NUTRITION

THROUGHOUT THE
LIFESPAN
THE HUMAN LIFE CYCLE
The major stages of the human life cycle are defined as follows:
 Pregnancy – The development of a zygote into an embryo and then into a fetus in preparation for
childbirth.
 Infancy – The earliest of childhood. It is the period from birth through age one.
 Toddler years – Occur during ages two and three and are the end of early childhood.
 Childhood – Takes place from ages four to eight.
 Puberty – The period from ages nine to thirteen, which is the beginning of adolescence.
 Older adolescence – The stage that takes place between ages fourteen and eighteen.
 Adulthood – The period from adolescence to the end of life and begins at age nineteen.
 Middle age – The period of adulthood that stretches from age thirty-one to fifty.
 Senior years, or old age – Extend from age fifty-one until the end of life.
NUTRITION IN
PREGNANCY
PREGNANCY (GESTATION)
 It begins when the sperm fertilizes the egg, and
the single cell formed this union (fertilized
ovum) then implants itself in the uterus,
undergoes differentiation, and grows until it
can support extra-uterine life.
 Lasts for a period of 266 to 280 days or 37-40
weeks (when counted from the first day of a
woman’s last menstrual period).
 It consists of 3 trimesters: first, second, and
third trimesters which corresponds to the 3
main phases: implantation, organogenesis, and
growth.
Nutritional Objectives
1. Ensure optimum nutrition before, during, and after pregnancy.
2. Provide adequate nutrition to meet increased maternal and fetal nutrient demands.
Calorie Allowances
 The total energy cost of storage plus maintenance (additional work for maternal heart and uterus and a
steady rise in basal metabolism) amounts approximately 80,000 kcal.
 The energy cost of pregnancy then is about 300 kcal per day.
 The energy intake should be 36 per kg of pregnant weight per day.
Weight Gain
TISSUE WEIGHT (POUNDS)
Fetus 7.5
Uterus 2.0
Placenta 1.5
Amniotic Fluid 2.0
Blood Volume 3.0
Extracellular Fluid Accretion 2.0
Breast Tissue 1.0
Fat 9.0
TOTAL 28.0
Maternal Weight
Underweight
a. High risk of having low-birth weight infants
b. Higher rates of pre-term deaths and infant deaths

Overweight and Obese

c. High risk of complications like hypertension, gestational diabetes, and postpartum infections
d. Complications of labor and delivery
e. Increased likelihood of a difficult labor and delivery, birth trauma, and cesarean section for large babies
f. Doubled risk of neural tube defects
Recommended Weight Gain During
Pregnancy
Pre-Pregnancy Weight Recommended Weight Gain Patterns Weight gain Patterns
Weight Gain First Trimester Thereafter
Underweight BMI < 18.5 28-40 lbs. 5 lbs. 1 lb. per week
Healthy Wt. BMI 18.5-24.9 25-35 lbs. 3 ½ lb. 1 lb. per week
Overweight BMI 25.0-29.9 15-25 lbs. 2 lbs. 2/3 lb. per week
Obese BMI ≥ 30 15 lbs.
Protein Allowances
 The FAO/WHO recommends an additional 9g of protein per day for the latter part of pregnancy.
 Adjusting for net protein utilization (NPU) of 63, an additional allowance of a Filipino pregnant woman
becomes 14 g/day or a total of 68 g/day for the adult pregnant woman.
 Pregnant adolescents should receive both the protein allowance for their non-pregnant body weight (59 g
for those aged 16-19) and an additional 14 g/day for the pregnancy totaling 73 g.
 A normal pregnant woman requires a total of 900-950 g additional protein for the 9 months gestation
period.
 Two-thirds of the proteins should be of animal origin of the highest biologic value such as meat, milk,
eggs, cheese, poultry, and fish.
Protein Allowances
Reasons for the additional protein:
1. To provide for the storage of nitrogen
2. To protect the mother against many of the complications of pregnancy
3. For the growth of the woman’s uterus, placenta, and associated tissues
4. To meet the needs for the fetal growth and repair
5. For the growth of the mammary tissues
6. For the hormonal preparation for lactation
Calcium Allowances
 The intake and retention of calcium are considerably increased during the latter half of pregnancy and the
quantity retained is more than what can be accounted for the fetal utilization and it perhaps represents
the establishment of a reserve supply which may be availed of during subsequent emergencies.
 The pregnant woman will have to sacrifice the calcium of her bones in favor of the developing fetus if
her diet is inadequate in calcium.
 The calcium retained in the fetus during the last two months of pregnancy is 65% of the total body
content of the full-term fetus.
 To satisfy additional needs, the daily intake of calcium must be increased from 0.5 to 0.9 to that of the
non-pregnant adult’s daily life.
Iron Allowances
 At least 700 to 1,000 mg of iron must be
absorbed and utilized by the mother throughout
her pregnancy.
 Of this total, about 240 mg is spared by the
cessation of the menstrual flow and the
remainder must be made available from the
diet.
 The rate of absorption is increased, therefore,
in the third trimester when the needs of the
fetus are highest.
Iodine Allowances
 Iodine is especially important during pregnancy
to meet the needs for fetal development.
 An inadequate intake of iodine may result in
goiter in the mother or the child.
 The increased need for iodine can be met by
the regular use of iodized salt in food.
Vitamin Allowances
 Thiamine and Niacin allowances are increased in proportion to the calorie increase while riboflavin
allowances are increased according to the higher protein level.
 The need for vitamin D is increased during pregnancy to make easier the utilization of greater amounts of
calcium and phosphorus.
 Ascorbic acid , vital in tissue structure, is required in considerably increased amounts.
 Vitamin A is important in epithelial cells during organogenesis and is necessary to ensure good vision.
 Folic acid and vitamin B12 are important in the synthesis of RBC.
 Vitamin B6 or pyridoxine requirement has been observed to be greater during pregnancy which have
been found to have much value in preventing severe nausea and vomiting associated with childbearing
Vitamin Allowances
 The infant often has low blood prothrombin levels until intestinal synthesis of vitamin K is fully
established during the early days of life and 1 mg to 2 mg can be given to the newborn after birth. The
use of vitamin K supplement during pregnancy is not necessary.
Food Allowances
1. One ounce or 30 g of meat or its equivalent
and an extra pint of milk to the normal diet.
2. Daily consumption of whole-grain cereals;
enriched bread; rice; leafy green and yellow
vegetables; and fresh and dried fruits.
3. Liver at least once a week
4. Egg in the daily diet
5. Fortified milk with vitamin D or fish liver oil
6. Six to 8 glasses of water daily
COMPLICATIONS OF PREGNANCY AND
POSSIBLE DIETARY MODIFICATIONS
Nausea and Vomiting
 Also called as “morning sickness” which is the
most common discomfort in the early part of
pregnancy that occur immediately after getting
up in the morning.
 It leads to malnutrition and loss of weight when
accompanied by lack of appetite.
 Nausea affect frequency of food intake
resulting in a decrease in calorie intake and
increased hormone secretion is in some way
responsible for this phenomenon.
Nausea and Vomiting
 Small frequent feedings instead of three large
meals, and high-carbohydrate, low-fat foods
such as crackers and jelly to overcome the
complications are recommended by nutrition
experts.
 Liquids are better taken between meals rather
than at mealtime
Rapid Weight Gain
 It is an increase of 3 kg or more per month in
the 2nd and 3rd trimesters.
 It is a sudden increase in weight after about the
20th week of gestation which is a cause for
suspecting that water is being retained at an
inordinate rate and should be regarded as a
warning sign of an impending eclampsia.
Rapid Weight Gain
 The primary weight management strategies
during pregnancy are dietary control, exercise,
and behavior modification and the goal is to
avoid excessive gestational weight gain then
working with a nutritionist can help patients
plan meals for optimum healthy gestational
weight gain.
Weight Loss
 A gain of less than 500 g/month during the 1st
trimester and 250 g during the 2nd is considered
a maternal risk factor.
 Seriously underweight entering pregnancy (<38
kg), or showing inadequate weight gain (<40kg
at the 20th week of pregnancy) are more likely
to deliver low-birth weight infants, or to have
premature deliveries, abortions, and offsprings
with brain and nerve damage.
Toxemia
◦ It complicates some 4% to 6% of pregnancies
that remains among the leading cause of
maternal deaths, prenatal deaths, low-birth
weight infants.
◦ Rapid weight gain, edema, high blood pressure,
excretion of albumin in the urine, and
convulsions are the clinical manifestations.
Classifications of Toxemia
Acute Toxemia of Pregnancy (Onset: After
Chronic Hypertensive (Vascular) Disease
the 24th week)
a. Pre-eclampsia – hypertension with a. Without superimposed acute toxemia
proteinuria and/or edema
b. With superimposed acute toxemia
b. Eclampsia – convulsions or coma, usually
both when associated with hypertension,
proteinuria, and edema
Toxemia
 Optimum nutrition is a fundamental aspect of
therapy that emphasized HBV (High Biological
Value) protein foods and sources of iron,
calcium, and minerals.
 Salt intake is restricted for edema
Anemia
 The classic macrocytic anemia of pregnancy
represents a combined deficiency of iron and
folic acid which produces anemia in babies and
increases the chances of premature birth.
 It is difficult to overcome anemia once the
condition is established even by raising the
level of iron in the diet although its absorption
can be enhanced by the inclusion of ascorbic
acid-rich foods in the same meal containing
rich sources of iron.
Diabetes
 Diabetic pregnant woman is more prone to
develop pre-eclampsia, pyelonephritis, and
polyhydramnios (excess of amniotic fluid) and
the baby has the higher risk of dying in utero or
at birth.
 Rigid control of maternal blood glucose
concentration is considered vital for a good
prognosis of the fetus.
Constipation
 Its causes are pressure by the developing fetus
on the digestive tract, lack of exercise, and
insufficient bulk in the diet, which if chronic or
habitual, gives rise to headaches and much
discomfort.
 Lots of fresh fruits, vegetables, fluid, and
regular exercise can correct this disorder.
Socio-economic and Cultural Factors
 Low-income groups tend to have big families, one reason for the decrease in kind and amount of food
available to the pregnant mother.
 Unusual eating habits such as frequent snacks rich in carbohydrates; irregular meals; special cravings
like green mangoes; and odd eating habits like chewing cigarettes, chicken manure, and soot of pots
deprive the mother of wholesome foods.
 Fallacies (eating eggplant causes beriberi in the mother; dark food results in dark complexion of babies;
and eating crabs produce physical abnormalities) should be ignored.
Nicotine
 Smoking during pregnancy lowers the mean birth weight and increases the risk of perinatal mortality.
 Smoking affects the conversion of dietary calories into weight gain.
 When segments of umbilical cord from mothers who smoke were studied, large areas of swollen and
irregular endothelial cells were found.
 Smoking increases the mother’s level of carboxyhemoglobin and nicotine causing a decrease in the
oxygenation of the fetus.
 Increasing the food intake of pregnant smokers can compensate for some of the effects of smoking.
Alcohol
 Excessive maternal alcohol ingestion is linked to fetal alcohol syndrome (FAS) and its major features are
CNS disorders, mental retardation, growth deficiencies, and facial deformities.
Caffeine
 It crosses the placenta to the fetus very rapidly.
 The drug-metabolizing ability of a fetus is extremely limited and the fetus can metabolize alcohol to a
limited extent but not caffeine.
 Caffeine, alcohol, and nicotine dramatically increase the circulating levels of catecholamines.
Mother’s Age and Associated Health
Concerns and Risks
Pregnancy In Adolescents (1 out of 20) Pregnancy in Older Women

a. Iron deficiency anemia a. Hypertension and diabetes

b. Prolonged labor b. Higher rates of premature births and low birth
c. Higher rates of stillbirths, pre-term births, weight
and low-birth weight infants c. Birth defects
d. Fetal death
NUTRITION IN
LACTATION
LACTATION
 It is the process of producing and releasing milk from the mammary glands in your breast.
 It begins in pregnancy when hormonal changes signal the mammary glands to make milk in preparation
for the birth of your baby.
Calorie Allowances
 It is generally suggested that the extra food calories should be about twice those secreted in the milk of
approximately 700 to 1,500 calories of food for 500 to 1,000 mL of the milk.
 The FNRI recommends an increase by 1,000 calories above the normal requirement for an average
production of 850 mL of milk, with an energy value of about 600 calories.
 Human milk is approximately 0.70 calories per mL or approximately 20 calories per ounce, and it
contains 1.2 g protein per 100 mL.
Protein Allowances
 The food intake of a nursing mother must contain sufficient proteins to supply both the maternal needs
and the essential amino acids to be transferred through her breast for the baby’s growth.
 Additional protein in the diet tends to increase the yield of breast milk while a decrease of protein lowers
the amount of milk secreted.
 If the amount of protein in the mother’s diet does not meet the body maintenance needs and the
necessary protein content of the milk secreted, a loss of maternal body tissues will result.
 The average protein allowance for the lactating mother is an additional 20.2 g protein to her normal
requirement. In such a case, a 20g factor may be used.
Calcium, Phosphorus, and Vitamin D
Allowances
 The demand for calcium and phosphorus is increased above the requirement of the pregnant woman
during lactation.
 The calcium allowance is 1.0 g daily for good milk production.
 If the protein requirement and other essentials of the diet are fulfilled, the increased need for phosphorus
will be met.
 The vitamin D requirement of 400 IU remains the same as during pregnancy.
Iron Allowances
 The loss of iron which is considered on an annual basis is probably similar to that which is lost in the
menstrual flow.
 A good allowance of iron in the mother’s diet during lactation does not convey additional iron to the
infant.
 Iron-rich foods are essential for the mother’s own health while supplements are included early in the
infant’s diet.
Vitamin Allowances
 There is an increased demand for vitamin A, niacin, riboflavin, thiamine, and ascorbic acid above the
requirements of pregnancy during lactation.
Mother’s Milk
 It is the best food for the baby
 It is easily digested, economical, has the right
temperature, and is free from harmful bacteria.
 It contains a substance called colostrum for the
first 3 to 4 days which has high protein content,
acts as a laxative, and contains antibodies which
help resist infection and should be given to all
newborn infants.
 A mother who wants to breastfeed her baby
should avoid too much fried foods, pickles, and
highly-seasoned foods and stimulants such as
drugs, nicotine, caffeine, theobromine, and
alcohol.
Breastfeeding Misconceptions
1. A mother sick with tuberculosis cannot
breastfeed.
2. Breastmilk is not good if the mother has
stayed long under the sun.
3. A mother cannot breastfeed during pregnancy
4. A mother cannot breastfeed with only one
breast if the other breast is painful.
5. A mother cannot breastfeed if she has a cold,
flu, or diarrhea.
Advantages of Breastfeeding
1. Breastmilk provides passive antibody transfer to the newborn.
2. Breastmilk is higher in lactose than cow’s milk.
3. Breastfed babies have no difficulty with the regulation of calcium-phosphorus level than those who are
bottle-fed.
4. Bottle feeding affects the dental arch.
5. Cow’s milk protein causes allergy.
6. Breastfeeding also benefits the mothers:
a. Less incidence of breast cancer in women who breastfeed
b. Less incidence of thrombophlebitis or inflammation of a vein with formation of blood clot
c. Rapid return of the original size of the uterus
Factors Affecting Milk Secretion
Diet
a. The volume of milk secreted is affected by
the diet, but the protein and calcium
compositions are not.
b. Meat and vegetable soups (tahong, tulya,
malunggay), milk and fruit juices have been
referred to as “galactagogues” .
c. Water should not be drunk beyond the level
of natural thirst because it suppresses milk
secretion through its action on the pituitary
hormone that regulates milk production
Factors Affecting Milk Secretion
Nutritional State of Mothers
a. Energy-yielding constituents of human milk
are maintained in the expense of maternal
stores while the water-soluble vitamins and
vitamin A are low in poorly nourished mothers.
b. Sufficient nutrient reserves in the mother’s
tissues before conception and during
pregnancy influence milk secretion.
c. Malnutrition and illnesses such as cardiac and
kidney diseases, anemia, beriberi, tuberculosis,
and infections can lessen the quality and
quantity of milk flow.
Factors Affecting Milk Secretion
Emotional and Physical Stress
a. Attitude affects milk secretion because when
the mother worries or frets about the
sufficiency of her milk, about her breast
contour, and about being tied down in her
home, the flow of milk stops.
b. A relaxed temperament, pleasant
surroundings, lots of rest, and good sleep
enhance milk secretion.
Factors Affecting Milk Secretion
Suckling
a. The presence of the baby and suckling,
immediately after delivery, stimulate the
milk-producing glands.
b. As the baby feeds for longer periods of time,
the supply of milk increases in proportion to
the body’s demands.
c. Increased frequency of nursing is positively
associated with infant weight and lactation
period.
Factors Affecting Milk Secretion
Use of Contraceptives and Drugs
a. Women who use contraceptives like pills
while breastfeeding depress milk flow and the
insufficiency of milk triggers the osteria
(cessation of lactation).
b. Most drugs, including alcohol and nicotine
from smoking, reach the milk sometimes in
physiologically large doses, thus affecting the
quality of milk secreted.