0313 - Nutrition in Infants and Children Flashcards
What are the components of a child’s energy requirements?
Basal metabolic rate (60-70%)
Energy expended in physical activity (EE) 30-40%
Energy cost of growth
What are the components of the energy cost of growth?
Energy used to synthesise new tissue
Energy deposited within the newly developed tissue.
How can birth weight impact later disease?
Low birth weight, the body is used to grabbing what it can. Particularly if the infant is overfed when they’re used to little food, this can lead to more obesity later.
How can infant diet affect later disease?
Providing a diet lower in nutrients to preterm and term infants confers later cardiovascular advantage independent of birth weight. Dose is related to the intake of breast milk.
Slower infant growth favours later cardiovascular health.
Which infantas have the greatest risk of later insulin resistance and endothelial dysfunction?
Infants born preterm and with rapid weight gain in first few weeks.
Those who grew less well had less insulin resistance and better endothelial function.
What are the principal reasons why children are malnourished? (KEY EXAM CONCEPT)
Most common - social and psychological (fatty/inappropriate diet, poverty, chronic pain, apathy, depression)
Medical causes (disease-related anorexia, malabsorption, increased energy needs, altered taste perception, poor oral mechanics, disability)
Hospital-specific features (treatments at meal times, wrong food for disability, poor feeding supervision, post-surgery)
KEY EXAM CONCEPT
How do children in developed countries present with malnutrition
Specific vitamin deficiencies, iron deficient, high infectious disease burden.
Hospital admissions NT - 20% undernourished 12% wasted, 5% stunted, 3% wasted and stunted.
How do children in underdeveloped countries present with malnutrition?
Kwashiorkor
Protein deficiencies lead to ascites, muscle wasting, oedema, flaking and depigmented skin, glossitis and cheilosis.
Chronic infection with vitamin deficiencies that lead to pellagra and blindness.
Very specific problems with refeeding.
What is the interplay between chronic disease and malnutrition?
There is a cycle - malnutrition leads to decreased immunity, impaired GI and cardiopulmonary function, and increased infection, leading to more chronic disease.
Chronic disease leads to anorexia, decreased intake, increased requirements, chronic inflammation, increased losses, all lead to negative energy and protein balance - malnutrition.
