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!
- do formula fed infants gain weight more rapidly than breast fed infants? - what hypothesis? explain
yes! gain more weight and have a higher serum IGF-1!
- “Early protein hypothesis”: increase early protein = increase plasma [insulin-releasing aa (leucine, isoleucine and valine)] = IGF1! –> stimulates rapamycin = growth!
- growth hormone/insulin-like factor 1 axis may be stimulated by excess protein intake and drive early differentiation and proliferation of adipocytes
fat reqs:
- AI for infants: 0-6 months vs 7-12 months –> how?
- older infants: based on what?
0-6 months:
- AI = 31 g/day of fat
- based on 0.78L/d of human milk and mean milk fat content (40g/L) = 31 g/d
7-12 months/older infants:
- AI based on avg intake of fat from human milk + complementary foods
- avg [fat] in milk (40g/L) * 0.6L/d consumed + complementary foods (5.7g/d) = AI = 30 g/d
fat reqs for children and adolescents aged 1-18 yo? and adults?
- are Canadian children usually above or below AMDR for fat?
- no AI, EAR or RDA for total fat intake for children ages 1-18 and adults
FAT AMDR: - 1-3 years: 30-40%
- 4-8 yo: 25-35%
- 47% of Canadian children 1-3 year were below AMDR for fat intake (30-40%) –> driven by fear of fat from caregivers
are there recs for linoleic acid and linolenic acid for children?
- 0-0.5 yo
- 0.5-1 yo
- 1-3 yo
- 4-8 yo
- 9-13 yo
- 14-18yo
- yes! AI!
linoleic / linolenic - 0-0.5 yo: 4.4g/d & 0.5g/d
- 0.5-1 yo: 4.6g/d & 0.5g/d
- 1-3 yo: 7g/d & 0.7g/d
- 4-8 yo: 10g/d & 0.9g/d
- 9-13 yo: 12g/d & 1.2g/d
- 14-18 yo: 16/d & 1.6g/d
water during infancy
- water needs typically met by (3)
- signs for dehydration (5)
- by consuming breastmilk, formula and other foods
1. reduced amount of urine OR dark urine
2. dry membranes in nose and mouth
3. no tears when crying
4. sunken eyes
5. lethargy, restlessness, irritability
water recs: how much and based on what?
- 0-6 months
- 7-12 months
0-6 months:
- avg volume of human milk = 0.78L/d
- 87% of human milk volume is water –> 0.68L of water is consumed
- AI of total water = 0.7L/d
7-12 months:
- water intake from complementary foods/bevs (0.32L/d) + milk volume (0.52L/d) = AI = 0.84L
water recs in children and adolescent
- is there a rec?
- normal hydration status?
- AI?
- no single water intake level can be recommended for ensuring adequate hydration and optimal health
- normal hydration status can be achieved with wide range of total water intakes (1st to 99th percentiles)
- AI for total water based on median total water intake of children and adolescents
vitamin and mineral AI for infants
- 0-6 months
- 7-12 months
0-6 months:
- mean intake data from infants fed human milk exclusively
- and [vitamin and mineral] of milk produced by well-nourished mothers
- all from breastmilk except for vit D and iron –> supplements are recommended (?)
7-12 months:
- nutrient intake from milk (concentration x 0.6L/d)
- AND nutrients provided by usual intakes of complementary weaning foods
