Nutrition Through the Life Cycle

Lifecycle Nutrition for RD Exam

What components make up total energy expenditure (TEE)?

basal energy expenditure, thermic effect of feeding (TEF), non-exercise activity thermogenesis (NEAT), and exercise-related energy expenditure

BMR

basal metabolic rate; amount of energy the body needs to sustain vital functions during rest

Measured with indirect calorimetry within 30 minutes of waking up, after 12-14 hr fast

RMR

resting metabolic rate; energy body burns at rest. includes energy expenditures beyond that from vital organs

Doesn’t require overnight fast, measured via indirect caliometry

Thermic effect of food

Energy body burns for digestion processes after eating

NEAT

Movement that’s not related to sleeping, digesting, or exercise

AKA walking, fidgeting, and typing

Physical activity levels (PAL)

Sedentary: only typical daily activities

Low Activity: TDL + 30-60 mins moderate activity

Active: TDL + 60+ mins moderate activity

Very active: TDL + 120 mins moderate activity

PAL Coefficients

Sedentary: 1-1.39

Low Active: 1.4-1.59

Active: 1.6-1.89

Very Active: 1.9-2.5

What is the major driver of both BMR and RMR?

fat-free mass beacuse it includes the metabolically active components of the body

What should you calculate estimated energy needs off of?

resting metabolic rate

What equations are common in estimating energy needs with RMR?

Harris-Benedict and Mifflin-St. Jeor

Protein RDA for pregnancy

1.1 g/kg/day

Protein RDA for lactation

1.3 g/kg/day

What are major concerns during pregnancy?

fish high in mercury, listeria in soft cheese or deli meats, and exposure to toxoplasmosis in soil or cat litter

What vitamins have increased requirements during pregnancy?

Vitamins A, C, E, and B (folate)

Folate DRI for pregnancy?

600 micrograms/day

There’s an increase in all minerals during pregnancy except for ______ because ______

Calcium because the body doubles intestinal absorption so a normal amount is fine!

For underweight pregnant women, how much weight should they gain?

28-40lbs

For normal weight pregnant women, how much weight should they gain?

25-35lbs

For overweight pregnant women, how much weight should they gain?

15-25lbs

For obese pregnant women, how much weight should they gain?

11-20lbs

What is the rate of wt gain for underweight pregnant women in 2nd/3rd trimester?

1-1.3 lb/wk

What is the rate of wt gain for normal wt pregnant women in 2nd/3rd trimester?

0.8-1 lb/wk

What is the rate of wt gain for overweight pregnant women in 2nd/3rd trimester?

0.5-0.7 lb/wk

What is the rate of wt gain for obese pregnant women in 2nd/3rd trimester?

0.4-0.6 lb/wk

During which life stage is energy requirements the highest?

Infancy at 100 kcal/kg, 1.5g/kg PRO, and fat at 50% total calories

Which vitamin and mineral are low in breastmilk?

Vitamin D: 400 IU supplement/day starting at birth

Iron: 1 mg/kg/day liquid iron at 4 months

Possibly fluoride after 6 months

Gestation age by weeks?

Term: 37-42 weeks

Preterm: <37 weeks

Post-Term: >42 weeks

Low Birth Weight Ranges?

LBW: 5.5lb, 2.5 kg

VLBW: 3.3lb, 1.5kg

ELBW: 2.2lb, 1kg

What 2 things help determine when a baby is ready for solids?

Nutrient needs and developmental stage

What occurs 0-2 months of an infant’s life?

Has rooting reflex and able to suck-and-swallow; breastmilk/formula

What occurs 2-4 months of an infant’s life?

Well-coordinated such-and-swallow reflux with breathing, head control; breastmilk/formula

What occurs 4-6 months of an infant’s life?

Reduced extrusion reflex, opens mouth for spoon, suck and bite, starts chewing, sits up with support; Breastmilk/formula, soft foods

What occurs 6-8 months of an infant’s life?

reduced extrusion reflex, moves tongue, hold bottle, sit up without support; breastmilk/formula, thicker puree, mashed foods, baby foods

What occurs during 8-10 months of infant’s life?

hols cup and finger foods; breastmilk/formula, mashed foods, soft chopped foods, finger foods

What occurs during 10-12 months of an infant’s life?

Drink from cup, feed self finger foods, bite and chew food

Age range for toddlers?

1-3 years

Food jags

eating the same food for a long period of time

High choking risk foods for toddlers?

nuts, popcorn, grapes, and hard candies

Portion size for toddlers?

1 tbsp of each food for each year of age per meal

2 year olds would get 2 tbsp of each food

Critical nutrients for toddlers/school age kids?

Iron, zinc, vitamin D, calcium, vitamin E, and essential fatty acids

Age range for “preschool age”

3-5 years

Age range for “school age” children?

6-10 years

Which nutrients are important for bone growth?

Vitamin D and calcium

Age range for adolescents?

12-21 years

Nutritional Concerns for adolescence?

vegetarian diet, disordered eating/disorders, obesity, hyperlipidemia/hypertension, physical inactivity, pregnancy

Sarcopenia

Loss of muscle mass that occurs with aging

Cachexia

wasting associated with aging and chronic disease, particularly in immune disorders and current physical activity, comorbidities, and current lifestyle

Factors that put older adults at risk for malnutrition include:

Social factors

Medical/psychiatric factors

Physiologic factors

Anorexia, cachexia, and sarcopenia