Adolescence

Question 1

On what is based the nutrient needs during adolescence?

Answer 1

height => kcal/cm

Question 2

when does menarche occur?

Answer 2

12-13 yo

Question 3

____ have a prepubertal period earlier than ____

Answer 3

girls, boys

Question 4

____ have a longer growth period than ____

Answer 4

boys, girls

=> more prolonged, more intense + occurs later

Question 5

During the growth spurt there is 2x more incorporation of minerals into bones. What are they?

Answer 5

Ca, Mg, Zn and Fe

Question 6

What factors affect nutrient needs?

Answer 6

• growth spurt intensity
• gender
• timing of growth spurt

Question 7

What are SMR?

Answer 7

Tanner’s Sexual Maturation Ratings

guide based on primary and secondary sexual characteristics

Question 8

TRUE or FALSE

Maturation timing is the same for all.

Answer 8

False

differs but same sequence

Question 9

What are the SMR stages and their characteristics?

Answer 9

SMR 1 = rapid growth but no sexual changes
SMR 2 = bone mass + skeletal growth in females
SMR 3 + 4 = bone mass + skeletal growth in males, LBM peak for females, peak growth spurt for females around breast stage 3
SMR 5 = LBM peak for males

Question 10

When does occur the peak weight accumulation for females and males?

Answer 10

females = 6-9 mo prior to growth spurt
males = same time as growth spurt

Question 11

What hormones play a role in growth spurt?

Answer 11

• adrenal androgens
• growth hormone
• estrogen

Question 12

what are the roles of testosterone in boys?

Answer 12

increase LBM and muscle growth + fat loss

Question 13

What can be the consequences of delayed puberty for girls?

Answer 13

lower bone mass density late as an adult

Question 14

What hormones are responsible for bone mineral deposition?

Answer 14

androgens and estrogens

Question 15

What characterizes max height velocity?

Answer 15

max fat loss and increase muscle mass in arms

Question 16

When does menarche occur in females?

Answer 16

1 year after breast dev => at the decrease of growth

Question 17

Do boys continue to grow after sexual maturation?

Answer 17

yes

Question 18

on what depends the timing of maturation?

Answer 18

environmental factors

Question 19

What are the % of bone mass and stature acquired by the age of 10?

Answer 19

50% BM and 80% stature

Question 20

TRUE/FALSE

The majority of female teens meet Ca needs.

Answer 20

False only 15%

Question 21

LBM in males ___ and in females, it ___ .

Answer 21

increases (80 to 90%)

decreases (80 to 75%)

Question 22

what are external factors influencing food behavior?

Answer 22

• nutrition knowledge
• family unit
• peers
• parenting
• mass media
• fast foods
• food fads
• personal experiences (drugs and alcohol)

Question 23

what are internal factors influencing food behavior?

Answer 23

• physiological needs
• self-concept
• body image
• personal values + beliefs
• food preferences
• psychological dev
• health

Question 24

what influence internal and external factors affecting food behavior?

Answer 24

social-economic political system + food availability production and distribution system

Question 25

Genes account for __% whereas environmental factors account for __% for obesity outcome.

Answer 25

20%, 80%

Question 26

Why does obesity can lead to avoidance of social contact?

Answer 26

decreased self-worth and discrimination

Question 27

What can cause a calorie restriction during growth spurt?

Answer 27

linear growth restriction = nutritional dwarfism

Question 28

How does anorexia nervosa is diagnosed?

Answer 28

``` wt is 15-20% below normal no known psychiatric or medical illness disturbed self-image anxious + fearful personality achievement-oriented families fear of gaining weight loss of menses for more than 3 cycles ```

Question 29

What are the characteristics of anorexia nervosa according to DSM-5?

Answer 29

1. energy restriction 2. fear of wt gain 3. influence of body wt and shape on self-evaluation

Question 30

What are the two types of anorexia nervosa?

Answer 30

restricting type + binging/purging type

Question 31

What can be the health risks associated with anorexia nervosa (10)?

Answer 31

1. organ system failure 2. electrolyte imbalances - > decreased BP = confusion - > low K + dehydration = kidney dysfunction - > cardiovascular risk 3. GI symptoms 4. Wernicke's encephalopathy => brain damage due to thiamin deficiency 5. muscle wasting = decreased BMR 6. defective thermoregulation (low-fat mass) 7. amenorrhea (low estrogen) 8. starvation like symptoms 9. growth cessation (atrophy of GI tract) 10. bone loss = osteoporosis

Question 32

How can recovery be first achieved in severe cases of anorexia nervosa?

Answer 32

gradual infusion of kcal (nasogastric or TPN)

Question 33

Why does the risk of osteoporosis increase for ppl with anorexia nervosa?

Answer 33

- adolescence = still period of growth - hormonal changes = increased cortisol and decreased IGF-1 + leptin, estrogen - loss of pro + minerals = decreased bone mass + strenght

Question 34

TRUE or FALSE | Exercise should be completely avoided for ppl diagnosed with anorexia nervosa.

Answer 34

TRUE | exercise puts more stress on bones = decreases bone mass = osteoporosis

Question 35

How does bulimia can be diagnosed?

Answer 35

binging for more than a week followed by purging for 3 months usually normal weight

Question 36

What is bulimarexia?

Answer 36

no purging periods | overexercising or fasting

Question 37

What are the health risks associated with bulimia? (8)

Answer 37

- tooth erosion = acid from vomiting - dental caries - irritation and infection of the esophagus (vomiting) - electrolytes imbalances - XS bicarbonate => hypokalemia => muscle twitching + weakness - SOB from XS bicarbonate - abnormal heart rhythms - kidney injury

Question 38

What is the treatment for eating disorders?

Answer 38

multi-disciplinary approach 1. treat depression, drug + alcohol abuse 2. anti-depressants 3. diet counseling 4. no exercise 5. replace beliefs regarding wt + food 6. promote breakfast to decrease binging 7. work with teens to encourage independence