Life Stage Requirements Flashcards
(103 cards)
1
Q
What are the benefits of breastfeeding for infants?
A
- Provides all micros and macros in the right proportion
- Contains bifidobacteria and prebiotic oligosaccharides x digestive tract colonisation -> build immune system
- Reduces risk of e.g. eczema, asthma, food allergies
2
Q
What are breastfeeding benefits for mothers?
A
- Convenient
- Delays return of regular ovulation
- Conserves iron stores
- Protective against ovarian and breast cancer
- Aids post birth weight loss
- Supports baby-mother relationship
3
Q
What is the macronutrient composition of breast milk?
A
88% water
6-7% carbs (lactose)
3-5% lipids
< 1% protein
Enzymes
4
Q
What is colostrum?
A
A pre-milk substance containing mostly serum with antibodies (IgA) and white blood cells
Produced 2/3 days after delivery
5
Q
What are the functions of colostrum?
A
- Protects infant from infection against which the mother has developed immunity
- Has a laxative effect to expel wastes accumulated in the GIT during foetal development
6
Q
What is colostrum high in?
A
Secretory IgA, vit. A, zinc, bifidus factors
7
Q
What is lactoferrin?
A
An IRON BINDING PROTEIN in breast milk -> prevents bacteria from accessing the iron they can use to grow
8
Q
What is lactadherin?
A
A protein in breast milk that fights virus that causes most infant diarrhoea
9
Q
What are some protective effects of breastfeeding?
A
- Delays in occurrence of atopic dermatitis, cow milk allergy, wheezing
- Developmental CDV disease (link to oxytocin and vasodilation)
10
Q
What is the mineral composition of breast milk?
A
- Calcium
- Zinc (+ zinc binding protein = highly bioavailable)
- Low sodium (immature kidneys)
- Little but very bioavailable iron
11
Q
When is most iron transferred to the baby?
A
Third trimester
12
Q
Why are iron stores used up quickly in infancy?
A
Blood volume increases with size
13
Q
Why may delaying umbelical cord clamping until it stops pulsating be beneficial?
A
Babies can get 30% more iron-rich blood, oxygen, erythrocytes, leukocytes and stem cells
14
Q
How can you support your clients to establish successful lactation?
A
- Consider hiring a doula
- Familiarise with local breastfeeding support “milk spots”
- Spend first week postpartum at home with baby, skin-to-skin contact
- Consider pumping one feed for mum to get some rest
15
Q
What are key postpartum nutrients?
A
Protein
Iron
Zinc
Bs
EPA/DHA
Vit. D
Probiotic foods
16
Q
What are the energetics of pregnancy?
A
Generally a time of MOISTURE (consider amniotic fluid) = more hunger, emotional, lethargic, congested (= all signs of moisture)
17
Q
What to avoid ENERGETICALLY during a pregnancy?
A
- Damp forming foods : dairy, refined sugars
- Excess fluids, cold green smoothies, mucilaginous foods
- Sweet and high water content fruits
18
Q
On what foods to focus during pregnancy?
A
DRYING FOODS (whole grains, legumes)
WARMTH helps counteract moisture (warm foods, small amounts of culinary herbs)
19
Q
What are energy requirements during lactation?
A
HIGH : inadequate nutrition may 1. Hinder breastfeeding benefits and 2. Leave mother depleted
20
Q
Why is it important to have regular meals throughout breastfeeding?
A
Erratic eating triggers stress response -> affect milk production
21
Q
Why should a mother avoid coffee/stimulants during breastfeeding?
A
Caffeine enters breast milk = make infant irritable and wakeful
+ may interfere with iron bioavailability
22
Q
Why should a mother avoid alcohol during breastfeeding?
A
Changes milk taste -> diminishes amount of milk consumed = sleepiness
Also interferes by inhibiting oxytocin
23
Q
Why should a mother avoid smoking during breastfeeding?
A
Reduces milk volume
Nicotine enters milk -> alters smell and flavour
= gain less weight
24
Q
What medicinal drugs are contraindicated during breastfeeding?
A
Anti-cancer drugs, lithium, oral retinoids, codeine, aspirin,…
25
How often should you be feeding your baby?
Feed on demand
26
How can a mother boost milk production?
1. Try galactagogues fenugreek or fennel seed tea
2. Milk supply increases with baby demands (feed more!)
27
What can lower breast milk production?
Stress (drink a chamomile or lemon balm!)
28
What can a mother do when noticing her milk does not agree with the baby?
Babies can develop GI symptoms towards foods in mothers diet -> investigate (exclude most common offenders : cow milk, eggs, fish, peanuts, tree nuts) and eliminate !
29
What is the problem with infant formula?
Ultimate refined food : sugar/lactose + dried skim milk + refined vegetable oils
Phthalates and heavy metals also found in formula
Additives (iron, AA, DHA, folic acid)
HEAT DAMAGE (= advanced glycation end products)
30
What is weaning?
The process of starting to introduce solid foods
31
What are sings that the baby is ready for weaning?
Sitting upright, taking interest in parents food, putting food in mouth
(Current guidance : not before 6 months)
32
Why is 6 moths an appropriate age to introduce weaning?
GIT and immune system have matured to a level where new foods are more likely to be tolerated
33
What is the risk of weaning too late/ too early?
Increase risk of allergies
Risk is decreased by breastfeeding whilst weaning (6-12 months)
34
How should food be introduced to babies?
One at a time, with 3-4 days of interval to observe any reaction
35
What foods should be introduced later?
Known allergens (eggs, peanuts, fish, wheat) -> introduce closer to 12 months
36
What are appropriate foods for weaning?
Initially small amount of runny puréed veggies -> increase to smooth paste to finally get to mashed / minced foods
Veggies and fruits : carrots, broccoli, pumpkins, apple, pear
Thin porridge : barely, millet, rice (with breast milk)
37
What is baby-led weaning?
Let baby feed themselves finger foods right from the start
38
What are the benefits of baby-led weaning?
Supports development of hand-eye coordination and chewing skills
Offers opportunity to explore taste, texture, aroma of foods
Encourages self regulation
39
What foods should be omitted at weaning?
- Concentrated sweets
- Products containing sugar alcohols (= diarrhoea)
- Canned veggies
- HONEY (botulism)
- Soya products (isoflavones)
- Cows milk
40
What is the problem with nappies?
Chemicals : dioxins, sodium polyacrylate, plastics, dyes and fragrances
41
What are nappies alternatives?
Natural cloth nappies
42
When does a child’s appetite start to change?
After 1 year -> appetite will diminish BUT food take will increase to coincide with growth and physical activity
43
What is the best approach to have with children and food?
Respect child’s innate intuition in regard to hunger
- Parent is responsible for what, when, where of feeding
- Child is responsible for how much and whether
44
What good eating habits should be taught to children?
- Make mealtime pleasant, include in conversation
- Chew well
- Put food in serving bowls and let child choose
Do not entice/manipulate to eat something
45
What is childhood obesity associated with?
- Eating ultra processed hyperpalatable foods
- Reduced energy expenditure
- Bigger food portions
- Gut dysbiosis
46
What can be done to prevent or manage childhood obesity?
- Prepare food at home
- Eat away from TV
- Be aware of age-related portions
- Encourage structured mealtimes (vs snacking)
- Discourage inactivity
- Promote adequate sleep
47
Carbs recommendations for children (1+)
Same as adults = 60-70%
Except fibre -> too much lowers food energy density
48
Fat recommendations for children
As long as energy intake is adequate, < 30%
More if child eats relatively less than other kids
49
Protein recommendations for children
Increase slightly with age (whilst decreasing requirement x body weight)
50
How can you avoid iron deficiency anaemia in children?
- No processed foods
- No cows milk (calcium and casein inhibit iron absorption)
- Optimising digestion and gut heath
51
What are signs and symptoms of iron deficiency in children?
Fatigue, listlessness, irritability, loss of appetite, apathy, impaired learning, slow growth, pallor, tachycardia, nail spooning
52
What is it important to do for children raised vegetarian/vegan?
Ensure adequate energy intake
DHA rich foods
Calcium
Non-haem iron
B12
Outdoors x vit. D
53
What is a good indicator of appropriate energy requirements?
BMI
54
What adolescents are at higher risk of inadequate energy intakes?
Dieting, frequently using alcohol or illicit drugs, those with chronic health conditions
55
What factors affect food choices in adolescents?
- Physiological (growth = increased appetite)
- Social (e.g. peers influence, body size/image preoccupation)
- Economical
56
What are protein needs for adolescents?
Needs vary with degree of physical maturation
Insufficiency is uncommon (except on diets), issue is often QUALITY (processed meats and dairy)
57
What can inadequate protein intake cause in adolescents?
Loss of lean body mass and delayed growth
58
Carbs recommendations for adolescents
Usually : low fibre high refined carbs intake (key factor in acne -> insulin promotes oily skin)
Should focus on whole grains, sourdough, sprouts, fresh fruits and veg
59
Fat recommendations for adolescents
Max 30-35% of caloric intake
EFAs particularly important for sex hormones production
60
Why do calcium requirements peak in adolescence?
A crucial time for bones development
61
What is the problem of a low calcium diet in adolescence?
Low calcium diets + physical inactivity = compromise peak bone mass development
62
How can bone development be supported in adolescence?
Support daily movement, avoid fizzy drinks, caffeine alcohol and fast food
Include vit. D and magnesium rich foods
63
What happens to iron requirements in adolescence?
Increase as blood volume increases with growth (needs remain high for females of reproductive age)
64
How can adolescents’ iron levels be supported
Include non-haem iron foods (almonds, apricots, avocado) and vitamin C rich foods
65
What nutrients are crucial during adolescence?
Nutrients supporting growth : calcium, zinc, iron, protein, Bs, selenium,…
66
How can one support healthy nutrition in adolescence?
- Encourage to eat well despite peer pressure
- Encourage activity
- Encourage micronutrients intake + vit. C
- Suggest cooking/nutrition and health classes
- Recognise adolescence stressors, need for independence and develop own lifestyle
- Maintain contact in this critical moment
67
What are some of the physiological changes of ageing?
- Lowered hormone levels
- Dysregulation of innate and adaptive immunity
- Loss of skin integrity
- Decreased bone density and muscle mass
- Stiffen heart valves and arteries
- Alveolar function
- Neurological function
- Lowered stomach acid and dysphasia
68
What can accelerate the ageing process?
Lifestyle, poor diet and no physical exercise, stress, no life purpose, socioeconomic status, diseases and medications
69
What are telomeres?
DNA-protein structures found a both ends of the chromosomes —> a small portion of telomeric DNA is lost with each cell division (normal cellular process)
= can serve as biological clock to determine cell/organism lifespan
70
What happens when telomeres length reach a critical limit?
Cell undergoes apoptosis
71
What increases telomeres shortening?
Lifestyle factors, e.g. smoking, poor diet
72
What are the energetics of ageing?
Dryness : wrinkles, joint stiffness, decreased strength
73
What foods should be increased with ageing?
Soups, stews, smoothies, sweet and high water content fruits and veg, root veg, nut milks, mucilaginous foods, herbal teas
74
What is the last energetic phase of old age?
Coldness : weakening of digestive power, circulation, mobility, exhaustion, withdrawal
75
What foods should be increased in old age?
Warm, cooked and mildly spiced foods
76
How does body composition change with ageing?
Fat and visceral fat mass increase
Lean muscle mass decreases
77
What is sarcopenia?
Agre-related loss of muscle mass, strength and function
= decrease mobility, increase fracture risk, lowers metabolic rate
78
What aggravates sarcopenia?
- Sedentary lifestyle
- Changes in body composition
- Poor nutritional status
- Hormonal changes
- Inflammation
- Chronic diseases
79
What 2 factors affect energy balance in ageing?
1. Decline in physical activity = loss of lean muscle mass = lowered BMR
2. Increased fat mass = increase CDV disease, diabetes, obesity risk
Comorbidities and infections also increase energy requirements while immobility reduces them
80
What factors may affect food choices in the elderly?
- Physiological : visual acuity, joint problems, hand tremors, …
- Social/psychological : reluctance to go shopping, isolation, depression, …
- Economical : isolation, low income
- Reduced appetite
81
What GIT changes occur with age?
1. Parietal cells IF production declines
2. Achlorhydria = poor digestion, absorption and biliary excretion, B12 deficiency, SIBO, iron deficiency,…
3. Gastric motility and emptying
82
How to support GIT changes in the elderly?
- Avoid drinking at meals
- Chew well (or less solids)
- Bitter greens
83
What CDV changes occur with ageing?
1. Arterial wall thickening/stiffening = increased systolic pressure
2. Decreased max heart rate
3. Increased left ventricle muscle mass
84
How to support CDV changes in the elderly?
- Focus on whole foods rich in antioxidants
- Increase bitter foods
- Heart nourishing foods (rosemary, garlic)
- Regular aerobic exercise
85
What changes occur in kidneys function and structure?
- Kidney cortex volume decreases
- Renal cysts increase
- Nephrosclerosis = decline in nephron number and GFR
86
What are consequences of decreased renal function?
Problems with urinary excretion and difficulty regulating sodium concentrations in the body
87
What happens to neurological function with age?
Neurological function declines and dementia/cognitive impairment increase ->
88
What is a risk factor in Alzheimer pathogenesis?
B vitamins deficiency (folate, B6 and B12) -> linked to cognitive impairment and raised homocysteine
89
Why do risk and severity of infection increase with age?
Dysregulation of both innate and adaptive immune function
90
What nutritional deficiency can exacerbate impaired immune function in the elderly?
- Protein energy malnutrition
- Micronutrients deficiencies (A, C, E, Zn, Se, Fe)
91
What skeletal changes occur with ageing?
BONES : mineral density declines (worse in women due to oestrogen reduction in menopause)
CARTILAGE : decreased water content = changes to extracellular matrix structure = collagen fibres cross-link = cartilage becomes stiffer = reduced delivery of nutrients and compression of intervertebral discs
92
What is NAD+?
An essential co-factor in all living cells that is involved in fundamental biological processes
93
What is NAD+ depletion associated with?
Hallmarks of ageing -> underlies wide range of age-related diseases, e.g. metabolic disorders and neurodegenerative diseases
94
How can NAD+ levels be increased?
Regular exercise
Adequate sleep
Fasting/periodic calorie restriction
Good diet
95
What is melatonin?
An hormone secreted by the pineal gland that regulates the circadian rhythm
96
Other than circadian rhythm regulation, what does melatonin do?
- Potent antioxidant
- Modulates immune defence
- Acts as tumour surveillance agent
97
How can melatonin levels be optimised?
Increase natural sunlight exposure
Regular bedtime
Dark room
Montmorency cherries
B6 rich foods
98
What should nutrition for healthy ageing look like?
1. Protein : higher intake can increase BMD and preserve muscle mass (too high = stress kidneys)
2. Carbs : 50-70% of total caloric intake ideally from veggies, fruits, whole grains, legumes (x micros and fibre)
3. Lipids : important x cognitive function, skin, joint health -> poly and monounsaturated fats, omega-3
Focus on COOKED FOODS and HYDRATION
99
What micros are fundamental for healthy ageing?
B12, vit. D, vit. E, folate, calcium, potassium (good x blood pressure), CoQ10
100
What is nettle leaf?
A diuretic
Relieves fluid retention, purifies blood, flushes out toxins, skin cleanser, nutritive, assist blood glucose balance, anti-inflammatory
101
What does dandelion root do?
Enhances digestion (bitter)
Support liver detox
Promotes peristalsis
Gentle laxative
Mild diuretic
102
What does peppermint do?
Soothe digestion (releases flatulence and nausea) + anti-microbial
103
What does chamomile do?
Relieves pain, flatulence, spasm in GIT
Calms nervous system -> promotes restful sleep
