Principle of dietetic management for different Age and Levels

What body needs?

Energy, Protein, Carbohydrate, Fat (Restricted Fat), Vitamin, Minerals (Except Sodium), Fibre, and Fluid.

Energy: About 20kcal per kg ideal body weight is prescribed for a sedentary worker and 25 kcal per kg body weight for a moderately active worker.

Proteins: About 0.8 to 1g of protein per kg body weight is prescribed for tissue repair and specific dynamic action.

Carbohydrates: A diet with a good amount of fiber helps to achieve a feeling of fullness with a lesser amount of calories. The carbohydrates which are present in sugar, jams, squashes, syrups, potatoes, and fruit juices are to be avoided since they are a quick source of carbohydrates and also, don’t contribute to the diet. Eating leafy vegetables and vegetables, nuts, seeds, lentils, and whole grains is recommended.

Fat: is a source of fuel and the major storage form of energy in the body. We need fats in our diet for good health. Fats in food come in several forms, including Saturated (Unhealthy fats which is found in Oil, Ghee, Cakes, processed meat, etc.), Monounsaturated (Monounsaturated fats are healthy fats found in olive oil, avocados, and certain nuts, it has several health benefits like weight loss, reduces the risk of heart disease and decreases inflammation), and Polyunsaturated (It is one of the healthy found in plant and animal foods, such as salmon, vegetable oils, and some nuts and seeds).

Vitamins: Including vitamin-rich food like green leafy vegetables, fresh fruits, and whole-grain cereals and sprouted legumes in the diet will provide the vitamins and minerals essential for our body. With prolonged restrictions of fats, there is likely to be a restriction of fat-soluble vitamins A and D which may be supplemented.

Minerals: Restriction of sodium as common salt is helpful in a weight-reducing diet as excess sodium predisposes to the retention of fluid. Research suggests that a calcium-rich diet especially one that includes dairy sources (with a limit in total calories) not only helps young women keep weight in check but may reduce overall levels of body fat. Calcium may depress certain hormones which consequently improve the body’s ability to break down fat in cells and slow fat production.

Fluid: Fluid can be taken liberally as extra fluids are excreted by healthy kidneys. Also, a glass of water before meals helps to cut down food intake.

Fiber: High fiber and low calories food like green leafy vegetables, fruits, vegetable salads, whole grain cereals, and pulses can be included in the diet. The inclusion of high fiber foods in the diet for obese has many advantages. They are:

a). Low in calories density.

b). Food like greens provides many vitamins and minerals which are difficult to meet through restricted foods.

c). Give satiety.

d). Helps in regulating bowel movements.

e). Reduce blood cholesterol.

f). Promote chewing and decreases the rate of ingestion. A higher intake of fiber automatically cut down fat and calories. British Nutrition Foundation (1990) has established the effectiveness of dietary fiber intake in achieving a significant reduction in body weight without any side effects.

Nutrients for different age and levels

The human body requires a continuous supply of nutrients. These nutrients are unutilized by the body to maintain health. The nutrients ought to be supplied daily in the right proportion for optimum utilization and proper body maintenance. This can be achieved by taking a balanced diet every day.

Diets for different age groups, stress periods, and work can be classified into the group. The life cycle of each person goes through five basic stages. These are as follow:

1. Infancy: Is the rapid first year of growth.
2. Preschool Children
3. Pregnancy: In which human life begins and develops to birth.
4. Adolescence: This is the teenage of rapid growth and sexual maturing.
5. Old Age

Infancy

The period, which spans from birth to one year of life, is a rapid growth period.

 Nutritional requirements of infants

 As the growth during infancy is very rapid, dietary adaptation is required. During early infancy, much of the nutritional requirements are met by breastfeeding and the RDA (Recommended Dietary Allowance ) of the infant is based on the nutritional composition of breast milk

Weaning:  Weaning begins from the moment when supplementary food is started and continues till the child is taken off the breast completely. There is an increase in activities of the enzymes at the time of weaning.

Infants in our country like India thrive on breast milk alone for up to 6 months of life and their growth rate during this period is satisfactory. Breast milk alone is not able to provide sufficient amounts of all the nutrients needed to maintain growth after the first six months. Increasing needs of calories and protein of growing children cannot be met by the diminishing output of mother’s milk. Milk is also a poor source of vitamin C and supplementation with fruit juice is essential. Iron stores in the liver of the infant would last only up to 4-6 months. Hence iron-rich foods should be given at least six months onwards.

Preschool Children

This period is a slow growth period. It is not as demanding as infancy and adolescence. A child needs to have a weight proportionate to the height. Growth during this period is in spurts. While at times the child is engaged in continuous and active play, he is passive at other times. The mental capacities of children are also being developed. His growth is fostered by a new environment in school. During these years specific nutrients such as protein, calcium, and iron need emphasis since bone growth and muscle development continue. Protein requirement also remains high. Vitamins especially C and A, are required for the growth and development of tissues. To meet the nutritional requirements milk, fruit, egg, meat, fish, legumes, and green leafy vegetables should be included in the diet.

Nutrition Requirements

A balanced diet is very important for a child this age, for good nutrition, helps ensure the sound growth and development of children, and it also helps build their ammine system.

1. A child this age needs high quantities of protein in his or her diet. It is said that 2 to 3 grams of proteins are needed for each kilogram of the child’s weight. Proteins are found in meat, fish, chicken, liver, milk, eggs, and legumes such as lintels, chickpeas, and beans.
2. A child this age needs sources of nutrition that are high in energy, these source of nutrition are often found in the regular food items consumed by the rest of the family.
3. At this age, children also need high quantities of vitamins A, D, and C. These vitamins are found in fruits, vegetables, and milk.
4. A child at this age also needs minerals and especially calcium. This requirement is fulfilled if he or she consumes 2 to 3 glasses of milk a day or it’s equivalent in dairy products.

Adolescence

At the time of puberty, the second rapid growth spurt occurs. Because of the hormonal changes involved, multiple body changes occur including the growth of long bones such as the femur, development of sex characteristics, and fat and muscle development growth period is earlier for girls, beginning at around 8 years and ending by 13-15 years of age. For boys this period being slightly later-around 9 years of age and ends by 18 years.

Nutrition Requirements

Puberty is a stage in one’s life categorized by rapid growth and the person’s possession of excess energy. It is therefore advised that the teenager eats three meals a day all of which are nutritiously balanced. Teenagers need a lot of calories, protein, vitamins, and especially vitamins A and B, calcium, and especially vitamins A and B, calcium, and iron alongside all other food elements.

Pregnancy

The nutritional requirement during pregnancy is increased due to the rapid growth of the fetus and other developments. To meet the additional nutritional requirements, foods that supply all the nutrients in a greater amount to sustain and support the pregnancy must be consumed by the pregnant woman.

Protein: The requirement of protein in pregnancy increases by about 30% over the normal requirement, e.g. if the normal requirement of an adult woman is 45g/day, during pregnancy she would be required to take an additional 14g/day during the second and third trimester of pregnancy. Good quality protein as that obtained from milk, meat, fish, eggs, and cheese should be eaten. The additional requirement of protein for vegetarians may be obtained from a combination of whole grain, legumes, and nuts.

Calories: Calories should be sufficient to meet energy and nutrient demands and to spare protein for tissue building. An increase of about 300 calories in the second half of pregnancy is recommended.

Minerals: Calcium and iron are the two minerals the need for which is urgent during pregnancy. Increase calcium is required for the growth and development of bones as well as teeth buds in the growing fetus. It is also an important constituent of the blood-clotting mechanism. More calcium is needed in the third trimester of the pregnancy as rapid mineralization of the skeletal tissues takes place during the period. Dairy products are the primary sources of calcium. Additional calcium may be obtained from legumes and leafy vegetables. During pregnancy, daily iron intake should be 32mg. This amount not only replenishes her menstrual losses but also restores her tissue reserves after each pregnancy.

Vitamins: All the vitamins, especially vitamin A, B complex, C and D, and folic acid are required in increased doses. Vitamin A requirement increases by about 25% over the usual adult intake. Liver, egg yolk, butter, dark green and yellow leafy vegetables, and fruits are the rich source of vitamin A. In the B complex group, folic acid supplementation may be required to protect against megaloblastic anemia. Thiamin, riboflavin, and niacin are also required in large quantities since they are the co-enzymes in several metabolic activities, especially energy production and in the functioning of muscle and nerve tissues. Vitamins C, besides its normal function, is involved in developing the connective tissue and vascular system as well as in the absorption of iron. It may be obtained from fresh fruits.

The need for calcium and phosphorus is increased; hence the requirement of vitamin D cannot be overlooked as it is involved in their absorption and utilization. As plenty of sunshine is available in our country, the requirement of vitamin D can be easily met through its biosynthesis in the skin. Food sources include butter, liver, egg yolk, and fish liver oil.

Old age : 

The process of aging brings about marked physiological changes in the body and these changes influence appreciable nutritional requirements.

Physiological change in aging:

There is a decrease in the metabolism tissues. Hence, there is a reduction in the basal metabolic rate. Demineralization of bones ( osteoporosis) is observed commonly. Therefore calcium requirement increases. Loss of teeth due to decay of teeth and gum is common in an aged person. Decreased secretion of saliva and decreased ability to digest starch has been observed in old people. Gastric acidity decreases in a large percentage/ peptic, tryptic, amylolytic, and lipolytic enzyme activities of the digestive secretions are decreased. Changes in intestinal mucosa result in decreased absorption of nutrients in old people. Changes in the heart muscle and coronary arteries lead to the less efficient functioning of the heart. The functioning of kidneys is reduced.

Nutrition requirement

At this age, adults could experience a severe loss of appetite. This is why they need

1. A smaller calorie intake.
2. To eat meals that are high fibers. Fibers are often found in vegetables, grains, wheat, and bread.
3. To drink 8 glasses of fluids a day.
4. To eat foods that are rich in calcium, iron, and vitamin B12 such as meat liver.
5. To eat vegetables and fruits rich in vitamin C such as lemon, orange, and tomatoes.
6. To eat foods that are rich in protein such as meat, and legumes. Excess consumption of protein however may hurt kidney functions.

Considering all the above-mentioned points, bakery products should be prepared to fulfill the requirements of the respective person. Therefore it is important to prepare bakery products which will fulfill the nutritional requirements as well as will be suitable for a different type of diseases. Hence it has become necessary to know the nutritional requirements of different age groups and during different diseases.

Summary:

The human body requires a continuous supply of nutrients. These nutrients are utilized by the body to maintain health. The nutrients ought to be supplied daily in the right proportion for optimum utilization and proper body maintenance. This can be achieved by taking a balanced diet every day. The nutritional needs for a common person in his life span- from conception through infancy, childhood, adolescence, adulthood, and old age- are modified according to the demands of growth and development at different stages of life. Different types of diseases are observed among people.

The normal diet may be modified:

1). To provide a change inconsistency as in fluid and soft diet.

2). To increase or decrease the energy value.

3). To include greater or lesser amounts of one or more nutrients.

4). To increase or decrease bulk high and low fiber diets.

5). To provide bland in flavor.

For Diabetic diets, foods must meet, but not exceed, the prescribed number of calories and amounts of protein, carbohydrate, and fats. The amount of food prescribe will help to make sure that weight stays at normal levels and that blood sugar levels are controlled.

Principle of diet for heart disease: Low calories, low fats particularly low saturated fat, low cholesterol, high in PUFA low carbohydrates, and normal protein, minerals, and vitamins are suggested for the patients of heart disease. A high fiber diet is also recommended. The rationale behind the dietary management in PMC is to provide levels of protein and energy that will not only meet immediate demands but will also promote ‘catch up’ growth. Food especially rich in protein or protein concentrates is unnecessary.

Anemia is found to be due to different causes such as iron deficiency, folic acid deficiency, vitaminB12 deficiency, and deficiency of vitamin C. However the most common type is iron deficiency, which occurs more commonly among women than among men. To avoid calcium deficiency, calcium-rich food should be included in the diet. The richest source of calcium among animals’ foods milk and among the vegetable sources it is green leafy vegetables.

In obesity low calories, normal protein, vitamin and mineral ( except sodium restricted), carbohydrates, restricted fat, and liberal fluid, high fiber diet is given in such cases.

Therefore it is important to prepare bakery products which will fulfill the nutritional requirements as well as will be suitable for a different type of diseases. Hence it has become necessary to know the nutritional requirements of different age groups and during different diseases.

Supported by Prof. Aparna Gawai