Nutritional needs of different groups

Explain the specific nutritional needs of a 14-year-old female vegetarian who is a competitive swimmer. (8 marks)",
"marks": 8,
"solution": "Introduction: A 14-year-old female vegetarian competitive swimmer has complex nutritional needs due to the combined demands of adolescence, menstruation, a restrictive diet, and high physical activity.

Paragraph 1 - Iron Requirements: As an adolescent female, she is at high risk of iron-deficiency anaemia due to menstrual blood loss. Her vegetarian diet excludes haem iron from meat, which is more easily absorbed than non-haem iron from plant sources. She must consume plenty of non-haem iron from sources like lentils, spinach, and fortified breakfast cereals. Crucially, she should consume these with a source of Vitamin C, such as a glass of orange juice, to maximise absorption.

Paragraph 2 - Protein for Growth and Repair: Adolescence is a period of rapid growth, and as a competitive swimmer, she requires additional protein to repair and build muscle tissue damaged during training. As she is vegetarian, she must combine different plant-based protein sources (e.g., beans on toast, or rice and dal) to ensure she receives all essential amino acids. Good sources include tofu, quinoa, nuts, and pulses.

Paragraph 3 - Energy and Calcium: Swimming is a high-energy sport, so she will need sufficient carbohydrates to fuel her training. Complex carbohydrates like wholemeal bread and pasta will provide a slow, sustained release of energy. Furthermore, she needs adequate Calcium and Vitamin D to achieve peak bone mass, which is critical during adolescence. Vegetarian sources of calcium include fortified plant milks, cheese, yoghurt, and leafy greens like kale.",
"examiner_commentary": "This is a Level 3 response, likely to achieve 7-8 marks. It successfully deconstructs the scenario, addressing each component (adolescent, female, vegetarian, athlete). It uses precise terminology (haem/non-haem iron, essential amino acids, peak bone mass) and demonstrates the 'Nutrient-Function-Source' chain effectively. To guarantee full marks, it could explicitly mention the role of iron in haemoglobin for oxygen transport, directly linking it to athletic performance."

Analyse the reasons why an elderly person (70+) has different dietary needs from a young adult (25). (12 marks)",
"marks": 12,
"solution": "Introduction: An elderly person's dietary needs differ significantly from a young adult's, primarily due to physiological changes associated with ageing. While energy requirements decrease, the need for specific micronutrients increases, a concept known as nutrient density.

Paragraph 1 - Energy vs. Nutrient Density: A young adult typically has a higher Basal Metabolic Rate (BMR) and is more physically active, thus requiring more calories from carbohydrates and fats for energy. In contrast, a 70-year-old has a lower BMR and is often less active, meaning their energy requirement is lower. However, their need for vitamins and minerals like Vitamin D, Calcium and B12 remains high or can even increase. Therefore, their diet must be more nutrient-dense, providing essential nutrients in fewer calories.

Paragraph 2 - Bone Health: A young adult is still consolidating bone density, whereas an elderly person is at high risk of osteoporosis, a condition where bones become brittle and fragile. The elderly person, therefore, has a critical need for Calcium to maintain bone strength and Vitamin D to aid calcium absorption. While a young adult also needs these nutrients, the focus for the elderly is on prevention of fractures and maintaining mobility.

Paragraph 3 - Muscle Mass and Digestive Health: The elderly person is at risk of sarcopenia, the age-related loss of muscle mass. Adequate protein intake is vital to slow this process. A young adult requires protein for maintenance, but the imperative is less critical. Furthermore, digestive health can decline with age, leading to constipation. A higher intake of dietary fibre from wholegrains, fruit and vegetables is therefore more important for the elderly person than for the young adult, who may have a more efficient digestive system.

Conclusion: In summary, the dietary shift from young adulthood to old age is marked by a reduction in energy needs but an increased focus on nutrient density. The key differences are driven by changes in metabolic rate, bone health, muscle mass, and digestive function, requiring a targeted intake of protein, fibre, and specific vitamins and minerals to maintain health and quality of life.",
"examiner_commentary": "This excellent response would achieve Level 4. It directly compares the two groups throughout and uses precise terminology like 'Basal Metabolic Rate', 'nutrient density', 'osteoporosis', and 'sarcopenia'. The structure is analytical, explaining why the needs are different, which is exactly what the command word 'Analyse' requires."

A local care home for the elderly has asked you to modify a beef lasagne recipe to make it more suitable for its residents. Explain the modifications you would make and justify your choices. (8 marks)",
"marks": 8,
"solution": "Modification 1: Increase Fibre Content: I would replace the standard white pasta sheets with wholemeal pasta sheets. I would also finely chop and add extra vegetables like carrots, celery, and courgettes into the bolognese sauce.
Justification 1: Elderly residents are prone to constipation due to reduced gut motility. Increasing the fibre content will help to promote regular bowel movements and support digestive health.

Modification 2: Enhance Calcium and Vitamin D: I would enrich the white sauce by using fortified milk (with added Vitamin D) and ensuring a generous layer of cheese on top.
Justification 2: This modification increases the Calcium and Vitamin D content, which are crucial for residents to maintain bone density and reduce the risk of osteoporosis and fractures. Vitamin D is essential for the absorption of calcium.

Modification 3: Reduce Salt Content: I would use low-salt stock cubes in the bolognese sauce and avoid adding any extra salt during cooking. I would use herbs like oregano and basil to add flavour instead.
Justification 3: Elderly people are at a higher risk of high blood pressure (hypertension). Reducing the salt content helps to manage this risk, which is a major contributor to cardiovascular disease.

Modification 4: Softer Texture: I would ensure the bolognese sauce is cooked for a longer period to make the meat very tender, and I would add a little extra liquid (e.g., milk or stock) to the white sauce to make it runnier.
Justification 4: Some residents may have difficulty chewing or swallowing (dysphagia). Ensuring the final dish has a softer, moister texture makes it easier and safer for them to eat.",
"examiner_commentary": "A full-mark response. The candidate has provided four distinct modifications, and each one is clearly justified with a direct link to a specific health need of the elderly. The use of terms like 'gut motility', 'osteoporosis', and 'hypertension' demonstrates excellent subject knowledge. The justifications are not generic; they are applied specifically to the residents of a care home."