Nutrition Exam #3

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Low income mothers may need food assistance

(WIC) is designed to ensure that pregnantwomen and mothers with young children have access to nutrition information and nutritious foods during the most critical years of growthand development. • WIC provides supplemental foods, health care referrals, and nutritioneducation for low-income pregnant and postpartum women and childrenup to age 5 who are at nutritional risk and who meet the program'seligibility requirements - it has been effective

Adolescent mothers face nutritional challenges + older moms may have concerns

- Adolescent bodies are still growing so their nutrional needs are higher than adult women - they are also likely to skip meals and have low nutrition - Could lead to lbw and reduced nutriton and health of the woman - teen moms are more likely to devolp pih, iron deficiency anemia, give birth prematurely = baby and mom at risk for health problems Older adults: today woman over 35 have 35% of the births in the USA. Fertility usually declines around 30 so pregnancy takes longer but more often results in multiple kids per pregnancy (1/3 of twin pregnancies = women over 30) - Though women in their late 30s and 40s often experiencenormal, healthy pregnancies, they are at higher risk for certaincomplications, including gestational diabetes and PIH;moreover, an older woman's fetus is more likely to be affected by Down syndrome or other birth defects.

Young children can grow healthyfully on a vegetarian diet

- As long as its balanced: Generally speaking, vegetarian diets are rich in whole grains,vegetables, and fruits—foods that experts encourage all children and adults to eat. • Vegetarian diets may be high in fiber, which is helpful in promoting GI health and function; however, too much fiber may prevent childrenfrom getting all the nutrients they need by making them feel full too quickly - Vegan children must be given vitamin - fortified foods or supplementsas their diets include no animal-based foods.

Discrimination leads to malnutrition

- In developing countries very few people own their own land and plentiful land usually only benefits the landowner - women specifically suffer from discrimination - Cultural practice may also affect access to food - amount of food available to an individual could be based on birth order, gender, education, age, and control of income - Gender inequity is a big problem - girls are given less food and education.

Global Nutrition - True or False

- Malnutrition is prevalent in every country of the world - including the USA (T) - More than 1/10th of the world population doesn't have enough to eat (T) - If you have a job you will never experience food insecurity (F) - Depression among mothers has been associated with food insecurity (T) - Farmers grow enough food to feed everyone on the planet today (T) - food waste, distribution, poverty, a lot of food goes toward farm animals - Fortifying food is a good idea but doesn't really affect malnutrition (T) - You can't be obese and food insecure at the same time (F) - Iodine deficiency is the world's most common and most preventable cause of brain damage in children (T)-

Climate Change, Natural Disasters, andDepleted Resources Limit Food Production

- droughts, floods, record-breaking heat waves, and emerging crop diseases and infestations ruin crops - in the usa technology can help farmers cope with effects of natural disasters and programs can help communities but crops are still lost - Floods and excessive rain can also destroy food crops and are major causes of food shortage. • Depletion of natural resources also threatens the world's food supply. Water is one example; this natural resource is not infinite.

Illness and Disability can lead to food insecurity

- less likley to earn a steady income or have a consistent job - disease symptoms and healthcare appointments can cause less working time - absences cause a decreased paycheck - they may have high out of pocket costs as well Mental illness and substance abuse disorders can also lead to food insecurity: - those with anxiety, depression, schizophrenia, alcoholism, etc. may lose interest in eating - difficuly to get and keep employment - mental health problems between mothers and children = more food insecurity - people who are homeless may be difficult to reach (don't want to go to shelters because they want drugs)

Assitance programs are working to end hunger worldwide

- many large and small organizations are working - World Foode Programme: has a goal of "zero hunger" - provides hundreds of thousands of lbs of food and it also provides cash and vouchers - UNICEF: channels money for humanitarian aid from those in developed countries to help feed children - Heifer international: wants to end hunger by providing people with animals - The peace corps: gives people the training and the support they need to change thier own situation Misfit market: 40% off food that looks a little bit off (good idea)

Food Insecuirty is more prevalent among certain groups

- single parent households, - single people living alone, - low income, - black and hispanic households, - households located outside metropolitan areas (6 states with highest food insecurity = Mississippi, Louisiana, Arkansas, Maine, Kentucky, and Alabama. - college students.

What factors lead to malnutrition worldwide

1.2 billion people (out of 8.1) live in developed countries - the rest live in the developing world where they may lack access to full goods and services - food and agricultural organization said there was 795 million undernourished people in the world

Judiasm

3 denominations: Orthodox, conservative, and reform - differ in beliefs about judiasm. - orthodox: laws are the direct commandments of god so they adhere strictly to dietary laws - keep kosher (defines dietary laws - how animals are slaughtered , food is prepared, consumed, and defines clean and unclean foods. - conservative: fall between the other 2 in their beliefs and adherance to the laws. - reform: follow the moral law but are more loose with other laws

What nutritional issues affect adolescents

3 important factors: social factors can influence health habits, diet can play a modest role in teen acne, and adolescents are at risk for disordered eating. - early intervention = critical - teens want control but are thinking short term and may not think about what the long term health affects of a poor diet may entail - acne isn't well understood but a good diet could help - Adolescents are sometimes at risk of developing disordered eating patterns due to poor body image, emotional issues, or peer pressure.

American Cuisine

A complex melting pot of foods and cooking methods that have been adapted and adopted from cuisines brought to the US by immigrants such as: • Early settlers • Native Americans • West African slaves • Mexican immigrants • Chinese and Italian immigrants - typical american diet is hard to define - driven by ease and convenience foods

Summer Food Service Program

A federally funded, state-administered program.+ USDA reimburses program operatorswho serve no-cost, healthy meals and snacks to children and teens. + Meals are served at summer sites in low-income communities, Eligibility: available to communities based on income data

What causes food allergies

A food allergy is an abnormal reaction of the immune system that occurs reproducibly in response to the consumption of a particular food. • The offending food component, called a food allergen, is usually a large protein that is not broken down during cooking or digestion. • Because they are not degraded, food allergens are absorbed intact and trigger an adverse reaction by the immune system,which responds to the allergen as a foreign invader.

People in poverty have unique risks for overnutrition

A lot of times those in poverty are actually overweight - high fat high kilocalorie diets are cheaper - for those with a limited budget - getting food takes precedence over getting nutritional food - those in food deserts don't even have access to nutritional foods - those in poverty are stressed but sugar can decrease stress. - cheaper foods tend to have lower protien and higher kilocalories

Hinduism

A number of health beliefs and dietary practices stem from the idea of living in harmony with nature • Ahimsa: Nonviolence as applied to foods • Another influential concept is that of purity

Benefits and dietary requirements of breastfeeding

A woman who has just given birth begins a period of lactation,that is, her body produces milk to nourish her new infant. • The infant's suckling at the mother's nipple stimulates milk production. • Nerve signals sent from the nipple to the hypothalamus in themother's brain prompt the pituitary gland to release two hormones: prolactin and oxytocin. Prolactin causes milk to be produced in the breast, while oxytocin triggers a letdown response, which releases milk so the infant can receive it through the nipple. • Through breastfeeding, or nursing, mothers provide food that isuniquely tailored to meet their infant's nutritional needs in aneasily digestible form Breast milk = best for nutritional needs of each infant, protects against infection, reduces risk of obesity, helps brain development - provides phyiscal, emotional, and financial benefits to mother (reduces stress and promotes bonding.)

Poverty influences childrens nutritional status

Accordingly, children and adults living in poverty consume diets of lower qualitythan those from higher-income families. • Their diets are often higher in calories, sugar, and fat and lower in vegetables, and they are 1.7 times more likely to be obese as compared to their higher-income peers. - helped slightly by SBP and NSLP and parents who try their best - energy dense foods cost less and families are more likely to purchase low cost low quality food to avoid hunger.

Women should practice heatlhy habits before and after pregnancy

Achieving a healthy body weight, eating a nutritious diet,and practicing other healthy lifestyle habits are importantf or preconception health and fertility as well as for pregnancy. • Achieve and Maintain a Healthy Weight • Consume Adequate Folic Acid • Eat Safe Fish • Keep Caffeine Intake Moderate • Avoid Cigarettes • Don't Drink Alcohol • Avoid Illicit Drugs • Beware of Botanicals

Effects of Chronic Undernutrition

Acute undernutrition can be reversible, where persistent malnutrition can start a downward health spiral that is hard to reverse. - as the kilocalorie deficit continues the body eats its own tissues = deterioration of muscle, organs, and stored fat. - children who are undernourished have impaired mental and physical growth - growth stunting: once it occurs it is usually permanent - impaired growth and development because of undernutrition Wasting: diminishing of fat and muscle - if malnutrition occurs at early and curcial points in brain development = permanent lower intelligence and impaired learning. long-term undernutrition is associated with increased anxiety,irritability, attention problems, and school absence and tardiness rates.

Nutritional needs of adolescents

Adolescence (9-19) - It is characterized by two significant physical changes, a rapid growthspurt and the onset of puberty—the period during which an adolescentbecomes sexually mature. • Adolescents attain about 15 percent of their adult height and about 50 percent of their ideal adult weight during this stage- bones grow, lean muscle mass and fat increase, for boys puberty is marked by onset of growth and maturation of genitals, for girls it is marked by menarche.

Adolecents need calcium and vitamin D for bone development

Adolescents experience rapid bone growth. • Most of the growth occurs in the epiphyseal plate, the area of tissue near the endof the long bones. • The growth plate determines the future length and shape of the mature bone. At some point during adolescence, bone growth stops, the plates close, and they are replaced by solid bone. • Almost half of peak bone mass is accumulated during adolescence. • Thus, adequate calcium and vitamin D intake are critical during this life stage

How can adults influence young children's eating habits?

Adults are responsbile for what is offered to kids to eat but the kids are responsible for whether or how much they eat - adults should serve normal portions and not force kids to finish their plate - caregivers = role models in getting kids to try new foods. - Food jags occur when a child refuses anything but a limitedselection of foods. This behavior of getting "stuck" on a smallselection of foods is quite common and normal in young children.Luckily, food jags are usually temporary.

Agricultural Challenges and Food waste limit the food supply

Advances in agricultural technology- while increasing crop yeild in the short term are unsustainable for the future - lack of access to infromation about modern farming may keep farmers from using their land to it's full potential - establishing efficient irrigation systems are hard - furrow irrigation is inexpensive and easy but water is lost in transit and it can lead to soil erosion - one third of all food produced is actually never eaten (food waste)

Older adults

Aging makes people more vulnerable to disease and disability. - Aging = natural process that begins at the cellular level and induces physical and psychological changes -It begins during early middle age, which may be considered the years from 35 to 50, when bodily functions begin to gradually decline. • Age 65 is often designated as the beginning of old age, but there is no single age at which people become old. • Senescence, another term for growing old, is defined as aprocess that begins at conception and ends at death

When and how food is eaten

All cultures eat at least once a day • Mealtimes vary according to culture • In the US, bad manners in eating may be associated with animal behaviors • Cultural values define desirable and undesirable personal and public behaviors and social interactions

Food Programs

Americas Harvest changed its name to feeding america !! what is it? - nonprofit that is a network of more than 200 food banks - largest hunger releif program in the US started to help those that are routinley without food - mission = eradicate hunger and make sure that no american goes to bed hungry - redistribute excess or donated food, raise awareness, and advocate -- have food banks, food pantries, and emergency kitchens - eligibility: anyone that needs food assistance, no salary or residency requirements

Food allergies remain a concern

An estimated 8 percent of U.S. children under age 18 have one or more food allergies. • Whereas most children outgrow allergies to cow's milk,egg, soy, and wheat, they are less likely to outgrow allergies from peanuts, tree nuts, fish, and shellfish. - FDA mandates the manufacturers clearly state if their product contains any of the 8 allergenic foods - most public schools have penut free zones

8 'highly allergenic' foods

Any food can cause an allergy, but 90 percent of food allergies are caused by • Eggs • cow's milk • Peanuts • Soy • Wheat • tree nuts (such as walnuts) • Fish • Shellfish

Toddler through Adolescence

As kids age their nutritional needs change - where infants are relativley immobile but when they learn to walk they like to explore instead of sitting and eating a snack- toddlers = new challenges -pre-schoolers = whole new set of problems

Added sugars should be limited in a young child's diet

As noted earlier, foods high in added sugars displace nutrient-dense foods and should be strictly limited in a child's diet.• These foods also promote tooth decay, the potential for whichbegins as soon as teeth emerge from the gums. (bacteria growth = tooth decay/ enamel - children should be encouraged to have healthy dental hygiene - excess sugar can cause weight gain.

Heartburn and Constipation are common discomforts

As the baby begins to put pressure on the stomach and intestines it can cause heart bearn because of reflux acid in the lower esophagus - hormonal changes can also cause food to move slower through the gi tract - to minimize heartburn women should eat frequent small meals and avoid spicy and seasoned foods - shouldn't lie down right after meals and should elevate head and shoulders

Heatlh behaviors for a successful pregnancy

Avoid alcohol, avoid cigarettes, healthy preconception habits in future moms and dads - important for fertility and heatlhy pregnancy - Prospectice Fathers should practice heatlhy habits: a healthy baby = product of two heatlhy parents (fathers need to make pre-conception healthy habits/ choices) - lifestyle can affect fertility - alcohol, drugs, and the use of some prescription meds can decrease the production and function of sperm - Adequate intake of zinc and folate can lead to healthy production of sperm, intake of antioxidants like vitamin c and vitamin e can protect sperm from damage by free radicals. - healthy habits from fathers can affect embryonic development and later risk of disease in adult offspring - Men should consume a balanced diet, with adequate kilocalories, and plenty of fruits and vegetables - Men shouldn't smoke and limit alcohol to 2 drinks per day max (moderation)

Groups at greatest risk for malnutrition wolrdwide

Because of their increased nutritional needs, infants,children, and pregnant and lactating women are at higher risk. Elderly, those that are ill, and thsoe in poverty are also at greater risk. Pregnant/ Lactating Women: higher nutritional needs: - impoverished mothers often give birth to malnourished children, women are encouraged to breastfeed (good nourishment) → mothers with HIV are encouraged to bottle feed instead Infants children: growing rapidly and have increased nutritional needs, infants with malnourished mothers are at higher risk, infants can be given inappropriate foods, exposed to contaminated food and water = diarrhea and dehydration, beginning to crawl and walk = susceptible to bacteria and parasites- parasitic infections can cause nutritional deficiences directly. Shortage of foods and proteins causes malnutrition (Kwashikors - remember) - loss or one or more of parents = less income and = higher risk of malnutrition. The ill and the elderly: those that are chronically ill may have malabsorption, liver and kidney disease can impair the bodies ability to process and use some nutrients (those with cancer or AIDS can lose their appetite) - elderly have lower kilocalorie needs but more vitamin D and protien needs. Also at higher risk because they have decreased taste and smell, immobility, malabosrption, and chronic diseases - they may also be missing teeth, be lonely, confusion,etc. all lead to malnutrition. They also may be living on a fixed income.

Hypertension:

Can cause damage to the woman's kidenys, higher risk of lbw, and higher risk of premature birth. - Pregnancy Induced Hypertenstion: PIH) includes gestational hypertension,preeclampsia, and eclampsia, each a progressively greater medical threat tomother and baby. - Gestational Hypertension: a form of PIH in a pregnant woman that has no history of high blood pressure - Preeclampsia: most common form of PIH (contains both protein in the urine and hypertenstion - can damage the kidneys.) - Eclampsia: can come from preeclampsia - causes seizures and is a leading cause of death for women in pregnancy - Only cure for (pre) eclampsia is childbirth - bedrest and hospitalization can be treatments

Young children need adequate carbs, proteins, and fats

Carbs- 45-65% of daily kilocalories doesn't change from toddlers to adulthood. - fruits, veggies, and grians should be the majority of carbs - added sugars should be strictly limited - at least 1/2 the grains in a child's diet should be whole grains - toddlers need 19 g of fiber where 4-8 yo need 25 g a day. Promotes bowel regularity and prevents constipation. A balanced diet can easily meet fiber needs of a toddler. Protein- 5-20% of needs for toddlers and 10-30% for children and adults -The RDA for protein for toddlers is set at 1.1 grams perkilogram of body weight and decreases to 0.95 gramper kilogram of body weight in school-age children. (0.8 for adults) - eating enough carbs allows protein to be used for growth and tissue repair rather than used for energy. Fat: 30-40% of total kilocalories for children 1-3 yo, 25-35 for 4-18. - Dietary fat contributes to normal development of the brain and nerve cells andis a concentrated source of energy to fuel growth.• Fat is used for the synthesis of the myelin sheath that insulates neurons and aidsin nerve impulse conduction - unsaturated fats should be the dominant fat in the diets of those 2 and older -It is also recommended that toddlers receive 0.7 grams of omega-3 fatty acidsand that school-age children consume 0.9 grams per day. Solid fats, such asbutter and lard, should be limited given their saturated fat content.

How to reduce food waste

Check the fridge before shopping, plan out meals for a week at a time, buy only foods you really need, when you shop stick to the list. Understand and use expiration dates accordingly, use older foods in the fridge first, have leftover night once a week, compost, serve yourself only what you can eat, cook meals in large batches; freeze portions for later.

What factors affect school age children's nutrition?

Children who are fairly sedentary have energy needs closer to the lower end of the range, whereas those who are active likely have needs at the higher end of eachrange. • During the school years, gross- and fine-motor skills become more refined, and children's growth rates are steady until the adolescent growth spurt. • While school-age children develop at different rates, they add, on average, 7 pounds and 2.5 inches per year. - toddlers need 1000-1400 and energy needs get higher and higher throughout young adulthood and peaks in young adulthood then declines.

Key events of prenatal deveopmental

Conception- moment when sperm fertilizes an egg Zygote- fertilized egg (at approximatley 72 hours) Early term - between 37 weeks and 38 weeks 6 days Full term- baby born between 39 weeks and 40 weeks 6 days Late term- baby born between 41 weeks and 41 weeks 6 days Pregnancy is divided into three roughly equal 13 week trimesters - preembryonic period- the 2 weeks after conception (begins as a fertilized egg (zygote) travel down the fallopian tube) - it then divides along the way creating a preembryo and embeds in the lining of the uterus. It then begins recieving nutrients from their mother- many physiological changes happen during the preembryonic period.

Prenatal Development

Critical Period: Developmental stages during which cells and tissues rapidly grow and differentiate to form body structures - Because of this rapid cellular activity, the embryo/fetus is most vulnerable to nutritional deficiencies, toxins, and other potentially harmful factors (also called insults) during this time. 2nd and 3rd trimester- further differentiation of cells and tissues and further maturation of the organ system - premature birth increases risk of medical complications - fetal lungs don't fully develop until 36 weeks. - Birth before then can cuause moderate to severe respiratory distress. - pre birth can also increase risk of brain hemmorhage, cardiovascular disease, and gastrointestinal problems. - Toxins and insufficent nutrients can cause irreversible damage to fetus - proper nutrition positivley influences metabolic programming which could prevent chornic disease -Maternal obesity at the time of conception increases the risk for birth defects, increased birthweight, childhood overweight and obesity, and early mortality in adulthood

The impact of Culture

Culture has a profound and unconcious effects on food. Race, ethnicity, and geography are often wrongly assumed to be culture - can lead to stereotypic grouping - subgroups within a culture affect food intake and nutritional status - culture defines what is edible, role of food, how food is prepared, symbolic use of food, when and how food is eaten, heatlh benefits - culture says what is edible: in order to be labled food- it must be readily available, safe, and nutritious enough to support reproduction - culture overrides falvor on what is offensive and unacceptable - disliking the idea of food rather than food itself (diff. cultures have different preferances.)

Experts recommend excercise

Daily exercise during pregnancy can help improve sleep, lower the risk of hypertension and diabetes,prevent backaches, help relieve constipation, shortenm labor, and allow women to return more quickly to their pre-pregnancy weight after birth- could also lessen depression, anxiety, and stress - women should get 150 minutes of moderate aerobic activity per week (ex: walking)

Developed, Developing, Least developed countries

Developed country: A developed country, or high-income country, is a sovereign state that has a high quality of life, developed economy, and advanced technological infrastructure relative to other less industrialized nations. Ex. US, UK, Canada • Developing country: Country that is growing in multiple areas, such as income per capita, life expectancy, rate of literacy, industrial capability,technological sophistication, and economic productivity. Ex. China, India, Malesia • Least developed country: Country that shows little growth in multiple areas such as income per capita,life expectancy, rate of literacy, industrial capability, technological sophistication, and economic productivity. Ex. Afghanistan, Ethiopia, Bangladesh remember example countries

Breastfeeding mothers have special dietary requirements

During first 6 months, mother produces about 3/4 of a liter of breast milk daily, in the second 6 months they produce about 1/2 liter daily - to support this production the women needs 13 cups of fluid daily (usually water) A breast-feeding woman's body requires 500 extra kilocalories daily during the first 6 months of lactating to make enough milk to feed her child. • Approximately 170 kilocalories are mobilized daily from fat that was stored during pregnancy, so she needs to eat about an extra 330 kilocalories. • After the first 6 months of breastfeeding, less energy is available from stored body fat, so a lactating woman needs to consume about 400 extra kilocalories daily to meet her needs • Limit caffeine and energy drinks and avoid alcohol

Health beliefs and dietary aculturation

Each culture has a unique point of view on life, health, and illness and the meaning of each in society • Some cultures define foods that create equilibrium within the body and soul • Culture also shapes body image Acultration occurs when the eating patterns of someone who moves changes to match the host country - in the us this is linked to obese or chronic disease (increases unhealthy eating patterns) - food habits are usually the last to change - first generation americans stick more to native eating habits but second generation are more likely to switch eating patterns (children adopt new ways quickly) - new foods are added, some traditional foods are replaced by new foods, and some traditional foods are rejected.

Nutritional needs for toddlers and preschoolers

Early childhood consists of two distinct age categories:• toddlers (ages 1 and 2)• preschoolers (ages 3-5). - still growing but less rapidly then in infancy (means their nutritional needs are lower and they have a lower appetite.) - during second year of life average weight gain is 3-5 pounds and 3-5 inches. - growth charts are used to track relative to other kids of the same sex and age - Growth charts can be used to assess whether a child is growing at aconsistent rate. In general, the growth of a healthy child should continueroughly along the same percentile for age and sex, and large increases ordecreases should be evaluated by a health professional.

Promote Education

Education plays a vital role in food security both directly and indirectly- directly by educating farmers and indirectly by preventing population growth. - educating girls and women is of utmost importance: Education must also focus on developing literacy,technical knowledge, agricultural skills, horticulture,human health and reproduction, and the preservation ofnatural resources

National School Lunch and National Breakfast Program

Eligibility: Children with families with incomes at or below 130% ofthe poverty level are eligible for free meals and those with incomes between 130% and 185% of the poverty level are eligible for reduced-price meals. NSLP provides lunch - National School Lunch Acy signed by Truman in 1946 SBP provides breakfast - Food and Nutrition Service administers SBP at the federal level

Key events of Preembryonic period

Embryo: fertilized egg through the 3rd and 8th week of pregnancy Placenta: organ that allows nutrients, oxygen, and waste products between the fetus and the mother - During the 3rd week the embryo develops 3 layers from which all tissues and organs will develop - when the placent begins to develop - the placenta through the umbilical cord allows the mothers organ system to function for the fetus while their organ system grows.

The role of certain foods in the diet

Every culture has a ranking for its foods - major food categories: core foods, secondary foods, and occasional foods - Core foods: Provide a significant source of calories and are regularly included in the diet, usually on a daily basis. Core foods are typically complex carbohydrates - Secondary foods: widely consumed but not on a daily basis - vary with availability - Peripheral foods: eaten sporadically - typically individual preference not cultural norms.

Consume adequate folic acid

Folic acid = the synthetic form of folate or vitamin b9 and is needed for cells to grow properly, meeting the DRI of folic acid perferably 1 month before conception or even earlier reduces the risk of having a baby with a neural tube defect like anecephaly or spina bifida. - nueral tube closes within one month of conception - NTD happens when the nueral tube fails to fold properly = incomplete brain and skull development (anecephaly) or exposure of the spinal cord (spina bifida) - both conditions are irreversible but anecephaly is incompatible with survival.

Food insecurity in the US

Food Security: House-hold level economic and social condition characterized by reliable access to adequate amounts of healthy foods - USDA has 4 levels to measure level (high food security - you're good, marginal food security - a little anxiety about food but little effect.), low food security - reports of reduced quality, variety, or desirability of diet, no report of less eating. Very low food security: reports of multiple indications of disrupted eating patterns and reduced food intake. Food Insecurity: Limited or uncertain access to adequate food within a household Nutrition Security: Having consistent access, availability, and affordability of food and beverages that promote well-being and prevent diseases

Gestational Diabetes

Form of diabetes that forms in women who previously weren't diabetic during pregnancy - should be tested during 2nd trimester (cause is unknown)... Could cause: -Macrosomia- A larger than normal baby who may be at risk of injury to itsshoulders during vaginal birth or may require cesarean birth - Jaundice: Yellowish coloring of the skin due to the presence of bilem pigments in the blood - breathing problems - birth defects Eating healthy, excercising regularly, and maintaining a healthy weight can all help prevent development

Adequate weight gain reduces the risk of complications

In a singleton (one baby) the fetus is about a third of the weight gained. - maternal tissues and fluids count for the remainder - amount of weight a woman should gain depends on her pre-pregnancy weight and health (based on pre-preggo bmi) <18.5 = 28-40 lbs 18.5-24.9= 25-35 lbs 25- 29.9= 15-25 lbs 30+ = 11-20 lbs

How can we reduce hunger

In the USA hunger relief efforts are common on many levels (local levels) - including hot meals, free food from shelters, etc. Improving Agriculture: long term relief = balancing the number of people in an area with the amount of food that can be locally produced. GMO foods can be more resistant to pests and increased yeilds. - better land management - famers could raise more food for human consumption not animal consumption - increasing farmers land ownership could be beneficial bc they will make better decisions Improve water and sanitation: 1.8 billion people lack access to safe drinking water - correlates with malnutrition - 88% of diarrhea illnesses are from unsafe drinking water - in some places solar energy is used to thermally purfiy water (heat and UV destroy waterborne pathogens) - lack of proper toilets and sewers can lead to pollution of other waters ...poor sanitation is linked to spread of disease.

Avoid Cigarettes, Alcohol, and Drugs

Increases the risk of infertility, prenatal exposure to cigs can stunt the childs growth and development and affect their future intellect and behavior, increases risk of birth defects, stillbirths, SIDS, and premature birth. - even second hand smoke can affect a mom and her baby - exposure to passive smoke in utero = stillbirth, premature birth, lbw, congenital abnormalities, neonatal and infant mortality, asthma, and respiratory infections. Alchohol: It can affect before the women even knows she's preggo, US surgeon general recommends that all who may become pregnant abstain from alcohol. - can lead to fetal alcohol spectrum disorders (FASD), can lead to learning and behavioral disabilites, there is no safe level of alcohol consumption Drugs: marijuana, cocaine, and other drugs can cross the placenta from the mother to the fetus, use is linked to miscarriage, preterm birth, hypertension, cognitive and behavioral problems, and other health issues. - those born to mother who use cocaine have a higher risk of SIDS, still birth, and lbw - there is no safe level - kids born to drug users can experience withdrawl symptoms (excessive crying, seizures, trembling, heart defects, behavioral and learning problems, and long term health problems.

What are infant nutrient needs and why are they so high?

Infants Grow at an Accelerated Rate• Typically, an infant doubles his or her birthweightby about 6 months of age and triples it by the ageof 12 months. Length doubles around the end ofthe first year as well - parents can monitor using CDC growth charts - Nutrient needs during the first year of life aresubstantial, and supplementation of vitamin K, vitaminD, and iron may be required. - first 3 months = only breastfed and cereal should be avoided before first 4 months

Cultural Food

Influences on Food: "you are what you eat" - Nutritional requirements for people of the same age and gender are essentially the same world wide. - Nutritional requirements vary based on: culture, SES, personal factors, and religion (remember)

Adolescents need iron for muscle growth and blood volume

Iron needs are highest during growth spurts and after the onset of menstruation • Adolescents need more iron than younger children to support their rapid muscle growth and increased blood volume. • Adolescent girls need additional iron to replace monthly losses due to menstruation. - teens (esp girls) can have inadequate iron if they restrict the amount of food they intake or don't eat lean meats, fortified grains, seafood, nuts, legumes. - sometimes iron supplements are perscribed along with a balanced diet

Adequate kilocalories, carbs, and protein are critical & experts recommend excercise

Kilocalorie needs increase at the beginning of the second semester - those who started at a healthy wegiht need to gain an additional 0.5-1 lbs per week and an additional 340 kilocalories - protein needs increase to 35% - in the third trimester 450 kilocalories extra are needed daily

Buddhism

Life revolves around nature with its two opposing energy system of yin and yang • Illness may result from an imbalance of yin and yang • Most Buddhists subscribe to the concept of ahimsa, so many are lacto-ovo vegetarian • Dietary practices vary widely depending on the sect and country

Weakened Immunity results in disease

Malnourished indiviudals are more susceptible to disease and infections. Diarrhea alone kills 2.2 million people a year. - diseases that most commonly kill postneonatal children are diarrhea, pneumonia, and malaria. - A deficiency of certain micronutrients contributes to weakenedimmunity. Vitamins A, C, and E, for example, are critical to a healthyimmune response, as are copper, iron, selenium, and zinc

Malnutrition

Malnutrition - lack of proper nutrition - can represent itself as undernutrtion - Undernutrtion: usually caused by not having enough to eat, not having enough of the right thing to eat, or not being able to use the food that you do have - either because of infection or poor nutrition absorption. - Example: Vitamin A deficiency leading cause of blindness (remember) - Overnutrition: can lead to overweight or obesity or a specific micronutrient toxicity. Overnutrition and undernutrition may coexist, as when an individual consumes a diet high in refined carbohydrates and low in micronutrients. -Example: Many Americans are deficient in calcium, iron, or another micronutrient.

Infant and Child Mortality rates increase

Malnutrition is a viscious cycle passes hunger and illness from one generation to another - unfortunatley many young women are undernourished in their own infancy and childhood = 1/2 of all pregnant women are thought to be anemic in developing countries. - in some countries low birth weight can be as high as 30% - girls who are undernourished in first five years of life might be less able to support a healthy pregnancy later on (physically stunted) - infants born to malnourished women are more likely to be malnourished.

Most children need more fruits and vegetables

Most children do not receive the recommended amount • In addition to providing well-prepared, fresh, and tasty vegetables,caregivers should give strong verbal encouragement—at school, at home,and in the community—to help children obtain their recommendedservings. T- try new things at every eating occasion A- all forms of fruits and veggies count S- shop smart T- turn it into a family activity E- explore the bountiful variety

Fortifiy Foods to increase nutrients

Most common micronutrient deficiencies iodine, iron, and vitamin a - fortification of foods can help these deficiencies. For fortification to work - the foods need to be shelf stable, affordable, and consistentley available in the food supply. - becuase fortification is inexpensive and beneficial it is being implemented all over the world

Islam

Muslims eat as a matter of faith and for good health • Health and food are considered acts of worship for which Allah must be thanked • Halal: Islamic dietary laws • Haram: foods that are prohibited

Nutrients and Health Behaviors in the second and third trimester

Naseua begins to decrease and appetite for women usually begins to increase, the baby is growing rapidly- eyes blink and lips are capable of sucking - weighs just under 2 lbs at second trimester and usually around 7 lbs 7 oz at the time of birth - mothers body changes too as she gains more fat, her breasts get bigger, and amniotic fluid and blood volume increase. - likely it is harder to move around, climb stairs, and sleep comfortably - During this period of growth, the mother should get adequate kilocalories,protein, and other nutrients; exercise on a regular basis if her pregnancy ishealthy; and become more aware of potential pregnancy complications.

The Nutrition Transition can lead to malnutrition

Nutrition transition: Shift in dietary consumption and energy expenditure that may occur as people in developing countries shift from their traditional diet to diets higher in sugar, fat, and animal-based foods. - some countries get richer and their people eat more (but not necessarily nutritious food) - people who formerly ate meals full of vegetables and grains may shift over to diets higher in saturated fats and sugars - some people move from the agricultural to the sednetary world which leads to a nutrition transition = obesity and potential malnutrition. Double burden of malnutrition: the coexistence of under and overnutrition can also be seen within a single family or even in individuals - the boys in a family may be overweight while the girls are underweight - or an individual can be obese but deficient in certain micronutrients.

Why are school age children experiencing high rates of obesity?

Overconsumption of Kilocalories • Genetics • The Family • Most Children Don't Move Enough • The Environment Outside the Home • Media and Advertising Target Children • Friends Can Negatively Influence Food Preferences

Political sanctions and armed conflict disrupts the food supply

Political sanctions can create or intensify food shortages by decreasing a population's access to agricultural supplies, fuel, or food imports •They can also result in higher local prices for fuel, food, and other essentials. •Sanctions that block exports to other countries can also contribute indirectly to a failing economy by decreasing household income when workers in businesses that rely on this trades lose their jobs. •War and civil and political unrest lead to malnutrition by Disrupting agriculture, food distribution, and normal community activities. •During wars and regional conflicts,government money is often diverted from nutrition and food distribution programs and redirected toward weapons and military support. •Political turbulence can compromise humanitarian Food distribution efforts, making it difficult for food aid to reach the people in need - good example = ukraine

Demographics of Aging in America

Potential lifespan of the human body= 120 years and hasn't changed much over the centuries - life expectancy has increased 48-81.2 for women and 46-76.3 for men from the early 1900s. - Fewer deaths from infectious disease at an early age, better nutrition, and advances in medicine, including interventions to diagnose, manage, and treat chronic illness, have led to increased longevity, or duration of life. • Some researchers now make a distinction between lifespan and health span and between longevity and healthy longevity; that is,the number of years of good health and functioning is a different consideration from the total number of years lived. - americas population is getting older and more diverse

Poverty contributes to food insecurity

Poverty: Lacking the means to provide for material or comfortneeds. • The U.S. Census Bureau estimated that for 2015, the poverty rate was about 13.5% of the United States population. • The poverty rate in 2015 for children under age 18 was 19.7% • People living in poverty often reside inrural regions or inner-city neighborhoodslacking healthy food stores. (food deserts - food deserts exist all over the US.)

WIC (Special Supplemental Nutrition Program for Women, Infants, and Children)

Provides federal grants to states for supplemental foods, health carereferrals, and nutrition education for low-income pregnant,breastfeeding, and non-breastfeeding postpartum women, and to infantsand children up to age 5 who are found to be at nutritional risk. + Eligibility: At-risk low-income pregnant and lactating women, infants, andchildren less than 5 years. - provides nutritious and culturally appropriate food - emphasizes nutrition education and referalls to healthcare providers

SNAP Supplemental Nutrition Assistance Program

Provides food benefits to low-income families to supplement their grocery budget so they can buy nutritious foods Eligibility: Low income (generally at orbelow 130% of the poverty line, for afamily of 3 is $2,072 per month, so, 130%will be $2,694 per month) + Eligible individuals are issued a debit card to purchase food at their local authorized supermarket. + None food things are not eligible (e.g., alcohol, supplements, hot food)

Food and Religion

Religion tend to have a greater impact on food habits than nationally or culture • Religion food practices vary significantly

Breakfast is important

Research suggests an association between eating breakfast regularly and both better diet quality and a healthier body weight in children andadolescents. - breakfast foods are sources of important nutrients for children - breakfast skippers may not makeup the nutrients they missed throughout the rest of the day. - Hunger during school could disrupt learning and behavior - If kids don't have time in the morning they should eat on the way to school.

Christianity

Roman Catholic, Eastern Orthodox, and Protestantism = 3 branches of christianity - Roman Catholic: Do not eat meat on ash wednesdays or fridays in lent, avoid food and drink an hour before communion, several fasts throughout the year. - Eastern Orthodox: numerous fasts and feasts throughout the year - Protestant denominations have food laws (Mormons and 7th day adventists) - Mormons: don't use coffee, tea, tobacco, or alcohol- some fast 1 day per month, limit meats - eats mostly grains - 7 Day Adventists: lacto-ovo vegetarians, overeating is avoided, coffee, tea, and all = prohibited. 5-6 hrs between meals without snacking.

SNAP - Ed

SNAP Education- federally funded grant program - is evidence-based and helps people make their SNAP dollarsstretch, teaches them how to cook healthy meals, and lead physically active lifestyles. - partners with state and local programs to meet people where they are - The goal of SNAP-Edis to implement a nutrition education and obesity prevention program for eligible individuals that promotes healthy food choices and physical activity consistent with the most recent Dietary Guidelines for Americans

Morning Sickness and Cravings are common

Sickness can occur at any time of the day (common in the morning) - starts during first trimester and usually ends by 20th week but 10% of women experience it longer - causes are unknown but low blood glucose, fluctuating hormones, and increased estrogne could play a role - can find releif eating frequent small meals that are high in carbs - salty foods along with sour and tart bevarages can help - ginger consumption helps Cravings: women can have certain cravings while having aversions to other foods. Chocoalte, citrus fruits, chips, and ice cream = common - no science behind it? - there is no harm in occasionaly bending to cravings but there is harm if women crave and ingest non food substances = PICA = abnormal compulsive eating of inedible items - can posion the fetus

When are solid foods able to be introduced to infants

Solid Foods May Be Introduced Once Certain Milestones Are Met • Usually between 4-6 months • Tongue-thrust reflex means baby is not ready • Head and neck control • Swallows with ease • Able to sit with support • Turn head away when full • Solid Foods Should Be Introduced Gradually/one at a time/wait 2-3 days to monitor - some foods are choking hazards - honey = costridium botinillium and can cause boulism in infants and should be avoided.

Why is formula a healthy alternative to breast milk?

Some women can't breastfeed (HIV) - commercial infant formula is the only healthy alternative- patterened after breast milk - modified from soy or cows milk - Cows milk should not be given before 1 year becuase it is too high in protein and some minerals and too low in fat - powdered and concentrated formulas needed to be mixed carefully - avoid putting babies to sleep with baby bottle to prevent tooth decay and ear infections

Adequate Micronutrient intake is a concern throuhgout pregnancy

Starting pregnancy a woman needs up to 50% more certain vitamins and minerals - a mother can get these foods by eating nutrient dense foods and taking a daily prenatal vitamin - folic acid- to preven NTD - iron - to make more red blood cells and prevent iron deficient anemia - zinc and copper- for protein metabolism & synthesis of DNA (zinc)/ partof enzyme & is needed in the production of energy, synthesis ofconnective tissues & the transport and use of iron (copper) - calcium: prevent osteoporosis and for bone formation in babies - vitamin d- to prevent poor absorption/ use of calcium AVOID over consumption of vitamin A - can lead to birth defects

Child and Adult Care Food Program

The Child and Adult Care Food Program(CACFP) is a federal program that provides reimbursements for nutritious meals and snacks to eligible children and adults who are enrolled for care at participating child care centers, day care homes, and adult day care centers. - also reimburses meals served to kids at after school programs and adults over 60 years old living with a disability and enrolled in a care facility Eligibility: available to communities based on income data

Food Insecurity is prevalent in the US

The ERS of USDA reports that 12.8% of food -insecure households in the USA - 87.2 are food secure. - 5% of households were in the lowest category of very food insecure

Eat safe fish and keep caffeine intake moderate

The FDA recommends that pregnant women eat 2-3 servings of fish a week - they recommend to avoid certain fish that are high in methylmercury. - too much mercury could harm the developing nervous system, all fish contain some but some are much safer than other - salmon, canned light tuna, crab, and shrimp are the best - Maahi maahi is good but not the best - sharks and swordfish should be avoided Keep caffenie intake moderate: during pregnancy the caffeine a mother intakes is passed to the baby, and fetus cannot metabolize so it will linger in the body longer, - recommeneded to intake 200 mg or less before and during pregnancy

School lunches contribute to children's nutritional status

The National School Lunch Program (NSLP) provides nutritionally balanced lunches forschool-age children throughout the UnitedStates. The NSLP serves more than 30 millionlunches each day.- could be healthiest or only meal kids eat all day

My plate can help guide food choices

The purpose is to encourage kids to: • Be physically active every day. • Choose healthier foods from each of the five food groups every day. • Eat more of some food groups than others • Make the right choices for the whole family. • Take it one step at a time. Start with one new, good thing a day and continue to add another new one every day.

What are the nutritional needs of adolescents

The timing of the growth spurt and the onset of pubertydepends on an interaction between the adolescent'sgenetics and environment, including nutritional status. - need to be careful of excess weight gain and need the right amount of nutrients and energy (1/5 adolescents are obese) - should choose nutrient dense foods

Overpopulation leads to food scarcity

The world population is projected to reach 8.5 billion people by 2030, and 9.7 billion by 2050. • Much of this growth is taking place in the least developed regions. • Whenever rapid population growth occurs in areas that are strained for food production, theresulting overpopulation can take a toll on the local people's nutritional status • People in the developing world tend to have more children than people in developed regions for a variety of reasons. • The infant and child mortality rate is high, so parents have more children to ensure that some of their offspring survive into adulthood. • Large families are also needed to work on farms to help generate income and to support older family members later in life. • Women in developing regions have reduced access to reliable methods of contraception, higher education, and career opportunities, all of which work to limit family size in developed nations.

Choking hazards:

To prevent choking in children under the age of 4, foodshould be cut into bite-sized pieces. Children should always sit while eating to avoid food entering the trachea during a stumble or fall - The American Academy of Pediatrics (AAP)recommends keeping hot dogs, nuts and seeds, chunksof meat or cheese, whole grapes, hard candy, popcorn,chunks of peanut butter, raw vegetables, raisins, andchewing gum away from children younger than age 4

Meals on Wheels - Meals for the Elderly

To support our senior neighbors to extend their independence and health as they age. + Eligibility: Age 60 or over and homebound + Provides meals at a community site or delivered to the home. + 1/3 of the meals are federally funded under the "The Older Americans Act" and the rest is supported by the communities.

Children need adequate iron, calcium, vitamin D, and fluid

Toddlers need 7 milligrams of iron daily and school-agechildren require 10 milligrams each day. - parents should offer iron rich lean meats, poultry, fish, and iron fortified grains - iron needs are highest during periods of rapid growth - deficiency can lead to iron deficient anemia- can impair cognition, behavior, and overall neural development, and can leave lasting damage. Calcium - toddlers need it for healthy bones - Children between 1 and 3 years of age should consume700 milligrams of calcium per day, and children age 4and 5 should consume 1,000 milligrams. - Children should drink cows milk or soy milk that is fortified with both calcium, and vitamin d. - 8 oz of cows milk, 8 oz of yogurt, and 1.5 oz of hard cheese = 300 mg The AAP recommends that all children over the age of 1 year consume 15 micrograms (600 IU) of vitamin D daily. - if they don't get enough from foods then supplements are advised - Two eight-ounce cups of milk and a variety of fortified foods daily can help to satisfy a child's vitamin D needs. Fluid: A child's daily fluid needs are based on age, body weight, andgender. • Young children require 5 cups of fluid per day (1-8 years ofage)- too much of any kind of fluid can inhibit nutrient uptake - Parents should montior fluid intake and limit just to 4-6 oz of 100% fruit juice - Kids could need more on hot days or with activity (with activity drink water every 15-20 min.)

Young children need small, frequent, nutrient dense meals and snacks

Toddlers need between 1000-1400 kilocalories a day from nutrient dense foods to fuel their activities. -they eat small amounts and may need several meals and snacks a day - these should consist of small amounts of protein rich foods, fruits, vegetables, milk, and whole grains. - parents shouldn't make them eat more than they want - use child sized cups and plates - parents should serve small portions and children will eat a different amount for each meal.

Nutrition from Preganancy through Infancy

When a woman is pregnant her body facilitates the growth, division, and specialization of millions of new cells- raw materials for this growth are provided through the nutrients in foods. - A woman's diet needs to be sufficient to maintain her health while fostering the proper growth and development of her baby - lifestyle choices are important for both the father and mother

Acheive and Maintain a Healthy Weight

Women who begin pregnancy at a healthy weight- more likely to concieve easily, have an uncomplicated pregnancy, have an easier time nursing - Overweight or obese women: have a harder time getting preganant, higher risk of complications (hypertension and gestational diabetes), less likely to have breastfeeding (more likely short), higher risk of birth defects and premature birth, should follow guidelines for recommended weight gain during pregnancy. - Underweight women: should also try to get a heatlhy weight before pregnancy- may have a harder time concieving, have higher risk of delivering preterm and a low birth weight baby (5lbs 8 oz) - higher risk of health problems (LBW) - developmental and intellectual disabilities, vision and hearing loss, and dying before one year of life. - at higher risk for SGA (small for gestational age) babies - who are born on time but are lighter than bottom 10% - some are small becuase of genetics but most come from growth problems that occur during pregnancy. (could have not recieved the nutrients and oxygen needed for proper growth.)

Nutrient and health behaviors in the first trimester

several developmental milestones happen in the first trimester , organs develop and function, brain begins to grow, heart begins to beat, limbs take shape, and liver starts to make red blood cells. - in first trimester the head (bc of the brain) is much bigger than the body - Fetus only weighs about 1/2 oz, 3 inches long by the first 3 months.

Beware of botanicals

some botanicals can be harmful or even dangerous (especially during pregnancy) - pregnant women should always check with their healthcare provider before taking supplements or botanicals - blue cohosh can be used to induce labor but it has also been associated with seizures, strokes, and heart attacks in newborns - Juniper, pennyroyal, goldenseal, and thuja, as well as teas such as raspberry tea, may also cause contractions of the uterus, which can lead to a miscarriage or premature labor - most teas on the market are safe but green tea can inhibit folic acid uptake so it can be dangerous - avoid having too much

How food is prepared and Symbolic Use of Foods

traditional seasoning and methods of preparation vary within cultural groups... - each culture has food customs and bestoms symbols upon certain foods - decide foods for comfort and food for celebration - used to express love, punishment/ rewards, express moral sentiments, demonstrate or seprateness from a group


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