12 adolescence Flashcards
1
Q
Adolescence
-period of rapid changes in
A
- physiological
- psychological
- cognitive functions
2
Q
Variability in
A
- growth rate
- development
- activity level
- timing of growth spurt
3
Q
Growth spurt
A
- peak height velocity
- highest nutritional needs
- 20% of height+ 50% of weight
- 2X higher incorporation of Ca, Mg, Zn, Fe into bone
4
Q
Boy
A
- finish later
- higher peak high velocity
- longer prepubertal growth
- sexual maturation begins early than height
- adult man higher height
- growth continue after sexual maturation
- greater growth spurt, prolonged, intense, later year
- Testosterone–> sig. increase in bone and muscle, loss of fat
- adult male 150% LBM vs. female
- 2X muscle mass
5
Q
nutrition requirement
energy + protein
A
- physiological or maturational age to deter
- intensity and extent of growth spurt
- gender and body composition
- timing of pubertal growth spurt
6
Q
SMR
A
Sexual maturation rating
- dtandard used clinically to describe the stage 1-5 (10-17yr) of development
- based on development of 1st and 2nd sexual characteristics
- same sequence, same order, timing varies
7
Q
SMR 1
A
- rapid
- no discernible sexual change
8
Q
bone mass and skeletal growth
A
- Girl SMR 2
- Boy SMR 3-4, 40% peak bone mass
9
Q
Girl
A
- Pubertal growth spurt–> tanner breast stage 3
- sexual maturation earlier
- environmental factors
- Menarche 1yr after breast
- later menses with longer period of growth
- sexual maturation stops, linear growth stop
- 1/3 skeletal mineral accumulated in 3-4 yr agter onset of puberty
- delayed puberty/ 2nd amenorrhea–> decrease BMD as adult
- height velocity decrease, fat resume
- 2X faster in girl
10
Q
Peak weight accumulation
A
Female–> before peak height velocity
Male–> same time as peak height velocity
11
Q
Lean body mass
A
Female–> SMR 3-4, after height complete
Male–> 5, after stature complete
12
Q
Hormone
A
growth hormone
testosterone
adrenal androgen
13
Q
Bone mass
A
- adolescence–> achieve bone mass–> protect from osteoporosis
- high intake of Ca (45% deposited in adolescence)
14
Q
Final stage of skeletal growth
A
- epiphyses fuse at end of long bone
- main portion of bone and growth in stature ceases
15
Q
weight
A
Male–> LBM/muscle increase (2x), muscle higher metabolism rate
Female–> drop, more fat,
16
Q
Female onset for menses
A
critical BM 47.8kg,
17% body fat composition
17
Q
Max fat loss and muscle mass increase in upper arm
A
time of peak height velocity
18
Q
Androgens + estrogens
A
bone mineral deposition
19
Q
Eating behaviour
External factors
A
sociocultural, neurochemical, psychological
- food availability–> developing country
- skipping meals
- parents practices
- peer pressure
- mass media
- fast food–> low nutrient and fibre, high sugar+ sodium
- snacks (25% kcal)
- food fads
- poor nutrition knowledge
- personal experience (drug, alcohol)
- smoking–> Nicotine decrease food intake, increase wt loss
- -> ease hunger signal–> nutrients deficiency
- -> quitting increase 10lb
20
Q
Internal
eating behavior
A
- physiological changes
- body image
- Self-concept
- personal value and belief
- food preference
- dieted, nutrient deficiency, life-long risk of weight cycling –> greater fat tissue than lean
- 10% drop in WT–> 15% drop in BMR
- eating disorder 20X higher in female, culture pressure
- independence
- irregular eating habits
21
Q
adolescence obesity
A
20% environmental+ 80% genetic
22
Q
Exercise
A
aerobic adaptation, stronger heart+ muscle, increase max. oxygen uptake–> increase efficiency of O2 utilizes by lung–> increase heart circultion
23
Q
interdisciplinary approach of obesity
A
diet+ exercise+ behaviour modification+ psychological support
24
Q
Calorie restriction
A
linear growth restriction+ nutritional dwarfism–> growth failure, short stature, delayed puberty
25
nutrition rehabilitation
2/3 catch up growth
26
Anorexia Nervosa diagnostic criteria
1. no know medical or psychiatric illness
2. 15-20% of below expected WT
3. intense fear of wt gain (even when underweight)
4. malnutrition--> no >=3 mensural cycle
5. disturbed self-image
27
2 type
1. restrictive--> no purging
| 2. binging/ purging--> binging followed by vomiting, diuretics, laxative
28
eating disorders
anorexia nervosa
bulimia
binging
29
DSM-5
1. restriction energy intake--> sig, low wt
2. intense fear of gain wt
3. undue influence of body wt or shape on self-evaluation, or denial current low wt
30
health risk of anorexia
mortally 2-20% due to multiple organ organ system
1. electrolyte imbalance--> cardiovascular abnormoalities (arrhythmia, irregular heart beat, inefficient heart pumping due to weak heart muscle)
2. GI system disorder (inflammatory disease, diarrhea ,fever, cramping)--> decrease estrogen
3. Amenorrhea--> loss body fat
4. decrease blood pressure
5. kidney dysfunction
6. irreversible brain damage--> wrenches' encephalopathy--> death
7. muscle wasting--> low LBM--> decrease muscle function--> decreased BMR
8. defective thermoregulation
9. starvation mode: dry skin, hirsutism, thin brittle dry hair+ hair loss, dehydration+ edema
10. growth cessation
11. premature bone loss+ osteopenia--> low bone mass, increase risk of osteoporosis
31
recovery
slow+ gradual infusion of calories
32
osteoporotic risk of anorexia
- loss of protein and mineral salts--> low bone mass+ strength
- continues or relapses, 20yr--> permanent bone loss
- increase cortisol, low IGF-1 and leptin--> slow down bine formation
33
only effect treatment of osteoporosis
wt gain--> increase bone mass (when period return)
34
Avoid
exercise
35
hypoestrogenism
| why
puberty delay or 2nd amenorrhea --> low BMD despite weight-bearing exercise
36
Bulimia
binging> 1/week followed by purging, 3 month
37
binging
- eating in a discrete period of time, excessive amount of food, lack of control
- compulsion eating not response to hunger
38
purging
regular self-induce vomiting, laxative, diuretics, enema
39
bulimarexia
non-purging type
- exercise or fasting after binging
- fasting+ depleted nutritional state
40
health risk of bulimia
- Irritation and infection of esophagus, salivary glands
- erosion of teeth and dental caries
- electrolyte/ fluid / water and pH imbalance--> hypokalemia--> severe, dehydration
- loss of acidic hydrogen via stomach acid
- increase risk of sub-clinical malnutrition
- XS bicarbonate, alkaline pH
- low bp, low urine, dry mouth, confusion
- perception problem: broken eye syndrome, think bigger than real
41
Hypokalemia
defect of K
| muscle weakness, twitching, cramping
42
eating disorder
delayed sexual maturation+ deteriorating linear growth
43
BED binge eating disorder
1. loss of control
2. marked distress over binge
3. at least 1/week for 3mo
- >=3 of following
- eating more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts of food when not physical hungry
- eating alone b/c being embarrassed by eating too much
- disgusted with oneself, depressed, guilty b/c overeating
44
Tx of eating disorder in teens
- specific approaches towards psychology of teens
- social acceptance--> good physical appearance--> good nutrition
- no severe energy restriction
- treat clinical depression, alcohol, cigarette abuse
- anti- depressant抗抑郁药 (wants high fat+ sweet)
- diet counselling
- no exercise
- replace distorted belief regarding wt and food intake
- work together with teen
- emphasize importance of breakfast
