Chapter 12: Child and Preadolescent Nutrition

Question 1

Middle Childhood

Answer 1

Children between the ages of 5 and 10 years; also referred to as “school-age”.

Question 2

Preadolescence

Answer 2

The stage of development immediately preceding adolescence:

• 9 to 11 years of age for girls
• 10 to 12 years of age for boys

Question 3

Bone Age

Answer 3

Bone maturation; correlates well with stage of pubertal development.

Question 4

Total Fiber

Answer 4

Sum of dietary fiber and functional fiber.

Question 5

Dietary Fiber

Answer 5

Complex CHO and lignins naturally occurring and found mainly in the plant cell wall. Dietary fiber cannot be broken down by human digestive enzymes.

Question 6

Functional Fiber

Answer 6

Nondigestable CHO including plant, animal, or commercially produced sources that have beneficial effects in humans.

Question 7

Pouring Rights

Answer 7

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.

Question 8

Competitive Foods

Answer 8

Foods sold to children in food service areas during meal times that compete with the federal meal program.

Question 9

Commodity Program

Answer 9

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.

Question 10

Physiological Development

Answer 10

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.

Question 11

Cognitive Development

Answer 11

• Beginning of rational thought and strategizing
• Diminished egocentric thought
• Increased independence
• Peer influence begins; family influence is still primary, but waning

Question 12

Feeding Skills

Answer 12

Mastery of eating utensils occur and food prep and meal-related chores can be reasonably expected.

Question 13

Eating Behavior

Answer 13

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.

Question 14

Body Image Issues

Answer 14

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.

Question 15

Energy Needs in School-Age Children

Answer 15

Equations for kcal needs are based on gender, age, ht, wt, and physical activity level. Needs also vary based on genetics and SMR.

Question 16

Protein Needs in School-Age Children

Answer 16

Age 4-13: .95 g/kg

Question 17

Fat Needs in School-Age Children

Answer 17

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.

Question 18

Fiber Needs in School-Age Children

Answer 18

Kids 4-8: 25 g/day

Boys 9-13: 31 g/day

Girls 9-13: 26 g/day

Few meet the current recommendations.

Question 19

Iron and School-Age Children

Answer 19

Anemia less of a problem than in toddlers and preschoolers.

Question 20

Calcium Needs in School-Age Children

Answer 20

Age 4-8: 1,000 mg/day

Age 9-18: 1,300 mg/day

Question 21

Fluid Needs in School-Age Children

Answer 21

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

Question 22

Hallmarks of Overweight in Childhood

Answer 22

• Taller with a more advanced bone age than expected
• Early sexual maturation
• “Adult” health risks apply

Question 23

Causes and Common Threads of Obesity in Childhood

Answer 23

• Sedentary lifestyle
• Early adiposity rebound
• Parental obesity; both genetic and environmental
• Low income/low cognitive stimulation
• More TV equals higher weight

Question 24

Stage 1: Prevention Plus

Answer 24

Encourage better nutrition and physical activity. Follow-up Objective: decrease BMIFA

Question 25

Stage 2: Structured Weight Management

Answer 25

Planned nutrition, < 1 hr screen time per day, 60 min active play per day. Monitoring with the goal of monthly follow-up/intervention.

Question 26

Stage 3: Comprehensive Multi-Discipline Intervention

Answer 26

Team for maximum behavior change, weekly follow-up, and avoid weight loss > 1#/month.

Question 27

Stage 4: Tertiary Care Intervention

Answer 27

For adolescents only, who have tried/failed other interventions. Bariatric surgery.

Question 28

CVD in School-Age Children

Answer 28

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.

Question 29

Physical Activity in School-Age Children

Answer 29

60 minutes of active play suggested daily. Ideal to begin organized sports at this time. Factors associated with more activity:

• Males
• Younger
• Warm
• Climate

Question 30

Nutrition Intervention in Schools

Answer 30

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.

Question 31

School Food Service Programs

Answer 31

• National School Lunch Program
• School Breakfast Program
• Summer Food Service

Question 32

Five Primary Requirements of School Lunch

Answer 32

1. Lunches meet certain nutritional standards
2. Free or reduced price lunches for the needy
3. Non-profit status
4. Accountability through reporting
5. School must receive commodity foods