Chapter 12: Child and Preadolescent Nutrition Flashcards
Middle Childhood
Children between the ages of 5 and 10 years; also referred to as “school-age”.
Preadolescence
The stage of development immediately preceding adolescence:
- 9 to 11 years of age for girls
- 10 to 12 years of age for boys
Bone Age
Bone maturation; correlates well with stage of pubertal development.
Total Fiber
Sum of dietary fiber and functional fiber.
Dietary Fiber
Complex CHO and lignins naturally occurring and found mainly in the plant cell wall. Dietary fiber cannot be broken down by human digestive enzymes.
Functional Fiber
Nondigestable CHO including plant, animal, or commercially produced sources that have beneficial effects in humans.
Pouring Rights
Contracts between schools and soft-drink companies whereby the schools receive a percentage of the profits of soft-drink sales in exchange for the school offering only the soft-drink company’s products on the school campus.
Competitive Foods
Foods sold to children in food service areas during meal times that compete with the federal meal program.
Commodity Program
A USDA program in which food products are sent to schools for use in the child nutrition programs. Commodities are usually acquired for farm price support and surplus-removal reasons.
Physiological Development
School-age is characterized by slow, steady growth (rebound adiposity typically occurs by early school-age), increased strength, coordination, and endurance. Loss of deciduous teeth/permanent dentition replaces.
Cognitive Development
- Beginning of rational thought and strategizing
- Diminished egocentric thought
- Increased independence
- Peer influence begins; family influence is still primary, but waning
Feeding Skills
Mastery of eating utensils occur and food prep and meal-related chores can be reasonably expected.
Eating Behavior
Family is still the greatest influence, but other influences are media, peers, and authorities. Satter “rules” are still appropriate. Family dinner is usually higher quality diet and snacks are needed for optimal nutrition.
Body Image Issues
By age 9-10 there is decreased responsiveness to internal eating cues. Sometimes made worse by parents with “authoritarian” approach to eating. Heavy restrictions can increase the risk of obesity or eating disorders.
Energy Needs in School-Age Children
Equations for kcal needs are based on gender, age, ht, wt, and physical activity level. Needs also vary based on genetics and SMR.
Protein Needs in School-Age Children
Age 4-13: .95 g/kg
Fat Needs in School-Age Children
Should be 25-35% of total kcal intake among 4-18 year olds. Minimize saturated fat and trans-fat intake. New emphasis on EFA. Further restrictions appropriate for those children with hyperlipidemia.
Fiber Needs in School-Age Children
Kids 4-8: 25 g/day
Boys 9-13: 31 g/day
Girls 9-13: 26 g/day
Few meet the current recommendations.
Iron and School-Age Children
Anemia less of a problem than in toddlers and preschoolers.
Calcium Needs in School-Age Children
Age 4-8: 1,000 mg/day
Age 9-18: 1,300 mg/day
Fluid Needs in School-Age Children
This age group is at risk for dehydration and heat illness because:
- Children sweat less than adults
- Certain fabrics and heavy equipment do not allow heat to dissipate well
- Smaller size of children vs. adults
Hallmarks of Overweight in Childhood
- Taller with a more advanced bone age than expected
- Early sexual maturation
- “Adult” health risks apply
Causes and Common Threads of Obesity in Childhood
- Sedentary lifestyle
- Early adiposity rebound
- Parental obesity; both genetic and environmental
- Low income/low cognitive stimulation
- More TV equals higher weight
Stage 1: Prevention Plus
Encourage better nutrition and physical activity. Follow-up Objective: decrease BMIFA
Stage 2: Structured Weight Management
Planned nutrition, < 1 hr screen time per day, 60 min active play per day. Monitoring with the goal of monthly follow-up/intervention.
Stage 3: Comprehensive Multi-Discipline Intervention
Team for maximum behavior change, weekly follow-up, and avoid weight loss > 1#/month.
Stage 4: Tertiary Care Intervention
For adolescents only, who have tried/failed other interventions. Bariatric surgery.
CVD in School-Age Children
General guidelines we give adults are also appropriate for children. Emphasize fruits/veggies, whole grains, low-fat dairy, nuts and seeds, and fish and lean meat.
Physical Activity in School-Age Children
60 minutes of active play suggested daily. Ideal to begin organized sports at this time. Factors associated with more activity:
- Males
- Younger
- Warm
- Climate
Nutrition Intervention in Schools
School-age children are ideal candidates for learning healthy behaviors. Schools can be a venue for transferring nutrition knowledge, and providing healthy meals as well.
School Food Service Programs
- National School Lunch Program
- School Breakfast Program
- Summer Food Service
Five Primary Requirements of School Lunch
- Lunches meet certain nutritional standards
- Free or reduced price lunches for the needy
- Non-profit status
- Accountability through reporting
- School must receive commodity foods
