Healthy and Strong

HEALTHY AND

STRONG

Nutritional Guide for Mothers, Kids and Adolescents DR. GEORGE D. PAMPLONA-ROGER

6

General Layout Chapter 1

Chapter 3

Preconception . . . . . . . . . . . . . . . . . . . . p. 10 Envisioning Pregnancy . . . . . . . . . . . . . . . . . . .

Folate and B12 Before Conception. . . . . . . . . . .

The Preconceptional Diet – 1 . . . . . . . . . . . . . .

The Preconceptional Diet – 2 . . . . . . . . . . . . . .

Foods for Future Pregnant Women. . . . . . . . . .

12 14 16 18 20

Chapter 2

Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . p. 22 Energy and Macronutrients During Pregnancy . . . . . . . . . . . . . . . . . . . .

Healthy Fats for Pregnant Women . . . . . . . . . .

Omega-3 and Pregnancy. . . . . . . . . . . . . . . . . .

From Plant to Animal Omega-3 . . . . . . . . . . . .

Omega-6 to Omega-3 Balance . . . . . . . . . . . . .

Important Vitamins and Minerals for Pregnant Women 1. Folate and Vitamin B6 . . . . . . . . . . . . . . .

2. Iodine. . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Iron and Zinc . . . . . . . . . . . . . . . . . . . . . .

4. Calcium, Selenium, Vitamins A and D . .

Iron Absorption . . . . . . . . . . . . . . . . . . . . . . . .

Foods to Increase During Pregnancy . . . . . . . .

Flaxseeds and Pregnancy . . . . . . . . . . . . . . . . .

Products to Limit or Avoid During Pregnancy .

Prevention of Food Borne Disease . . . . . . . . . .

Meat and Pregnancy . . . . . . . . . . . . . . . . . . . . .

Processed Meats: Dangerous for Pregnant Women . . . . . . . .

Fish and Pregnancy . . . . . . . . . . . . . . . . . . . . . .

What Type of Fish and How Much . . . . . . . . .

Mercury, the Dark Side of Fish . . . . . . . . . . . . .

Iron Supplements . . . . . . . . . . . . . . . . . . . . . . .

Prenatal Nutritional Supplements . . . . . . . . . .

Fish Oil Supplements . . . . . . . . . . . . . . . . . . . .

Other Supplements During Pregnancy. . . . . . .

Important Nutrients During Pregnancy for Vegetarians . . . . . . .

Healthy Vegetarian Diet for Pregnant Women Suggested Menu for Pregnant Vegetarians . . . .

Adolescent Pregnancy . . . . . . . . . . . . . . . . . . . .

Common Pregnancy Conditions – 1 . . . . . . . .

Common Pregnancy Conditions – 2 . . . . . . . .

Common Pregnancy Conditions – 3 . . . . . . . .

Herbs and Pregnancy . . . . . . . . . . . . . . . . . . . .

Lifestyle for a Pregnant Woman . . . . . . . . . . . .

Caffeine, not so Harmless . . . . . . . . . . . . . . . . .

Prenatal Influences . . . . . . . . . . . . . . . . . . . . . .

Fetal Origins of Adult Disease . . . . . . . . . . . . . .

Prevention for Birth Defects . . . . . . . . . . . . . . .

24 26 28 30 32

34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94

Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . p. 96 Breast Milk Composition . . . . . . . . . . . . . . . . . 98 Features of Breastfeeding . . . . . . . . . . . . . . . . 100 When and When not to Breastfeed . . . . . . . . 102 Exclusive Breastfeeding. . . . . . . . . . . . . . . . . . 104 Successful Breastfeeding . . . . . . . . . . . . . . . . . 106 Starting Breastfeeding . . . . . . . . . . . . . . . . . . . 108 Benefits of Breastfeeding – For the Infant – 1 . . . . . . . . . . . . . . . . . . 110 – For the Infant – 2 . . . . . . . . . . . . . . . . . . 112 – For the Mother. . . . . . . . . . . . . . . . . . . . 114 Breastfeeding in Special Cases – Infant Conditions . . . . . . . . . . . . . . . . . 116 – Maternal Conditions . . . . . . . . . . . . . . . 118 Overcoming Breastfeeding Difficulties – Because of Infant’s Conditions . . . . . . . 120 – Because of Maternal Conditions . . . . . . 122 Expressed Milk Feeding – 1 . . . . . . . . . . . . . . . 124 Expressed Milk Feeding – 2 . . . . . . . . . . . . . . . 126 Supplements for Infants . . . . . . . . . . . . . . . . . 128 Bottle Feeding with Infant Formula . . . . . . . . 130 Soy Infant Formula . . . . . . . . . . . . . . . . . . . . . 132 Supplements Added to Infant Formula . . . . . 134 Lifestyle of the Nursing Mother . . . . . . . . . . . 136 Nursing Mother’s Diet . . . . . . . . . . . . . . . . . . 138 Energy Cost of Lactation . . . . . . . . . . . . . . . . 140 Meeting Nutrient Requirements During Breastfeeding . . . . . . . . . . . . . . . . 142 Fats in Nursing Mother’s Diet . . . . . . . . . . . . . 144 Maternal Nutrition and Breast Milk Quality . 146 Foods to Include in Mother’s Diet During Breastfeeding . . . . . . . . . . . . . . . . 148 Products to Limit or Avoid During Breastfeeding . . . . . . . . . 150 Vegetarian Diet and Breastfeeding . . . . . . . . . 152 Dietary Goals for Vegetarian Lactating Mothers . . . . . . . . . . 154 Vitamin B12 and Breastfeeding . . . . . . . . . . . . 156 Supplements for Nursing Mothers . . . . . . . . . 158 Galactagogues . . . . . . . . . . . . . . . . . . . . . . . . . 160 Medications and Breastfeeding . . . . . . . . . . . . 162

7

of the Work Chapter 4

Complementary feeding . . . . . . . .

Chapter 5 p. 164

Weaning from the Breast . . . . . . . . . . . . . . . .

Types of Weaning . . . . . . . . . . . . . . . . . . . . . .

Continued Breastfeeding . . . . . . . . . . . . . . . .

Ready for New Foods . . . . . . . . . . . . . . . . . . .

Feeding Schedules for Infants and Young Children . . . . . . . . . . .

Complementary Foods – 1 . . . . . . . . . . . . . . .

Complementary Foods – 2 . . . . . . . . . . . . . . .

Introduction of Complementary Foods . . . . .

First Foods and Brain Development . . . . . . . .

First Complementary Foods: 1. Cereals and Fruits . . . . . . . . . . . . . . . . .

2. Vegetables . . . . . . . . . . . . . . . . . . . . . . .

3. Legumes, Nuts and Seeds . . . . . . . . . . .

Some Popular Weaning Foods . . . . . . . . . . . .

Fermented Cereals and Legumes . . . . . . . . . .

Germinated Cereals . . . . . . . . . . . . . . . . . . . .

Some Complementary Foods Rich in Proteins . . . . . . . . . . . . . . . . . . . . .

Nutrients During Complementary Feeding: 1. Carbohydrates, Proteins, Fats, and Water . . . . . . . . . . . . . . . . . . .

2. Vitamins, Fiber, and Supplements. . . . .

Iron Intake During Complementary Feeding . . . . . . .

Zinc Intake During Complementary Feeding . . . . . . .

Preparing Baby’s Food . . . . . . . . . . . . . . . . . . .

First Recipes for Babies: 1. Cereals and Fruits . . . . . . . . . . . . . . . . .

2. Vegetables . . . . . . . . . . . . . . . . . . . . . . .

Foods and Products to Avoid or to Limit . . . .

Meat as Complementary Food . . . . . . . . . . . .

Cow’s milk as Complementary Food . . . . . . .

Animal Source Foods in Developing Countries . . . . . . . . . . . . . .

Vegetarian Diet for Babies. . . . . . . . . . . . . . . .

The Total Vegetarian Baby . . . . . . . . . . . . . . .

Guidelines for Vegetarian Babies . . . . . . . . . .

Complementary Foods for Ill Babies . . . . . . .

Prevention of Iron Deficiency Anemia . . . . . .

Prevention of Diarrhea . . . . . . . . . . . . . . . . . .

Lifestyle to prevent Allergy . . . . . . . . . . . . . . .

Foods to Prevent Allergy . . . . . . . . . . . . . . . . .

Food Allergy . . . . . . . . . . . . . . . . . . . . . . . . . .

Living With Food Allergy . . . . . . . . . . . . . . . .

Allergenic Foods for Babies . . . . . . . . . . . . . . .

Teaching good eating habits . . . . . . . . . . . . . .

Paternal Feeding Styles . . . . . . . . . . . . . . . . . .

166 168 170 172 174 176 178 180 182 184 186 188 190 192 194 196

198 200 202 204 206 208 210 212 214 216 218 220 222 224 226 228 230 232 234 236 238 240 242 244

Childhood . . . . . . . . . . . . . . . . . . . . . . .

p. 246

Energy and Supplements for Children . . . . . .

Proteins for Children . . . . . . . . . . . . . . . . . . .

Fiber for Children . . . . . . . . . . . . . . . . . . . . . .

The Vegetarian Child . . . . . . . . . . . . . . . . . . .

Nutrients of Concern for Vegetarian Children Proteins and Growth of Vegetarian Children Eating vegetables. . . . . . . . . . . . . . . . . . . . . . .

Grains, Nuts, and Other Seeds . . . . . . . . . . . .

Soy Products for Children. . . . . . . . . . . . . . . .

Soy Milk for Children . . . . . . . . . . . . . . . . . . .

Non-Dairy Milks for Children . . . . . . . . . . . .

Fruit juices for Children . . . . . . . . . . . . . . . . .

Snacks for Children . . . . . . . . . . . . . . . . . . . .

Healthy Fast Food for Children . . . . . . . . . . .

Healthy Menus for Children . . . . . . . . . . . . .

Diet and school performance . . . . . . . . . . . . .

Educating Appetite . . . . . . . . . . . . . . . . . . . . .

Drinks to limit or to avoid . . . . . . . . . . . . . . .

Foods and Products to Limit or to Avoid – 1. . .

Foods and Products to Limit or to Avoid – 2. . .

Reasons to Avoid Meat During Childhood . .

Meat and Childhood Cancer . . . . . . . . . . . . .

Dietary Prevention of Some Diseases in Children . . . . . . . . . .

Constipation and Vomiting . . . . . . . . . . . . . .

Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Child Obesity . . . . . . . . . . . . . . . . . . . . . . . . .

Prevention of Child Obesity . . . . . . . . . . . . . .

Food Intolerance . . . . . . . . . . . . . . . . . . . . . . .

Lactose Intolerance . . . . . . . . . . . . . . . . . . . . .

Hyperactivity and Diet . . . . . . . . . . . . . . . . . .

Prevention for Adult Life . . . . . . . . . . . . . . . .

248 250 252 254 256 258 260 262 264 266 268 270 272 274 276 278 280 282 284 286 288 290 292 294 296 298 300 302 304 306 308

Chapter 6

Adolescence . . . . . . . . . . . . . . . . . . . . .

p. 310

Physical and Intellectual Performance . . . . . . 312 Healthy Snacks for Adolescents . . . . . . . . . . . 314 Drinks to avoid during adolescence . . . . . . . . 316 The Vegetarian Adolescent . . . . . . . . . . . . . . . 318 Anorexia and Bulimia . . . . . . . . . . . . . . . . . . . . 32

To the Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Epilogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322 Nutrient Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . 324 Units, Abbreviations, and Acronyms . . . . . . . . . . . 328 Diseases index. . . . . . . . . . . . . . . . . . . . . . . . . . . . 330 Alphabetical Index . . . . . . . . . . . . . . . . . . . . . . . . 331

10

The planning of a pregnancy in the family must include the future parents' nutrition.

Chapter 1

Preconception The time to make dietary changes to prepare for pregnancy is before conception.

W

hen pregnancy is planned, there is a wondrous time during which the imagination soars and dreams collect in one’s mind: from the moment pregnancy is considered until the biological moment of conception. This period of time, prior to conception, is a wonderful opportunity for the mother-to-be to make healthy changes regarding her diet and lifestyle. A successful pregnancy and nursing are forged since the preconceptional stage. Ideally, preconceptional care should begin at least two years prior to pregnancy (see timetable in p. 12).

It is easily understood and commonly accepted that once a woman becomes pregnant, she must pay attention to her diet and lifestyle. But current research is discovering that what a woman consumed months or even years before getting pregnant, will also determine the health and development of her future baby.

If, as it appears, diet before conception is as important as diet during pregnancy for the wellbeing of the fetus, a new burden of accountability is placed upon all women of childbearing age. As conception may occur at any moment, any woman of childbearing age who is considering a future pregnancy should be committed to following a healthy preconceptional diet from her early youth. Thus, when conception does happen, she will have an optimal nutritional condition for the development of a new baby.

HEALT LTHY

AND

STRONG ·

1·P

(1) Uteru so (2) Fallop ian (3) Ovary (4) Vagin a (5) Fimbri ae (6) Follicl e (sac (7) Ovula tion (8) Ovum (9) Layer of jelly (10) Nucl eus of th It stores g en in chromo e som

2 1

3

4 Negative external influences such as poor nutrition, tobacco, alcohol, or drugs at any time during the life of a young woman, even long before conception, may have subsequent severe consequences for her offspring.

Facts and Figures About Preconception 400,000

Average number of immature dormant ova in both ovaries of a girl at puberty..

400

Average number of mature ova released from ovaries during the reproductive lifetime of a women.

46

Number of chromosomes in any body cell (except in ova or spermatozoa).

23 14

5

Ova Are N

ot

Renewed Although a female’ s d ova are w u ri Number of chromosomes in a reproductive cell (ovum or spermatozoid). ng a woman onderfully ’s lif to extern al factors etime, they are exp protected and st Average weight of an ovary. such as an deficienci ored osed, eve e n certain m s, tobacco smoke inadequate diet, n before birth, , alcohol, edication u tr itional drugs, ch s or X-ray Ova are n emical po s. o llutants, factors m t renewed, so a d am ay be rele ased at th aged ovum by su develop into an e e time of ch extern mbryo. ovulation al Therefore and poss , ibly attention it is important that to their d iet and b girls and young w may occu ody even o r. years befo men pay special re concep tion

Foods for Future Pregnant Women S

7

8

9

ome Defin

itions

• Diet: pregnancy Dietary awareness before requires little effort, The u refers to sual food consum the restri ed by a ction obenefi erson.the and it will be rewarded with spring.

• Lifefar-reaching f food intatspfor Diet aloff style: A so ke . values an manner of living d attitud reflecting es. a person’s • Ovulati on: usually m The release of an idway in ovum fro the menst m • Ovum (o rual cycle the ovary, va . from ova ): The female repro ries. ductive ce ll release • Concep d tio ovum lead n: The fusion of m al ing to the e sperm an developm • Precon d cep ent of an a female embryo. concepti tional: Before or ar on. ound the time of

6

10

Key Terms Birth defec Diet befo ts . . . . . . . . . . . . . 14 re Preconce Father . . conception . . . 16 p ..

Preconce tional care . . . . . 13 Fats. . . . . . . . . . . . . . . . . . . . 12 ptional d ......... iet . . . . . 16 Pr o te .

Folate . . . . . . . . . 18 ins . . ..

Supplem . . . . . . . . . . . . . . . 19 Folic acid . . . . . . . . . . . . . . . 14 ents . . . . ......... . . . . . . . . 19 Timeline Foods to . . . . . . . 14 .. ea Trans fat . . . . . . . . . . . . . . . 12 Foods to t every day . . . 20 ......... limit . . . . .

Vi . . . . . . . 17 ta min B12 ..

Infertility . . . . . . . . . . . . . . . 20 Weight . . . . . . . . . . . . . . . . 14 . . . . . . . . 17 ......... . . . . . . . . 16

A good heritage for children begins with a good preconceptional nutrition.

et – 1 i D l a n o i ncept

16

o The Precobesity nor a restrictive dieat niscyco. nvenient Neither

gn ning of pre at the begin

of portance

The Im ceptional Diet nt, y ing pregna make health Precon out becom y until 20 ab ks in Waiting to one’s diet and th an nanc When a wombe certain of her preg ce, the changes to til a pregnancy en t she will no after conception. H g will also lifestyle un ve is better than ks in ti several wee nal diet she is follow g these early test is posi wever, it may, io preconcept pregnancy diet. Durin ow that she is nothing; ho o late to ensure to y be her earl a woman may not kn particularly indeed, be alth outcome n , is the best he ture baby. As weeks, whe e new being, embryo . of one’s fu oman of egnant, th tritional imbalances pr ural w nu yo, called ne rineawareness before pregnancy requires little effort, soon as a sensitive to g age plans of the embr ks of inDietary traute em st sy s childbearin e must ou ee The nerv ps in these early w and sh e be rewarded with far-reaching benefits for the offspring. can clitoswill pregnancy, e dietary tube, develo that the neural tube is necessary r initiate som changes it th de y, life. In or around the 28 da ood at • Unpasteurized milk and dairy products, t in her bl and lifestyle of her or Avoid Before esenLimit successfully l of foFoods late be prto ve for the sake like soft cheeses (Brie, feta, Camembert, and le ir (and During) Pregnancy a fa at . th by ba future Roquefort) that may be contaminated with ng theseof high-mercury riamount du moment. at yo • Fish: Avoid any th br s em nt y e trie Listeria monocytogenes, a bacteria that causes and nush sswordfi A large stud e pment offith in lo m ve sh, like shark, and others (p.

58). ta vi de r e th he Th at ot an, miscarriages. a wom requiresMethylmercury performed anford by ks ee ed (the organic form of mercury w w y llo rl fo ea St et egnant, willinedthe bloodstream • Raw or undercooked eggs (i.e. home made late. The di pr University of S) has fo is s found in fi sh) accumulates e de sh si at ir be g th ,U ients requa proper diet, it may knowinover mayonnaise) to avoid salmonella poisoning.

(California more that l nuertrfollowing of alAft even before main so urcetime. e proven once rich in th e take over a year for the levels of methylmercury m • Fast or junk foods high in saturated or trans fat, co be et di . y by th al ba he re a to significantly drop. like hamburgers and commercially deep fried by her futu bles and fruits, vegeta and low – If fish is eaten,wlimit the products as french fries, fried chicken or fried htintake of medium ig s, e e l b grain cereal ell as the ita fish, like canned light tuna sulow-mercury onion rings (p. 151). a or w g even in or v s th ie h on in meat, as itamin Ac t and than 12ghounces (340 g) essed m to less addrsardines, • Refined carbohydrates like white bread, rwei ve be O ld y. ou nc use of multiv prior to sh perin week (p.na61). g preg Obesity t to ts regular cookies, doughnuts, cakes, and other supplemen ay reduce years before consider egnancy should star eight m • Meats: commercially baked goods because they are low se w lean cuts or ing pr If meatriiseseaten, lochoose d an pregnancy, h defects women envision lo and avoiden ca is y it pt , rt bi skinless poultry, cold cuts and other em in B vitamin, iron and fiber. the risk of .a e intake of likely to occur. By th th it lim % processed or cured meats. is diet.

• Sugary snacks, candies, soda and soft drinks. eption by about 50 a slimmingmeats because before conc te–to t barbecued ar Avoid of their high st MI of la • Preservatives, colorants and other additives, are obese (B already too who content of mutagens. an which are mainly present in processed products. that women e of conception have n ow kn is – Avoid undercooked or raw fi sh or meat It ) by the tim er gh hi or products that may be contaminated with 30 ring sk of: ations du viruses, or parasites plicbacteria increased ri icpathogen ed al com iac and pulmonary es, 51). rd • Having m su(p. ch as ca and diabet pregnancy ational hypertension st disease, ge ive sleep apnea. (p. 94). ct and obstru ild with birth defects ch • Bearing a

Foods for Future Pregnant Women

Foods to Eat Every Day During Preconceptional Period

nancy Begin preg weight e at a suitabl couraged to ould be en Women sh ncy with a BMI (Dody enter pregna s the 30, ideally les Mass Index) d 25. an between 19

Botto woman is ready for conception at any time.

Taking each of these foods every day,AMa, young , Siega-Riz , Munger RG ion Study. Reduced nt ldkamp ML , Yang W, Fe l Birth Defects Preve With Higher Diet SL l ae ich 61 fts tiona a. Carm ofacial Cle bMed PMID: 219693 for the Na and Or REEN ALAD RUITS AND EGETABLES Pu fectsOF LD, Shaw G; l TuORTION 2011 Oct 3. ura be De Risks of Ne Pediatr Adolesc Med. Take at least three pieces or a daily food portion (one chMay include lettuce, corn salad (mâche, lamb’s lettuce), Ar ty. ali Qu

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avocado and other green vegetables like spinach, broccoli and asparagus (when tender, spinach, broccoli and other vegetables can be eaten raw provided that they are thoroughly washed). This salad provides a fair amount of folate necessary for the prevention of neural tube defects in the embryo during an first few weeks of pregnancy.

vulatory in In practice fertility. , th a 125 g (abo is means that replac ing, every da ut 4.4 oz) st similar soy eak with a y, m sa infertility by eat, cuts down the ri me weight, sk of ovulat 50 % (b ot h portions, ory meatless, co m nt the 5% of to ain about 25 g of pr eat and otein, prov tal energy in idin diet). take for a 2, 000 calorie g

Multiv and Miniteamin rals Supp lements Taken at le ast 6 month s m

prior to co ultivitamin nc certain bene and mineral supplem eption, ents provid fits: e c. Chavarr o JE, and ovulator Rich-Edwards JW, Ro sn PubMed PM y infertility. Am J Ob er BA, Willett WC. Pro stet Gyneco ID: 182266 l. 2008 Feb;1 tein intake 26.

98(2):210.e 1-7.

Taking of meat incr plant protein instea d eases fertilit y in women .

3F

2V

of them, citric) and two brightly colored vegetables like tomatoes, bell peppers or carrots.

Fruits and vegetables are the best source of dietary antioxidants protecting the ovules (reproductive cells) from genetic damage.

Before and during pregnancy choose organic fruits and vegetables.

22

A complete diet in this stage is the best help against premature babies and problems in the development of the newborn.

Chapter 2

A

mong heredity, environment, diet, and other determinants of health, diet has the greatest impact on the health condition of a child or an adult. And the same can be stated about a pregnant woman: Her diet and the resulting nutritional condition Diet during pregnancy certainly affects growth, will be the most important intellectual development and future health of a child. factor for her own wellness and for her future child’s health.

Thus, pregnancy is a special time in life, particularly suitable for practicing good nutrition and a healthy lifestyle. Pregnancy, as breastfeeding, is also a time of increased nutritional needs to support the growing fetus.

Seldom in life will nutrition have more farreaching consequences than during pregnancy.

A woman’s diet at this time will have an impact on the future baby not only at birth, but also the rest of his or her life. Many chronic diseases in adults, such as obesity, diabetes or hypertension, can originate at the fetal stage in connection with the mother’s diet.

A nutritious, well-balanced diet is perhaps the greatest gift for a future baby. The ideal is to adopt a healthy diet and lifestyle before conception (p. 16). But if this was not the case, the beginning of pregnancy is still a good time to bring about healthy changes in the diet.

Pregnancy

Important Vitamins and Minerals for Pregnant Women 1. Folate and Vitamin B6

Feeding the Fetal Brain

Facts and Figures About Pregnancy 280 days (=40 weeks)

Normal duration of pregnancy.

9 mm (3/8”)

Length of the embryo at 4 weeks of pregnancy.

30 g

Amount of calcium transferred from mother to fetus during pregnancy.

11 to 16 kg (25 to 35 lb)

Average weight gain during pregnancy.

1.3 g

Additional amount of essential polyunsaturated fatty acids from plants needed daily during pregnancy.

3g

Additional amount of fiber needed daily during pregnancy.

25 g

Additional amount of protein needed daily during pregnancy.

45 g

Additional amount of carbohydrates needed daily during pregnancy.

Neuronal body

Myelin sheath (contains DHA)

Dietary Guidelines to Enhance Conversion From Plant to Animal Omega-3

Neuronal membrane (contains DHA)

While fish can contribute to a pregnant woman’s supply of long-chain omega-3 EPA and DHA, it can not be the main or the only source of these fatty acids. Mercury contamination forces a limit on fish intake (p. 57).

Consequently, conversion from plant omega-3 to long-chain animal omega-3 becomes necessary and unavoidable, both for fish and for non-fish eaters. These guidelines contribute to making conversion more efficient.

1. KEEP AN ADEQUATE BALANCE OF OMEGA-6 / OMEGA-3 (P. 32) 2. CUT DOWN ON TRANS FAT Trans fat interferes and slows down the conversion process from plant ALA to animal omega-3 EPA and DHA. Processed foods, partially hydrogenated vegetable fat, margarines, commercially baked goods, fast food, french fries and other commercially fried foods are common sources of trans fat (p. 151).

3. LIMIT THE INTAKE OF SATURATED FATS Meat, particularly sausages, cured and luncheon

3.

Main sources of monounsaturated fat: Olive oil (77%), canola oil (58%), avocados, olives, almonds, hazelnuts, pistachios, peanuts, cashews, and macadamia nuts.

5. INCREASE FLAVONOID INTAKE Bright colored fruits and vegetables are the main sources

Axon

en and other seeds, and gre Flaxseed, nuts, soy, chia nt pla of s rce sou jor ma leafy vegetables are the lenic acid), a precursor of omega-3 ALA (alpha-lino ntaenoic) and DHA pe osa the fatty acids EPA (eic ic). no (docosahexae ts of ial, structural componen EPA and DHA are essent rons. neu y larl ticu par es, ran the body ’s cellular memb is g the axons of neurons The myelin sheath coverin A. made up of EPA and DH a constant f h f t l brain requires

Foods to Increase During Pregnancy Some foods are specially beneficial to pregnant women.

HEALTHY AND STRONG · 2 · Pregnancy

There are chemical substances than can reach the fetus and threaten its brain development.

23

A Time for Thoroughness Pregnancy is the time when an expectant mother must act sensibly and prudently concerning her health, with the support of the future father.

Breaking the laws of good health during this period of life usually carries life-long consequences for the offspring. Pregnancy means accountability.

Some Definitions • Congenital malformation or birth defect: A physical defect present in a baby at birth, regardless of whether the defect is caused by a genetic factor or by prenatal events that are not genetic.

• Heme iron: The iron found in meat and fish; nonheme iron is found in plant foods and eggs.

• Planned pregnancy: An intended and desired pregnancy. When pregnancy is unplanned or accidental, health risks for a mother and her baby are usually higher • Lifestyle: A set of habits and attitudes that determine personal health.

• Omnivore: A person who eats all types of foods.

• Pregnancy: The period between conception to childbirth.

• Processed meats: Meat products preserved by means of curing, smoking, salting or chemicals.

• Total vegetarian (vegan): A person who does not eat any animal products.

• Teratogen: Causing birth defects.

• Vegetarian: A person who does not eat any meat, poultry, fish, and shellfish, but occasionally consumes cow’s milk, dairy and/or eggs.

Caffeine, not so Harmless AND ALTHY

STRONG

· 2 · Pre

gnancy

75

HE

Coffee, green tea and black tea, maté, and cola drinks are common caffeinated beverages that are inadequate during pregnancy.

Dinner Key Words

The last

Abortion. . . . . . . . . . . . . . . . .

Adolescent pregnancy . . .

Adult disease, fetal origins . . . . . . . . . . .

Alcohol . . . . . . . . . . . . . . . . . .

Birth defects . . . . . . . . . . . . .

Caffeine and coffee . . . . . .

Calcium. . . . . . . . . . . . . . . . . .

Calories . . . . . . . . . . . . . . . . . .

Carbohydrates . . . . . . . . . . .

Constipation . . . . . . . . . . . . .

Dental conditions . . . . . . . .

DHA supplements . . . . . . .

Diabetes . . . . . . . . . . . . . . . . .

Energy . . . . . . . . . . . . . . . . . . .

EPA and DHA . . . . . . . . . . . .

81 76 92 95 94 88 40 24 24 79 78 69 79 24 27

Fats. . . . . . . . . . . . . . . . . . . . . .

Fats, healthy . . . . . . . . . . . . .

Fatty acids . . . . . . . . . . . . . . .

Fiber. . . . . . . . . . . . . . . . . . . . .

Fish. . . . . . . . . . . . . . . . . . . . . .

Fish oil supplements . . . . .

Flaxseeds . . . . . . . . . . . . . . . .

Folate and folic acid . . . . . .

Foodborne disease . . . . . . .

Foods to increase . . . . . . . .

Foods to limit . . . . . . . . . . . .

Heartburn . . . . . . . . . . . . . . .

Herbs . . . . . . . . . . . . . . . . . . . .

Iodine . . . . . . . . . . . . . . . . . . .

Iron. . . . . . . . . . . . . . . . . . . . . .

Iron absorption . . . . . . . . . .

25 26 27 25 56 66 46 34 50 44 48 78 84 36 38 42

ome dietary sources of iron

Weight

Common measure

Soybeans, boiled

172 g

1 cup

8.84 mg

Lentils, boiled

198 g

1 cup

6.59 mg

Spinach, boiled and drained

180 g

1 cup

6.43 mg

Wheat flour, whole grain

120 g

1 cup

4.66 mg

Raisins, seedless

145 g

1 cup

2.73 mg

Mushrooms, cooked

156 g

1 cup

2.71 mg

28,35 g

1 onza

2.29 mg

Beef, broiled

85 g

3 ounces

2.21 mg

Chicken breast, grilled

172 g

1 breast

1.78 mg

Egg, whole, hard-boiled

50 g

1 large unit

0.87 mg

Milk, low fat

244 g

1 cup

0.07 mg

Pumpkin seeds, roasted

the day

o hours least tw

before

Iron content per measure

bedti

time.

with a ole rice well a wl of wh One bo logue, tofu, or a n meat a g r. eg be fi d d ke o an co proteins

m

• Source

Probiotics . . . . . . . . . . . . . . . . 68 Iron supplements . . . . . . . . 62 Proteins . . . . . . . . . . . . . . . . . 24 Leg cramps . . . . . . . . . . . . . . 83 Selenium . . . . . . . . . . . . . . . . 40 Lifestyle . . . . . . . . . . . . . . . . . 86 Supplements . . . . . . . . . . . . 64 Magnesium, sources . . . . . 83 Meat . . . . . . . . . . . . . . . . . . . . 52 Vaginal infections . . . . . . . . 82 Vegetarian diet . . . . . . . . . . 70 Meat, cured . . . . . . . . . . . . . . 54 Vegetarian pregnant . . . . . 73 Medications . . . . . . . . . . . . . 69 Vitamin B6 . . . . . . . . . . . . . . . 34 Mercury . . . . . . . . . . . . . . . . . 60 Menu, vegetarian . . . . . . . . 74 Vitamin A and D . . . . . . . . . 40 Nausea and vomiting . . . . 78 Vitamins and minerals. . . . 34 Omega-3 . . . . . . . . . . . . . . . . 28 Weight gain. . . . . . . . . . . . . . 25 with asoned Omega-3, conversion . . . . 30 Whims . . . . . . . . . . . . . . . . . la sa . . d91se blespoon of Omega-6/o-3 balance . . . . 32 Zinc . . . .w. .ve ..g . .et . .a. b . .le. . . . .a. n39 d a ta ra e, f o ic n ju Preeclampsia . . . . . . . . . . . . 80 mins ne portio il, lemon and vita Pregnancy conditions . . .O. 78 eed or chia o n, folate xs Prenatal influences . . . . . . fl. a90 t germ , fiber, iro id ac ic whea a-linolen es alph • Provid B and E.

on is widely present in plant and animal based foods, except cow’s milk, which poor in iron. Indeed, many plant food portions contain more iron than meat or sh portions, as can be seen in this table.

Food

meal of

ken at ust be ta

g night

rn durin

tbu oid hear me to av

of

ivalent r its equ ) with cado (o le One avo d as guacamo bread re prepa slices of acid), toasted (oleic • Rich in

fats . healthy n, and folate iro

These t meals. snacks re frequen d more ke one or mo an r le smal als. Ta require lementary me ay m h ic al) as supp ces, wh ity redu gnant women (option . h’s capac pre Snacks stomac d suitable for care provider s, e ss alth rogre s an by a he utritiou nancy p fiber.

As preg d snacks are n tritional advice e 2 carrots ta-carotene and u SNACK B suggest cording to n be Rich in ac • ay d per ground chios, its with es ds, pista isins or biscu ss f almon ra SNACK A Toast(s) eds and mola andful o azelnuts with inerals. h se A e m m or h iron. sesa fats and m, and m healthy ts, calciu or fruit ja thy fa es heal • Provid

• Source

m of calciu A glass soy milk fortified , calcium,

of

de with

ma Biscuits flour

ns of protei ega-3..

• Source and plant om

ydrates of carboh • Source

ple d fiber an n. iro soluble • Rich in dants; source of xi tio an

heat

whole w

r. and fibe

One ap

Meat and fish are good sources ickpea of iron, although not indispensable soned ch on of o mus (sea C to achieve a goodSiron ith hum and one tablesp NACKstatus. w s st a To 0) aPlant foods rich in iron, combined puree, see p. 00 d a-3 alph d omeg ee in the same meal with fresh fruits ground flaxsoteins, minerals, an pr and juices (sources of vitamin C) • Source icof acid. en greatly contribute linol ates figs, or d prunes, healthy sugar, to an improved iron status.

6 dried r. of d fibe

• Source

iron, an

nana

One ba

gar, althy su

of he • Source r. and fibe

vitamin

B6

5): nts (p. 6 of ppleme month daily su d ir se e th th ke of the ber to ta the end l ti n u Remem th μg ek until id: 400 μg a we • Folic ac cy. r 2,000 a day o n. pregnan g μ r 0 o 0 gnancy in B12: 1 lactatio • Vitam pregnancy or d of pre l the en ti n u end of ay ad : 200 μg • Iodine n. lactatio

ents

Supplem

96

Breastfeeding creates a bond between the mother and the baby that is a unique and unforgetable experience.

Chapter 3

Nursing For a baby, no gift is more precious than mother’s milk.

Vegetarian Diet and Breastfeeding

N

ursing primarily means to nourish at the breast, that is, to breastfeed. Nevertheless, in this chapter we shall also include other nonbreast ways to nourish infants, like expressed milk feeding (indirect breastfeeding) (p. 124) and bottle feeding with formula (p. 130).

Breastfeeding, the main way of nursing, is a special kind of partnership between a loving mother and her hungry baby. Particularly at this time, mother and baby need each other.

Through this co-dependency, well-planned bothAgain satisfaction andvegetarian diet can easily meet the nutritional needs wellbeing. This creates a of a breastfeeding woman with some advantages for her baby. strong emotional bond between mother and baby, which benefits may last a lifetime.

In modern societies, the tyranny of the clock and the urge to measure everything HEALTHY AND STR can interfere with the emotional of ONG · 3 Fathbond · Nursing er’s Role in 10 breastfeeding. To avoid these interferences, Breastfeed in g A fafrom modern women should learn ther’s traditional involvemen t in otio cultures to forget the clockem and the measurements nally , and biolog the breastfeeding These sim ex ica when breastfeeding their babies.

If pl achieved, e tasks strethe lly bound to her in perience is a factor of pleasant. ngthen th e tie betw fant, but a father ne wellbeing for all th time for feeding will be determined by a baby’s een a fath er and his eds to develop a deepe family. A mother is demand and satisfaction (the best way to measure baby, mak ing a mothe bond with his new physically, off r’s nursing sufficiency of milk) rather than by the clock or a process m spring. ore certain number of milliliters, respectively. Then, breastfeeding will truly become pleasant and healthy for both participants.

Facts and Figures About Nursing 6 months

Optimal duration of exclusive breastfeeding.

10 a 20 ml

Capacity of a newborn’s stomach.

12 g

Amount of fat stored daily by an infant up to 3 months old.

20 minutes

Time of digestion of mother’s milk by infant.

724 ml

Average daily volume of breast milk produced after the first month of breastfeeding.

Provide em ot to the mot ional support he love and ca r, expressing re.

Perform ho

usehold ch

ores.

Asssu As um me som such as carrye caring taskkkss, s, the baby or ing or bathin ng g ch A fa f ther shou anging diapers. his baby w ld cuddle ith skin-to-sk Take care of contact at in the family’s lea children. older to establish st once a day a strong bo nd.

Main Intern ational Sta

tements on • Conventio Breastfeed n role breast on the Rights of th ing e Ch fe attainable eding plays in the ac ild: Recognizes, in standard of Article 24, hievemen t of the ch th health. a • Innocent ild’s right to e important i De the highes of Breastfe claration on the Pr t otection, Pr eding, spon om Fund) in 19 sored by W 90 HO and UN otion and Support Developm , and co-sponsored ICEF (Unite ent and th by d Na the United tions Child e Swedish that all wom States Ag ren’s Inte and all infa en should be enable rnational Developm ency for Internatio nal nts should d ent Author b of age. be fed exclu to practice exclusiv e breastfeed ity. It stated sively on br ing eastmilk fro • Maternity m birth to Pr 6 months Organizatio otection Conventio n, n) breaks or re in the year 2000. Gr adopted by ILO (In ternationa duction of ants the w l La or w bo ki or • Global St ng king hours r rate to breastfe woman the right to ed her child by all WHO gy for Infant and Yo ha un (World He (see p. 118) c ve daily alth Organi g Child Feeding, un Assembly . in May 2002 d zation) mem animously . ad ber states a. United at the 55th opted Nations Ge W or ld Health neral Asse http://www mbly. Conv 2.ohc

hr.org en b. http://w ww.unicef.o /english/law/crc.ht tion on the Rights of c. http://tr the Child. rg/nutritio m ain New York, d. WHO. Glo ing.itcilo.it/ils/CD_Un/index_24807.html 1989. se_Int_Law bal Strategy _web/Add https://ww for Infant an itio w.who.int/ html child_ado d Young Child Feed nal/Library/English lescent_he /Convention ing. WHO, alth/topics Ge /preventio neva, 2002. Down s/C183.HTM loa n_care/ch ild/nutritio d at: n/global/e n/index.

124

g–1 in d e e F k il M d e Express y allows the flexibilit ilk expressed breast m .

Feeding a baby with ntages of breast milk va ad e th th wi ed bin m co ng of bottle feedi

Steps To Express and Use Breast Milk

uld not be an Resuming work sho breastfeeding. e hindrance to continu milk may be sed Feeding with expres of great help.

1. Preparation

milk, also Feeding expressed feeding, ast bre ct called indire cup, spoon, can be done with a e, or bottle. eyedropper, syring ative to ern alt r tte be a is It infant formula breastfeeding than is, in fact, lk mi sed res since exp nutrients its all th wi breast milk . and antibodies

Send to a milk bank.

pressed Benefits ofkEx eding Fe il M Breast

with e feeding an infant • Allows to continu mother a en wh ces tan ms breast milk in circu not feel comfortable es lacks privacy or do c. bli breastfeeding in pu ut for a short trip witho ve lea can r the • A mo ry. ng hu be ll baby wi worrying that her d care provider can fee er oth y an or d Da • er, pp dro eye , on p, spo best the baby with a cu e. A bottle is not the or a feeding syring its use an infant will er aft se cau feeding. option, be turn back to breast become reluctant to g din fee ast bre ine comb • Makes it easier to ks. tas or rk wo r’s and mothe s breast milk to babie • Allows feeding of or are unable to suckle -on ch lat t no that can such as: well on the breast, s.

– Premature babie or palate. defects like cleft lip – Babies with birth

Breast milk is the best food for a baby. Besides nurturing, it protects the child against different diseases.

2. Breast expression

3. Storage or freezing

Recently expressed milk can be fed right away to a baby. If not refrigerated or frozen, use within 6 or 8 hours of expression.

Expressed milk Signs of a Good Latch on from HIV-positive mothers must be • The baby’s mouth is completely open. heat-treated.

• A baby’s mouth covers both the nipple and a large portion of the darker area around the nipple (areola).

• A baby’s lips are flared outward, not folded in (inverted).

4. Thawing • A baby’s chin and/or nose touches the breast.

• No suction sounds.

Common Breastfeeding Positions Underarm or football U ho hold Good for prematures G or after a cesarean.

Classic, front hold, or craddle Easy to get a good latch-on.

Correct infant latch on or attachment position.

Good attachment.

Sitting itting Good for infants nfants with esophageal reflux.

Lyin down Lying Goo Good after a cesarean or when the floor of the pelvis is sore beca because of delivery.

Poor attachment.

Breast milk not only benefits the baby, but also favours the mother's health.

This is a key time in life to inculcate in the children the taste for healthy foods, like cereals and fruits.

Complementary feeding feeding mentary ompplleem · 4 · Com

NG ONG RO R TR T AND S HY AN TH T LT L AL EA HEA

165

First Complementary Foods

ble age vulnera The most riod from pe l na tio to si The tran rmula feeding in s fo od breast or or solid family fo ’s ild id ch ol a is in sem t critical es is the mos uently, it deserv n. eq life; cons careful attentio

1. Cereals and Fruits

finitions

at of infant synonym sed as a u is it k oo In this b rmula • Baby: semester of life. nal or fo ning an mater second other th t during the wea d o fo : Any infan • Beikost is given to an nt that is milk that f a nutrie . d io action o per fr e Th : lability d.

HO, “The • Bioavai and assimilate ing to W o longer n : Accord absorbed feeding t milk alone is ts of ry ta en as en m re • Comple starting when b tritional requirem ids are u u ss n liq and proce t the t to mee ore other foods en ci ffi su ef t milk.” . and ther food or infants, ong with breas or solid al semisolid rmula milk used needed, ods: All fo fo t n ry fa ta men t or in • Comple ifferent to breas ry small c liquids d art of weaning. zin ed in a ve st e th al requir ealth. Iron and er from in m A h nts and ineral: l role in • Trace m but plays a vita minerals for infa amount, ost critical trace lid are the m olid or so ng . ki of semis children duction who is only drin o tr in e g: Th baby • Weanin to the diet of a foods in formula milk. r breast o

Some De

s Key Word. . . . . . . . . . 193

tion 181 Introduc foods . . . . . . . . . 2 of new . . . . . . . . . . . . . 20 of s 0 od 24 ....

Iron. . . .

Africa, fo foods . . . . . . . . 2 erica, 191 23 ic Latin Am . . . . . . . . . . . . . . 3 Allergen evention . . . . . . 8 22 foods of eat. . . . . . . . . . 24 Allergy pr evention . . . . . 8 to 188 21 pr Learning . . . . . . . . . . . . . . . 4 Anemia urce foods . . . . 1 21 19 Legumes . . . . . . . . . . . . . . . .

Animal so s of . . . . . . . . . . . 8 16 .

Meat . . cal Asia, foodweaning . . . . . . . 2 182 18 gi . . d . . lo . .

-le . . ro . . t.

Neu Baby ent . . . .

2 181 velopmen developm. . . . . . . . . . . . . 17 Brain de for new foods. . 4 s.

192 18 . . od ar . . . . fo . . nd . . le . . ew . .

N Ca ..... ..... . . . .

8 7 . . .

18 22 s . . . . . nt s . . .... .....

Nutrie Cereal seeds . . first aid 205 176 Nuts and . . . . . . . . . . . . . . 6 Choking entary foods . . 0 id 20 17 . g ac em . . in pl ic . . feed Phyt Com .... d breast 196 216 g food .

Preparin h foods . . . . . . . 8 Continue . . . . . . . . . . . . . . 8 20 21 ilk ric Protein- . . . . . . . . . . . . . . . . 7 Cow’s m g countries . . . 0 19 23 in . . . s . .

Recipe . . . . . . . . . . . . . .

Develop prevention. . .

222 242 Tempeh tal vegetarian) . 6 Diarrhea bits. . . . . . . . . . . .

18 . ha (to . . g n . ....

Vega Eatin . . . . . .

7 es 220 17 Vegetabl n diet . . . . . . . . . 6 Feeding hout the day . . 5 16 17 . . ria . . . . ta . . . . throug ge . .

Ve ..... dules . . .

4 he . . sc 24 . g . ......

Weaning Feedin styles . .

190 192 Weaning orldwide . . . . . 4 Feeding d cereals . . . . . . 6 23 foods w . . . . . . . . . . . . . 20 Fermentergy . . . . . . . . . . . . 2 21 ....

Zinc . . .

Food alle avoid . . . . . . . . . . 4 18 Foods to . . . . . . . . . . . . . . . . 4 19 .

Fruits . . ed foods. . . . . . . 6 22 Germinat foods . . . . . . . . . , es Ill babi

1,200 1,100 1,000 900 800 700 600 500

Energy intake (kcal/day)

Energy intake (kcal/day)

Energy Provided by Breast Milk According to the Age of Introduction of Complementary Foods

Family foods Transitional foods Breast milk

0

3

6

9

12

15

18

21

Child’s age (months) Period of complementary feeding

Early introduction of complementary foods (around 3 months) Early introduction of complementary foods leads to a decline in breast milk production from the third month.

Maintaining breastfeeding up to 12 months is no longer possible.

1,200 1,100 1,000 900 800 700 600 500

Family foods Transitional foods Breast milk

0

3

6

9

12

15

18

21

Child’s age (months) Period of complementary feeding

Introduction of complementary foods at proper time (around 6 months) When complementary foods are introduced from the sixth month, breast milk production is maintained beyond 12 months, which confers additional benefits to both mother and child.

same meal.

182

First Foods and Brain Development

Citrus juice Feed two spoons of citrus fruit juice after each cereal meal to enhance iron absorption.

Foods eaten early in life influence intellectual development.

Research has shown that the early diet of a human being during infancy, when the brain is rapidly growing has an impact on brain structure

reast B e h t m o fr Weaning

166 Foods that are received during infancy and childhood have great influence on brain development. This influence becomes particularly . ’s nutrition important during the transitional period between ge in a baby breastfeeding and table or family foods, when A major chan babies are highly vulnerable to nutritional deficiencies. Thereby, a healthy and nutritious complementary feeding, starting by weaning r Breast oods afte F foods, is critical to achieve a good, intellectual st ir F e Th la Milk development.

What or Formu mother will ask herself: ilk drains m g st in ea rs br nu y m Every y baby after feeding his baby with e m ed fe I l m shal ther hat shall co other or fa Higher IQ with a Healthy Diet off? The m also thinks about “W ilk m a ul rm fo The University of Southampton (UK) conducted nt because next?” urse, releva research aimed at unveiling the connection ns are, of co is as nutritious and tio es qu e ld between the weaning diet (from 6 to 12 months), or Thes od in the w and the cognitive and neuropsychological no single fo ilk for babies. m development later in childhood.b Two food suitable as patterns were identified: • The so-called “infant guidelines” pattern- characterized by high consumption of fruit, vegetables, and home-prepared foods, and low intake of commercial baby foods in jars.

• The “adult foods” patternned ust be plan characterized by high frequency of rever Weaning m out ilk is not fo must map a m rs, st he ea ot Br m d. consumption of savory snacks, processed meats, to an en l event in rly nursing n will come of living s, particula aning, the most crucia t weaning tio nt uc re od Pa and chips. pr e challenge breast milk king abou ans for we

Foods First Complementary Seeds 3. Legumes, Nuts and

. ter th th Sooner or la confronted then wi east (or formula) milk br will be other than s The infant od fo m fro

in thorough pl ent. Reading and th required for parents lopm d. by is child’s deve entary feeding for ba s of this exciting perio ge em and compl me the many challen co er to ov

ocess of st is the pr tary om the brea complemen Weaning fr oducing a range of ued. Weaning tr in in gradually breastfeeding is cont breastfeeding, foods while ply a sudden stop to entary foods em im should not bination with compl m rather its co of several months. veal that od ent times re over a peri s from anci ranges from 1 to 2 rd co re l ca ning Histori celebration time for wea the average Traditionally, a family d from the ne e. ea ag w of as s nt w year ary hen an infa en custom occurred w t cultures, it has be the first teeth os n m he In w . s st es ea oc br weaning pr onth. to start the , around the sixth m east is gy from br er en erupt, that , riod weaning pe t 50% of infant’s e th g in ur HEALTHY AND STRO ou D NG · 4 · Comple provide ab olid or solid mentary feedin milk should requirements. Semis provide t total energy ry foods offered mus icularly iron, ta rt en pa RDA (Rsec complem om d min meralBs,de vitamin an vitamen in 6. d Dietary Allowance) of Iro enoughInfa d an n (mg per day) , A nts from in m 7 to ta 12 mon ths old and adolesc zinc, vimenstru ents ating females 18 mg

mg per day

Fruits and vegetables enhance intelligence High consumption of fruit, vegetables, and home-prepared foods from 6 to 12 months is associated with higher IQ (Intelligence quotient) at childhood.

Cereals plus fruits Cereals can be mixed with banana, mango, or other mashed or pureed fruit.

per day. Figures exp(particularly girls) need a high intake ress the Dietary Refe of iron. Male adults nee rence Intake of iron from birth to 18 yea d 8 mg of iron per day an rs (p. 326).

Girls: 15

11 10 Boys: 11

7 8 0,27

There is a great diversity of foods that facilitate the proper development of children.

0 to 6 months

Infant relies on iron 7 to 12 stores. Milk provides months little iron.

Milk alone does not meet iron requirements.

1 to 3 years

4 to 8 years

9 to 13 years 14 to 18 years

Girls need more iron because of menstruation.

Iron Content of So

me Complementa

ry Foods

Childhood

Understanding how to eat healthy fosters the child's learning development and maturity.

A time to set healthy eating habits.

HEALTHY AND

ildhood

STRONG · 5 · Ch

247

Meeting Protein Needs A vegetarian diet, even without milk or eggs, will meet protein needs of a child provided that these two conditions are fulfilled: • Sufficient calories are ingested.

– Cereals (as oats, corn, or rice), tubers (as potatoes, cassava, or yam), dried fruits (as raisins, figs, plums, or dates), and nuts are good sources of calories.

• A variety of plant proteins are included in the diet.

– Soybeans, soy products, other legumes, cereals, and nuts are the main sources of proteins in a total vegetarian diet.

y Words

ns Some Definitio

Ke Fruit juices for Children

to a adding nutrients The process of s of nutrients during • Enrichment: los the for e sat ent” food to compen erence between “enrichm cal e diff tical. For practi processing. Th ore the y inl ma ” is and “fortification ent is used as a synonym of hm ric purposes, en fortification. nt reaction of ty: An unpleasa ds, including • Food sensitivi gin to certain foo l pain. unspecified ori a, bloatedness, or abdomina ins and am heartburn, nause vit g din ad : The process of of whether these • Fortification ds, irrespective fore minerals to foo ginally or not in the food be ori nutrients were g. ion ret sin proces ers to the sec d alone, milk ref . In many • Milk: When use nds of mammalian animals of mammary gla onym of “cow’s milk”. a syn cases, “milk” is itish nutritive lks: White or wh ers, such • Non-dairy mi ned from nuts, seeds, or tub tai ob es ag bever lk. mi as almond or soy n-dairy milks”.

Equivalent to “no een • Plant milks: especially betw al, me ick qu • Snack: A small, . als me regular

. . . . . . . . . . . 276 Menus . . . . . . . . . . . . . . . . 268 n . . . . . . . . 293 Milks, non-dairy n. . . . . . . 292 Acne preventio 280 . . . . . tio ion Mucus preven . . . . . . . . 262 Appetite educat n . . . . . 292 ... . . tio . . . ven . . i pre a esl Mu Asthm iting . . . 295 Nausea and vom . . . . . . . . 262 Calcium . t . . . . . . 257 Nuts and seeds . . . . . . . . 263 in dairy-free die e . . eas . . . dis rs ar Nut butte Cardiovascul . . . . . . . . 309 Nutrients prevention . . . . . . . . . 286 t. . . . . 256 ..... in vegetarian die nts 249 Chocolate . . .

307 . . . . . . pleme l cia Nutritional sup . . . . . . . . 298 Colorants, artifi n ... . . . . atio . . ent ty esi lem Ob Comp . . . . . . . . 250 Osteoporosis of proteins . . . . . . . . . 294 . . . . . . . . 309 ..... prevention . . .

Constipation . 7.6. . . . . . . 285 .

2 . . . . .

Prevention, Cow’s milk 288 . . . . . . . . . . . . 309 tion for adult life . . . . . . . . 291 Diabetes, preven . . . . . . . . 296 .. ...

Processed meats . . . . . . . . 250 Diarrhea . . . . .

282 . . . . . . . . . . . ...

Proteins . . . . .

Drinks to limit . . . . . . . . 251 . s ute s stit tein Pro Egg sub s . . . . . . . 258 ment . . . . . 248 for vegetarian . . . . . . 287 Energy require . . . . . . . . 252 ..... ...

Red yeast . . . .

Fiber. . . . . . . . . . 262 . . . . . . . . . . . . . 287 . . . . . . . ds . . . foo .

Refined Flakes . . . . . . . . . . . . . . . 274 . . . . . . . . . . . 270 Sandwiches . . nce . . . . 278 Fruit juices . . . . . . . . 302 . . . ma ce for ran per ole School Food int . . . . . . . . . . . 272 Snacks . . . . . . .

Foods to limit . . . . . . . . . . . 283 . . . . . . . . 284 Soft drinks . . . or to avoid . . . . . . . . . 284 . . . . . . . . . . . . 266 . . . . . . . . . milk .

Soy Game meats 262 . . . . . . . . . . . . . 264 seeds Soy products Grains, nuts, and rian . . . 258 . . . . . . . . . . . 286 eta ed. veg add Sugar, Growth of 273 . . . . . . ction . . . . . 260 .....

Vegetable reje . . . . . . . . 254 Hummus . . . . . . . . . 307 . . ld . . . chi . y rian ivit eta Veg FAST Hyperact . 256 (p. 262) AK 302 . . .

RE . . .

B d . . . . . . . . . .es . foo VitaminoBm12e. .made flak s.

Intolerance to ce . . . . . 304 it •H u ran fr ole int ed e tos Lac with slic . . . . . . . . 290 Meat and cancer f soy milk • A cup o flour biscuits.

Meat as source . . . . . . . . 250 ole . . . s (p. 315). with wh of protein 288 . . ood walnuts ldh Meat during chi lad with

Fruit juices should be used as part of a meal or snack, but not sipped throughout the day.

dren l i h C r nus fo ately combined. e M y h Healt n dishes and snacks adequ Vegetaria

Menu A

• Fruit sa

LUNCH

hoe le horses • Vegetab (p. 275). nuts eas with • Chickp .

0) t 25 (p. read toas -wheat b • Whole elette (p. 315). with om or other banana • Mango, e (p. 273). ak sh fruit

DINNER

Menu B 2). ice (p. 26 orange ju soaked in (p. 263) er tt u • Muesli b d n ith almo • Toast w lasses or honey. and mo h fruit. es fr g of • A servin LUNCH getable • Raw ve 5). salad. eat (p. 26 h soy m tato • Rice wit o p ed or pure • Baked ach. es, with spin ed prun ful of dri • A hand , or figs. es at raisins, d

BREAKFAST

DINNER

otatoes sweet p • Mashed les (p. 187). h vegetab tofu wit • Grilled .

5) (p. 26 h fruit. g of fres • A servin

le soup.

• Vegetab 5) rger (p. 26 • Soy bu ot sticks. with carr h fruit. g of fres • A servin

SNACKS

h sandwic • Apple as and/or (p. 274) r other se gu erries (o • Strawb h soy or milk yo it w fruit) (p. 314).

SNACKS

le uacamo s with g • Nacho and/or 5) 31 . (p sesame uce with • Applesa . (p. 209)

e menus

Notes

. In thes is dinner others it e day; in eating habit. th f o l mea mily time. the main ing to fa fore bed

lunch is

the main

me

Food Rejec

HEALTHY

tion Can Be

AND

STRONG · 5

· Childhood

Overcome According to inherit the research studies, m an ta love fruits ste for meat but ne y children ed an approach, d vegetables (p. 28 to learn to 0) disliked fo ods may be . With a smart Teaching th co me liked. e vegetables child the health be ne an when harv d fruits, and show fits of ing es improve ac ting, buying, or eatin enthusiasm ceptance. g them will help

Dress up ve ge y children, tables: Use something lik oyyeed d uliflower, or e adding melted chee enjo se to peanut butte r to carrots. o e creativity to t particular make it fun: Food s in ly played in an the rejected ones, sh general,, ou d be mbining br attractive way at the ld ight food co ta lors and sh bllee,, ake up a pl ap at getables (b e of appealing and co es. aby corn, ch lo cks...). erry tomat red oes, caarr rrot ot t vegetables in ve dipping to artistic shapes. sauce with vege dren like to dip vegetabl tables, ass e. e chunks in na the senses : Allow the ected food child to ex pl w smell and ta ith all senses: sight, he ore ste. arin ng, g aw: Cooke d jected, whe or boiled vegetables ar re er) or steam as the same food raaw e w cooked can grilling, or frying vege be accepted d.. tables is an notthe her

A bad nutrition during infancy can condemn a person to suffer dangerous diseases in adult life.

261

248

Energy and Supplements for Children Meeting energy requirements is the first nutritional need for children.

Prefer it ra egetables ar w e an cooked often better accepted or boiled. Ba ed vegetabl ked, grilled, es can also be enjoyed.

Children need energy because they expend energy. The energy requirement is the amount of food calories needed to maintain body size, body composition and advisable physical activity, plus the calories needed to support growth.

Energy Requirements Being overweight must not be seen as a sign of child’s good health.

The side table “Average daily energy requirement of children and adolescents” displays accurate data from FAO (Food and Agriculture Organization of the United Nations).

To get an estimate of energy requirements this simple calculation can be applied: Every day a child needs about 40 calories per inch of height, equivalent to 17 calories per centimeter.

Energy demands for growth constitute about 35% of the total energy requirement during the first three months of life. The proportion of energy needed for growth decreases to about 17% of total energy requirements from months 3 to 6, to about 6% up to 12 months, and to about 2% during the second year until the end of adolescence. Beyond 20 years of age, no more energy is needed for growth.

ty i s e b O d l i Ch nsequences.

g co ic with lifelon m e id p e rn e d A true, mo

Nutritional Supplements A child eating a balanced diet rarely needs to take vitamin or mineral supplements. Nevertheless,

Energy needed for growth

If the the child’ss intake int ntak akee off energy energgy is not not ssuffi uffi ffici cien cient, ent, t, may halt it m ay sslow low w or h alt al lt gr ggrowth. ow wth th..

Children need energy to perform physical activity and to grow.

310

Chapt

HEA EAL LTH LT HY H

er 6

Y AND

e c n e c s e l o d A

· 6 · Addol o escenc e

C

Facts

escence. ring adol scence ined du t Adole u eight ga o w e. l b nc ea A ce adult id adoles ures during of final and Fig reached rcentage

25-50% 15-20%

ht girls. ult heig olescent ge of ad fat for ad Percenta boys. of body olescent entage rc ad r pe fo al t Norm body fa tage of en rc pe Normal

Pe

Some De

finit

ions • Adoles ce that occu nce: The period in human adulthoo rs between the beginnin development d. g of pube • Eating rty and di eating ha sorder: A conditi on define or excess bits that may in volve eith d by abnormal ive food physical intake as er insuffi an nervosa d mental heal sociated with da cient th. are the m m ost com Bulimia and an aged • Family mon spec or m ific type exia share fo eal: A happy tim s. od, thou e w hen ghts, an • Pubert d emotio family members y: nal wellb functionaThe period whe eing. n emerge l and the second the sex glands : like chan be ar in girls. ges to vo y sexual charac come teristics ice in bo ys and to breasts

lifetime b at the Un enefits. Accordin g to rese iversity of sharing arch con Illinois three or more mea (USA), a adoles ducted their par ce en overweigh ts receive signifils weekly at hom nts ew ca t and eati ng disor nt protection ag ith ainst ders like an or ex ia. a. Hamm ons AJ , Fiese the nutri tional he BH. Is frequen Jun;127 (6):e156 alth of children cy of shared fam 5-74. Pu bMed PM and adolescents? ily meals related ID: 2153 to Pediatrics 6618. . 2011

Key Word

s

Alcoholic Anorexia beverages. . . . .

31 Athlete, . . . . . . . . . . . . . . . . 6 adolesce 32 Bulimia nt . . . . . 0 .

31 Drinks fo . . . . . . . . . . . . . . . . 2 320 r adoles Intellect cents . . . ua 31 Legumes l performance 7 31 Physical for adolescents 3 perform 313 Snacks fo an r adoles ce . . . 312 cents . .

314

Soft drin ks Sports nu . . . . . . . . . . . . . .

31 Vegetaria trition . . . . . . . . . 7 31 n adoles cent . . 31 2 8

Anorexia and BulimiaHealthy Snacks for Adolescents 23% 17%

Parents and caregivers can detect early signs of an eating disorder, thereby reinforcing preventive measures.

There are many more options than the typical and hardly adequate burger and chips.

Excessive snacking can lead to becoming overweight, but one or two daily, healthy snacks can be adequate for adolescents.

uacamole Nachos with G

the ith guacamole, os combined w ado, onion, and/ ch na ze ai m y avoc Crisp dip made with d salt. typical Mexican asoned with lemon juice an se d because s an nt s, ce er es pp ol pe ad r or fo y very adequate of their health Avocados are ated ur at ns ou mon fats, proteins, ts. and iron conten

Physical and emotional changes in adolescents demand a special care in diet.

31

Family m eals are nts regu larly ta prev are less lik king part in fam entiv ily el have eatiny to become over meals weigh g di than adol escents fresorders or use dr t, ug quently eating ou s t.

Adolesce

d. dulthoo od to a o h d il h from c period nsition a tr e Th

te. But iform ra se in a vely un a relati sudden incre other at w gro ny ,a hildren 5 years of age ater than in a dolescent rs, gre 0 to 1 life. A from 1 velocity occu first year of 8 and 24 e 1 growth pt that of th gins between ce nal time ex spurt often be than in boys. additio ls ir th g ires an grow sooner in th requ e time, is s w th ro n g o l m sica e sam anges ent phy nd at th ural ch Adolesc f nutrients, a onal and cult r. The o supply d with emoti eating behavio l needs and a te a associa tly impacting sed nutrition ional pressure . a it frequen ation of incre leads to add or caregivers combin g feeding style nd for parents ity and v a in ti g ts si sen scen chan food r adole dose of g with both fo eed an extra when dealin n e Adults nal knowledg scence. nutritio sues of adole is e related t Hom ting a ecome graduaalllsy a E f o b to its y me Benef adolescents neemdily unit, famille, at least ib fa h g e ss u o th o p as us Alth from as long nutritio ipated emanc e maintained family meals ghters and b g au should ay. By makin adolescent d reat gift with g d once a yable to their wing them a jo and en rents are besto a sons, p

STR TRO ONG ON G

Adolescents may easily feel hungry, even while eating three regular meals a day because of their greater need for energy and nutrients. Resorting to a burger and French fries or to candies leads the way to weight gain, diabetes and high cholesterol. Fortunately, there are healthy snack alternatives which can satisfy hunger until the next regular meal while providing energy and avoiding weight gain.

Some snacks and sandwiches suitable for children may also appeal to adolescents.

Strawberries with Yogurt Good source of antioxidants, proteins, and calcium.

Strawberries can be replaced with other fruits, in chunks. Milk yogurt can be replaced with soy yogurt, which provides the same amount of calcium if enriched with this mineral.

30

Units, Abbreviations, and Acronyms

Diseases index Units

Infants and babies

Pregnancy

Allergies, 121, 234 ncy, 228 Anemia, iron deficie ction Candida albicans infe 241, 302 , 181, Celiac disease: 178 227 , Choking first aid Colic, 120 Diarrhea, 226 Food allergy, 236 Jaundice, 121 Ill babies, 226 mia, 228 Iron deficiency ane Oral thrush, 120 Reflux, 121

ous), 81 Abortion (spontane 82 Bacterial vaginosis, Birth defects, 94 ction, 82 Candida albicans infe Constipation, 79 , 78 Dental conditions es, 79 Gestational diabet Heartburn, 78 Leg cramps, 83 78 Morning sickness, g, 78 Nausea and vomitin Preeclampsia, 80 Thrush, 82 Vaginal yeast infection, 82 Vaginosis, 82

Childhood and adole

Nursing mothers

scence

Acne, 293 Allergy, 234 a, 320 Anorexia and bulimi Asthma, 292 Cancer, 290 Constipation, 294 Diabetes, 292 Diarrhea, 296 302 Food intolerance, Hyperactivity, 306 Lactose intolerance, 304 Nausea and vomiting, 295 Obesity, 298

s, 123 Breast engorgement Breast implants, 119 Mastitis, 123 r, 122 Milk production, poo d, 122 cracke Nipples, sore and , 122 Poor milk production 118 sion, Postpartum depres ples, 122 nip d Sore and cracke Twins, 116

ºC: Celsius degrees Calorie: In this book, equi valent to kcal (kilocalorie). d: Day. ºF: Farenheit degrees. fl oz: Fluid ounces. 1 fl oz = 29.6 ml g: Gram. 1 g = 1,000 mg = 1,000,000 μg J: Joule. Unit of energy in the International Syst em of Units.

1 J = 0.000239 kcal kcal: Kilocalories. Unit of energy used to express the energy content of food s. In practice, the prefix ‘‘kilo’’ is usually omitted. A popular convention is to designat kilocalorie by calorie. Othe e r synonyms of “Kilocalo rie” are large calorie, dietary calorie, nutritionist’s calo rie, or food calorie.

A kilocalorie or calorie appr oximates the energy needed to increase the temperature of 1 kg of wate r by 1 °C. 1 kcal = 4.184 kJ Kilocalories or calories are not included in the International System of Units (SI). The SI energy unit is the Joule (J). kg: Kilogram. 1 kg = 1,00 0g kJ: Kilojoule. A unit of ener gy equivalent to one thou sand Joules. 1 kJ = 1,000 J = 0.23 9 kcal l: Litre. 1 l = 1,000 ml m: Month. mg: Miligram. 1 mg = 0.00 1 g = 1,000 μg ml: Mililitre. 1 ml = 0.00 1l μg: Microgram. 1 μg = 0.00 1 mg = 0.000001 g oz: Ounce. 1 oz = 28.35 g

ADULT WOMEN

Bold framed cel

ls correspond

Nutrient Vitamin A (μg/d) [1] Vitamin C (mg/d)

to nutrients wh

Vitamin K (μg/d) Vitamin B1 or Thi amin (mg/d) Vitamin B2 or Rib oflavin (mg/d) Vitamin B3 or Nia cin (mg/d) [3] Vitamin B6 or Pyr idoxine (mg/d) Vitamin B9 or Fol ate (μg/d) [4] Vitamin B12 or Cob alamine (μg/d) Pantothenic acid (mg/d) Biotin (μg/d) Choline (mg/d)

700

1 teaspoon: About 5 ml (5 ml of wate r)

more than 30%

770 85 15

15

15

90*

14 1.3 400 2.4 5* 30* 425*

Chromium (μg/d)

1,000 25*

during pregnan

IDR (RDA or AI) for pregnant wo men 19-50 y

75

1.1

1 tablespoon: About 15 ml (15 g of wate r)

1 cup: About 240 ml (240 g of water)

dex Alphabetical In

d minerals

15

Calcium (mg/d) opper (μg/d

ich DRI increases

1.1

Abbreviations and acron yms

AAP: American Academy of Pediatrics.

ADA: American Dietetic Association.

AI: Adequate Intake. AI is the reco intake level based on obse mmended average d rved or experimentally determined approximation s or estimates of nutrien intake by a group (or grou ps) of apparently healthy people that are assumed to be adequate. AI is used when sufficient scientifi c evidence is not available t calculate an RDA. ALA: alpha-Linolenic acid , an omega-3 polyunsatura ted fatty acid found in seed s and other plant foods.

ARA: Arachidonic acid, a omega-6 LC-PUFA foun d main in meat. In excess, ARA has a pro-inflammatory effec DDT: Dichloro Diphenyl Trichloroethane. DDT is a pestic having a great impact on heal has been banned worldwid th and environment. It e, remain for years in the food although being a POP chain.

DFE: Dietary Folate Equi valent, used to express the vitamin B9 activity of a food or medication. 1 DFE = 1 μg of food folate = 0.6 μg of folate from fortified food or as a supplement cons umed with food = 0.5 μg of a

for vitamins an

IDR (RDA or AI) for non-pregna nt lactating wome nonn 19-50 y

Vitamin D (μg/d) [2] Vitamin E (mg/d)

syn: Synonim y: Year.

Common measures

Tableaux de s nutriments Dietary Referenc e Intakes (DRI)

p: Page. ppb = parts per billion.

1 ppb = 0.001 ppm ppm: Parts per million.

1 ppm = 1,000 ppb = 1 mg/kg μg/g

90* 1.4 1.4 18 1.9 600 2.6 6* 30* 450* 1,000

us, 81 Abortion, spontaneo , 42

Absorption of iron Acne, children, 293 241 IDR (RDA or AI)Additives, food allergy, for lactating wo Additives food in pregnancy, 49 men 19-50 y ADHD – and diet, 306 1,300 nce, 303 – and food intolera 120 Adolescence, 310 15 – definition, 311 , 321 – eating disorders 19 – pregnancy, 76 90* – vegetarian, 318 vention, 308 Adults, diseases, pre 1.4 Africa, 1.6 193 – fermented foods, 190 17 – weaning foods, ALA fatty acid, 27 2.0 rs, 145 – for nursing mothe 500 – plant sources, 29 2.8 Alcohol, ects, 95 – cause of birth def 7* 316 – in adolescence, 35* – in pregnancy, 93 , 27 550* Alfa-Linolenic acid plant sources, 29 – 1,0 5

cy or lactation

.

ds, 191 Asia, fermented foo 292 Asthma, children, feeding, 107 Attachment, breast lerance, 303 Autism and food into

Babies,

198 – carbohydrates, – cereals, 184 foods, 184 ry – complementa – cow’s milk, 216 – definition, 97 – energy, 199 – fats, 199 – fiber, 201 n, 206 – food preparatio to limit, 212 – foods to avoid or – fruits, 185 foods, 183 – hand and finger – ill, foods, 226 – iron, 202 – legumes, 188 – meat, 214 – nuts, 189 – proteins, 198 – recipes, 208-210 – seeds, 189 – supplements, 201 , 222 – total vegetarian

astfeedin Breast implants, bre Breast milk, rition, nut – and maternal – antibodies , 110 – composition, 98 6 – expressed, 124 –12 – fatty acids, 155 160 – galactagogues, – iodine, 146 , 122 – poor production – selenium, 147 – vitamins, 146 Breast, – engorgement, 123 – implants, 119 – mastitis, 123 ause – sagging, not bec breastfeeding, 100 Breastfeeding, – attachment, 107 infan – benefits for the mot – benefits for the need – carbohydrates, – continued, 170 – definition, 97 – difficulties, 120 14 – energy required, – exclusive, 104 – features, 100

HEALTHY AND

STRONG An adequate nutrition during childhood and adolescence is one of the great tools for preventing and fighting diseases in a human being life. In reality, it is one of the great legacies parents transmit their children. Hence the importance to have a complete children’s food guide.

Healthy and Strong represents an indispensable nutritional manual through the children development process, since pregnancy, lactation and adolescence.

Its reading and implementation of the exposed advices may imply the prevention of future health problems in our sons and daughters.

GEORGE D. PAMPLONAROGER is a physician and surgeon and an expert in Public Health. Through his professional life as a surgeon, he has come to know the human body well, both inside and out. And with his broad-ranging experience as an educator in the field of healthcare, he has an excellent ability to communicate and reveal scientific knowledge, making its many complexities easy to understand. Dr. Pamplona-Roger authored the Encyclopedia of Medicinal Plants and the Encyclopedia of Foods and their Healing Power, which have been translated into major languages from all over the world and published by Editorial Safeliz, in addition to other printed works.