Nutrition for the Young, Women and Older People - Exceed Nutrition

Nutrition for the Young, Women and Older People

A lot of nutrition books and general advice have been created with the ‘average’ person in mind. 

These do not take into account the additional needs of certain groups within the population.

It is therefore important to have an understanding of how your dietary recommendations may impact upon these specific groups and know how to adjust it to successfully accommodate these needs. 

The most common groups of people that may need additional consideration are the young, females and older people. Therefore age and sex can have a significant impact on what nutrition you should recommend to your clients. 

This article will look at each of these groups and highlight the important nutritional needs of each. 

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Nutritional Needs For The Young

The difficulty we have with recommendations for these groups is that there is little extensive research to support what we may know.

This becomes even more evident when there are variations within these groups. For example, the nutritional recommendations to a normal young person would be very different to a young person who plays sport at a high level.

We will therefore only be looking at the most common nutritional needs that will apply to everyone, it is by no means an exhaustive list. 

It is just as important to consider the nutrition of young people, as in any other stage in their life. At this time they are at their peak bone accretion years and also laying the initial foundations to their life long relationship with food.

So there is not only the physiological consideration here but also a psychological too.

As nutrition coaches it may become our responsibility to educate and programme the young on good nutrition. The problem we may face is that many children depend on their parents when it comes to food intake.

Therefore, a better approach is to also educate the parents in better eating too, which will produce a much higher success rate. 

CALORIC INTAKE

The main point for any young person is to ensure they are satisfying their daily energy needs to support growth and development.

Athletic young people will have additional needs, as further energy will be required to meet their training demands and to support any recovery and injury as a result.

When we typically calculate caloric needs, it is generally through consideration of BMR and activity levels. With the young, it is also important to consider age, gender, height, weight, activity level and growth rate. This makes it difficult to estimate the caloric needs of young people.

We can therefore use the Medicine's Dietary Reference Intakes (DRI's) general recommendations for estimating this starting point.

These recommendations provide an average daily energy intake predicted to maintain energy balance while supporting growth and development in a healthy child of a defined age, gender, height, weight and an ‘active’ physical activity level.

Diagram 1

Normally with adults we track changes in bodyweight to dictate that caloric requirements are being met. If they are not, weight goes down, if they are, weight is maintained and so on.

With the young this is not the correct approach as they should be growing and developing.

A better indication is to track height readings instead, and with time this will show a reflection of results. It is suggested that between the ages of 2 and puberty, children should see a fairly consistent growth. 

To better understand the adequacy of growth in children, we can use the paediatric growth charts provided by the National Health and Nutrition Examination Survey (NHANES) website. 

MACRONUTRIENTS 

Once the energy intake is established, it’s important to consider its macronutrient breakdown. 

Diagram 2 below highlights recommended daily allowance (RDA) for both carbohydrates and protein, as set by the Institute of Medicine.

These RDA’s have been established to meet the nutritional needs for the majority (97-98%) of healthy individuals based on their age and gender.

Diagram 2

What isn’t clear here is the RDA’s for fat intake. This is when we have to resort to the Acceptable Macronutrient Distribution Ranges (AMDR), diagram 3, to get a more balanced objective.

Diagram 3

What isn’t clear here is the RDA’s for fat intake. This is when we have to resort to the Acceptable Macronutrient Distribution Ranges (AMDR), diagram 3, to get a more balanced objective.

It should be noted that very active or athletic young persons will require a higher daily protein intake and this may be better set at 1.5g/kg/day. 

MICRONUTRIENTS

The bulk of micronutrients functions in a young person’s diet will come from good food choices with ample amounts of fruit and vegetables. You may need to highlight the importance of these food groups for optimal growth and development.

If it is clear that any micronutrients deficiencies are occurring, then supplementing with a good quality multivitamin is a good idea. 

The only additions to this would be the minerals calcium and iron, which are important for bone mass development and the transport of oxygen in the body. 

These two minerals are reported to be the most common micronutrient deficiencies in the young, particularly those with a high activity level or those not meeting daily energy needs. 

A lack of calcium can leave bones more porous and brittle, which may lead to future bone loss and osteoporosis. An adequate calcium intake via the diet or supplementation will ensure optimal bone mineral content and density by the end of puberty. 

Iron is also important as it carries oxygen in the blood and muscles. Iron deficiency, particularly in females, can be common and can result in anaemia. Anaemia and non anaemic iron deficiency may impair athletic performance. 

When assessing the young for an anaemic iron deficiency, it is important to assess not just haemoglobin and haematocrit values but also total iron binding capacity, serum ferritin, and transferrin. 

Diagram 4 below shows the DRI’s for both calcium and iron for the youth. 

Diagram 4

Nutritional Needs For Women

Nutritional requirements for certain females may need some further consideration.

Females, just like men, need to have a healthy and balanced hormonal profile. The difference between males and females is that females will see greater fluctuations and variations of these hormones.

This is largely due to the menstrual cycle, and the key hormones at play are oestrogen and progesterone.

This is something we will look at in more detail later in the course. In general, good nutrition can be very important to females in balancing and controlling those hormones, including how regular this cycle is. 

Just like young persons, females (particularly active) can be commonly deficient in calcium and iron. The more active the female is, the greater chances of calcium and iron deficiency. 

Low intakes of both these minerals via the diet are the most common contributor to a deficiency, but it can also be caused by menstruation – related blood loss. 

Diagram 5

Diagram 6

One of the most important health considerations for females is during pregnancy. At this time, the mother’s nutrition will not only be affecting her, but the baby too. 

Good food choices are a given i.e.: high nutrient, with a focus on whole single ingredient foods with healthy balanced protein, fats and carbohydrates.

Further emphasis should be put on the reduction of processed and refined foods, as they offer little or no nutritional benefits to the consumer. 

Alcohol and caffeine should also be reduced as these can lead to birth defects and spontaneous abortion.
Other foods to avoid are cured meats, raw eggs, raw seafood, as they potentially carry a higher foods poisoning risk. 

When eating fish, it may be important to reduce this unless eating organically or Atlantic caught varieties. This is because of the potential heavy metal contamination these may carry. 

ENERGY REQUIREMENT

A healthy weight should be seen throughout a pregnancy, and this is to encourage the optimal growth of the fetus. 

If the mother is underweight or doesn’t gain weight to support the growing baby, this can result in low birth weight and/or delayed development. This can also have long-term consequences, even when the person reaches childhood. 

During pregnancy it is important for the mother to increase daily calories by 300-500 kcals per day to support this increased energy demand. This is healthy and should be encouraged. 

Weight gain during pregnancy varies greatly. Most pregnant women gain between 10kg and 12.5kg (22lbs to 26lb’s) putting most weight on after week 20. 

Most of the weight gain will be due to the baby growing, but the body will also be storing fat, ready to make breast milk. 

MACRONUTRIENTS

A balanced diet from all macronutrients should be a priority throughout pregnancy. 

Adequate protein intake is a given and this is of particular importance during the second and third trimesters. At this stage the body is putting more protein towards the growth and development of the foetus and placenta. 

Healthy fats should also be part of a balanced diet, again coming from the typical whole food choices. Omega 3 can become of greater importance during pregnancy as the active EPA and DHA has been shown to benefit infant brain development and reduce post partum depression in the mother after pregnancy. 

Supplementation of a high quality Omega 3 liquid is a good option throughout the pregnancy. It should be noted not to supplement with any oil derived from the liver of the fish, due to the high levels of vitamin A in these that can lead to toxicity. 

Carbohydrates should also be included in the diet. Throughout the pregnancy the body will want and need to make things grow i.e. the baby. As we know carbohydrates are very anabolic, they help things grow, creating an ideal environment for a developing baby. 

Many pregnant females will also get cravings during this time, which can be perfectly normal. If this is for low nutrient processed foods then some restrictions may need to be applied. Pregnancy should not be an excuse to drastically overeat on poor food choices. 

MICRONUTRIENTS

Aside from getting adequate micronutrients from high quality whole food choices, a good quality multivitamin and mineral pack may be beneficial to reduce any potential for deficits. 

There are also a number of micronutrients that should be included and perhaps even increased during pregnancy. There are:  

Calcium

A condition called ‘pre-eclampsia’ can occur in pregnant women if calcium levels are too low. Symptoms are high blood pressure, protein in the urine and swelling of body parts. Aside from high calcium foods, supplementing with the RDA is advisable. Vitamin D supplementation (or sun exposure) will also ensure adequate calcium absorption. 

Iron

Females are commonly low in iron and it can be even more important to have adequate levels throughout pregnancy.

Folate

Vitamin B9 is important throughout the early stages of pregnancy as it can help reduce the potential of ‘neural tube defects’ that can affect the brain and spine of the foetus. A folic acid supplement is typically recommended.

Zinc

It is important to ensure adequate levels of zinc throughout the pregnancy to support the ongoing growth of the baby. A deficiency may lead to congenital malformations such as heart defects, limb defects or Down-syndrome.

Vitamin B12

This vitamin is mainly found in animal meats and is important for cell development. If the mother is following a low to no meat diet, supplementation is essential. 

Nutritional Needs For Older People

Many nutrition coaches or trainers fail to see the importance of good nutrition for the older generation.

This is wrong, as it is equally important that active older adults adequately fuel themselves to boost health markers and to help them continue to maintain and build muscle mass. 

ENERGY REQUIREMENTS

In general, older people see a decline in their daily energy requirements, mainly due to reduced activity level and muscle mass loss. 

This could therefore be offset by maintain activity levels and undertaking exercise to maintain and develop muscle mass, such as weight training. 

There are no set guidelines or studies that suggest the RDI for older people and therefore the traditional BMR x activity level, formula is a good estimation. 

MACRONUTRIENTS

Just like with energy requirement there are no separate suggestions for daily macronutrient intake for older people. 

An all round balanced macronutrient diet is important, with a primary focus on high quality single ingredient foods. One study found that an RDI of 0.8g/kg/day of protein was enough to maintain muscle mass in active weight training older people. 

MICRONUTRIENTS

Vitamin D and calcium are of utmost importance for this age group, as they are both linked to bone health. 

It is common for this group to be deficient in these minerals, which can lead to increased rates of bone loss. Calcium can help reduce this and combat the effects of bone resorption. 

Vitamin D promotes calcium absorption and bone mineralization. A deficiency in this vitamin can lead to osteomalacia, which is the softening of the bones. 

Older people also have a higher rate of deficiency of the vitamin due to decreased synthesis and a decrease in conversion of vitamin D to its active form by the kidneys. 

As we know, it is very difficult to receive the RDA’s of vitamin D via our foods and due to lack of sun in the UK. Supplementation is therefore advisable. 

Diagram 7

HYDRATION

Hydration levels are also important, as older people can be prone to dehydration. This is due to changes in thirst mechanisms and thermoregulation, which is caused by a decrease in blood volume, a reduction in renal water conservation capacity and changes in sodium to water balance in the body. 

On an extreme level, these physiological changes can lead to an increase in plasma sodium concentrations greater than 145mEq/L, caused by excessive loss of water and electrolytes.

This is known as hypernatremia, and for older people, age related decreased thirst levels might be the primary cause. Certain medical conditions and/or their related medications can also lead to hypernatremia.

Hydration is therefore extremely important in older people, particularly those participating in sport or physical activities.

If hypernatremia occurs, it may be treated through the replacement of lost fluids. 

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You now understand the specific nutritional requirements for the young, women and older people who may have additional need in optimizing their health and well-being.

It’s now clear that no matter what your age, good nutrition is as important now as it will ever be.

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References & Further Reading