Nutrition Chapter 10

80 and 90

Decreased ability to absorb or synthesize nutrients Nutrition requirements Concerns of malnutrition and underweight Dehydration Nutrition screening

Ages 4-6

Eating characteristics Independence Variable hunger and appetite levels Continued introduction of new foods Food jags Nutrition requirements Energy: 1800 kcal Protein: 24 g

Ages 7-12

Growth slows, but body is preparing for growth spurt of puberty May be reflected in prepuberty weight gain Encourage staying in touch with internal cues of hunger and being physically active Peer influences increase Healthy snack options Nutrition requirements Energy: 2000 to 2200 kcal Protein: 28 to 46 g, depending on sexual maturity Calcium requirements: AI increases from 800 mg at age 8 to 1300 mg throughout adolescence Iron and zinc requirements increase

Ages 1-12

Knowledge Relationship of nutrients and kilocalories to growth needs Role of adults in providing nourishment and health guidance Techniques MyPlate Kids' Place Fruits & Veggies—More Matters Community Supports School food service • Entitlement programs • National School Lunch Program • Lunch and breakfast programs • Current recommendations for meal content • Summer Food Service Program for Children Classroom nutrition education

old age

Nutrition requirements DRIs for healthy adults; adjusted for acute or chronic illness Requirements constant from age 51, except for vitamin D • Synthesis reduced • After age 70, AI increases to 15 µg (10 µg for ages 51 to 70 years) Digestion and absorption may be reduced • Decreased production of intrinsic factor: may decrease amount of vitamin B12 absorbed • Recommendation: vitamin B12 supplementation or increased intake of vitaminB12-fortified foods Other factors affecting nutritional status • Dental health • Zinc: marginal deficiency alters taste receptors • Sugar, sodium, or both: diet-related disorders • Constipation: risk as GI tract muscularity decreases

20 and 30

Nutrition requirements Growth completed in early 20s for men; late teens for women Energy: 2900 kcal for men; 2200 kcal for women Protein: 58 to 63 g for men; 46 to 50 g for women After age 18, calcium and phosphorus needs decrease: • Calcium: 1000 mg for adults • Phosphorus: 700 mg for adults For women: attention to maintaining calcium and iron intakes continues

60,70 and 80

Shifting U.S. populations: increasing number of older adults; senescence Consideration of social, economic, and physiologic aspects of aging Quality of life depends on health status Level of wellness reflects health behaviors of previous life span stages Older adults may be at nutritional risk because of demographic and lifestyle factors • Gender • Smoking • Alcohol abuse • Dietary patterns • Educational level • Dental health • Chronic illnesses • Living situations

Ages 13-19 Techniques

Techniques MyPlate Fruits & Veggies—More Matters Scheduling of meals Inclusion in meal planning and food preparation Community supports No specific programs for adolescents Comprehensive school health programs

Nutritional well being old age

Access to food and ability to prepare meals • Living arrangements • Preference for familiar foods Protein adequacy and micronutrients Association between BMI and health risk in older adults

Physical, mental and emotional functioning old age

Adjustment to retirement Effects of death of family members and friends Depression: may affect nutritional status Economic realities Alcohol abuse Disorientation, memory loss or dementia Fluids and dehydration

40 and 50

Continuation and changes Family demands and career involvement Positive dietary patterns and exercise prevent or delay diet-related diseases Nutrition requirements Cell loss rather than replication Kilocalorie needs decline • Lean body mass lost and replaced by body fat • Loss slowed by aerobic exercise and strength training Energy: after age 50, decreases to 2300 kcal for men; 1920 kcal for women Iron: after menopause, decreases to 8 mg for women Dietary pattern: nutrient-dense, low-fat, high-fiber

serving size guidelines toddlerhood

Fruit or vegetable serving: 1 tbsp per year of age Bread and cereal: one fourth of adult serving Milk: 2 to 3 cups per day Meat or meat alternative: offered twice a day

Obesity

Increase among children and adolescents Etiology: multifactorial Clinical assessment and intervention • Health history • Intervention: motivation/weight-associative disorders • Physical symptoms such as sleep apnea

Role in Wellness

Knowledge: learning new information about benefits or risks of behaviors Techniques: strategies to apply new knowledge Community supports: environmental or regulatory measures available to support health-promoting behaviors within a social context

Iron-deficiency anemia

Poverty: risk factor • Lead poisoning and chronic hunger increase risk. Affects ability to learn Public health issue Role of nurses • Educate teaching staff about relationship between iron deficiency and learning ability.

Ages 13-19

Responsibility for own behavior increases, but adult guidance still required Physical and emotional support of adults • Guidelines for dietary patterns • Providing food for consumption Adjusting to demands of college environment Influence of fast food Responsibility for own behavior increases, but adult guidance still required Physical and emotional support of adults • Guidelines for dietary patterns • Providing food for consumption Adjusting to demands of college environment Influence of fast food Knowledge High-energy needs for sports and growth Calcium for bone mineralization School-based curriculum on nutrient needs Effects of disordered eating and substance abuse on nutritional status

Transition from one stage of life span to another

Separation from family of origin; career development; reproductive decisions Establishment of food patterns Effects of childbearing and caring for young children on women

Lead Poisoning

Sources of lead Consequences of lead poisoning Relationship with iron-deficiency anemia Role of nurses • Awareness of high-risk factors • Lowering lead levels in the environment

nutrition during childhood

Stages of development reflect psychologic and physiologic maturation Childhood (ages 1 to 12 years) Growth fluctuations National Center for Health Statistics growth charts Dietary Reference Intakes (DRIs) for children Role of adults in nourishing children

Health promotion techniques

Strategies to promote positive health status and reduce risk of diet-related disorders • Shopping tips • Reorganizing work and personal priorities • Use of MyPlate and Fruits & Veggies—More Matters • Consuming dietary sources of bone health nutrients • Dietary pattern: low fat, low sodium, and high fiber • Maintaining healthy body weight with diet and exercise

food asphyxiation

Toddlers and elderly persons at higher risk Foods associated with choking Prevention and Heimlich maneuver

Health promotion community supports

U.S. Food and Drug Administration and nonprofit organizations such as the American Heart Association provide health and nutrition information Corporate employee health promotion centers Government programs: • Including Child and Adult Care Food Program; Senior Nutrition Program (Congregate Meals and Home-Delivered Meals programs)

Rationalizing

a defense mechanism to assign reasonable explanations for a person's behavior Rationalizing poor eating habits

Dietary Guidelines for Americans

for children older than 2 years of age • Recommendations: Fat: 30% to 35% of kilocalories, ages 2 to 3 years Fat: 25% to 35% of kilocalories, ages 4 to 18 years • Acceptable Macronutrient Distribution Ranges (AMDR): Fats ≈ 30% of kilocalories; added sugars > 25% of total kilocalories Dietary fiber: >19 g/day for ages 1 to 3 years 25 g/day for ages 4 to 8 years 31 g/day for boys aged 9 to 13 years 26 g/day for girls aged 9 to 13 years

Aging

gradual process that reflects influence of genetics, lifestyle, and environment over life span Some body systems more affected than others • Changes may begin to affect nutritional status In each stage of adulthood, particular life stressors that may affect adult nutritional status

Toddlerhood

issues of autonomy Mealtimes Maintain consistency Regulate portion sizes Encourage self-feeding Include snacks Nutrition requirements Energy: 1300 kcal Protein: 16 g Begin to offer lower-fat foods Introduce variety Problems with excess milk and juice intake

Type 2 Diabetes

mellitus Risk factors: overweight during childhood and lack of physical activity Genetics and race: predispose some individuals Prevention approaches: individual and public health

gerentology

study of aging

Health promotion

• Adequate intake of nutrients found in food • Relationship between diet and disease • Moderate kilocalorie intake coupled with exercise

Type 2 diabetes treatment

• Include the family • Goal: maintain current weight while growth continues • Goal: develop and maintain a healthy lifestyle

Type 2 diabetes role of nurses

• Sensitivity to emotional, social, and physical dimensions associated with weight and body composition