CHAPTER 10

CHAPTER 11

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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; 16-
19years 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 non-
pregnant, 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, small-
boned 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
as they are exercised.
recommend 30 minutes of exercise 3 – 6
times a week and calcium supplements if the
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