Childhood Nutrition Flashcards
1
Q
Childhood
A
- Slower growth than infancy
- Food preferences established
- Gross motor skills refined
- Independent eating and feeding skills refined
- Primary recommendation: eat wide variety of foods
- Toddlers and preschoolers retain ability to **self-regulate food intake **
- Wide range of nutrient reuqirements **based on body growth and weight rates **
2
Q
Toddlers
A
Age 1-3
- Behavior parallels adolescent behavior
- Seeking more independence
- Temper tantrums, easily frustrated, negative attitude
3
Q
Preschool Age
A
Age 3-5
- Learn to control body functions
- Behave in socially acceptable manner
- Interact with others
4
Q
Middle School / Preadolescence
A
Middle School: Age 5-10
Preadolescence: Girls 9-11, Boys 10-12
- More responsive to external cues of appetite
- Develop personal independence
- Establish scale of values
- Individual variations become more noticeable with regards to:
- GR
- Activity patterns
- Nutrient reqs
- Personality
- Food Intake
5
Q
Food Acceptance
A
Influenced by:
- Parental food selection
- Mealtime environment → scolding vs. happy
- Peer pressure, advertising
- Previous experiences with that food
6
Q
Physical Growth
A
- GR slows
- Average yearly weight gain: 4-7 lbs/year (for all ages)
- Average yearly length gain:
- Toddler: 4-5 inches
- Preschool: 2-3 inches
- School age: 2-3 inches
- From 6→puberty, gender differences start to be noticed
7
Q
Body Composition
A
- Changes significantly
- Muscle Mass increase
- Skinfold decreases
- Subcutaneous fat→ females > males
- Head size proportion decreases (relative to body)
-
Brain growth
- 75% by 2nd year
- 100% by ages 6-10
-
Body Fluid
- Similar to adult by 2-3 years
- Extracellular fluid decreases
- Intracellular fluid increases
- Less vulnerable to dehydration than during infancy
- Decreased ratio of body surface area to body mass
- Elongation of leg bones and constant bone remodeling
8
Q
Growth Assessment
A
Growth charts
- Birth-36 months → recumbent measure
- 2-20 years → standing measure
- Growth Channels
- Progressive regular growth patterns of children
- Guided along individual genetically controlled channels
- influenced by nutritional and health status
- Should be maintained once established
- Maintaining weight-height % is more important than ht-for-age
9
Q
Growth Charts
A
- Based on NHANES III Data
- Measuring weight
- Stocking feet
- Standard exam clothing
- Beam balance scale
- Measuring weight
- Using Charts
- Detection of excess or inadequacies in nutrients
- 10-25th and 75-90th percentile → close observation
- Extremes → risk of overgrowth or failure → closer evaluation
- NHANES III
- more minorities
- New percentiles: 3rd and 97th
- Age increased to 20
- Data shows increased weight for children 6-20
- This increase not reflected in charts
- Charts no longer describe American population
- First time for making reasonable judgments about growth channels
10
Q
BMI for Age
A
- Main concern → overweight
- Don’t want to set growth standards on obese data
- Replaced weight for height
- More reliable index for overweight
- In kids, BMI is age and gender specific
- Reference points change with age
- 85% added to help identify risk for obesity
-
BMI decreases during preschool
- Lowest point at 4-6 years
- Followed by “BMI Rebound”
- Early BMI rebound → more at risk for being overweight or obese as an adult
- Advantages
- Compares well with:
- **weight for stature **
- measures of body fat
- Reference for adolescents was not previously available
- Consistent with adult index
- Can be used continuously to adulthood
- Compares well with:
11
Q
BMI for Age Cut Offs
A
>95th% → obese
85-94th% → overweight
5th-84th% → acceptable
<5th% → underweight
12
Q
Feeding Skills
A
- With increased age and strength, feeding skills are mastered
- Physical growth reflected in development of self-feeding
- Children learn to feed independently during 2nd year of life
- Ulnar deviation (articulation of wrist joint) enables spoon feeding
- Develop coordinated movement of wrist and hand
- Handedness is not established at 1 year
- Refined pincer grasp makes finger feeding preferable → children often place food in spoon
- By 18-24 months, children can tilt cup effectively
- Ability to chew hard, fibrous foods increases through school years
- Avoid foods with high choking risk
- Dried, sticky fruits
- Small fruits with skins and peels
- Graps, hot dogs and nuts cut in half
- Popcorn and chips
- Peanut butter
13
Q
Energy Requirements
A
- Based on
- REE
- GR
- Physical Activity
- Small gender difs until age 10
- Growth charts show adequacy of intake
- Catch up growth increases needs
- Age 1-3
- 102 kcal/kg/day
- EER = (89 x wt(kg) - 100) + 20
- Catch up growth → 150-250 kcal/kg
- Age 4-6
- 90 kcal/kg/day
- > 3 years Table 10.4, p. 283
- Ages 7-10
- 70 kcal/kg/day
- RDA’s provide guidelines for studying groups, but not evaluating diets of individual children
14
Q
Protein Requirements
A
- Based on:
- Maintenance of tissue
- Changes in body composition
- Synthesis of new tissue
- As child grows, protein intake relative to body size decreases
- Adequate intake determined by:
- Adequacy of growth
- Quality of protein in diet
- Age 1-3 →** 1.1 g/kg**
- Age 4-13 → .95 g/kg
15
Q
Minerals
A
- Inadequate intake may →
- Slow GR
- Inadequate bone mineralization
- Anemia
- Minerals of Concern
- Ca
- Fe
- Zn
16
Q
Calcium
A
- Required for bones
- >98% of Ca in body is bone
-
Absorption range from 30-60%
- Lactose increases absorption
- Phytic (wheat grains) and oxalic acid (green leafies, corn, soy, tofu, wheat germ) decrease absorption
- Age **1-3 **→ 700 mg/day
- Age 4-8 → 1,000 mg/day
- Age **9-18 **→ 1300 mg/day
- As protein increases → urinary calcium increases
- Recommended intake is high, relative to body size
- More Ca needed during rapid growth
- Milk and dairy products primary source
17
Q
Zinc
A
- Necessary for protein synthesis and growth
- Deficiency results in:
- Growth retardation
- Hypogeusia (low taste threshold) and diarrhea
- Impaired wound healing
- Impaired cell-mediated immunity
- Children don’t consume enough
- Increase Zn intake in deficient children → increased linear growth
- Meats are good source
- Absorption decreased by:
- Fiber
- Phytates
