NHM 101 1nd Edition Lecture 32 Outline of Last Lecture I. Lifestyle Nutrition: Pregnancy, lactation and InfancyOutline of Current Lecture II. Nutrition and Lactation III. Nutrition during infancy Current LectureLactation- 75% of women attempt breastfeeding- Thus, 25% of newborns are given formula in their first 2 days of life- Only 22% make it through the first year- 25% of employers have lactation programs- AAP recommendation: 1 year or longerBreastfeeding benefits of the mother - Hormonalo Suppression of ovulation and menstruation- Physicalo Reduced risk of breast and ovarian cancers and osteoporosiso Better health outcomes in general- Psychosocialo May lower risk of postpartum depressiono Fosters maternal-infant bondingBreastfeeding benefits of the infant- Human milk exactly matches infants needs- Immunological benefits- Fewer acute illnesses- Lower infant mortality rates in developing countries - Reduction in chronic illnesses- Childhood overweightThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Cognitive benefits - Reduction in pain Common Barriers to breastfeeding- Lack of knowledge - Embarrassment- Time and social constraints- Lack of support from family and friends- Concerns about provider misinformation o Inadequate health care provider lactation management trainingo Disruptive hospital policies Nutrition during lactation- Energy for mothero 500 additional calories per day- Fats- Vitamin Do Supplementation needed if exclusively breastfeeding - Watero 12+ cups per day Nutrition during infancy - Weight gain- Energy nees- Protein intake- Fluoride- Vitamin D- Introduce food and cup at 6 monthso First food is rice cereal Nutrition during childhood - Evaluating growtho Growth charts/BMIo 1/3 children are overweight or obese- Trends in dietary intakeo Beverages contribute to 20-25% of calorieso Decline in milk, veggies, and eggso Increase in fruit, fruit juices, sweetened beverages, poultry, and cheese Dietary guidelines- Nutrients of concern in 2005 for childreno Calcium, fiber, magnesium, potassium- Nutrients of concern in 2010 for childreno Vitamin Do Potassium and calciumo Dietary fibero SoFAS= solid fats and/ or added sugars SoFAS make up 1/3 of a childs intake in the U.S.Physical Activity in Childhood- Physical activity o 60 minutes or more each day of physical activity/play timeo Limit screen time to no more than 2 hours per day Nutrition during adolescence- Growtho Males-weight gain and linear growth coincideo Females- linear growth typically happens before peak weight gain- Overweight and obesityo ~34% are overweight or obeseo ~18% are obese Nutrients of concern- Deficiencieso Folateo Vitamins A, B6, Eo Irono Zinco Calciumo Fiber- Excesso Total fato Saturated fato Cholesterol o Sodiumo Sugar Define vegetarian - Semi-vegetariano Exclude red meat- Lacto-ovo-vegetariano Exclude meat, poultry, fish, and seafood- Lacto-vegetariano Exclude meat, poultry, fish, seafood, and eggs- Vegano Consume no animal products Adolescent vegetarians- Approximately 4% of adolescents - 11% report being vegetarian at some point during adolescence - Reasons includeo Cultural or religious beliefs, health beliefs, as a means to restrict calories or fat intake, as a means to exert independence - Adolescent vegetarians consume more:o Fruits and vegetableso Fewer sweetso Fewer salty snack foodso Less fat- Must monitor intake of protein, calcium, Vitamin D, B6 and B12- Adolescent vegetarians are more likely too Report binge eatingo Twice as likely to report frequent or chronic dieting o Four times more likely to report purgingo Eight times more likely to report laxative use- When compared to non-vegetarian adolescents What do we recommend?- Adolescents can make their own choices- Assess their reason for becoming a vegetarian- Educate them on how to get the essential nutrients in that they may be missing out on - Ask questions to assess possible disordered eating Adolescent Nutrition: eating disordersWhat is an eating disorder?- Its not about food- The most common element in all eating disorders is the lack of self esteem- It is a psychiatric diagnosis—caused by a variety of emotional factors and influences - It can be the result of POOR “diet” choices and unsuccessful “dieting” attempts - 35% of “normal dieters” may progress to pathological dietingWho suffers from eating disorders?- 5-10 million girls and women- 1 million boys and men- Other stats:o 80% of American women say they are dissatisfied with their appearance o Average American women is 5’4” tall and weighs 140 poundso Average model is 5’11” tall and weighs 117 pounds Characteristics of Anorexia Nervosa- Refusal to maintain body weight of less than 85% expected- Fear of gaining weight even though underweight- Distorted image of body weight and shape - Amenorrhea- Two types of anorexiao Restricting o Binge eating/purging Characteristics of Bulimia Nervosa- May be of normal weight or even a little over weight- Recurrent episodes of binge eating- Recurrent inappropriate compensatory behaviors o These behaviors occur at least twice weekly for 3 months- Distorted view of body image - Clinical depression Characteristics of binge-eating - May be normal weight up to severely obese - Recurrent episodes of binge eating (at least twice weekly for 6 months)o Eating more rapidly than normalo Eating until feeling uncomfortably fullo Eating large amounts when not hungryo Eating alone or secretlyo Feeling disgusted, depressed or guilty after eating- Not associated with compensatory behaviors What causes eating disorders? - Psychological factors o Low self-esteem; feelings of inadequacy or lack of control in lifeo Depression, anxiety, anger or loneliness- Interpersonal relationshipso Troubled family and personal relationshipso History of being teased about size or weighto History of physical or sexual abuse What causes eating disorders?- Social factorso Cultural pressures to be thin and possess the “perfect” bodyo Definition of beauty that includes men and women of a specific weight o Cultural norms that value people on basis of physical appearance, not inner qualities - Biochemical/ Biological