Childhood and adolescence Flashcards
How long is childhood?
2-20 years
What two things rapidly increase in adolescence and which of those increases more in females?
Lean mass (all mass excluding fat) and fat mass which increases more in females.
Age range of pre-school?
1-5 years
Age range of school age?
5-12
Adolescence age range?
9-19
What are the 5 determinants of nutrient needs?
Age, body size, activity, rate of growth (something on power point 1 slide 5), changing in circumstances such as having an illness or infection.
What is optimal intake?
Satisfies your body’s needs, and allows normal growth and activity.
What are pre-school children’s requirements, quantity and appetite for food?
Requirements
High in relation to size
~95 kcal/kg body weight (adult = 35 kcal/kg)
Quantity
Small stomachs which prevents them consuming large quantities of food at one time
Appetite
Variable, related to fluctuations in growth rate and physical activity
What are some common nutritional problems in childhood and adolescence?
Overweight and obesity Micronutrient deficiencies Iron Vitamin D Food refusal Growth Faltering Dental Problems Constipation Diarrhoea Food allergies
Approaches to prevention/ management of childhood obesity?
Reduce energy intake without reducing volume of food
Increase time required to consume foods/ increase satiety by ‘wholefood’ versions
Organise mealtimes and snacks so eating confined to recognized episodes rather than continuous process
Reduce intake of ‘empty’ calories and unnecessary energy dense foods
Discourage inactivity
Encourage activity
What supplements are recommended and for which groups especially?
Vitamin A and D supplement each day is recommended
Especially for fussy eaters, toddlers of Asian, African and Middle Eastern origin and those living in northern areas of UK
What percentage of children from impoverished inner city areas have iron deficiency anaemia and what is the main cause of this?
25-35% Usually when breast and formula milk replaced by:
Cow’s milk , which limits the absorption of iron
Nutritionally inadequate solid foods
What is recommended to prevent/reduce iron deficiency anaemia?
Iron rich foods at each meal No cows milk (as main drink) under 1 year Avoid excessive milk after 1 year Encourage other dairy products Follow-on formula if any doubt Avoid substances (with meals) which reduce iron absorption Phytates, tannins in tea etc Include Vitamin C containing foods enhances iron absorption
What is rickets and how can it be passed on?
Vit D deficiency and can be passed on during pregnancy.
How common is rickets in the uk and which group of children is effected the most by it?
1 in 100 and it is common in children with limited opportunities to play outside.
How can parents exacerbate food refusal?
Increased attention for negative behaviour
Inappropriate idea of ‘normal’ intake
Little knowledge of foods consumed elsewhere
Battle-ground (parents fighting) can result in lost appetite
Force-feeding
Normal bowel frequency throughout life in industrialised countries?
~4 per day in first week of life
2 per day at 1 year
Adult frequency usually attained by 4 years
Once per day (range 3 per day to 3 per week)
Constipation causes?
Pain from anal fissure Fever, dehydration, immobility Infection Psychological problems Poor dietary and fluid intake Excessive milk intake Inadequate dietary fibre intakeLow fluid intake Faddy eating Coercive toilet training Family history
Constipation treatment?
Toilet training
Give plenty of water : 6 – 8 drinks/ day of 100- 120mls each, more in hot weather or after physical activity
Increase fibre intake: no dietary recommendation, but ~5-7g per day, give wholegrain cereals sometimes, encourage high fibre breakfast cereals, encourage vegetables and pulses, encourage fresh fruit
Limit milk to 3 x 120mls per day
When does toddler diarrhoea occur and end?
Presents between 6 and 20 months.
Usually ceases at 3 years
Causes of toddler diarrhoea?
Minor infections
Low fat intake
Excessive fruit juices
Causes of dental problems in children?
frequent consumption of foods/liquids containing simple sugars and sticky foods
Prolonged bottle feeding e.g. sleeping with bottle in mouth
Acidic foods
Dental health recommendations for children/adolescence?
Oral hygiene (brush twice per day) begins before 1 year of age Fluoridated toothpaste if drinking water not fluoridated Avoid sugary foods between meals
Recognising satiety signals in toddlers?
They say no, Keep mouth shut when food offered, turn head away from offered food, push spoon/bowl/plate away, hold food in mouth and refuse to swallow, repeatedly spit out food, cry, shout or scream, gag/retch
What is the difference in quantity and regularity of food needed of school children compared to toddlers/pre-schoolers?
Do not eat as many times per da
Tend to be less hungry (maintain blood glucose longer)
Can eat more food at each sitting
Research shows that tackling what two key areas will dramatically have an impact on childhood nutrition
Planning for healthy lunches/snacking at home
School meal provision (school milk program and healthy lunch/snack provision)
In adolescence what vitamin and minerals that support growth and development?
Vit A, C, folate and zinc
in adolescence the vitamins and minerals needed for bone growth?
Vit D, calcium, phosphorus
Why are iron needs high in adolescence?
Growth and menstration
What 3 nutrients are commonly imbalanced in adolescence?
sodium, potassium and water
Why are calcium needs high in adolescence?
½ of peak bone mass accumulates in adolescence
1,300 mg for ages 9–18 years
Inadequate calcium intake can lead to low peak bone mass and is a risk factor for osteoporosis
Why do adolescence need iron? What is an additional recommendation because of this? Recommendations for 14-18?
Additional iron supports muscle growth and increased blood volume
Adolescent females need iron to support menstruation
RNI for iron
Females aged 14–18 years = 14.8 mg/day
Males aged 14–18 years = 11.3 mg/day
Iron deficiency is common in adolescence, especially among individuals who limit intake of enriched grains, lean meats, and legumes
Recommend source of vitamin C with every meal
When is early adolescence?
10–14 years of age
When is late adolescence?
15-19 years.
When is young adulthood?
20-24 years
What is adolescence marked by?
physical and sexual maturation, social and economic independence, development of identity, acquisition of skills needed to carry out adult relationships and roles, and the capacity for abstract reasoning.
Adolescence is the second fastest period of growth what is the first?
Infancy
Delete
What is the importance of the age group 10-24 years old?
Epidemiologically, the age group from about 10to 24 years is a quarter of the global population and, in any population, it is the healthiest of any age group and the group best able to raise the economic productivity of the resident country
Why is nutrition so important for adolescence?
Because it is a period of rapid growth, adequate nutrition is crucial for achieving full growth potential, and failure to achieve optimal nutrition may lead to delayed and stunted linear growth and impaired organ remodelling (reorganisation and restoration of existing tissues).
What is the leading cause of years lived with disability among children and adolescence?
Iron-deficiency anemia
Why has there been an increase in interest in adolescence nutrition in developing countries?
it’s a means to improve the health of women and future generations of children on the reasoning that interventions targeted at adolescents allow time for the interventions to have the maximum impact on optimizing health in the years ahead, including the health of women during future pregnancies and the related health of the next generation
What is hidden hunger?
occurs when the quality of food that people eat does not meet their nutrient requirements, so they are not getting the essential vitamins and minerals they need for their growth and development
What type of malnutrition appears to be in the top 10 causes of death among children and adolescence?
protein-energy malnutrition.
Where is underweight girls between 13 and 15 years old an issue?
Some low and middle income countries in Africa and Asia
What is age range of puberty?
Can start as early as 8 and extend beyond 19 years of age?
… … hormones and … hormones generally increase together and are responsible for the enhanced … growth and … maturation
Pubertal sex, growth, skeletal, sexual
how much of adult weight is gained during adolescence?
50%
What 8 things increase in size during puberty?
bone mass, muscle mass, blood volume, heart, brain, liver, kidney
What needs to be considered for adolescence in the workforce?
That there is robust nutritional support and opportunities for adequate sleep are considered in the health of adolescent girls and boys, who may be in the workforce and forced to sleep out of synchrony with their natural clocks
The timing and duration of body composition changes are linked directly to … … so nutritional requirements depend more on this than on …?
sexual maturity, age
What is menarche?
occurrence of first mensural period
What usually happens one year after menarche? What is the exception?
final or adult height is usually achieved1 year after menarche and also includes increased bone mineralization and fat accumulation. However, in low-income settings, the pubertal growth spurt is frequently extended, thus allowing a sub-stantial degree of catch-up in height and weight compared with the international growth reference standards
What is metabolism made up of?
Energy cost of growth (ECG), Basal metabolic rate (BMR) and activity energy expenditure (AEE)
What happens if total energy intake falls below bmr in childhood?
ECG and AEE will be compromised and can lead to growth stunting pubertal delay, menstrual abnormalities in girls, and interference with bone mass accumulation
Why do adolescence have special requirements for vit d and calcium and amino acids?
for bone and muscle growth
Why is the caloric need of adolescent men higher?
they have greater increases in height, weight and lean body mass.
What things influence eating patterns and behaviours in adolescence?
peer influences, parental modelling, food availability, food preferences, costs, convenience, personal and cultural beliefs, mass media, and body image
…% or more of total daily calories should come from … with no more than …–…% of calories derived from …, such as … and … … … syrup.
50%, carbohydrates, 10, 25, sugars, sucrose, high fructose corn syrup.
When is protein requirements per unit of height highest for women?
11-14 years
When are protein requirements per unit of height highest for men?
15-18
Existing data suggest that, when energy is constrained, the physiology of younger adolescents invests in …, while that of older adolescent females privileges … … adipose tissue
growth, reproductively valuble
Which 4 micronutrients were shown in an intervention to be helpful to adolescent mothers? What else?
calcium, iron, zinc and folic acid. nutritional education sessions to enable them to improve nutritional intake and pregnant adolescents had access to a nutritionist they could consult as part of antenatal care.
What increases the chances of preeclampsia (pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys) In adolescence?
pre-pregnancy obesity and excessive weight gain during pregnancy
What are the personal factors that effect eating behaviours?
attitudes, beliefs, food preferences, self-efficacy (individual’s belief in their capacity to execute behaviours necessary to produce specific performance attainments) and biological changes
Environmental factors that effect eating behaviours?
family, friends, peer networks, school, fast food outlets, and social and cultural norms
Macrosystem factors the influence eating behaviours?
food availability, food production, distribution systems, mass media, and advertising
What are the risks for adolescents who were exposed maternal preeclasmia to foetuses?
structural and functional changes in their hearts, including greater relative wall thickness and reduced left ventricular end-diastolic volume compared with controls
Common eating behaviours teens develop which is different to younger children?
Teens as a group tend to snack and graze, miss meals, eat away from home, consume fast foods, and diet (especially females) more frequently than younger children
What 5 things do teens tend to consume in excess?
total fat, saturated fat, cholesterol, sodium and sugar
Prevalence of obesity among adolescents worldwide, explained by widespread nutrition transitions to ..-… diets and a decrease in … …, especially among … adolescents
lipid, rich, physical activity, urban
0.3% of adolescents aged 13–18 years have … …, 0.9% have …, and 1.6% have a … … …
anorexia nervosa, bulimia, binge eating disorder.
