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Nutrition through life > 6.2 Adolescence > Flashcards

6.2 Adolescence Flashcards

1
Q

adolescence = period of rapid changes in (3) functions
- growth spurt = _____ _____ ______ = ______ nutritional needs
- gain of __% of adult height and ___% of weight
- high _________ in timing of growth spurt
- does age alone determined stage of maturity?
- best index for determining nutrient needs?

A
  • physiological, psychological and cognitive functions –> can impact eating habits and eating reqs
  • growth spurt = peak height velocity = highest nutritional needs
  • gain of 20% height + 50% weight
  • high variability in timing
  • no!
  • caloric requirements based on kcal/cm
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2
Q

explain height gain curve vs age, in girls bc boys
- age of puberty
- peak height velocity
- total height gain

A
  • really rapid growth rate from 1-3 yo –> at 3, rapid drop in heigh gain –> into a steady quiescent period of growth
  • then, girls have their peak height velocity at around 12 (9cm/y) vs boys are still in quiescent period (= longer period of growth) until around age 14 (10.3cm/y) peak
  • then, rapid decrease and no more height gain for girls at 15 ish and 17 for boys
    GIRLS:
  • age of puberty: 10-11 (8-14)
  • peak height velocity: 9cm/y (at age 12)
  • total height gain: 25 cm
    BOYS:
  • age of puberty: 11-12 (9-15)
  • peak height velocity: 10.3cm/y (at age 14)
  • total height gain: 28 cm
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3
Q

why are boys generally higher than girls? (2)

A
  • bc they have a higher peak velocity
  • and bc they have an overall longer period of growth (since their peak height velocity is reached later
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4
Q
  • adolescence encompasses what?
  • puberty includes what?
  • how is puberty progress defined?
A
  • encompasses entirety of transformation from childhood to young adulthood
  • puberty = transition period –> includes only physical changes that occur as a child attains reproductive capacity
  • progress defined by sexual maturity ratings (SMRs) 1 through 5 (also called Tanner stages) –> characterizes when growth typically appears
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5
Q
  • SMR = standards used clinically to describe what?
  • based on development of what?
  • sexual maturation: predictable _______, but _______ varies
  • best guide for _______ and __________
  • timing of growth is predictable based upon what?
  • more accurate than growth charts?
A
  • clinically to describe stage of development
  • based on development of primary and secondary sexual characteristics
  • sexual maturation = predictable sequence but timing varies
  • best guide for growth and development
  • predictable based upon sexual stage of maturation
  • yes! growth charts are less accurate at puberty bc of crossing of growth channels
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6
Q
  • what are some secondary sex characteristics used for tanner stages of development? girls vs boys?
  • at what stage does peak growth velocity occurs for girls vs boys?
A

GIRLS:
- breast growth
- pubic hair growth
- menarche
- peak growth velocity often occurs soon after stage 2 (age range 8-15)
BOYS:
- testes growth
- penis growth
- pubic hair growth
- 20% of boys reach peak growth velocity during stage 5 (age range 13-18) (figure: between stage 4 and 5)

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7
Q

prepubsertal SMR1 –> adult SMR5
FEMALES:
- does sexual maturation happen before/at same time/after growth? when does growth stop?
- timing depends on what?
- menarche tends to occur when?
- at the deceleration phase of growth, later menses associated with what?
MALES:
- does sexual maturation happen before/at same time/after growth? when does growth stop?
- how do they have a greater growth spurt (3)

A

FEMALES:
- sexual maturation takes place earlier, then growth stops (no growth after sexual maturation) –> sexual maturation continues though
- timing depends on environmental factors –> ie lighting can impact growth (affects pineal gland + melatonin –> inhibits gonadal development and 2° sex charac (?))
- occur 1 year after breast development
- later menses associated with longer period of growth
MALES:
- growth can continue after sexual maturation has ended (most sexual maturation before peak height velocity ish) (contrary from females)
- more prolonged + more intense + occurs at a later year = longer total period of growth

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8
Q
  • describe the external (9) and internal (6) factors that can affect lifestyle –> which affects individual food/easting behavior
  • can internal factors affect external factors and vice versa?
A

INTERNAL:
- physiological needs and characteristics
- body image –> used as self-concept + can be distorted by environmental factors
- personal values and beliefs –> greater independence of thought can change eating habits + can integrate societal values, modified by media –> can lead to wanting to modify body shape
- food preferences and meanings
- psychosocial development
- health
EXTERNAL:
- family unit and family characteristics! –> disrupting family unit can cause rebellion or predispose to ED –> meal eating in family = protective factor against inappropriate eating behaviors
- parenting practices
- peers
- social and cultural norms and values
- mass media
- fast foods
- food fads
- nutrition knowledge
- personal experiences (alcohol, social drug use, cigarette)
*yes! ie social values and mass media can modify personal values and beliefs

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9
Q

what (2) influences external and internal factors that impact lifestyle/eating behaviors?

A
  • social-economic political system
  • food availability, production and distribution system
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10
Q

internal factors of adolescence
- multiple _________ changes (new body image) –> altered eating behavior
- ___% of females 14-18 yo have dieted (only ___% classified as obese) –> increase risk of (2)
- explain risk of weight cycling

A
  • multiple physiological hanges
  • 70% of females (15% obese)
  • increase risk of nutrient deficiencies and life-long risk of weight cycling
    WEIGHT CYCLING:
  • body uses set point to maintain body weight
  • 10% drop in body weight (fat AND muscle) = 15% drop in BMR –> then change to normal diet again –> greater weight gain (mostly adipose) –> leads to overall shift of increase adipose vs lean tissue…
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11
Q

what are 4 factors that impact negatively adolescent’s eating behaviour?

A
  1. big eaters of fast foods: low nutrient and fiber + high sugar and sodium
  2. poor nutrition knowledge: 20% believe that fat should be removed altogether from diet
  3. personal experiences (drugs, alcohol)
  4. smoking
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12
Q

adolescents:
- ___% of cals = snacks
- big eaters of fast foods –> low (2) but high (2)
- poor nutrition knowledge –> fear of what?
- risks of smoking? (3)

A
  • 25% cals = snacks
  • fast foods = low nutrient and fiber + high sugar and sodium
  • fear of fat!
  • increasing incidence of smoking, especially in girls:
    1. nicotine = decrease food intake and increase weight loss
    2. smoking eases hunger signals (animal studies) –> increase risk of nutrient deficiencies
    3. quitting associated with mean increase of 10 lbs (bc no anorexic effect of nicotine anymore)
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13
Q

how can family affect dietary intake during adolescence?
- prevalence ish?
- should encourage what?

A

*frequency of family meals associated with improved nutrient intake
- number of family meals drops off during high school
- should encourage adolescents and families to find time to incorporate family meals several times a week

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14
Q

what influence do peers have on nutritional status/eating behavior? (3 ish)

A
  1. minimal influence on fruit and veg intake
  2. stronger influence on consumption of whole grain foods, dairy products and breakfast
  3. snack and soft drink consumption grater when adolescent’s peers had high consumption of these items
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15
Q
  • which meal is often skipped in adolescents? –> leads to (3)
  • why skip meals?
  • eating fewer meals associated with what?
A
  • meal skipping is common, especially breakfast!
    1. can cause disturbances to appetite regulation
    2. may lead to overeating during subsequent meal times
    3. can lead to undereating overall
  • to lose weight
  • associated with reduction of diet quality (can lead to iron and zinc deficiency)
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16
Q

what are 4 ways media affect dietary intake during adolescence ish?

A
  1. no longer restricted to television and print –> social media
  2. more time spent on media that in school –> most children and teenagers have TV in bedrooms
  3. susceptible to marketing of foods high in sugar, fat and sodium impacts dietary choices
  4. sets unrealistic body image expectations –> must help adolescents understand that images in advertisements are manipulated
    *teens integrate societal values during that time period and internalize
17
Q

how can school influence dietary intake during adolescence? (2 ish)

A
  • at least one meal per day at school
  • vending machines are a concern –> increase fast foods –> most common items are soft drinks, chips and sweets
18
Q

what are (physiological ish) consequences faced by food insecure adolescents? (5)

A
  • experience increased irritability + lower grades + poorer psychosocial functioning
  • have lower energy intake + decrease fruit and veg intake
19
Q

how can fad diets influence dietary intake during adolescence?

A
  • adolescents often concerned about weight loos as their bodies change
  • often exposed to fat diets in media –> more often used by teenagers with lower self-esteem
  • positive influences protect against unhealthy eating
20
Q
  • obese children vs teens –> impact of obesity on psyche?
  • explain impact on teens. Vicious cycle
A
  • obese children: no impaired socialization/long term psychological harms if they lose weight before adolescence
    VS teens: obesity affects psyche much more than earlier years
  • poorer self worth –> greater passivity and dependency –> increase teasing and discrimination
  • food = source of comfort –> vicious cycle –> greater obesity
21
Q

4 ways to prevent/treat pediatric/adolescent overweight and obesity

A
  1. educate parents about risks to children –> parent targeted interventions more successful
  2. intensive lifestyle and diet modifications remains primary treatment
  3. motivational interview used to treat obesity –> strengthens personal motivation for change in atmosphere of acceptance + emphasize behavioral goals
  4. weight maintenance usually the goal for children 2-11 years old –> allows for decrease in BMI values
22
Q

anorexia nervosa
- use what to diagnose?
- diagnosis criteria
- in the context of what?
- intense fear of what? even though what?
- disturbance in what?
- ________ of seriousness or current low body weight

A
  • diagnostic and statistical manual of mental disorders (DSM-5)
  • restriction of energy intake relative to requirements leading to significantly low body weight in the context of age, sex, developmental trajectory and physical health
  • psychological element: intense fear of gaining weight or becoming fat, even though underweight
  • disturbance in way in which one’s body weight or shape is experienced –> undue influence of body weight or shape on self-evaluation
  • DENIAL! resists intervention –> difficult to treat therapeutically/psychologically bc pt might lie to therapist
23
Q

anorexia nervosa:
- mortality rates: __-___% due to what? (2 examples)

A
  • 2-20% due to multiple organ system failure including electrolyte imbalance, leading to cardiovascular abnormalities (arrhythmia: inefficient heart pumping due to weakened heart muscles and due to inadequate nutrient/food intake)
24
Q

health risks of anorexia nervosa (11 ish)

A
  • growth cessation
  • atrophy of GI tract
  • GI symptoms (diarrhea, cramping and fever)
  • cessation of menstruation (need 18% body fat to maintain)
  • change in body functions characteristic of starvation (dry skin, hirsutism (excessive body hair), thin brittle dry hair/hair loss, dehydration and edema (from low protein status: low albumin = water drawn in tissues)
  • high risk of premature bone loss: greatly increase risk of osteoporosis in early adulthood (driven by low estrogen levels)
  • muscle wasting and decrease BMR
  • defective thermoregulation
  • decreased blood pressure, dehydration
  • kidney dysfunction
  • death may be due to Wernicke’s encephalopathy (from thiamine deficiency)
25
Q

adolescent eating disorders:
- treatment goals (2)
- treatment includes (4)
- refeeding syndrom characterized by (4)

A
  • reach suitable weight for body type, age, and height + reestablish healthy eating habits (+ good nutrition knowledge)
  • medical stabilization + treatment of complications + refeeding (careful!) + psychosocial rehabilitation –> all in a specialized clinic where no food restriction at all –> normalize eating behaviors)
    REFEEDING SYNDROM:
  • hypokalemia, hypophosphatemia, hypomagnesemia, thiamin defiency
26
Q

what are 4 characteristics/diagnostic criteria for bulimia?

A
  1. binging > once /week followed by purging, for 2 months
    *binging = eating in a discrete period of time an excessive amount of food and a lack of control while eating
  2. compulsion to eat not a response to hunger (used as stress management)
  3. distorted/ill-informed attitudes regarding food and nutrition
  4. self evaluation according to body shape and weight; fear of gaining too much weight
27
Q

vomiting behavior in bulimia:
- leads to irritation and infection of (2)
- _______ can cause (2) in the mouth)
- when vomiting is severe –> __________
- __________ imbalances
- prolonged vomiting –> loss of what via what? –> explain consequence

A
  • irritation and infection of esophagus and salivary glands
  • acidity can cause erosion of teeth and dental caries
  • dehydration
  • electrolyte imbalances
  • prolonged vomiting –> loss of acidic hydrogen particles via stomach acid
    *excess bicarbonate (alkaline pH) –> body aims to restore water and pH balance –> hypokalemia
    *hypokalemia leads to muslce weakness, twitching, cramping
    *excess bicarbonate –> slower breathing rate
28
Q

how to treat bulimia? 2ish

A
  • cessation of binging and puring activity and normalization of weight gain
  • suggest frequent small meals to enable normal hunger and satiety cues + reduce binging and purging behavior

Nutrition through life (13 decks)

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