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CHAPTER 11
Life Cycle Nutrition:
Healthful Eating Throughout
the Ages
Practical Applications for Nutrition, Food
Science and Culinary Professionals
CHAPTER MENU
Objectives 475 Diet, Dementia and Alzheimer’s
Introduction: Normal and Specialized Life Disease 530
Cycle Nutrition 476 Cooking for the Aging—Foods for
475
One or Two
Main Courses 477 531
Pregnancy and Lactation 477 Tasty Foods When Taste and Smell
Decline
Infancy 486 532
Childhood 496 Serve it Forth 533
Adolescence 506 What’s Cooking? 534
The Middle Years 521 Over Easy 536
Aging 522 Check Please 537
Bite on This Hungry for More? 537
Preparing Homemade Infant Foods 494 Take Away 538
Feeding the Picky Eater 498 Kids in the Kitchen 538
ELSEVIER
Healthy Snacks for Children 504 The Benefits of Breakfast 540
OBJECTIVES
1. Identify the nutritional needs before, during and after pregnancy and lactation
2. Plan recipes, meals and menus for pregnant and lactating women
3. Discriminate among food and nutrition choices for infants and children
4. Apply knowledge of food allergies to infant and child nutrition
Culinary Nutrition. DOI: http://dx.doi.org/10.1016/B978-0-12-391882-6.00011-X
2013 Elsevier Inc. All rights reserved.
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Culinary Nutrition
5. Plan recipes, meals and menus for infants and children
6. Determine healthy food choices for toddlers and school-age children
7. Assess teenage food choices compared to nutrient needs
8. Develop foods, recipes and menus for normal teenage diets
9. Create foods, recipes and menus for specialized teenage diets
10. Recognize physiological changes of aging and corresponding nutrient needs; plan
recipes, meal and menus for changing tastes due to aging; and evaluate foods and
beverages designed for each stage of the life cycle
Morsel “Food is a central INTRODUCTION: NORMAL AND SPECIALIZED
part of our lives. It provides the body LIFE CYCLE NUTRITION
with fuel and raw materials for mainte- Life is a succession of birth, life and death. Making the
nance, growth and repair. It draws together most of one’s life through proactive life choices—consuming
family and friends, anchors celebrations and nutritious foods and beverages, exercising, refraining from
rites of passage, and sometimes soothes the smoking, consuming alcohol in moderation, if at all, and
soul.” —Ethan Becker (Author of practicing overall body maintenance—should be lifetime
The Joy of Cooking, 1997 version) goals. By making wise nutrition and diet choices throughout
the life cycle, the quality and quantity of one’s life may
improve.
476 This chapter begins with life in utero and focuses on maternal nutrition. It continues with infant nutrition
and the choices between breastfeeding and commercial infant formulas. As infants develop into toddlers and
throughout childhood, their food and nutrition needs change—from higher to meet toddlers’ active lifestyles
to lower as children settle into school.
While early childhood seems busy, children generally do not accelerate in growth until their middle years.
Then prepuberty brings a host of increased food and nutrition needs, including calories for energy and
healthy fats for hormone formation.
Teenage years bring tremendous growth and development, with parallel needs for wide-ranging nutrients.
Teenage athletes require increased energy and nutrients, including the B vitamins, vitamin D, calcium,
iron and zinc, to name a few. Eating disorders may become noticeable at this age and require the health
ELSEVIER
professional intervention. Obesity is as much an eating disorder as anorexia or bulimia. Obesity interventions
should start much earlier, since childhood obesity is on the rise.
The years between 20 and 50 years of age are a period of maintenance and health promotion, rather than
growth. During these years, it is best to consume the right amount of calories and other nutrients for weight
and health maintenance.
When the older years begin after age 50, many nutrient requirements actually decrease because the body’s
systems are slowing down. By keeping active and eating right, one may be able to offset some of the profound
changes that occur throughout aging. Changes in taste and smell might offer some of the most challenging
tasks for choosing and consuming healthy foods and beverages.
Many opportunities exist for nutrition, food science and culinary professionals in the realm of life cycle
nutrition. Whether it is at the start of life or toward its end, the challenges of infant, children, adolescent
and senior nutrition are ever-present. Developing nutritious, age-appropriate foods and beverages, and
positioning them within healthy lifestyle stages are some of the most important roles that food and nutrition
professionals may have.
CHAPTER 11
Life Cycle Nutrition: Healthful Eating Throughout the Ages
MAIN COURSES
Pregnancy and Lactation
A HEALTHY START: NOURISHMENT BEFORE, DURING AND AFTER PREGNANCY
Creating a new life begins from the ground up, much like the construction of a new building. A building
complex demands high-quality building materials, an intricate working structure, and a finely tuned
communication network, among other systems. A building of this nature can take many months in execution.
A human body requires high-quality nutrients (building materials); a complex maze of cells, organs and
systems (intricate working structure); and countless signals from chemical messengers about the blood levels
of nutrients, hormonal balance, sensory signals and more (finely tuned communication network). That is
why the creation of a new human body requires nine months.
If a woman is at her nutritional best before she conceives, this may increase her chances of birthing a healthy
infant who will be able to grow and thrive. If there are any weak links along the way, the mother, infant or
both may suffer—much like the flaws in a complex building structure.
The childbearing years, which may include pregnancy and lactation, present a unique set of nutritional needs
for women. A woman must ready her body to ensure a healthy start for an infant. This means abstaining from
certain substances and ingesting others—sometimes well in advance of pregnancy. Nutrition and culinary
specialists who create food for women of childbearing years should learn the right nutritional and lifestyle
approaches for healthy pregnancies and translate this information into healthy recipes, meals and menus.
A pregnant woman’s heightened nutritional needs undergo additional changes during lactation, or milk
production. These additional nutritional needs also require skilled diet design and culinary interpretations by
trained nutrition and culinary specialists.
THE CHANGES AND CHALLENGES OF PREGNANCY
Pregnancy is the period of time from conception to birth when a woman carries a developing embryo or fetus 477
in her uterus. An embryo is a developing human being from the time of implantation to the end of the eighth
week after conception (when the major body structures have formed). A fetus is an unborn offspring from the
end of the eighth week after conception until birth.
The lifeline between a mother and a fetus is an organ that is called the placenta. During pregnancy, the
placenta delivers oxygen and nutrients to the fetus and removes wastes. It is attached to the fetus by the
umbilical cord, which is cut after birth, after which the placenta is expelled.
The fetus is surrounded by the uterus, also called the womb. When a woman is pregnant, the baby grows
inside of the uterus until birth. The amniotic sac is a bag of fluid within the womb where the fetus develops
ELSEVIER
and grows. It is filled with clear fluid in which the fetus floats and moves. The amniotic sac cushions the
fetus from injury, provides it with fluids that it can swallow, and helps to maintain a constant temperature.
Everything a pregnant woman takes into her body may affect the growth and development of the fetus, in
addition to these structures that support the fetus.
PRENATAL NUTRITIONAL NEEDS
The prenatal period is the period of time before birth. A woman’s nutritional needs are high during this time.
Because a woman may not know that she is pregnant, she may be poorly nourished. She may also consume
alcohol or caffeine in excess, which may affect the growing embryo or fetus.
A woman should be at nutritional readiness for pregnancy during her childbearing years. Her body weight
should be at a desirable level. She should consume a wide range of foods and beverages that contain a variety
of nutrients, including an assortment of fruits and vegetables—particularly those that are rich in iron and
folate to help prevent anemia and neural tube defects—and calcium for growth, development and repair. She
should be at her peak of physical fitness to handle the tremendous physical stresses of pregnancy. Yet, even
nutritional and physical readiness does not ensure a healthy, risk-free pregnancy or birth.
Culinary Nutrition
The risk factors of pregnancy include alcohol intake, chronic disease such as diabetes or hypertension, drug
intake, eating disorders, excessive dieting, folic acid deficiency, iron deficiency, lack of health care, multiple
pregnancies, nicotine use, overweight, poor education, poor pregnancy outcomes, poverty, previous abortions,
teenage pregnancy and/or underweight.
THE NUTRITIONAL NEEDS OF PREGNANCY
A normal human pregnancy consists of three trimesters of three months each, for a total of nine months.
The nutritional needs of the mother and the fetus increase during each trimester.
Calories
A pregnant woman needs about 150 to 200 additional calories daily during the first trimester. During the
second trimester, she requires about 350 calories daily, and during the third trimester, about 450 additional
calories. The third trimester is when the fetus is doing most of its growth. Based on the Daily Value (DV) of
2,000 calories daily for most healthy adults over the age of 18 years, this amounts to about 2,350 calories
daily during the second trimester and 2,450 calories daily during the third trimester.
Protein
The Dietary Reference Intake (DRI) for a nonpregnant adult woman is 46 grams of protein daily, and the DRI
for a pregnant woman is 71 grams of protein daily. This is an increase of about 20 grams of protein daily. This
protein requirement is based on body weight (see Chapter 5). A woman’s body weight increases to support
the growing fetus and maternal nutrient stores [1].
Carbohydrates
Also based on the DRIs, a pregnant woman requires about 175 grams of carbohydrates daily. This amounts
to about 700 calories’ worth of carbohydrates daily (175 grams of carbohydrates × 4 carbohydrate calories
478 per gram = 700 daily calories). At least half of these carbohydrates should be from whole grains for fiber and
nutrients. The Adequate Intake (AI) for fiber for pregnant women is 28 grams daily.
Lipids
While a recommended level of lipids during pregnancy has not been determined, an AI level of the essential
fatty acids linolenic and alpha-linolenic acids have been established. These are 13 grams/day of linolenic
acid, and 1.3 grams/day of alpha-linolenic acid. Both are important to consume in balance for fetal brain
development. Linolenic acid is found in plant oils such as corn oil, safflower oil and sunflower oil. Alpha-
linolenic acid is found in seed oils, such as flaxseed, soybean and walnut oils.
Vitamins ELSEVIER
By consuming a wide range of foods and beverages and the right amount of calories, most vitamin
requirements during pregnancy should be met. The need for folate is exceptional.
Folate (folic acid, folacin) is a B vitamin that is naturally found in broccoli, citrus fruits and juices, green leafy
vegetables, and legumes. Folic acid is the synthetic form of this B vitamin that is used in supplements and in
fortified foods. Folate is only partially absorbed by the body, while folic acid is almost completely absorbed.
Folacin is another term for this B vitamin. Folate, folic acid and folacin are often used interchangeably.
A pregnant woman’s need for folate increases by 50 percent over her prepregnancy folate needs due to an
increase in her blood volume and fetal growth. Folate also helps prevent neural tube defects—birth defects that
affect the fetal brain and spinal cord that can cause disorders in the central nervous system of the developing
fetus. The two main types of central nervous system disorders include spina bifida, and anencephaly.
Spina bifida is a central nervous system disorder that is characterized by the incomplete closure of the bony
casing around the spinal cord. Anencephaly is distinguished by a partial brain or no brain.
The neural tube closes before the sixth week of pregnancy, so sufficient folate is recommended during the first
trimester, as well as three months prior to conception. Since so many pregnancies are unplanned, this is why
women of childbearing years should have a regular intake of folate.
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