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4) Nutrition Through Life > 10) Adolescence > Flashcards

10) Adolescence Flashcards

1
Q

Define a growth spurt.

A

Peak height velocity (fastest rate at which we are gaining height)

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2
Q

What is the period of highest nutritional needs during adolescence?

A

During growth spurts

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3
Q

During the growth spurt, there is an accretion of __% of the adult height and __% of weight.

A

20

50

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4
Q

How does the timing of the growth spurt vary between individuals?

A

There is a high variability in terms of the timing of the growth spurt

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5
Q

What age determines sexual maturity?

A

Age alone does NOT determine the stage of maturity of the adolescent

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6
Q

What is the best index for determining nutrient needs in an adolescent?

A

Caloric requirement is based on kilocalories per centimeter of height

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7
Q

What are the periods post-utero in which growth velocity increases?

A

Puberty is the ONLY period post-utero in which growth velocity increases

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8
Q

How does the age of puberty vary between girls and boys?

A

Puberty starts earlier in girls

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9
Q

What are the two factors that explain the fact that adult men are taller than adult women?

A

1) There is a longer of pre-pubertal growth in boys because the growth spurt occurs later in boys
2) Boys have a greater peak height velocity

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10
Q

When does menarche occur?

A

12 or 13 years old

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11
Q

The pubertal growth spurt is characterized by twice the incorporation of which nutrients into bone?

A
  • Calcium
  • Magnesium
  • Zinc
  • Iron
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12
Q

Chronological age is a (better/worse) indicator of nutritional requirement than maturational age.

A

worse

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13
Q

Nutrient needs during adolescence are determined individually according to which three factors?

A

1) Intensity and extent of the pubertal growth spurt
2) Gender differences in growth and body composition changes
3) Differences among individuals in terms of the timing of the pubertal growth spurt

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14
Q

What are Tanner’s SMRs? What are they based on?

A
  • Sexual Maturation Ratings
  • Used clinically to describe the sexual stage of development
  • Based on differences in primary and secondary sexual characteristics
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15
Q

How is the timing of growth related to SMRs?

A
  • The sequence at which development occurs is predictable

- The timing of growth is predictable

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16
Q

How are growth charts used during puberty?

A
  • Growth charts are less accurate during puberty

- The rates and patterns of growth vary, often producing crossing of growth channels

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17
Q

What are the SMR stages?

A

Vary from SMR 1 (pre-pubertal) to SMR 5 (adult)

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18
Q

What are the characteristics of SMR 1?

A

Rapid growth, but no discernable sexual changes

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19
Q

How does the timing of bone mass accretion and skeletal growth vary between boys and girls?

A

They DIFFER between females and males due to variability in the stage at which the growth spurt occurs

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20
Q

When is the peak weight accumulation in females in relation to peak height velocity?

A

6 to 9 months PRIOR to peak height velocity

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21
Q

When is the peak weight accumulation in males in relation to peak height velocity?

A

At the same time as peak height velocity

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22
Q

When does lean body mass occur in females and males? What SMR stage does that correspond to?

A
  • Females: peaks at SMR 3-4

- Males: SMR 5 (after stature gain is complete)

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23
Q

When does sexual maturation takes place in females in comparison to males? How does the end of sexual maturation relate to growth in females?

A
  • Takes place earlier in females than in males

- Growth normally stops when girls finish their sexual maturation

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24
Q

When does menarche occur in relation to breast development?

A
  • One year after breast development begins

- Usually occurring at the deceleration phase of growth

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25
Q

Menses at a later age is associated with a (shorter/longer) period of growth.

A

longer

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26
Q

How does the end of sexual maturation relate to growth in males?

A

Growth can continue after sexual maturation has ended

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27
Q

How does the total period of growth and pre-pubertal growth vary between boys and girls?

A

Boys have a longer total period of growth and longer pre-pubertal growth

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28
Q

Which hormones are responsible for development during adolescence?

A
  • Growth hormone
  • Testosterone
  • Adrenal androgens
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29
Q

What is the mechanism by which the final stage of skeletal growth occurs?

A

When the epiphyses fuse with the main portion of the bone

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30
Q

What is the importance of calcium during adolescence?

A
  • Adolescence is a critical period for achieving bone mass

- Prevents osteoporosis and osteopenia

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31
Q

How does adolescence affect lean body mass in males and females?

A
  • Increases LBM in males

- Decreases LBM in females

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32
Q

Why do males require higher amounts of nutrients and calories during growth spurts than females?

A

Because they possess a higher proportion of LBM, which has a higher metabolic activity than fat mass

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33
Q

What characteristics must be present in females to allow for the onset of menses?

A
  • Must possess a critical body mass of 47.8 kg (105 pounds)

- Must possess a body fat composition of at least 17%

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34
Q

How does testosterone affect development in boys during adolescence?

A
  • Significant increase in bone and muscle growth

- Loss of fat

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35
Q

How does the quantity of LBM and number of muscle cells differ between adult males and females?

A

Adult males possess 150% the LBM of females and twice the number of muscle cells

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36
Q

When do skeletal minerals accumulate in females? How much?

A

1/3 of total skeletal minerals accumulated in the 3 to 4 years after the onset of puberty

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37
Q

What is delayed puberty and secondary amenorrhea associated with in adult females?

A

Decreased bone mineral density

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38
Q

What occurs in females as height velocity decreases?

A

Fat accumulation resumes

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39
Q

What corresponds to the time of peak height velocity?

A

Maximum fat loss and muscle mass increase in upper arms

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40
Q

Which hormones promote the deposition of bone minerals?

A

Both androgens and estrogens

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41
Q

What characteristics govern external and internal factors that influence eating behaviours in adolescents?

A
  • Socio-economic and political system

- Food availability, production, and distribution system

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42
Q

What are external factors that influence eating behaviour?

A
  • Family unit and family characteristics
  • Parenting practices
  • Peers
  • Social and cultural norms
  • Mass media
  • Fast foods
  • Food fads
  • Nutrition knowledge
  • Personal experiences
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43
Q

What are internal factors that influence eating behaviour?

A
  • Physiological needs and characteristics
  • Body image
  • Self-concept
  • Personal values and beliefs
  • Food preferences and meanings
  • Psychosocial development
  • Health
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44
Q

What types of parenting practices adversely affect eating behaviour? How?

A
  • Extreme rigidity and extreme permissiveness

- Rebellion, purging, binging, food faddism, and fasting

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45
Q

What are the risks of food fads in adolescents?

A
  • Food fads are popular among adolescents (used to exert their independence)
  • If they do not possess the proper knowledge, they may suffer from nutritional deficiencies
46
Q

How is smoking related to eating behaviours in adolescents?

A
  • Nicotine decreases food intake and increases weight loss
  • Smoking eases hunger signals
  • Quitting smoking is associated with weight gain
47
Q

What are the risks of dieting during adolescence?

A
  • Increases the risk of nutrient deficiencies

- Increases the risk of life-long weight cycling

48
Q

How does dieting lead to weight cycling?

A

1) A drop in body weight causes a drop in BMR
2) Changing back to the regular diet causes a greater weight gain
3) The weight gain is associated with a greater gain of adipose tissue, further decreases the BMR, making it harder to lose weight

49
Q

What may allow teenagers to exert more independent food choices?

A

Developing conceptual problem-solving skills

50
Q

Obesity is caused by a complex mix of environmental (__%) and genetic factors (__%).

A

20

80

51
Q

How many genes are associated with obesity? Give examples of their roles.

A
  • 130 genes
  • Genes may regulate the speed at which the gut informs the brain that the individual is full, or how effectively the body converts extra calories into fat
52
Q

What are possible aerobic adaptations of exercise? How do they vary among individuals? What does that indicate?

A
  • Stronger heart and muscles, increased maximal oxygen uptake by lungs, and increased heart circulation
  • Certain individuals do not respond to exercise in the same way (indicating a genetic component)
53
Q

How does obesity affect teenagers as opposed to younger children?

A
  • Obesity affects the psyche of teenagers much more than younger children
  • Obesity in children does not impair socialization nor cause long-term psychological harm
54
Q

What may a sense of poor self-worth lead to?

A

Greater passivity and dependency, as well as an increased risk of teasing and discrimination

55
Q

What may drive a teenager to use food as a comfort source? What does it result in?

A
  • A teenager withdrawing from social contact and physical activity
  • Results in greater obesity, bullying and discrimination
56
Q

What percentage of obese teenagers remain obese as adults?

A

80%

57
Q

Why must a teenager be conscious of the pubertal growth spurt?

A

To prevent them from restricting their calories in hopes to avoid weight gain

58
Q

What are the consequences of a restriction in calories during the pubertal growth spurt? (2)

A

Linear growth restriction and nutritional dwarfism (growth failure, short stature, and delayed puberty)

59
Q

Which socio-economic populations are susceptible to eating disorders?

A

White, middle/upper class females with depression and/or family dysfunction

60
Q

What are the four diagnostic criteria for anorexia nervosa? (4)

A

1) Absence of known medical or psychiatric illness
2) Body weight is 15 to 20% below expected body weight
3) Intense fear of gaining weight
4) Absence of at least three menstrual cycles

61
Q

What personality traits do individuals with anorexia tend to possess?

A

Anxious, fearful, or dependent personality

62
Q

What type of family do individuals with anorexia tend to arise from?

A
  • Achievement-oriented families

- Psychopathology or dysfunction within the family is a common characteristic

63
Q

What are the two types of anorexia nervosa?

A

1) Restrictive anorexia nervosa

2) Binging-purging anorexia nervosa

64
Q

What are characteristics of restrictive anorexia nervosa?

A

Restriction of caloric intake, in which there is a lack of purging behavior

65
Q

What are characteristics of binging-purging anorexia nervosa?

A

Food binging, followed by purging through vomiting, diuretics, laxatives, or intense exercise

66
Q

What is the usual cause of mortality in anorexia nervosa?

A

Multiple organ failure

67
Q

How does anorexia nervosa cause cardiovascular abnormalities?

A
  • Electrolyte imbalance may lead to arrhythmia

- Inefficient heart pumping due to weakened heart muscles

68
Q

What are GI issues that may be observed in anorexia nervosa?

A
  • Diarrhea, cramping, fever

- Common symptoms, similar to Crohn’s disease and ulcerative colitis

69
Q

Which eating disorder is Wernicke’s encephalopathy related to?

A

Anorexia nervosa (may result in death)

70
Q

What is Wernicke’s encephalopathy?

A

Irreversible brain damage due to a deficiency in thiamine

71
Q

What are other physiological effects of anorexia nervosa?

A
  • Decrease in blood pressure
  • Kidney dysfunction
  • Muscle wasting
  • Decreased BMR
  • Defective thermoregulation
72
Q

How may the restriction of food intake lead to the cessation of menstruation?

A
  • The body progressively reaches a starvation stage

- Decreased estrogen levels

73
Q

What are symptoms characteristic of changes in body function in response to starvation?

A
  • Dry skin
  • Hirsutism
  • Thin, brittle, dry hair
  • Hair loss
  • Dehydration
  • Edema
74
Q

What is the diagnostic criterion for osteopenia?

A
  • Decrease in bone density greater than 1 standard deviation, but less than 2.5 standard deviations, below the adult mean
  • Increases the risk for osteoporosis
75
Q

What is the diagnostic criterion for osteoporosis?

A

Decrease in bone density greater than 2.5 standard deviations below the adult mean

76
Q

What does the recovery from bone loss in response to anorexia nervosa require?

A

A gradual infusion of calories, either by nasogastric feeding or total parenteral nutrition

77
Q

Why is bone loss particularly critical in individuals with anorexia nervosa?

A
  • Anorexia nervosa normally develops during adolescence, a period in which bones are still growing
  • Malnutrition, or low-weight, may slow down or halt bone development
78
Q

How does a decrease in nutrient and energy intake cause hormonal changes? What are their effects?

A
  • Increase in cortisol
  • Decrease in IGF-1 and leptin
  • Slow down bone formation and increase bone loss
79
Q

What is the ONLY effective treatment of osteoporosis due to anorexia nervosa?

A
  • Weight gain

- Bone mass will increase after weight gain, particularly if periods have returned

80
Q

What exercise regime should be recommended in individuals with anorexia nervosa, experiencing osteoporosis?

A

Exercise should be AVOIDED in these individuals (as opposed to the elderly)

81
Q

Why should exercise be avoided in individuals with anorexia nervosa?

A
  • Abnormal bone metabolism and osteoporosis are developing as a direct consequence to negative energy balance
  • Exercise would be counter-productive to restoring energy balance
82
Q

What condition may lead to low bone mineral density despite adequate weight-bearing exercise?

A

Hypoestrogenism due to pubertal delay or secondary amenorrhea

83
Q

What are the characteristics of the psychological profile of individuals with anorexia nervosa?

A
  • Distorted perception of their body proportions
  • Psychological stress
  • Disturbed family interactions
84
Q

When does bulimia typically occur?

A
  • Late adolescence or early adulthood

- After a series of unsuccessful weight-reducing diets

85
Q

What personality traits do individuals with bulimia tend to possess?

A
  • Outwardly successful
  • Busy
  • Frustrated
  • Delay in psychosocial development
86
Q

How is bulimia primarily distinct from anorexia nervosa?

A
  • Individuals with bulimia normally possess a normal body weight
  • They may undergo significant weight fluctuations in a short period of time
87
Q

What are the four diagnostic criteria for bulimia? (4)

A

1) Individual is binging and purging over once per week for at least three months
2) Involves compensatory behaviours to prevent weight gain
3) Possess a distorted or ill-informed attitude regarding food and nutrition
4) Often self-evaluate according to body shape and weight, possessing a fear of gaining too much weight

88
Q

Define binging.

A

Eating an excessive amount of food in a discrete period of time, characterized by a lack of control while eating

89
Q

Define purging.

A

Regular self-induced vomiting or use of laxatives and diuretics to prevent weight gain

90
Q

What is the non-purging type of bulimia called? What does it involve?

A
  • Bulimarexia

- Involves the use of exercise or fasting, followed by binging

91
Q

What are the characteristics of the psychological profile of individuals with bulimia?

A
  • Anticipation, anxiety, and urgency to begin binging
  • Rapid and uncontrollable intake of food
  • Relief and relaxation followed by disappointment and shame
92
Q

What are three consequences of the vomiting behaviour of bulimia? (3)

A

1) Irritation and infection of the esophagus and salivary glands
2) Erosion of teeth and dental caries
3) Electrolyte imbalances

93
Q

How does excessive vomiting alter pH?

A
  • Results in the loss of acidic hydrogen particles via stomach acid
  • Excess bicarbonate, resulting in an alkaline pH
94
Q

How does an excess of bicarbonate affect respiration?

A

May slow breathing rate

95
Q

How does vomiting affect sodium and potassium?

A
  • The body aims to restore water and pH balance by retaining sodium
  • Results in hypokalemia (muscle weakness, twitching, and cramping)
96
Q

What are other physiological effects of bulimia?

A
  • Abnormal heart rhythms
  • Kidney issues due to UTIs
  • Dizziness
  • Low blood pressure
  • Decreased urine, dry mouth
97
Q

What are emetics?

A

Drugs that induce vomiting

98
Q

What are the effects of the overuse of emetics?

A

Heart failure due to fluid and electrolyte imbalances

99
Q

Why do certain bulimics complain of heaviness and puffiness in their body?

A
  • They think that it is due to fluid retention
  • This is NOT true
  • It is a perceptual problem dubbed broken eye syndrome
100
Q

What is broken eye syndrome?

A

An individual perceives that they are bigger than they are

101
Q

What are characteristics of non-specified eating disorders?

A
  • Fear of obesity
  • Hypercholesterolemia
  • Decrease in food intake
102
Q

What type of eating disorders do non-specific eating disorders include?

A
  • Binge eaters who consume less during a binge, rarely purge, and show less restraint in dieting
  • Atypical eating disorders (e.g. pica and rumination disorders)
103
Q

What emotions do binge eaters share with other eating disorders?

A
  • Lack of control
  • Guilt
  • Self-disgust
  • Anxiety
104
Q

What may reduced food intake and years of inadequate weight gain in non-specific eating disorders lead to?

A

Delayed sexual maturation and deteriorating linear growth

105
Q

What are the four diagnostic criteria for binge-eating disorder? (4)

A

1) Loss of control over the amount of eating
2) Marked distress over the binge episode
3) Occurs at least once per week for three months
4) Three or more of typical characteristics

106
Q

What are the five characteristics that may be present in binge-eating disorder? (5)

A

1) Eating more rapidly than normal
2) Eating until feeling uncomfortably full
3) Eating large amounts of food when not feeling physically hungry
4) Eating alone because of embarrassment over how much one is eating
5) Feeling disgusted with one-self, depressed, or very guilty after over-eating

107
Q

What must healthcare professionals treated individuals with eating disorders keep in mind?

A
  • Must appeal to the need for social acceptance

- Must instruct that a severe energy restriction results in a stronger trigger for binging

108
Q

What pharmacological substances may be prescribed for individuals with eating disorders?

A

Anti-depressants (e.g. fluoxetine, Prozac, naloxone)

109
Q

What is diet counselling used for in eating disorder treatment?

A

To allow individuals to incorporate nutritious eating habits in terms of quantity and quality to replace the distorted beliefs

110
Q

What is the importance of eating breakfast?

A

Eating breakfast restricts greater energy intake at later meals, decreases the risk of binging, and is associated with an overall lower fat intake

4) Nutrition Through Life (19 decks)

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