-26 kg in weight (boys and girls). Extra energy and nutrients are therefore required to support growth and development. Reduce the risk of ill-health now and in the future, e.g. obesity, heart disease, cancer, and type 2 diabetes

Dietary recommendations Teenagers should consume a variety of foods from each of the four main food groups: Fruit and vegetables (33%) Bread, rice, potatoes, pasta and other starchy foods (33%) Meat, fish, eggs, beans and other non-dairy sources of protein (12%) Milk and dairy foods (15%)

Aaverage intakes Nutrients Macronutrient Recommended intake Boys average intake Girls average intake (% food energy) (% food energy) (% food energy) Fat 35% 35.4% 35.9% of which saturates 11% 14.2% 14.3% Carbohydrate 50% 51.6% 51.1% of which added sugars (NMES) 11% 16.7% 16.4% What about dietary fibre? Reference values: - 15 g/day (11-14 years) - 18 g/day (15 years or above) What about salt? Recommended maximum daily salt intake: - 11 years and over: up to 6 g/day.

Teenagers and iron Girls need more iron than boys to replace menstrual losses (boys 11.3 g/day, girls 14.8 g/day). Lack of iron leads to an increased risk of iron deficiency anaemia and associated health consequences. Teenagers who follow a vegetarian diet or restrict food intake (e.g. to lose weight) particularly at risk. Iron from meat sources (heme iron) is readily absorbed by the body. Vitamin C helps the body to absorb iron from other sources (non-heme iron).

Teenagers and calcium Teenagers have high calcium requirements. Around 50% of the adult skeleton is formed during the teenage years ( boys 1000 mg/day, girls 800 mg/day). A lack of calcium may have consequences for future bone health e.g. increased risk of osteoporosis.

21 Teenagers and energy balance Teenagers, especially girls, often try to control their weight by adopting very low energy diets or smoking. Restricted diets may lead to nutrient deficiencies and other health consequences. Teenagers of unhealthy weight may need guidance on lifestyle changes to help them achieve a healthy weight.

Teenagers physical activity At least 60 mins of moderate-intensity physical activity each day is recommended. Include activities that improve bone health, muscle strength and flexibility at least twice per week.

Glycaemia The brain appears to be sensitive to shortterm fluctuations of glucose supply and therefore it might be beneficial to maintain glycaemia at adequate levels to optimise cognition. Eating breakfast leads to improved energy and concentration levels throughout the morning. Breakfast consumption may improve cognitive function related to performance in school. Other benefits of breakfast include better nutrient intakes and weight control. Hoyland A et al. (2009) A systematic review of the effect of breakfast on the cognitive performance of children and adolescents Nutr Res Rev 22(2): 220-43.

24 Fluids and hydration Even mild dehydration (1-2%) can lead to headaches, irritability and loss of concentration. This level is not enough to cause feelings of thirst. drink 6-8 glasses/day (1.2 litres) to prevent dehydration. All drinks without sugar are best between meals. Diet and IQ Much speculation about the importance of long chain omega-3 fatty acids to behavioural and cognitive development, including IQ. Current recommendation is one portion of oily fish (140g) per week. Willatts P. (2002) Long chain polyunsaturated fatty acids improve cognitive development J Fam Health Care 12(6 suppl):5.

25 Diet and mood/behaviour There are a number of foods that have a pharmacological effect in the body which affects mood: * caffeine * artificial food colours (hyperactivity)

Eating disorders an eating pattern that becomes harmful to health. Trigger is multi-factorial and often linked to emotions. Anorexia Nervosa the refusal to eat enough to maintain a normal body weight. Sufferers have the impression that they are overweight and often picture themselves as being fat even though they are already underweight. becoming aware of an inner voice that challenges views on eating and exercise.

Bulimia Nervosa Sufferers are obsessed with the fear of gaining weight and undergo a recurring pattern of binge eating, which is usually followed by self-induced vomiting. Sufferers may also use large quantities of laxatives, slimming pills or strenuous exercise to control their weight. Many bulimics have poor dental health due to regular vomiting; vomit is acidic and can erode teeth in a characteristic way. disappearing to the toilet after meals to vomit food eaten

Teenagers - dietary improvements needed More fruit and vegetables, pulses, wholegrain foods. More milk and diary foods. More iron-rich foods. More oily fish Less foods high in saturated fat and added sugars. Less salt.

Adulthood Nutritional requirements do not change much between the ages of 19 to 50, except during pregnancy and lactation. Early = 21-39 yrs Midlife = 40-59 yrs Old Age = 60+ yrs Reduce fat intake to 30% or less; limit saturated fats to less than 10%; limit cholesterol to 300 mg/day Five or more portion s of fruit and vegetables daily Maintain moderate protein intake Limit salt to less 6g/day

Adults Limit alcohol intake; 2-3 units/day for women; 3-4units/day for men, with 2-3 alcohol free days in the week Balance food intake and physical activity to maintain normal weight Main health issues; obesity, inactivity, high cholesterol, high blood pressure, prevention of diseases eg. CVD, cancer Body Mass Index is used to estimate your total amount of fat. It is only an approximate measure of the best weight for your health.

32 Nutritional Indices in Adults BMI is computed using the following formula: BMI = Weight (kg)/ Height (m²) Evidence shows that high BMI (obesity level) is associated with type 2 diabetes & high risk of cardiovascular morbidity & mortality

http://www.cancer.org.au/preventing-cancer/reduce-your-risk/maintain-ahealthy-weight.html

Waist circumference measurement Waist circumference measurement is also an indicator of whether a person has a healthy body weight. Abdominal or visceral fat (i.e. fat carried around the waist) is known to be a greater risk to health than weight carried on other parts of the body. Waist measurements should be below: 80 cm (31.5 in) for all women 94 cm (37 in) for men (black and white) 90 cm (35 in) for Asian men

36 Older adults Requirements for energy gradually decrease after the age of 50 as activity level falls. Older adults is the term usually referring to people over the age of 65 Older people may eat less for different reasons, for example: difficulty in chewing and swallowing; dental problems; changes in sense of smell and taste; difficulty in shopping, preparing and cooking food; living alone; financial problems; Illness

37 Changes with ageing - 1 Increased risk of chronic disease, cognitive impairment and dementia, arthritis Activity level usually declines Decline in lean body mass (muscle) and BMR Reduction in bone density (especially in women) increased risk of fractures Impaired dentition Impairments in digestive function (e.g. gastric acid and digestive enzymes) can lead to reduced nutrient bioavailability

Changes with ageing - 2 Skin changes (less vitamin D produced) Changes in taste perception (by age 74-85 the number of taste buds falls by 65% and sensitivity to salty and bitter tastes decrease) Changes in sense of smell can reduce pleasure of eating Eyesight & arthritis may make food preparation difficult Psychosocial factors may also exert a substantial effect on food choice and intake, and hence nutritional status

Older adults After menopause (when menstruation stops), women lose bone strength at an increased rate. Older adults should have plenty of calcium intake from the diet, but also remain active and have adequate vitamin D from foods, or through the action of sunlight on the skin. Adults over 65 years who are housebound should take a daily supplement of vitamin D as skin synthesis of this vitamin requires sunshine.

40 Older People Some nutrients are of particular importance in older people; fibre (constipation), calcium and Vitamin D (fractures), Vitamin B 12 and Iron (anaemia) Some specific nutrients may be needed in increased amounts for individuals; eg. Protein and zinc (wound healing) Ill health and ageing process impacts on nutrition Main age-related body changes; decrease in muscle mass, slower uptake of vitamin A, decline in immune function, decreased absorption of certain vitamins and minerals

Nutrition Needs with Aging o Calorie needs decrease with age o Carbohydrate provides energy o Careful planning needed to get all the nutrients needed in fewer calories o Most carbohydrate should come from the grains, fruit and vegetable groups o Sugar rich foods should be kept low

Nutrition Needs with Aging o o o Protein needs do not decrease with age Protein is important for older adults Protein comes from the: Meat & bean group o o Fat High fat is a risk factor for health conditions Fat comes from: Higher fat choices from food groups Vegetable Oils Milk group Fish group

43 Nutrition Needs with Aging Fiber is helpful for many conditions Fiber comes from: Whole grains in grain group Fruit group Vitamins and Minerals Some changes in need occur with age: Decreased need - Vitamin A Vegetable group - Iron (women after menopause) Increased need - Calcium Water : Older adults need 6 to 8 cups of water daily Water can come in many forms - Vitamin D Decreased absorption - Vitamin B12 Balanced diet will meet needs

9 nutrients for older adults 1. Vitamin B12 B12 is important for creating red blood cells and DNA, and for maintaining healthy nerve function. Eat more foods rich in B12. The richest sources include fish, meat, poultry, eggs, milk, and milk products. 2. Folate/Folic Acid Now that breakfast cereals are fortified with folate, deficiencies are less common. 3. Calcium Coming up short on calcium has been shown to increase the risk of brittle bones and fractures The body needs both calcium and protein for bone health, So the ideal source of calcium is dairy products, not supplements.

45 4. Vitamin D Vitamin D helps the body absorb calcium, maintain bone density, and prevent osteoporosis. In older people, vitamin D deficiency has also been linked to increased risk of falling. Many foods are fortified with vitamin D, including cereals, milk, some yogurts, and juices. vitamin D is also found in salmon, tuna, and eggs. 5. Magnesium Getting enough can help keep your immune system in top shape, your heart healthy, and your bones strong Fill your plate with as many unprocessed foods as possible, including fresh fruits, vegetables, nuts, whole grains, beans and seeds, all of which are great sources of magnesium

6. Potassium Getting enough potassium in your diet may also help keep bones strong. This essential mineral is vital for cell function and has also been shown to help reduce high blood pressure and the risk of kidney stones. 7. Fiber Fiber helps promote healthy digestion by moving foods through the digestive tract. Eat more whole grains, nuts, beans, fruits, and vegetables. 8. Omega-3 Fats "New evidence suggests that omega-3s may also reduce the risk of Alzheimer s disease and perhaps even keep the brain sharper as we age,". Some vegetable source of omega 3 such soybeans

47 9. Water Water is especially important if you are increasing the fiber in your diet, since it absorbs water. Nutritionists recommend you drink 3 to 5 large glasses of water each day, One sign that you re drinking enough is the color of your urine. It should be pale yellow. If it is bright or dark yellow, you may need to drink more liquids.

48 Digestion, Food Tolerance and Nutrition Changes in Digestion and Food Tolerance Changes in digestion and food tolerance can get in the way of good nutrition Decreased Stomach Acid Stomach acid may decrease with age This can cause feelings of indigestion Atrophic Gastritis Atrophic gastritis affects many older adults This condition can hinder vitamin B12 absorption Vitamin B12 may be better absorbed from dietary supplements than food Changes in Fat Tolerance Fat tolerance may decrease with age Fat intolerance can cause abdominal pain and diarrhea

49 Tips if Fat Intolerance is a Problem Decrease fat added to foods Choose lower-fat foods Use low-fat preparation methods Changes in Lactose Tolerance Tolerance of milk and milk products may decrease in age Lactose intolerance can cause abdominal pain, bloating and diarrhea Tips if Lactose Intolerance is a Problem Smaller amounts or milk or milk products Fermented milk products Consuming milk or milk products with a meal Lactaid or Dairy Ease

50 Constipation is a common problem for adults Several lifestyle factors can help combat constipation Fiber can help reduce constipation Foods are the best way to increase fiber Fruits Vegetables Whole grains Dried peas and beans Nuts and seeds Increase fiber in the diet slowly Drink plenty of water when increasing fiber Water can help reduce constipation Older adults need 6 to 8 cups of water daily