Adolescent

CHAPTER 10

CHAPTER 11

exit

ADOLESCENT

b

ADOLESCENCE THIS PERIOD IS CHARACTERIZED BY:

• Accelerated growth and development • Changes in lifestyle and food habits • Involvement in social and physical activities • Emotional problems associated with increased personal and academic responsibilities and psychological concerns • Problems with some teenagers that demand special nutritional needs, smoking, drug and alcohol abuse,

Stages of Adolescence • A. Prepuberty/Adolescence-10 to 12 years old; endocrine changes start and for some girls, menarche or onset of menses occur • B. Puberty/Pubescence- 13-15 years old; maturation of total body at which stage the adolescent gains about 20% of adult height and 50% adult weight; linear growth and weight gains continue until 19 for females and early twenties for males, with the latter gaining more length in the long bones than females.

C. Postpuberty/postpubescenc e • Final process of adolescence; 1619years old • Maturation of sex organ functions • Cessation of growth for females and the beginning of adulthood

ADOLESCENT is a transition period of human development that occurs between childhood and adulthood. Girls go through this period earlier than boys do. Nutrient Objectives: 2.Provide optimum nutritional support for demands of rapid growth and high-energy expenditure. 3.Support development of good eating habits by providing a variety of foods through a regular pattern Nutrient Allowances •Calories – The reference 44 kg boy between 13 to 15 years needs 310 k calories more than what the girl of the same weight and age does. This is due to the higher energy expenditure brought about by intense physical activity. As a consequence, thiamine, riboflavin, and niacin allowances are also increased. Around 0.5 mg/1000 calories is set for the allowance for thiamine and riboflavin and 6.6 niacin equivalents for every 1000 k calories

1. Protein – The needs are high among teenagers because of the accelerated growth and development. Protein allowance for adolescents aged 13 to 15 years is 59 grams for both boys and girls. However, for those aged 16 to 19 years, protein allowance for the reference 55 kg boy increases to 65 grams while that of a 48 kg reference girl remains the same. 2. Vitamins – Allowances for Vitamin A is the same for all levels. Vitamin C allowance is constantly higher among boys than among girls aged 16 to 19 years. The older male adolescents have higher RDA for Vitamin A, Thiamin, Riboflavin, Niacin, and Vitamin C than female counterparts. 3. Minerals – The calcium RDA of the 13 to 15 age group is higher (700 mg) compared to the 16 to 19 age group (600 mg). This difference reflects the spurt of bone development between 13 and 15 and the plateau by ages 16-19. Growth acceleration during sexual maturation period increases iron requirements primarily for hemoglobin production. Boys whose average yearly gain of doing. Childhood is 10 kg, 300 mg of iron is required to maintain a constant concentration of hemoglobin in an expanding blood volume while girls whose average yeraly gain is 9 kg requires about 200 mg iron. More iodine should be supplied

Meal Planning for Teenagers (13-19 years old) “barkada” has something going on all the time. Parents always wonder where the teenager gets his energy and vitality. This is the time when the teenager needs most body builders and energy foods. *Use the family menu, but add more foods rich in: 1. protein (fish, meat, beans, milk), 2. calories (rice and root crops such as kamote, ube, gabi); 3. iron (eggs, liver, green leafy vegetables); and 4. vitamin C (papaya, atis, anonas, guava, etc.). Your Guide to Good Nutrition The recommended daily amounts of nutrients from each of the food groups keep a normal person strong and healthy. Teenaged boys need more energy and bodybuilding foods than girls since they are usually more active.

Possible Nutritional Problems: 4.Low intakes of Calcium, Vitamin A and C 5.Low intake of iron in girls 6.Anemia 7.Obesity or underweight 8.Skin problems 9.Nutritional deficiencies related to: 1.Psychological factors – food aversions and emotional problems 2.Fear of overweight or crash diets 3.Food diets 4.Poor choice of snack foods 5.Irregular eating pattern 6.Additional stress of pregnancy

ADULTHOOD

b ack

ADULTHOOD is the period of life when one has attained full growth and maturity (between 21 – 50 years of age) Nutritional Management It includes maintenance of DBW. By the age of 60, the average adult has accumulated about 7 extra kilograms. To prevent overweight and obesity (which increases chances of developing chronic disorders associated with aging like high blood pressure, increased levels of blood cholesterol and triglycerides, hyperuricemia and diabetes), it is recommended that the daily caloric allowances be reduced with increasing age. A decrease of 3% is suggested by FAO for each decade of 30 to 39 years and 40 – 49 years because the resting metabolic rate declines brought about by loss of lean body mass. Phyical activity may also be curtailed. Men occupation requiring light activity are found to have fairly constant activity patterns between ages 20 and 45. Studies of energy expenditure and food intake of healthy adult males with an average weight of 56 kg show that 2580 kcal/day (44 kcal/kg)

Between the 56 kg reference men and 48 kg reference woman, the energy, protein, thiamine, riboflavin and ascorb ic acid and iron allowances differ. About 12% of the energy intake must be in the form of protein, 1.2 gm/kg body weight for adults. Since Vitamin C enhances the absorption of iron, its adequate intake (70 mg for woman and 75 mg for men) helps alleviate the 27% prevalence of anemia among adult nonpregnant, non lactating woman in contrast with only 15% prevalence among men. Nutrition experts recommended adequate Vitamin D from the diet and exposure of the skin to sunlight, 1200 to 1500 mg calcium,

•

Feeding the Adult

To stay healthy, the following must be observed and followed: 2.Eat variety of foods 3.Maintain ideal weight 4.Avoid too much fat, saturated fat and cholesterol 5.Eat foods with adequate starch and fiber 6.Avoid too much sugar 7.Avoid too much sodium 8.If you drink alcohol, do so in

Avoid too much fat, saturated fat, cholesterol and too much sugar.

OSTEOPOROSIS Osteoporosis is a silent enemy.

It is a bone disease that leads to an increased risk of fracture. The spine may compress, then later collapse causing “dowager’s hump”. It is less common in men than in women. Women at risk of developing osteoporosis include: thin, smallboned women; women with a family history of the disease; women whose ovaries were removed at an early age; and sedentary women. Smokers and drinkers are also at risk. For proper bone mass to be maintained, bones must be stressed

To prevent bone loss, experts recommend 30 minutes of exercise 3 – 6 times a week and calcium supplements if the as they are exercised.

CANCER The American Cancer Society has gathered evidences that diet and cancer are related. Here are the recommended foods that we should eat to fend off cancer: •Carotene (a form of Vitamin A present in cantaloupes, peaches, broccoli, spinach, all dark green leafy vegetables, sweet potatoes, carrots, pumpkin, winter squash, tomatoes, citrus fruits and brussel sprouts) lowers the risk of cancer of the larynx and esophagus. •Cabbage, broccoli, brussel sprouts and cauliflower reduce the risk of GI and respiratory tract cancer •Frits, vegetables, and whole grain cereals such as oatmeal, bran, and wheat may help lower the risk of colorectal cancer. •Foods high in fats, salt, or nitrite-cured foods like ham and fish and types of sausages smoked by traditional methods should be eaten in modulation. •Milk, especially 2-3 cups of Vitamin D fortified skim milk a day, may help ward off colon cancer •Cabbage prevents cancer. In fact, all the vegetable which fall into a group of plants known as cruciferae have an anticancer effect. Some cruciferous vegetables are cabbage, cauliflower,

Avoid Vices Avoid smoking and drinking alcoholic beverages

Fruits and Vegetables Fruits and Vegetables that are highest in

Junk foods that should be avoided

ELDERLY refers to the period being past middle age. Food Needs of the Aging and the Aged Aging is a continuous process that starts in the womb and end in the tomb. It a developmental suquences of all living processes as they change with the passage of time. Old age is said to be related to psychological aging. During psychological aging, cellular changes occur. The changes in function in relation to aging are believed to be caused by a loss in the number of cells. The collagen in the connective tissues undergoes chemical changes with aging. The sense of taste and sense of smell are less acute, affecting the appetite. Less saliva is secreted and swallowing of food is difficult. Old persons therefore tend to take in more carbohydrate rich foods which require minimum chewing and less intake of other foods like protein, vitamins and minerals. Digestion is also affected due to a reduction of volume, acidity and pepsin content. Reduced acidity has an adverse effect on the absorption of calcium and iron and the lowering of Vitamin B12 levels in the blood. Fats are poorly tolerated because they retard gastric evacuation, the

Elderly persons are advised to cut down gradually on their food intake especially if their lifestyle becomes more sedentary. However, they should retain the more nutritious foods (vegetables, fruits, cereals, low calorie foods and milk) and eliminate the less nutritious or higher calorie foods such as sugar in beverages, candies, cakes and confectionaries. The habits of a lifetime are established and are very resistant to change The nutrient allowances for the old people, based on the Philippine RDA are divided into 2 groups: allowances for the elderly aged 50 to 69 years and the elderly aged 70 years and older. d.Calories A reduction of calories is recommended because of reduced basal metabolism and physical activity. Statistics have shown that by age 60, the average adult accumulates about 7 extra kilograms. The recommended decrease in calories intake follows: 45 – 55 years = 7.5% decrease

Around 50% to 60% of the total calories should come from carbohydrates and about 25% to 30% from fats in the form of polyunsaturated fatty acids. Refined sugar and saturated fatty acids have been known to increase triglyceride and cholesterol levels in the blood. Not only the quality but also the quantity of fat should be guarded as they are poorly tolerated by the old. c.Proteins An allowance of 1.1 gm/kg body weight is required. This is necessary for the prevention if progressive tissue wasting and susceptibility to disease and infection. Older persons who have poor dietary habits or illnesses may benefit from an increased intake. e.Vitamins and Minerals Calcium, Iron, Vitamins A, and C are important minerals and vitamins commonly found lacking in the diet for the aged because of low intake of meat, milk, green leafy vegetables and fruits. The B-complex vitamins may be in adequate amounts if enriched cereals and bread are consumed. Vitamin and mineral supplements may be resorted to further augment in the intake of these nutrients

How to Live Longer 3.Avoid red meat and substitute fish whenever possible in diet 4.Eat vegetables rich in Beta-carotene (broccoli, spinach, carrots, sprouts, cantaloup). They are proven to reduce the risk of cancer 5.Eat vegetables more frequently than red meats and dairy products 6.Adhere to a low fat, low calorie diet 7.Avoid preserved foods, especially those preserved with nitrates 8.Cut smoked meats out of diet 9.Take vitamin supplements daily 10.Don’t smoke 11.Drink hard water 12.Avoid all fats and oils 13.Avoid all sugars 14.Severely limit salts 15.Severely limit cholesterol 16.Avoid alcohol, black tea and caffeinated drinks 17.Freely use whole grain products 18.Freely use tubers and legumes 19.Drink plenty of water 20.Eat a good breakfast daily

Foods that Help Slow Down Aging 3.Nuts 4.Wheat germ 5.Whole Bran 6.Oatmeal 7.Chicken Legs 8.Spinach 9.Pinto Beans 10.Sardines 11.Red Salmon 12.Peas 13.Lima Beans and White Beans Common Problems Among the Elderly 17.Difficulty in chewing due to loss of teeth and not getting used to dentures Solutions : s.Chop meat or flake fish t.Slice or chop vegetables into small bite-sized pieces for easy

1. Lack of Appetite solutions : c. Do light exercises like walking and gardening to improve appetite and keep the body fit. d. Eat in pleasant surroundings to make your meal enjoyable e. Make the food attractive by varying color shape, and size. 7. Unwanted weight and due to lack of physical activity and / or to overheating Solutions: i. Exercise regularly j. Eat only the lean part of the meat or fish. Avoid the fatty portion k. Taken in only moderate amounts of energy food. Steam, boil, or broil foods. Avoid rich sauces, salad dressings, and pastries or cake with heavy icings 13.Anxiety, confusion, insecurity or loneliness Solutions: o. Start the day right with a good breakfast p. Have a hobby

1. Poor digestion leading to constipation, gas pains, or diarrhea Solutions: c. Include fruits and vegetables in your daily meals to prevent constipation d. Have 4 light meals. Eat the heaviest meal at noon e. Drink 6 to 8 glasses of water and fruit juices everyday f. Help digestion and keep normal flow of body fluids 8. Poor absorption leading to anemia and other vitamin deficiencies Solutions • Iron-rich foods like liver, lean meat, eggyolk, saluyot, kulitis, himbabap, and seaweeds will protect you from anemia • Vitamin C-rich foods like papaya, mango and dalanghita will help absorb iron and speed up healing • Take in foods like milk, milk products, dilis, alamang and other leafy vegetables. These food contain calcium needed for strong bones. Exposure to sunlight helps maintain the bone structure

Foods Needed Daily by the Elderly The elderly needs to eat certain foods in adequate amounts for good health. The food groups and recommended servings listed on the next page show the kind and amounts of foods needed daily by the elderly. Usually, the elderly needs less energy foods due to less physical activities but more protein foods to repair worn out tissues. e.One cooked rice (160 grams) 5 cups pan de sal bout 15 grams each 4 slices of load bread about 17 grams each 1 1/3 cups cooked corn meal, 270 grams 1 cup cooked kamote or about 1 small kamote, 170 grams f.One Serving Meat Raw lean meat: 60 grams or about 4cm cube cooked lean meat: 30 grams or about 3 cm cube Raw dried beans: 60 grams or about 1/3 cup Cooked Dried Beans: 300 grams or about 1 ½ cups Medium-sized Fish: 2 pcs, about 16 cm long, 55 to 60 grams each as purchased

Family Nutritional Needs and Costs B. Nurse’s role in nutritional counseling 1. Establish rapport 2. Identify nutrition problems 3. Collect pertinent information concerning influences on food habits and patterns. a. Age, weight, height, sex, and activity of family members b. General appearance and health status c. Cultural and religious customs d. Social and psychological meaning of food e. financial status f. Physical and mental capacity g. Good storage, preparation and serving facilities h. Food marketing and preparation methods i. Knowledge of nutrition

1. Take nutritional history a. Kind and amounts of food in usual pattern on daily and weekly basis including weekend variances b. Distribution and time of meals and snacks c. Personal preferences d. Time and number of meals e. Place where meals are eaten 2. Evaluate nutritional intake based on standards of nutrition 4. Set goals and work out a practical food plan with the family, within their life situation and style, for meeting identified nutrition needs 6. Plan follow-up visit for continued support, education and encouragement 8. Use available resource persons and materials • Nutritionist, dietitian, physician, social worker • Community agencies, associaations, clinics, and

•

Economic

considerations in food planning

1. Plan menus and market lists in advance 3. Select most economic market 5. Take advantage of food discounts/bargains 7. Purchase food in season 9. Purchase food sizes and amounts in grades most suitable 11.Compare prices according to method of preserving, freshness, edible portion, etc. 13.Compare nutritive return in relation to cost

Ways to maintain Healthy lifestyle Exercise and Having adequate leisure time

A Good Rest and Sleep A Happy Family

Vitamins and Minerals, Balanced Diet and a Happy Relationship