6.3 Nutrient reqs during infancy, childhood and adolescence Flashcards
infancy energy needs:
- need more energy per lb of body weight than what?
- relative to size, needs are ______ as much as that of an adult
- most infants require approximately ____kcal/kg bw after 3 months
- recommended AMDR for infancy: fat vs prot vs carbs
- ____ essential in diet to meet needs –> why?
- more energy than any other time in life
- needs are twice that of an adult
- 100 kcal/kg bd after 3 months
- 40-50% fat + 7-11% protein + remainder CHO
- FAT essential! bc small stomach of infant + high caloric need –> need high energy density from fat
figure:
- what are the components of energy for infants: 0-2 months, 3-4 months and 5-12 months?
- compare!
0-2 months:
- about 120 kcal/kg/day
- growth + activity + basal
- ALSO thermal stress! bc inability to regulate temp through shivering –> non shivering thermogenesis: uses brown adipose tissue (rich in mitochondria) –> uncoupled respiration: use FA in e- transport chain to generate heat and not ATP
3-4 months:
- growth + activity + basal
- less growth than 0-2 months
- more activity
- no thermal stress
- about 105 kcal/kg/day
5-12 months:
- basal + increased activity! + very little growth
- around 100 kcal/kg/day
in children who are really cold, why do we see an increase in glycerol in the blood?
- cold –> increased SNS innervation –> increased lipolysis –> increased FFA: gets oxidized in mitochondria to generate heat (uncoupled respiration by brown adipose tissue) + increase glycerol goes to bloodstream
energy expenditure during infancy:
- energy cost of growth (% of total E req) increases/decreases from ___% at 1 month to __% at 12 months
- energy cost of growth remains high/low until when? where what happens?
- mild cold exposure = neonate increase what? = increase _______ _______
VS lower temperatures when older = _________ ____________
- does PA increase or decrease as child grows?
- decreases from 35% to 3%
- remains low until pubertal growth spurt (where increase to 40%)
- neonate increase nonshivering thermogenesis (bc muscles don’t have capacity to shiver) = increase metabolic rate –> increase oxidation of FA by brown adipose tissue
VS older –> shivering thermogenesis - PA increasingly larger component of TEE as child grows
- define WAT vs BAT functions
- BAT = highly _______ and innervated by what?
- BAT = ________ and lots of _________
- what happens in BAT?
- white adipose tissue (WAT) = primary site of energy storage
- brown adipose tissue (BAT) = burns fat to produce heat and regulate body temperature
- BAT = highly vascularized and innervated by CNS –> SNS –> b-adrenergic receptors linked to adipocytes
- BAT = multilocular and lots of mitochondria
- UCP1 in BAT’s mitochondria activated by FFA –> uncoupled oxidative respiration from ATP production –> energy dissipated as heat
nutrient recs during childhood and preadolescence:
- total energy req increase/decrease as children grow
- higher in boys or girls? why?
- marked variability for boys and girls’ EER –> variations in (2)
- most important component of energy expenditure = ____ –> depends on (3)
- increase!
- higher in boys! due to weight and fat free mass differences
- variations in growth rate and physical activity
- BMR! depends on
1. mass of metabolically active tissue
2. proportion of each tissue
3. contribution of each tissue to energy metabolism
how to calculate energy requirement of infants/child/teens? formula
- how many different formulas?
- which time period has the highest growth? compare with other periods!
- EER = TEE + energy deposition
- formulas different for males and females –> input age (y), height (cm) and weight (kg)
- 0 to <3 months - highest growth! –> males: 200 kcal vs females 180 kcal of energy deposition!
- 3-6 months: same formulas but M(50 kcal) VS F (60 kcal)
- 6-12 months: same formulas but M(20 kcal) VS F (20 kcal)
- 1-<3 years: same formulas but M(20 kcal) VS F (15 kcal)
at what age does EER equations consider level of physical activity?
- from then on, which age range has the highest energy deposition? compare with other periods!
- from age 3-<4 years!
- PA category inactive, low active, active or very active!
- 3-<4 years: M(20 kcal) vs F(15 kcal) = quiescent growth period
- 4-<9 years: M(15 kcal) vs F(15 kcal)
- 9-<14 years: M(25 kcal) vs F(30 kcal) –> growth spurt during puberty!! = highest energy deposition!
- 14-<19 years: M(20 kcal) vs F(20 kcal) = quiescent growth period
why do we add an energy deposition in EER formula? where does that energy go?
energy deposition for deposition of protein and fat –> tissue deposition/growth!
why do girls have a higher energy deposition during puberty than boys?
girls: 30 kcal vs boys: 25 kcal
- bc girls have higher adipose tissue that needs to be supported to help with menstruation and reproductive cycle!
- boys: gain more muscle mass
dietary CHO: how much and based on what?
- 0-6 months of life
- 7-12 months of life
- rest of life: reqs remain the same?
0-6 months:
- from volume of breastmilk consumed –> 0.78L/day –> 60 g CHO –> around 37% of total food energy!
- this amount of CHO and ratio of CHO:fat in human milk assumed to be optimal for infant growth and development over 1st 6 months of life
7-12 months:
- from median CHO intake from weaning/complimentary foods (50 g/day) + avg volume human milk intake (0.6L/d x 74g/L = 44 g CHO/day) = 95 g CHO
REST OF LIFE:
- recs remain the same after 1 yo for the rest of life!
- 130 g CHO –> based on needs for brain
fiber recs
- below the age of 1?
- age 1-3
- age 4-8
- age 9-13
below age of 1:
- no recs –> not consequential in 1st year of life but olisacs in breastmilk kinda like fibers –> has benefits
AFTER AGE of 1:
- 14g/1000 kcal = greatest protection against coronary heart disease!
AGE 1-3:
- AI = M (19g/d) and F (19g/d)
AGE 4-8:
- AI = M (25g/d) and F (25g/d)
AGE 9-13:
- M (31g/d) and F (26g/d)
- benefits of fiber in children?
- do children usually get that intake?
- AI for ages 2-3 vs 4-5?
- plays important role in reducing child’s risk fo and incidence of numerous disease + supports gut microbiome
- intake often half of amount recommended for children
- AI 2-3 yo = 19g/day
- AI 4-5 yo = 25g/day
risk of excessive fiber intake?
decrease bioavailability of nutrients like iron and zinc
protein reqs during infancy: based on what and how much?
- 0-6 months
- 7-12 months
- 1-3 yo
- 4-8 yo
- 8-13 yo
- 14-18 yo
0-6 months:
- AI based on avg milk volume (0.78L/d) and avg protein content (11.7g/L)
- AI = 9.1g/d OR 1.52g/kg/d (reference wt of 6kg for 2-6 month olf infant)
7-12 months:
- EAR for older infants = 9.9g/d OR 1.1g/kg/d
- RDA = 1.5 g/kg/d
- based on nitrogen equilibrium and protein deposition
FROM 1-18 yo:
- criterion = nitrogen equilibrium (to maintain protein status) + protein deposition
- after 18 yo: no more growth = no more protein deposition
- 1-3 yo: EAR = 0.88 g/kg/d
- 4-8 yo: 0.76 g/kg/d
- 8-13 yo: 0.76 g/kg/d
- 14-18 yo: 0.73 g/kg/d
- > 18 yo: 0.66 g/kg/d
- is there more protein in breastmilk or formula?
- which is better? ish
- breast milk = 1g/100 mL
- formula = 1-1.5g/100 mL
- higher protein intakes in formula fed infants!
- no evidence that lower protein intakes in breast-fed infants are associated with adverse outcomes:
*wt and LBM gains: higher in formula-fed infants, but when controlled for E intake, protein intake was not associated with length gain
*Breastfed infants have better immune function and behavioural development!
