ADVANCED DIPLOMA IN PRINCIPLES OF NUTRITION · PDF fileAdjust diet to help reduce symptoms ......
Transcript of ADVANCED DIPLOMA IN PRINCIPLES OF NUTRITION · PDF fileAdjust diet to help reduce symptoms ......
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ADVANCED DIPLOMA IN PRINCIPLES OF NUTRITION
@ShawPhotoTomCourse Educators: Thomas Woods, William Eames
BY AMANDA BRODERICK BSc ANutR
BSC HONS Sports Biomedicine and Nutrition
BY AMANDA BRODERICK LESSON: 2
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Course Educator:
Amanda Broderick Course Educator
B.A. (Hons.)
Semester 1: Nutrition through the LifecyclePractical Lesson 3
@ShawNutritionA [email protected]
Nutrition for Teenagers
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Practical Lesson 3 Learning Outcomes:
Menstruation
Premenstrual syndrome
Case study
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Menstruation
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• Menstrual cycle: time between the 1st
day of period through to next period.• Menstruation or menses- period
• Day 1- first day of period• Day 14- ovaries release an egg
(ovulation)• Day 28- uterus begins to shed if
pregnancy has not occurred
Menstrual Cycle- An Explanation
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• Typically follows a 28 day pattern
• During the menstrual cycle, hormones that fluctuate significantly are:
• Follicle-stimulating hormone (FSH)• Luteinizing Hormone (LH)• Oestrogen• Progesterone
Menstrual Cycle
Follicular Phase (proliferative) days 1-14Ovulation (Not a phase) usually day 13-14Luteal Phase (secretory)-Days 15-28
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Low body fat % to weight Strenuous and consistent exercise Extreme dieting Menopause Illness Pregnancy Polycystic ovaries High stress Undiagnosed gluten sensitivity, coeliac disease or
malabsorption Undiagnosed autoimmune syndrome/disease
Common Cycle Disturbances
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Premenstrual Syndrome
• Premenstrual syndrome (PMS)- occurrence of physiological and/or psychological symptoms during the luteal phase of the menstrual cycle and which are relieved by the onset of menstruation
Common physical symptoms:Bloating, Weight gain, Mastalgia (breast tenderness), Lack of energy, Headache
Common psychological effects:Depression, irritability, anxiety, tension, aggression, feeling overwhelmed
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Most women experience at least mild symptoms 5-8% of women experience severe symptoms
which can disrupt normal life Length of symptoms- a few days to 2 weeks Symptoms are worse 6 days before menstruation Symptoms peak 2 days before menses starts Anger and irritability are the most severe
complaints Symptoms usually fade on first day of period but
can linger into the next menstrual cycle Anxiety disorders also occur at a higher rate in
women with PMS
Prevalence of PMS
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Diagnosis: daily charting of symptoms over 2 menstrual cycles
Women with PMS should be investigated for depression, dysthymic disorder, anxiety disorders and hypothyroidism
Medication for PMS: Use of progestogens e.g. progesterone Antidepressants e.g. selective serotonin-reuptake
inhibitors (SSRIs)
Prevalence of PMS
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Premenstrual Dysphoric Disorder
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Calendar method is easiest way to chart cycle
Day 1 is 1st day of bleed Day 14- ovulation Day 14- oestrogen and luteinizing hormone
peak during ovulation Day 20-28- oestrogen peaks a 2nd time with
progesterone….this is when the majority of PMS symptoms peak during the luteal phase
Chart Your Cycle< Jul 2014 >
Sun Mon Tue Wed Thu Fri Sat
1 (15) 2 (16) 3 (17) 4 (18) 5 (19)
6 (20) 7 (21) 8 (22) 9 (23) 10(24) 11(25) 12(26)
13(27) 14(28) 15 (X 1) 16 (2) 17 (3) 18 (4) 19 (5)
20 (6) 21 (7) 22 (8) 23 (9) 24(10) 25(11) 26(12)
27(13) 28 (O) 29(15) 30(16) 31(17)
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Adjust diet to help reduce symptoms Oestrogen may also increase the efficiency of
insulin causing hypoglycaemia-sugar/carbohydrate cravings
Most women with PMS feel great during the follicular phase or after the start of menses-oestrogen and progesterone along with luteinizing hormone are at their lowest levels
LUTEAL PHASE- balanced nutrition, sleep, exercise and stress management are most important during this time
Chart Your Cycle
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Plentiful fruit and veg Increase complex carbohydrates- Low GI diet- raises
levels of tryptophan (pre-cursor of serotonin and other neurotransmitters)
Plenty of fluids Avoid Caffeine Reduce sugar intake Avoid alcohol Reduce salt
Achieve a healthy weight- BMI positively associated with PMS
Get regular exercise- aerobic exercise preferable Get plenty of sleep CBT
Stop smoking-increases risk of PMS
Healthy Lifestyle To Treat PMS
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Calcium carbonate-1,200mg/day…good evidence Vitamin D- 400mg IU/day Vitamin B6-neurotransmitter formation and
influence on mood- up to 100mg/day…no conclusive evidence,
Doses >200mg/day can cause neuropathy
Dietary Treatment of PMS
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Vitamin B1 (thiamine)- 1.1-1.9mg/day…2-3 servings of fortified cereals, legumes, nuts and red meat
Vitamin B2 (Riboflavin)- 1.1-2.5mg/day…1-2 servings fortified cereals or 6-7 servings riboflavin rich foods such as cows milk or soy milk, spinach, red meat
Better to obtain Vitamins B1 and B2 through food than supplements
Vitamin E- up to 600IU/day, although limited belief Magnesium- up to 500mg/day…mixed evidence, may
improve mood and decrease water retention Manganese Zinc- lowers risk of PMS Iron-high intake non-haem iron associated with
decreased PMS, >20mg/day may be helpful Potassium- may actually worsen PMS, more studies
needed
Dietary Treatment of PMS
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Other Supplements Chasteberry supplement- anti-prolactin effects….may have benefit Evening primrose oil-Ƴ-linolenic acid (GLA), usually taken in the
form of evening primrose oil or starflower oil, can improve symptoms of breast tenderness, probably as a result of its effects on prostaglandin production – 500-1,000mg/day
Chaste tree extract- 30-40 mg/day, few adverse effects St. John’s Wort- no controlled trials evaluating use for PMS, long-
term effects unknown, a small pilot study showed efficacy in PMS St. John’s Wort has known interactions with SRIs and other
medications Natural progesterone- shown to be ineffective in controlled trials Gingko- no controlled trials, potential for drug interactions Kava- no controlled trials, potential for hepatotoxicity Dong Quai- no controlled trials, unsafe in pregnancy, should not be
used by patients on anticoagulants Black cohosh- stimulates oestrogen receptors, used to treat anxiety,
breast pain, no controlled trials
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Katie is a 15 year old elite-level gymnast.
She is concerned about her weight as she
recently gained 2kg in weight which will
affect her athletic performance.
She is weighing herself every morning
Skipping breakfast
Ends up snacking on junk food
Starving in the evening and eats huge
portions
What would you advise her??
Case Study
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Not concerned overly about health at this point in life
Body shape- many think they are too heavy and exhibit body dissatisfaction
Body image- important contributor to choosing food
Parental control Age Gender Media influences Peer pressure Personal issues during puberty Dieting Food knowledge
Factors Affecting Adolescent Food Choice
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Not meeting macronutrients requirements-carbs, fats and protein
Not meeting calcium and iron requirements Snack choices-high in fat, e.g. potato crisps and
chocolate Evening meals- prepared with high fat cooking
techniques Eating late in the day-resulting in lack of energy
and inability to recover after training Skipping breakfast
Assessment of Katie’s diet
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Consider: Food preferences- what foods does she
like/dislike? Food constraints- are the meals suitable for her
parents to cook for the family? Can she bring an extra portion to school?
Practicality- the suggested changes must not pose too great a burden in terms of time, effort or complexity – we know she is very busy
Healthy snacks must be included It is important to assess Katie's diet and establish
her needs, problems and usual eating habits
Considerations
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Increase: Fruit and veg consumption Include dairy in the diet or other forms of calcium to prevent
osteoporosis- 3 portions Vitamin D - 400-800IU/day Increase iron intake - may need a supplement Adequate calcium Long chain omega - 3 polyunsaturated fatty acids Adequate protein - 2 portions Fat - include oil rich fish 1 to 2 portions per week Increase fluid intake
How Can she Improve Her diet?
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Breakfast- 2 slices wholegrain bread with a boiled eggs, low fat natural yoghurt and fruit (approx. 500calories)
Mid-morning snack- handful nuts and an apple (approx. 150 calories)
Lunch-1 cup wholegrain rice, steamed vegetables (2 servings) and salmon (approx. 350 calories)
Mid afternoonChopped vegetables (2 servings) and low fat natural yoghurt (150 calories)
Dinner-Wholegrain rice, grilled chicken and sautéed vegetables (2 servings)Mixed fruit salad (approx. 400 calories)….total 1550 calories
6-8 glasses of water in the day
Fruit-3Vegetables- 6Olive oil- cookingDairy products- 2Carbohydrates-wholegrainOily fish and lean poultry
Use calorie counting websites or apps to help you to become
familiar with working out calories
Meal Plan for Katie
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Try attend all of the sessions live and see your knowledge grow
Lesson 4 will cover Optimising Nutrition as we Age
Recordings are uploaded within 24 hours of the completion of each live session
Further reading links are available if you wish to learn more
Next Steps
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Further Learning
To expand upon the subjects covered in todays lesson:
• Basic nutrition- Diploma in Nutrition
• Weight loss- Ultimate weight Loss Programme
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Advanced Course Resources
• Free Short Videos• Topical Items that Pop Up Frequently• Easy way of communicating that free content is
available without spamming you!!!!
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Before we begin let us gauge your experience level
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