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nutrition thru life > Adolescence > Flashcards

Adolescence Flashcards

1
Q

Adolescence is a period of rapid ____.

A

change: physical, psychological, cognitive

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2
Q

How does the rate of growth in adolescence compare to infants or young kids?

A

decreasing rate of growth in entire life, EXCEPT during growth spurt in adolescence

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3
Q

The highest nutritional needs during adolescence occur during ____. What happens during this period?

A

growth spurt

  • reach peak growth velocity, peak height
  • gain 20% adult ht, 50% adult wt
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4
Q

what are the difficulties in determining nutrient needs throughout adolescence?

A

high variability in timing of growth, magnitude of growth, individual variation

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5
Q

How does the growth spurt compare in girls and boys?

A

girls: begin sooner (~11 yrs), less peak velocity, less total gain
boys: begin later (~13 yrs), higher peak vel, more gain

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6
Q

How are nutrient needs determined for adolescents?

A

age is NOT good estimate
-> look at physiological/maturation age
GROWTH PATTERNS good indicator for energy/protein
(kcal/cm)
consider growth/development/activity, etc

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7
Q

adolescent nutrient needs depend on:

A

extent and timing of growth spurt
gender
body composition
individual variation

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8
Q

What is the best guide used clinically that is consulted for adolescent growth and development? What is it based on?

A

tanner’s sexual maturation ratings

based on dev. of primary and secondary sex characteristics

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9
Q

What signals the end of growth?

A

fusing of epiphyseal plates

Girls: end of sexual maturation (boys will continue bit longer)

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10
Q

Describe the SMR:

A
  • many different milestones for sex characteristics
  • divided into stages (1, 2, 3, etc)
  • occur at different ages, but usually in same order (predictable sequence)
  • can predict growth pattern based on maturation stage
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11
Q

The timing of the growth spurt in girls is usually at tanner stage ___.

A

3

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12
Q

During SMR1 there is ____ but no ____.

A

rapid growth

no obvious sexual changes

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13
Q

When is peak weight gain reached? How much of the adult weight is reached?

A

Girls: before peak height gain
Boys: same time as peak height gain
about 50% of adult weight (slight more in boys, less in girls)

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14
Q

when is peak LBM gain reached?

A

Girls: same time as peak height gain
Boys: stage 5, after height gain complete

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15
Q

How can environmental factors affect puberty in females?

A

age for menarche decreasing over the years (environmental estrogens?)
earlier puberty -> earlier end of puberty (less growth)

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16
Q

The rapid growth is due to action of ____. What changes happen internally to major systems?

A

hormones (GH, testosterone, adrenal androgen, sex hormones)

increase in LBM, bone mass, heart/lungs/viscera, sex organs

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17
Q

Adolescence is a critical period for achieving _____, so adequate ___ is needed for this rapid period

A

bone mass

Ca; need high intake! 45% of total body deposits happen in this time

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18
Q

What happens to LBM in males vs females? How does this affect nutrient needs?

A

males: increase
females: decrease (more adipose)
males will need more nutrients and calories; LBM is more metabolically active and requires maintence

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19
Q

What is required for menses to start? What happens if this criteria is not met?

A

17% body fat, usually at least 105 lbs female

not met -> late menses -> delay puberty, lower BMD as adult (1/3 of minerals accumulated in first years of puberty!)

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20
Q

Boys have more of the hormone ____, which will promote:

A

testosterone

more LBM, increase in bone, loss of fat

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21
Q

What are the types of factors that affect eating behaviour in teens? They may be classified as ___ or ____.

A

neurochemical
psychological (body image, perception of health)
sociocultural (mass media, food availability, etc)
INTERNAL or EXTERNAL

22
Q

what are examples of external factors that affect food behaviour in teens? (9)

A 
family environment/behaviour
parenting
peers
social norms/values
mass media
fast food
food fads
nutrition knowledge
personal experience (drugs/alcohol)
23
Q

What are examples of internal factors that affect food behaviour in teens? (7)

A 
physiology (needs/characteristics)
body image
self-perception
beliefs & values
food preferences
psychosocial development
health
24
Q

how does smoking affect eating behaviour?

A

smoking: reduce appetite -> less intake

25
Q

why do many adolescent girls choose to diet, and what risks does this have?

A

changing physiology + media -> perceive as “fat” -> diet
risks:
nutrient deficiencies
lifelong weight cycling

26
Q

What is “weight cycling?”

A

yo-yo dieting: go on diet, lose weight, but then gain back -> need to diet again

drop in body weight -> drop in BMR -> once off diet, will regain weight, as ADIPOSE
(% of adipose will increase in body, makes harder and harder to lose weight)

27
Q

How does body perception compare in teen boys vs girls?

A

70% females have dieted, feel overweight

60% males feel like they need to GAIN weight

28
Q

obesity can have both ____ and ____ factors, but it is mainly due to ____.

A

genetic; environmental

genetic (80%)

29
Q

How does adolescent obesity compare to childhood obesity?

A

much greater psychological damage (seek approval from peers, much more self-aware)
can create vicious circle -> isolated, rejected, little activity, seek food as comfort -> greater obesity

30
Q

How should adolescent obesity be treated?

A

interdisciplinary approach: diet, exercise, behaviour modification, psychological support

31
Q

How do genetics impact obesity risk?

A

affect BMR, satiety, food regulation, metabolism, behaviour, conversion efficiency, response to exercise

32
Q

What is the risk of extreme calorie/food restriction during adolescence?

A

nutritional dwarfism; don’t have enough nutrients for growth spurt

33
Q

Anorexia nervosa is most common in: ____. What other factors are commonly present?

A

girls

white, upper/middle class, high achievers, depression, family dysfunction

34
Q

What are the characteristics of anorexia nervosa?

A

distorted body image perception
fear and anxiety concerning food/deny food needs
desire for extreme thinness

35
Q

What are the diagnostic criteria for anorexia nervosa?

A
  1. no medical/psychiatric illness
  2. 15-25% below expected wt
  3. intense fear of wt gain
  4. intense restriction of energy intake (or with compensation behaviour)
  5. distorted perception of own body, weight, (denial)
  6. > 3 missed periods (female)
36
Q

subtypes of anorexia nervosa:

A 
binging/purging type (with vomiting, laxatives, diuretics, exercise)
restrictive type (no purging)
37
Q

What are the harmful health effects of anorexia? (13)

A 
risk of organ failure
electrolyte imbalance > arrhythmia, cardiac failure 
dehydration & edema
GI damage, GI tract wasting (poor absorption)
amenorrhea
bone loss (no estrogen, poor nutrition)
no growth
brittle hair, dry skin, hair growth
low BP
muscle wasting
defective thermoregulation (cold)
kidney dysfunction
Wernicke's encephalopathy (no B1 -> brain damage; can be fatal)
38
Q

What is the recovery treatment for severe anorexia?

A

may require hospitalization: interdisciplinary approach
(dietician, doctor, psychologist, etc)
usually bedrest
NG tube feeding or TPN to supplement with slow infusion of cal + energy

39
Q

How is anorexia related to osteoporosis? What is the treatement?

A

starvation -> fat loss, low hormones (but high cortisol)
not enough minerals and protein intake

mineral losses from bone (lack of estrogen, low Ca)
*during adolescence, period when need to build up BMD!

treatment: weight gain (exercise NOT effective, since still hypoestrogenism)

40
Q

What hormones increase/decrease in anorexics?

A

higher cortisol

lower estrogen, IGF1, leptin

41
Q

When does bulimia nervosa usually occur?

A

females: succesful, busy individuals

late adolescence, after many failed tries at dieting

42
Q

Bulimia nervosa is characterized by:

A

> 1 binge per week (consuming vast amount of food in small time; not driven by hunger)

  • followed by purging/other compensation (exercise, fasting)
  • usually normal weight
43
Q

What are the emotional stages in a binge?

A 
anticipation
anxiety
urgency to begin
rapid uncontrolled intake of food
relief
shame
44
Q

The health risks of bulimia:

A 
vomiting:
 irritate esophagus, saliva glands
erode teeth (caries)
electrolyte imbalance
kidney injury, UTIs

high risk subclinical malnutrition

45
Q

How does bulimia contribute to electrolyte imbalance, and what can this cause?

A

vomiting: expel HCl -> can’t compensate for acid loss, excess bicarb -> try to compensate, result in low K
vomiting also cause dehydration

hypokalemia -> muscle weakness, twitching, cramps
abnormal heart rhythms

excess bicarb -> slow breathing

dehydration -> dizziness, low urine, dry mouth, confused

46
Q

What are emetics, and when used in bulimia, what can it cause?

A

causes vomiting when taken

excess use -> abnormal heart rhythms, dehydration

47
Q

What is the diganosis criteria for BED?

A

binge eating disorder:

lose control over eating
distress over binge episode
>1 per week, for 3 months

\+3 or more of:
eating very rapidly
eat until uncomfortably full
eat large amounts even though not hungry
eating alone (embarrassed)
disgust, depression, guilt after eating
48
Q

People who binge less severely or show fewer restrictions may be classifed as:

A

non-specified eating disorders

49
Q

atypical eating disorders:

A

pica

rumination syndrome

50
Q

What is the treatment approach for eating disorders in teens?

A

appeal to teen psychology of wanting to be accepted
good nutrition -> good physical appearance

NO severe restriction: hunger can lead to greater binging (importance of breakfast)
treat depression, drug use
diet counseling to change behaviour
psychologist: fix distorted beliefs, accomodate need for independence

exercise not recommended

nutrition thru life (15 decks)

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