Toddler to Teens- Older Adult

Objectives- Toddlers to Teens

State 3 nutrition related principles for feeding 1-5 year olds

Identify fluid needs for hydration during illness State 3 nutrition related principles for 5-10 year olds Identify 4 components to a weight management

program for kids Identify calories and nutrients needed by teens Identify 4 nutrition related issues for teens. State reasons to increase meals for kids

Objectives- Older Adults

Identify 7 most significant nutrition concerns with aging

Identify strategies to prevent weight loss Define sarcopenia Identify strategies to increase protein List vitamin D needs Identify 4 side effects of dehydration State 2 most significant “red flags” for

malnutrition

Objectives- Older Adult

Identify side effects of malnutrition State the importance of “liberalizing” the diet

for older adults Describe ways to improve dietary intake and

eating environment for older adults List 6 lifestyle factors related to longevity

1-5 years

Rate of growth slows Add 200 calories per year 2 yo ~1000 calories, 3 yo ~ 1200 calories

Appetite dependent of activity level and growth spurts “picky eating”, “food jags”

1-5 years

Food Provides Nutrients Decision making, motor skill development

My Plate Balance Model good eating patterns Provide healthy choices Smaller portions

1 Tblsp. year portions Establishment of eating behaviors, food preferences

Dental Caries No bottles in bed

Stool Concerns

Stooling Stool consistency and

frequency varies DISCOMFORT

Diarrhea-Dehydration Viral infection, formula

contamination, antibiotics Replace fluids

Oral hydration formulas 2 oz of fluid per pound of

body weight

Best Time to Teach Nutrition

Pre-school and grade school years Love to cook, help with food

3 yo- wrap, pour, mix, shake, spread 4 yo- roll, juice, mash, peel 5 yo- measure, grind, grate, cut

Less peer influence

5-10 Years Continued slow growth

10 y.o.- 1800 calories/day

Regular meals and snacks 5-7 eating times/day Breakfast, snacks, < sweetened beverages

Concerns Dental caries, iron deficiency anemia Obesity

High blood cholesterol (>170 mg/dl), hypertension, high blood sugars

Obesity

BMI 85th-95th percentile- at risk > 95th percentile- obese

Healthy Diet Portion control Balance

Physical Activity Self-Esteem Family involvement

Adolescents

Rapid growth triggered by hormones Girls 10-11 y.o., fat increases, 35 pounds, 6” Boys 12-14 y.o., muscle increases, 45 pounds,

8” Calories up to 4000-5000/day during growth

spurts Iron, calcium, vitamin D, protein

Nutrition Issues Peer influenced eating Eating disorders Obesity Iron deficiency anemia Low calcium intake- girls Vegetarianism Sports nutrition

Adequate calories to support growth and activity

+500-1500 calories/day

Importance of Mealtime

Better….. School performance, health, family relationships Nutrition Intake

Adequate vegetables, fruit, low-fat dairy, grains, fewer soft drinks/empty calories

Social skills Family time

Distraction-free Enjoyable Try to increase!

Older Adults General decrease in all physiological functions Wide variation physical and cognitive abilities

Great variations in nutritional needs, social, economic, lifestyle

Various levels of nutrition Health improvement Treatment Support life

Sensory Losses

Taste Smell Vision Thirst

Most Significant Nutrient Concerns with Aging…

Unintentional Weight Loss Loss of Lean Body Mass Low vitamin D Dehydration Malnutrition Depression Food Insecurity

Weight Loss

middle age- weight gain; peak weight- 75 yo, weight loss- after 75

Difficulty regaining weight Loss of functional ability 25-30 calories/kg body weight

Strategies: Calories

Avoid unnecessary dietary restrictions Encourage use of nutrient

dense foods

Use more frequent meals plus supplements or snacks

Strategies: Calories

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

Sarcopenia

Loss of lean body mass Affects physical function, strength, overall health, quality of

life, activities of daily living

Adequate Calories Adequate Protein

1.2 grams/kg Animal sources, supplements 25 grams at a time (snacks and meals)

3-5 times a day

Resistance Exercise

Food Protein Sources (grams)

3 oz meat = 21 1 oz meat = 7 1 cup milk = 8 1 cup yogurt = 8 2 T. peanut butter = 7 1 egg white = 7 ½ oz. nuts/seeds = 7 ½ c. legumes/soy = 7 ½ cup grain = 3 1 slice bread = 3 ½ cup vegetables = 2

1 cup soy milk = 8 ¼-½ cup meat substitute = 7-14 Veggie Burger = 14 ½ oz. tofu = 18 Scoop of protein powder = 24 Protein Bars- 7-14 MyPlate- 76 grams

Dietary Protein/Calorie Dietary Protein/Calorie SupplementsSupplements

Liquid supplements Liquid supplements 13+ grams13+ grams

Protein powdersProtein powders 25 grams a scoop25 grams a scoop SmoothiesSmoothies

Food intake is often Food intake is often ↓ by use of these supplements, ↓ by use of these supplements, but overall nutritional intake is improvedbut overall nutritional intake is improved

Considered a “supplement” not meal replacementConsidered a “supplement” not meal replacement

Oral Supplements

100 kcal/1 oz

10 gm protein

330 kcal/1.5 oz

7 gm protein

6 gm/pkt

23 kcal/Tbl

Vitamin D

2010 Dietary Guidelines 600 IU up to 70, 800 IU after 70 Common Supplementation- 1000 IU

Repletion Guidelines (based on lab tests) 50,000 IU for 6 weeks 1000 IU a day

Dehydration

Affects constipation, blood pressure, dementia

(confusion), muscle function 8-11 cups of fluids a day Ideas to increase intake:

Availability, pitchers, variety of fluids, flavors

Malnutrition Risk

DETERMINE Disease Eating Poorly Tooth loss or mouth pain Economic hardship Reduce social contact Multiple medications Involuntary weight loss or gain Need for assistance with self care Elder at an advanced age

Malnutrition Easier to prevent than to cure… Side Effects

Poor immune system Frequent illness Increased risk for infection Poor wound healing Poor drug tolerance Skin conditions Depression, apathy Weakness Dehydration Unnecessary or long hospital stays

Long-Term Care

Liberalize the diet Quality of life issue All issues covered…+ pressure ulcers

Pressure Ulcers, Decubitus Ulcers, Bed Sores

Pressure, poor nutrition High calories and

protein Vitamin C

500 mg a day

Zinc Sulfate 220 mg for 14 days

Multivitamin-mineral Hydration

Encourage Healthy, Regular Eating

Eat regular/routine, small, frequent meals Easy-to-prepare foods Flavorful, familiar foods Treats Good lighting cooking and eating areas Limit alone eating in isolation Physical activity Community Resources if food insecure

Live to Be 100 http://ngm.nationalgeographic.com/ngm/0511/

sights_n_sounds/index.html Mediterranean Type Diet

Home-grown foods, fruits, vegetables, olive oil, fish, whole grains, drink tea-coffee-red wine, few processed or refined foods

Maintain healthy weight Reduced calories and exercise

Social Networks Family, friends,

Spiritual life, “sabboth” Reason for living-purpose Rural living