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Life Cycle

• Fetal Growth and Development• Embryo

• Two to eight weeks• Development of vital

systems• Fetus

• Next seven months• Organs grow to maturity• From less than 1 ounce to

6 ½ to 9 pounds

Pregnancy

• Critical periods are finite periods of intense development and rapid cell division.• Neural Tube Defects

• The critical period is 17-30 days gestation.

• Anencephaly affects brain development.

• Spina bifida can lead to paralysis or meningitis.

Pregnancy

•Weight Gain during Pregnancy

• Recommended Weight Gains• Underweight

<18.5 BMI: 28-40 pounds• Healthy weight 18.5-

24.9 BMI: 25-35 pounds• Overweight 24.9-

29.9 BMI: 15-25 pounds• A Obese ≥30

BMI: 15-pound minimum• pregnant with twins:

35-45 pounds

Maternal Weight

• Weight Gain during Pregnancy• Weight-Gain Patterns

• 3 ½ pounds first trimester

• 1 pound per week thereafter

Maternal Weight

• Weight Gain during Pregnancy• Components of Weight Gain

• Increase in breast size = 2 pounds• Increase in mother’s fluid volume = 4

pounds• Placenta = 1 ½ pounds• Increased blood supply = 4 pounds• Amniotic fluid = 2 pounds• Infant at birth = 7 ½ pounds• Increase uterus and muscles = 2

pounds• Mother’s fat stores = 7 pounds

Maternal Weight

• Energy and Nutrient Needs during Pregnancy

• Energy• Second trimester +340 kcal/day• Third trimester +450 kcal/day

• Protein• + 25 grams/day• Use food, not supplements

• Essential Fatty Acids—especially long-chain omega-3 and omega-6 fatty acids

• Folate• B 12• Iron• Zinc

• Ca and Vit D for bone development• Other nutrients support growth,

development and health of mother and fetus

Nutrients for blood and cell growth

• Adequate energy is important.• Should include milk and milk products• Should contain a variety of legumes,

cereals, fruits, and vegetables• Plant-only diets may cause problems during

pregnancy.• Supplements of iron, vitamin B12, calcium,

and vitamin D may be required.

• Vegetarian Diets during Pregnancy and Lactation

• Common Nutrition-Related Concerns of Pregnancy

• Nausea• Morning (anytime) sickness• Ranges from mild queasiness to

debilitating nausea and vomiting• Hormonal changes

• Malnutrition and Pregnancy

• Malnutrition and Fetal Development• Fetal growth retardation• Congenital malformations• Spontaneous abortion and stillbirth• Premature birth• Low infant birthweight

High-Risk Pregnancies

• Food Assistance Programs• Supplemental Nutrition Program for

Women, Infants and Children (WIC)• Nutrition education • Food vouchers for nutritious foods only

High-Risk Pregnancies

• Maternal Health• Preexisting Diabetes

• Proper management is important.

• Risks include infertility, hypoglycemia, hyperglycemia,

spontaneous abortions, and pregnancy-related hypertension.

• Gestational Diabetes• Routine screening • with glucose

tolerance test

High-Risk Pregnancies

• Gestational Diabetes• Risk factors

• Age 25 or older• BMI >25 or excessive

weight gain• Complications in previous

pregnancies• Symptoms of diabetes• Family history of diabetes• Hispanic, African American,

Native American, South or East Asian, Pacific Islander or indigenous Australian

• Consequences• Complications during labor

and delivery• High-birthweight infant

High-Risk Pregnancies

• Maternal Health• Preexisting

Hypertension• Heart attack and

stroke• Low-birthweight infant• Separation of placenta

from wall of uterus resulting in a stillbirth

• Transient Hypertension of Pregnancy• Develops during

second half of pregnancy

• Usually mild• Returns to normal

after birth

High-Risk Pregnancies

• Pre eclampsia • High blood pressure• Protein in the urine• Edema all over the

body• Affects all organs• Retards fetal growth

• Eclampsia• Also known as

Toxemia• Severe stage of pre

eclampsia• Seizures and coma• Maternal death

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Infant Feeding

• First milk – Colostrum• 2-3 days• High antibodies and

white blood cells• Breast Milk

• Lactalbumin – easily digested

• Correct proportions of vitamins and minerals

• Calcium is well absorbed• High bioavailability of

Iron and Zinc

• Benefits of Breastfeeding• For infants

• Appropriate composition and balance of nutrients with high bioavailability

• Hormones that provide physiological development• Improves cognitive development• Protects against infections• May protect against some chronic diseases• Protects against food allergies

Nutrition during Lactation

• For mothers• Contracts the uterus• Delays the return of ovulation,

thus lengthening birth intervals

• Conserves iron stores• May protect against breast

and ovarian cancer• Other benefits

• Cost savings• Environmental savings• Do not have to purchase or prepare formula

Nutrition during Lactation

• Prenatal and

postnatal growth

retardation

• Impairment of brain

and central nervous

system.

• Abnormalities of

face and skull and

birth defects.

Fetal Alcohol Syndrome: Symptoms

• Another rapid state of growth occurs during adolescence.

• Nutrient needs rise, and iron and calcium are especially important.

• Busy lifestyles make it challenging to meet nutrient needs and develop healthy habits.

• Peer pressure is significant among adolescents.

• Energy needs vary• Depends on activity• Weight gain possible (esp. females)

• Vitamin and mineral needs increase• Iron deficiency anemia• Calcium and vitamin D

Nutrition during Adolescence

• Physiological Changes• Immune System

• Compromised immune systems can occur with age.

• Incidences of infectious disease increase

• GI Tract• Slower motility

resulting in constipation

The Aging Process

• GI Tract • Atrophic gastritis impairs

digestion and absorption of

nutrients due to:

• stomach inflammation,

• bacterial overgrowth,

• lack of hydrochloric acid

and intrinsic factor.

• Dysphagia is defined as

difficulties in swallowing and

can result in nutritional

deficiencies

• Physiological Changes• Tooth Loss

• Tooth loss and gum disease can interfere with food intake.

• Edentulous is lack of teeth.• Conditions that require

dental care• Dry mouth• Eating difficulty• No dental care in 2 years• Tooth or mouth pain• Altered food selections• Lesions, sores, or lumps

in mouth• Ill-fitting dentures

• Physiological Changes• Sensory Losses

and Other Physical Problems• Vision problems

can make driving and shopping difficult.

• Taste and smell sensitivities may diminish.

• Other Changes• Psychological Changes

• Depression and loss of appetite commonly occur together.

• Support and companionship of family and friends are helpful.

• Economic Changes• Older adults have lower incomes and are at

risk for poverty.• Only 1/3 receive aid from federal assistance

programs.• Social Changes

• Loneliness is directly related to low energy intakes.

• Malnutrition is common.

• Water• Dehydration

increases risks for:• urinary tract

infections, • pneumonia, • pressure ulcers, • confusion and

disorientation.• Fluid needs are not

recognized.• Mobility and bladder

problems

Energy and Nutrient Needs

• Energy and Energy Nutrients• Energy needs decrease.• Protein to protect muscle

mass, boost the immune system, and optimize bone mass

• Carbohydrate for energy• Fiber and water to reduce

constipation• Fat to enhance flavors of

foods and provide valuable nutrients

• Vitamin and minerals to meet needs

Energy and Nutrient Needs

•Food Assistance Programs

•Congregate meals are group settings at community centers.•Meals on Wheels is a home-delivered meal program.•The Senior Farmers Market Nutrition Program allows low-income older adults to exchange coupons for fruits, vegetables, and herbs.

Food Choices and Eating Habits of Older Adults

• Nutrient Needs• Energy – decreased

BMR• Protein – needs to not

decline• Fats – 20 – 35% energy

needs• Fiber• Water – monitor intake

and output• Vitamins B6 and B12,

Vitamin D, • Calcium• Antioxidants – Vitamin

E, C, β-carotene

Nutrition and Aging

• Preventing food insecurity• Economic Limitations

• Programs provide nutrition education• Social Limitations

• loneliness• Physical Limitations

• Limited mobility• Medical Limitations

• Dental problems• Difficulty chewing, dental caries, gum disease

• Changes in sense of taste and smell• Intolerance of food

• Medical conditions• Medical nutrition therapy education

• Prescriptions and over-the-counter drugs• Drug nutrient interaction

Nutrition and Aging

• Federal Older American Act (OAA)• Title III

• Serves at least one meal five days a week to persons 60 years and older

• Congregate meals, faith based organizations

• Nutrition Screening Initiative• National program that

promotes nutritional screening and more attention to nutrition in all health-care and social-service settings that provide for older adults

Nutrition and Aging

• D – Determine• E – Eating poorly• T – Tooth loss or mouth pain• E – Economic Hardship• R – Reduced social support• M – Multiple medicines• I – Involuntary weight loss (or

gain)• N – Needs assistance in self care• E – Elder above age 80

Nutrition and Aging