N9 Nutrition Across The Lifespan and Management of Alterations PDF

University Of The Philippines Manila
COLLEGE OF NURSING
The Health Sciences Center
WHO Collaborating Center for Leadership in Nursing
Development CHED Center of Excellence
Nutrition Across the Lifespan
Mary Joan Therese C. Valera, RN, MPH
University of the Philippines Manila

COLLEGE OF NURSING
A WHO Collaborating Center for Leadership in Nursing
Continuing Education and Community Services Program
After the lecture, students will be able to:
1) Discuss 3 main strategies to address nutrition
problems and practices for healthy lifestyle
Achieving Desirable Body Weight
- Healthy nutrition practices
- Choosing foods correctly
2) Perform correct nutritional assessment by:
• Computing: BMI, WHR, DBW
• Doing diet analysis based on the 24-hr food recall
• Identifying nutrient deficits and/or excess
3) Determine the reasonable TEA by meal planning
COLLEGE OF NURSING
NUTRITION AND HEALTH
• Primary nutritional disease–occurs when

nutrition is the cause of the disease.
• Secondary nutritional disease–occurs as a

complication of another disease or condition.

COLLEGE OF NURSING
Life Cycle Changes
• Nutritional needs change as a person grows and

develops.
• Changes generally based on growth needs,

energy needs, nutrient utilization.
• Nutritional assessment should be conducted to

ascertain the nutritional needs of the individual.

COLLEGE OF NURSING
Pregnancy and Lactation
• Nutrient needs during period of intensive growth, such as

pregnancy and infancy are greater than any other time in
life.
• Evidence has proven that optimal nutrition during

pregnancy reduce risk of complications during pregnancy
and delivery.
• Health diets and avoid alcohol and caffeine play an

important role prior to and after pregnancy.
COLLEGE OF NURSING
Concerns in Pregnancy
• Weight gain:
• Discomforts and complications:
• Practices to avoid:
• Lactation:

COLLEGE OF NURSING
Infancy
Yearlong of dependency, growth and development

COLLEGE OF NURSING
• The time from birth to 1 year of age is one of the
rapid growth and development
• The average infant birth weight triples by the first

birthday.
• Nutrition is important for proper growth and

development.

COLLEGE OF NURSING
• Breast Milk:
• Regular cow’s milk:
• Solid foods:
Single-ingredient foods
Food high in iron
Commercially prepared baby foods have allergens
Juice for infants younger than 6 months
Children having juice bottles/cups

COLLEGE OF NURSING
Childhood
This is a critical time to instill good dietary habits.

COLLEGE OF NURSING
– At 1 year of age, appetite generally tapers off, growth slows for now.
– Children still need adequate nutrition.
– The younger the child, the smaller the portions needed.
– If children are offered nutritious foods in pleasant surroundings and in non-

threatening ways.
– The parents should decide which foods to serve at what time; the child should
be able to decide what and how much to eat.
– This is also the time children test their independence.

COLLEGE OF NURSING
Encouraging Good Dietary Habits
• Meals at the table at regular times.
• Relaxed and enjoyable.
• Variety of foods.
• Do not force children to eat or clear plates.
• Small servings.
• Introduce new foods one at a time.
• Nutritious snacks.
• Limit sweets.
• Encourage physical activity.
• Adults are to set good eatingUniversity

habits.of COLLEGE
the Philippines Manila
OF NURSING
Adolescence
These years are of both physical and emotional growth.

COLLEGE OF NURSING
Diets are often filled with kilocalorie-rich and nutrient-poor
snack foods.
Common dietary inadequacies include iron and calcium.
Many teenagers experiment with alcohol and drugs, which

have detrimental effects on nutrition.
Obesity is a common problem; weight reduction diets should

be attempted only under the advice of a physician and
with the guidance of a dietitian.

COLLEGE OF NURSING
Adult
With energy, activity decreasing, weight gain increasing:

Nutritional needs start to decrease.
COLLEGE OF NURSING
Older Adult Considerations
• Aging may affect the eating process.
• Aroma and taste of food may change.
• Changes in the digestion process.
• Kilocalorie needs decrease .
• Numerous medications.
• Social and mental changes.
• Chronic medical conditions.University of the Philippines Manila

COLLEGE OF NURSING
Nutritional Concerns of Adults
in Long Term Care Facilities
Malnutrition is a common problem among nursing home residents

and profoundly influences physical health and quality of life.
Residents should be offered familiar foods that taste good.
Fluids should be offered to residents at all meals and between

meals.
Dehydration is very common and easily corrected in long term care

facilities.

COLLEGE OF NURSING
Nurses must understand the value of mealtime as a pleasant, social experience.
Cultural and personal preferences should be considered.
Many residents need assistance or encouragement.
Lack of adequate staffing play a large role in patient nutrition.
Many patients are on restricted diets.
Pressure sore due to lack of mobility, and nutrition.
Nutrient-Drug interactions.

COLLEGE OF NURSING
Caffeine
• Caffeine:
Drug
Central nervous system stimulant and diuretic.
Nervousness
Irritability
Anxiety
Insomnia
Heart arrhythmias
Palpitations
See Caffeine Content of Selected Beverages and Foods.

COLLEGE OF NURSING
The Vegetarian Diet
• Lacto-ovo vegetarians–use dairy products and

eggs but no meat, poultry, or fish.
• Lacto vegetarians–use dairy products but no

meat, poultry, or eggs.
• Vegans–avoid all animal foods.

COLLEGE OF NURSING
ENERGY BALANCE
 The relationship of energy derived from food and the
energy used by the body
 Energy Intake : Energy Output (BMR, Thermic

effect of food, Physical activity)
• Basal Metabolic Rate= resting energy expenditure
• Thermic Effect of Food= estimated amount of energy used for digesting,
metabolizing, absorbing, and storing nutrients
• Physical Activity= energy requirement=% energy x BMR

COLLEGE OF NURSING
Physical Activity
Energy Expenditure
20% SEDENTARY
30% LIGHT ACTIVITY
40% MODERATE ACTIVITY
50% HIGH ACTIVITY

COLLEGE OF NURSING
Reasonable Energy Allowance
Kcal/Kg DBW/day ACTIVITY
27.5 BED REST BUT MOBILE

(HOSPITAL PATIENTS)
30.0 SEDENTARY
(mostly sitting)
35.0 LIGHT ACTIVITY
(tailor, jeepney driver, MD, RN)
40.0 MODERATE ACTIVITY
(carpenter, housepainter, heavy housework)
45 VERY ACTIVE
(Swimming, lumberman)

COLLEGE OF NURSING
Assessing Nutritional Status
DIRECT METHODS – physical signs or body components
• Anthropometric measurements – wt, ht, BMI, WHR
• Biochemical data - EXPENSIVE
• Clinical signs of nutritional status – IDENTIFY DISEASE
INDIRECT METHOD – on dietary history of intake

• Diet assessment (ADEQUACY OF INTAKE)
1. Retrospective – 24 hr Food Recall
2. Prospective - Food Frequency Questionnaire
COLLEGE OF NURSING
Assessing Nutritional Status
• Vegetables = no of servings per day and usual
types
• Fruits = no of servings per day
• Fat = no of servings meat and poultry, which
part, how often fried foods are eaten, how
often eating out
• Sodium/Salt = How often preserved, canned,
instant foods are eaten, how much salt is used

COLLEGE OF NURSING
Anthropometric measurements
WAIST CIRCUMFERENCE
• Direct measurements
Along the umbilicus; the narrowest
circumference
HIP CIRCUMFERENCE
Mid upper arm circumference
(MUAC) – left upper arm, Along the pelvic bone line;
midway between tip of shoulder the widest circumference
and tip of elbow
A measure of fat, skeleton, and muscle. Rapid
nutritional status screening even when age of child
is unknown, increasingly used in adults

COLLEGE OF NURSING
Anthropometric measurements
Skinfold measurements
(Triceps Skinfold Thickness)
• Direct measurements Indicates the amount of body fat, the
main form of stored energy; half of
fat reserves is subcutaneous
Mid upper arm circumference
(MUAC) – left upper arm,
midway between tip of shoulder
and tip of elbow
A measure of fat, skeleton, and muscle. Rapid
nutritional status screening even when age of child
is unknown, increasingly used in adults

COLLEGE OF NURSING
• Calculated measurements
Waist-Hip Ratio
Indicates central abdominal obesity,

or Upper Body Obesity (UBO)
Body Mass Index
Indicates whether the person’s weight is

appropriate for height and provides a useful
estimate of obesity

COLLEGE OF NURSING
• Identify current height in cm
• Identify current weight in kg
BMI = weight in kilograms

(height in meters)2
- measurement of fat adiposity, correlated

with risk of mortality for adults

COLLEGE OF NURSING
ANTHROPOMETRIC ASSESSMENT METHOD
Assessment Criteria (Asia Pacific Obesity Guidelines 2000):

a. BMI < 18.5 - UNDERWT
18.6 – 22.9 - NORMAL
> or = 23-24.9 - OVERWT/at RISK
25 – 29.9 - OBESE 1
30 & above - OBESE 2
Severe thinness <16.00 <16.00
Moderate thinness 16.00 - 16.99 16.00 - 16.99
Mild thinness 17.00 - 18.49 17.00 - 18.49

COLLEGE OF NURSING
ANTHROPOMETRIC ASSESSMENT METHOD
Assessment Criteria:
b. WC – clinical thresholds
90 cms MALES (=40 INCHES)

80 cms FEMALES (=35 INCHES)

COLLEGE OF NURSING
ANTHROPOMETRIC ASSESSMENT
METHOD
c. WHR
1. ANDROID OBESITY = central abdominal obesity or
upper body obesity; most common in males than
in females; fat distribution in abdomen, chest,
shoulders, and nape, “apple-shaped”
(M > 102 cms, F > 88 cms)
1. GYNOID OBESITY = fat distribution around hips and
bottom, more common in females than in males,
“pear-shaped”
COLLEGE OF NURSING
ANTHROPOMETRIC ASSESSMENT
METHOD
• Measure waist circumference in cm
• Measure hip circumference in cm
c. WHR
Upper Body Obesity >/= 1.0 MALES
>/= 0.85 FEMALES
- Adiposity highly CVD, DM, other diseases

COLLEGE OF NURSING
Biochemical Data
• Hemoglobin and Hematocrit Indices

– Low hemoglobin level maybe evidence of iron deficiency
anemia
– Elevated hematocrit may indicate dehydration

COLLEGE OF NURSING
Biochemical Data
• Serum albumin
– Low serum albumin level is a useful indicator of prolonged
protein depletion
– Indicator to determine protein status

COLLEGE OF NURSING
Biochemical Data
• Transferrin
– Blood protein that binds with iron and transports it
throughout the body
– Sensitive indicator of protein malnutrition than albumin
level
– Levels are high when iron stores are low

COLLEGE OF NURSING
Biochemical Data
• Nitrogen balance
– Decreased BUN levels may be caused by a low-protein diet
– Elevated BUN may occur with starvation or excessive
protein intake
– Elevated BUN may also be caused by severe dehydration or
general ill health and malnutrition

COLLEGE OF NURSING
Biochemical Data
• Creatinine excretion
– Product of the creatine produced when energy is released
during skeletal metabolism.
– Rate of creatinine formation is directly proportional to the
total muscle mass
– Creatinine excretion reflects a person’s total muscle
massm

COLLEGE OF NURSING
CLINICAL SIGNS OF NUTRITIONAL STATUS
Body part Normal Abnormal

Hair Shiny, neither dry Oily, dry dull,
or oily patchy in growth
Skin Smooth, slightly Dry, oily, broken
moist, good turgor out in rash, scaly,
rough, bruised
Eyes Bright, clear Dry, reddened

COLLEGE OF NURSING
Tongue Pink, moist Reddened in
patches, swollen
Mucous Reddish pink, moist Reddened, dry,
membranes cracked
Cardio Heart rate and BP Rapid heart rate,
vascular within normal elevated BP,
ranges, heart irregular heart
rhythm regular rhythm
Muscles Firm, well- Poor in tone, soft,
developed Universityunderdeveloped
of the Philippines Manila
COLLEGE OF NURSING
Gastro Appetite good, Manifesting anorexia,
intestinal elimination regular and indigestion, diarrhea,
normal constipation
Neurologic Reflexes normal, alert, Reflexes decreased,
good attention span, irritable, inattentive,
emotionally stable confused, emotionally
labile
Vitality Vigorous, energetic, Lacking energy, tired,
able to sleep well apathetic, sleeping
poorly
Weight Normal for age, build Overweight,
and height underweight
COLLEGE OF NURSING
Nutritional Guidelines for Filipinos
1. Eat a variety of foods everyday
2. Breastfeed infants exclusively from birth to 4-6
months, and then, give appropriate foods while
continuing breastfeeding.
3. Maintain children's normal growth through proper
diet and monitor their growth regularly.
4. Consume fish lean meat, poultry or poultry or
dried beans.
5. Eat more vegetables, fruits, and root crops.
COLLEGE OF NURSING
Nutritional Guidelines for Filipinos
6. Eat foods cooked in edible/cooking oil daily.
7. Consume milk, milk products or other calcium-rich
foods such as small fish and dark green leafy
vegetables everyday.
8. Use iodized salt, but avoid excessive intake of salty
foods.
9. Eat clean and safe food.
10. For a healthy lifestyle and good nutrition, exercise
regularly, do not smoke, and avoid drinking
alcoholic beverages. University of the Philippines Manila
COLLEGE OF NURSING
Nursing Diagnosis
• Imbalanced nutrition:
– Less than body requirements
– Obesity, Overweight
• Disturbed body image
• Ineffective breastfeeding
• Impaired dentition

COLLEGE OF NURSING
• Deficient knowledge (specify)
• Impaired oral mucous membrane
• Pain
• Feeding self-care deficit
• Chronic low self-esteem
• Risk for impaired skin integrity

COLLEGE OF NURSING
Planning / Outcomes
• A plan should be formulated by the nurse and client

to achieve mutually agreed-upon goals and
outcomes
• The plan is individualized to meet the client’s

specific needs.

COLLEGE OF NURSING
NUTRITIONAL STATUS ASSESSMENT
• INDIRECT METHOD
1. 24 Food Recall
2. List foods consumed in a day using household
measurements
3. Use hand out on ESTIMATING NUTRIENT CONTENT OF
FOOD
4. Derive all the MACRO AND MICRONUTRIENTS and
compare with RECOMMENDED ENERGY & NUTRIENT
INTAKE or From the list of foods consumed in a day,
compare with Daily Nutrition Guide Pyramid
COLLEGE OF NURSING
MEAL PLANNING
• SERVING = the amount of food that can be normally
consumed by a person in a meal, or at 1 time
• EXCHANGE LISTS = basic tool applied in diet therapy

where 1 food group can be “exchanged” to another
to fit the required diet of patients
 7 Food Groups: Vegetables, Fruits, Milk, Rice,
Meat and Fish, Fat, Sugar

COLLEGE OF NURSING
MEAL PLANNING
• DBW – Desirable Body Weight
- the “ideal body weight” based on standards
- reference weight
• Total Energy Allowance
- For each level, there has to be enough energy that an
individual can use

COLLEGE OF NURSING
MEAL PLANNING
• Determine the reasonable total energy allowance
(TEA) based on Activity
• Formula: TEA = DBW x PA Level
• Bed rest but mobile = 27.5
• Sedentary = 30
• Light = 35
• Moderate = 40
• Active = 45
COLLEGE OF NURSING
MEAL PLANNING
PHYSICAL ACTIVITY LEVEL Kcal/kg DBW per day
BED REST BUT MOBILE (hospital patients) 27.5
SEDENTARY (mostly sitting) 30.0
LIGHT (tailor, jeepney/bus driver, MD, Nurse) 35.0
MODERATE (home improvement workers) 40.0
VERY ACTIVE (athletes, lumberman) 45.0

COLLEGE OF NURSING
MEAL PLANNING
1. Determine DBW
Broca’s Method
DBW = Ht (cm) – 100
For Filipinos: DBW-10%
e.g. 154.94 cm – 100 cm = 54.94 kg
54.94 kg – 5.49 (10% of 54.94) = 49.95 kg

COLLEGE OF NURSING
MEAL PLANNING
2. Determine the reasonable energy allowance of the
person: TEA = DBW x PAL
3. Determine distribution: TEA is distributed among

CHO, CHON, and Fats
• CHO = 55-70%, CHON = 10-15% Fats = 20-30%

COLLEGE OF NURSING
MEAL PLANNING
Normally allow:
CHO=65%, CHON=15%, Fats=20%
For Burn/Dialysis Patients:

CHO=65%, CHON=20%, Fats=10%

COLLEGE OF NURSING
MEAL PLANNING
4. Calculate the number of foods (CHO, PRO, Fat) by
dividing the calories for each macronutrient by the
physiological fuel values:
Divide kilocalories to factors of CHO, CHON, Fat to

convert to grams: (CHO = 4; CHON = 4; Fat = 9)
 Round off calories to the nearest 50
 Round off CHO, PRO, Fat to the nearest 5 grams
 Consider client preferences, habits, behavior
COLLEGE OF NURSING
MEAL PLANNING
• Determine the CHO, Protein & Fat Distribution of TEA

***
• % of TEA: CHO = 55-70%
• PRO = 10-15%
• FAT = 20-30%
Normally, CHO=65%, PRO=15%, FAT=20%
• round off to the nearest 50

COLLEGE OF NURSING
MEAL PLANNING
• Determine the CHO, Protein & Fat :

• TEA = 1500 kcal
Female, normal, sedentary client
weighing 50 kg
CHO=65%, PRO=15%, FAT=20%

COLLEGE OF NURSING
MEAL PLANNING
• CHO = 1500 x 0.65 = 975 kcal

• PRO = 1500 x 0.15 = 225 kcal
• FAT = 1500 x 0.20 = 300 kcal
-in terms of energy contribution

Round off to the nearest 50 the kilocalories

COLLEGE OF NURSING
MEAL PLANNING
• Grams of each:
• CHO = 4
• PRO = 4
• FAT = 9
• round off to the nearest 5

COLLEGE OF NURSING
MEAL PLANNING
• Physiologic fuels of CHO, CHON, FATS are 4, 4, 9
• CHO = 975 ÷ 4 = 245 g
• PRO = 225 ÷ 4 = 56.2 g
• CHO = 300 ÷ 9 = 35 g
Round off to the nearest 5 the grams
DIET PRESCRIPTION FOR A FEMALE SEDENTARY CLIENT:
1,500 kcal with CHO 245 g, PRO 55 g, and,
FATS 35 g

COLLEGE OF NURSING
MEAL PLANNING
Construct a table with all food groups:
1. Vegetables A, B, Fruits, Milk, Sugar
2. Rice
3. Meat and fish
4. Fat
Add columns for exchanges, CHO, CHON, FAT, ENERGY

COLLEGE OF NURSING
MEAL PLANNING
1. List all food furnishing the CHO group with the

exception of rice:
• Allow 2-3 exchanges of Vegetable A & B per day
• Unless there is a strict restriction for simple CHO,
allow 3-4 Fruit exchanges

COLLEGE OF NURSING
MEAL PLANNING
• Allow 1 exchange of Milk or depending on the needs,
economic considerations
• Allow 5-9 Sugar exchanges per day, except if diabetic
or at risk/has family hx

COLLEGE OF NURSING
MEAL PLANNING
2. To determine how many Rice exchanges:
• Subtract the total number of exchanges from
Vegetables, Fruits, Milk, & Sugar from the prescribed
grams of CHO. Then divide it by 23 (no. of grams CHO
furnished by 1 Rice exchange)
• The nearest whole quotient is the number of Rice
exchange allowed.

COLLEGE OF NURSING
MEAL PLANNING
• 3. To determine how many Meat & Fish exchanges
are allowed;
• Add the proteins furnished by the food groups
already listed, subtract this sum from the prescribed
grams of PRO, and divide the difference by 8 (no. of
grams PRO furnished by 1 Meat & Fish exchange).

COLLEGE OF NURSING
MEAL PLANNING
• The nearest whole quotient is the number of Meat &
Fish exchanges allowed
• If client is on fat restricted diet, such as in

hypertension, hyperlipidemia, CVD, etc, use low fat
Meat & Fish exchange and instruct client to limit
choices to those in the food exchange list

COLLEGE OF NURSING
MEAL PLANNING
• 4. To determine how many Fat exchanges are
allowed:
• Add the fat furnished by the food groups already
listed, subtract this sum from the prescribed grams
of FAT, and divide the difference by 5 (no. of grams
FAT furnished by 1 FAT exchange).
• The nearest whole quotient is the number of FAT
exchanges allowed

COLLEGE OF NURSING
Implementation
• Interventions accomplish the outcomes, and
outcomes attain goals
• May include diet therapy, assistance with
meals, weight and intake monitoring, and
nutritional support.

COLLEGE OF NURSING
FOOD QUALITY AND SAFETY
• Proper storage, preparation, sanitation, and cooking

are necessary to help prevent or reduce the risk of
food-borne illnesses.

COLLEGE OF NURSING
FOOD LABELING
• Required on virtually
all retail food products.
• Labels must follow the
approved uniform
format and use
standard serving sizes
and household
measurements.

COLLEGE OF NURSING
WEIGHT MANAGEMENT
• Based on relationship between intake and use
of kcal.
• Overweight: 11%–19% above
• Obesity: 20% or more above
• Underweight: 10%–15% under

COLLEGE OF NURSING
DIET THERAPY
• The treatment of a disease or disorder with a

special diet.
• A client must not be given anything to eat or

drink without an order.

COLLEGE OF NURSING
Purpose of Diet Therapy
The dietary prescription is written for one or more of the

following purposes:
• Provide the client with nutrients needed for

maintenance or growth.
• Prepare a client for diagnostic tests.
• Treat the client with a disease or condition.

COLLEGE OF NURSING
Diets
• REGULAR DIET - provides a well-balanced diet and ensure
that individuals who do not require dietary modifications
receive adequate nutrition
• SOFT DIET - soft in texture, moderately low in fiber, and
processed by chopping, grinding or pureeing to be easier to
chew. Most milk products, tender meats, mashed potatoes

COLLEGE OF NURSING
Diets
• GENERAL LIQUID DIET – provides easily tolerated foods;
milk, strained and creamed soups, grits, creamed cereal and
fruit and vegetable juices.
• CLEAR LIQUID DIET - supply fluid and calories without
residue; It includes coffee, tea, clear juices, gelatin and clear
broth.
• NPO

COLLEGE OF NURSING
Renal disease diet
When you have chronic kidney disease, changes in:
• Limiting fluids
• Eating a low-protein diet (this may be recommended)
• Restricting salt, potassium, phosphorous
• Getting enough calories if you are losing weight
This recommended diet may change over time if your

kidney disease gets worse, or if you need dialysis

COLLEGE OF NURSING
Tube Feedings
– Administration of nutritionally balanced liquefied foods or
formula though a tube inserted into the stomach,
duodenum, or jejunum by way of a nasogastric tube or a
feeding ostomy.
– Indicated when a patient is unable to chew or swallow, has

no appetite, or refuses to eat.
– Tube feeding used only when all or at least part of the GI

tract is functioning.
– Feeding given continuously or intermittently.

COLLEGE OF NURSING
Figure 21-7
Tube feeding
sites.

COLLEGE OF NURSING
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6Leadership
A WHO Collaborating Center for th ed.]. St.inLouis:
NursingMosby.)
Administering nasogastric tube
feedings

COLLEGE
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions OF NURSING
and clinical skills. [3rd ed.]. St.
Louis: Mosby.)

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University Of The Philippines Manila

Nutrition Across the Lifespan

Mary Joan Therese C. Valera, RN, MPH

University of the Philippines Manila

• Primary nutritional disease–occurs when

• Secondary nutritional disease–occurs as a

University of the Philippines Manila

• Nutritional needs change as a person grows and

• Changes generally based on growth needs,

• Nutritional assessment should be conducted to

University of the Philippines Manila

• Nutrient needs during period of intensive growth, such as

• Evidence has proven that optimal nutrition during

• Health diets and avoid alcohol and caffeine play an

• Discomforts and complications:

University of the Philippines Manila

Yearlong of dependency, growth and development

University of the Philippines Manila

• The average infant birth weight triples by the first

• Nutrition is important for proper growth and

University of the Philippines Manila

• Regular cow’s milk:

University of the Philippines Manila

This is a critical time to instill good dietary habits.

University of the Philippines Manila

– Children still need adequate nutrition.

– The younger the child, the smaller the portions needed.

– If children are offered nutritious foods in pleasant surroundings and in non-

– This is also the time children test their independence.

• Relaxed and enjoyable.

• Do not force children to eat or clear plates.

• Introduce new foods one at a time.

• Encourage physical activity.

• Adults are to set good eatingUniversity

These years are of both physical and emotional growth.

University of the Philippines Manila

Common dietary inadequacies include iron and calcium.

Many teenagers experiment with alcohol and drugs, which

Obesity is a common problem; weight reduction diets should

University of the Philippines Manila

With energy, activity decreasing, weight gain increasing:

• Aroma and taste of food may change.

• Changes in the digestion process.

• Kilocalorie needs decrease .

• Social and mental changes.

• Chronic medical conditions.University of the Philippines Manila

Malnutrition is a common problem among nursing home residents

Residents should be offered familiar foods that taste good.

Fluids should be offered to residents at all meals and between

Dehydration is very common and easily corrected in long term care

University of the Philippines Manila

Cultural and personal preferences should be considered.

Many residents need assistance or encouragement.

Lack of adequate staffing play a large role in patient nutrition.

Many patients are on restricted diets.

Pressure sore due to lack of mobility, and nutrition.

University of the Philippines Manila

See Caffeine Content of Selected Beverages and Foods.

• Lacto-ovo vegetarians–use dairy products and

• Lacto vegetarians–use dairy products but no

• Vegans–avoid all animal foods.

University of the Philippines Manila

 Energy Intake : Energy Output (BMR, Thermic