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Exam In January > Childhood Nutrition > Flashcards

Childhood Nutrition Flashcards

1
Q

What are nutrients

A

A nutrient is a substance that an organism needs to live and grow

Macronutrients are taken in large amounts and provide energy or calories: the 3 main groups are carbohydrates, lipids, proteins

Micronutrients are substances required in trace amounts for example vitamins and some dietary minerals for example calcium and iron

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2
Q

Reference nutrient intake

A

The amount of nutrient that is sufficient to meet the daily dietary needs of about 97% of a give. Population

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3
Q

Fat soluble vitamins

A

Vitamins A,D,E,K

Stores in the liver

Not easily absorbed or excreted

Vitamins A and D are toxic in excess

Excess vitamin A is teratogenic

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4
Q

Water soluble vitamins

A

Vitamins C and B groups

Not stored extensively

Required regularly in diet

Generally non toxic in excess

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5
Q

A balanced healthy diet

A

Provides energy and material for normal body growth and function

Contains a balance of the main nutrient groups

Supplies the reference nutrient intake

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6
Q

Maternal nutrition

A

Eating a healthy varied diet in pregnancy is essential for mothers and their developing baby’s

It’s recommended that women take
400mcg folic acid is (5mg I’d if at high risk) from before pregnancy and up to until 12 weeks pregnant (to prevent spina bifida)

10mcg vitamin D of after 12 weeks into the pregnancy and while breastfeeding to prevent rickets

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7
Q

Nutritional goals of childhood

A

Promote good health and well-being

Promotes optimum growth and development

Promotes a life long attitude relating to the biological and psycho social values of food

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8
Q

Breast milk

A

Recommended in infancy

Optimal infant nutrition- provides all the protein, sugar and fat needed

Provides immunoprotection

Promotes GIT maturation

Has maternal benefits

Reference value for formal milk

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9
Q

Breast milk immunipretection

A

Colostrum and breast milk contains the following which benefits the baby immune system and so his or her ability to fight enteric and respiratory infections

Antibodies IgA, IgM, IgG, IgA in particular promotes the maturation of the baby’s GIT

Immune factors, interferons

White blood cells neutrophils, macrophages, T lymphocytes

Colostrum gives the most potent boost to the new born immune system

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10
Q

I modified cows milk is unsafe for infants

A 
Too high in 
Sodium 
Potassium 
Calcium 
Phosphorus
Casein 
Saturated fats

Too low in
Carbohydrates
Iron
Vitamin A and D

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11
Q

Formula feeding essentials

A

Safe water supply and clean equipment

Infant modified formulas which are available and affordable

Sounds health education programmes

Growth monitoring programmes

Health surveillance

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12
Q

Potential risk of bottle feeding infants

A

Risk of inception

Risk of allergy

Additional workload on immature kidney

Potential risk to airway from prop feeding

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13
Q

Scientific milk adaptation

A

Protest modified

PUFAs added

Vitamin and minerals added

Calcium

Low sodium

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14
Q

Milk intake in childhood by type

A

Infant < 6 months - breast/infant formula milk

6 months to 1year- breast/infant formulae milk

1 year - while cows milk, follow on or soya milk

2 year- can have semi skimmed cows milk

5 years can have skimmed cows milk

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15
Q

Weaning

A

Introduction of solids should start at 6 months

Breast or formula feeding should continue until 12 months

Full fat cows milk can replace formula or breast milk after 12 months

Process of expanding diet to include foods and drink other than breast milk at 6 months

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16
Q

Weaning biological rationale

A

Meeting nutritional needs
.low energy value of breast and formula milk
. Low iron and zinc in breast/ formula milk

Improved GIT maturation by 6/12
• full complement of pancreatic amylase
•adequate production of hydrochloride acid
•progressive kidney and liver maturation

Developmentally
•oro-motor skills ready
•promotes mouth and tongue co-ordination
•promotes growth of facial bones, facial muscles and dentition

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17
Q

Foods to avoid

A

Salt - risk of hypernatraemia

Sugar- risk of tooth decay

Honey- risk of infection for example botulism and too decay

Whole nuts- risk of choking and allergy

Low fat foods- babies need calories to grow

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18
Q

Healthy start vitamins for infants

A

These vitamins are for infants from 6 mouths to 5 years

Vitamin A for growth, vision in dim light and healthy skin

Vitamin C healps maintain healthy tissue in the body

Vitamin D for strong bones and teeth

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19
Q

Healthy start voting for infants

A

8% of children under five in the Uk don’t have enough vitamins A in their diet

Families in lower income groups tend to have less vitamin C in their diet

Pregnant and breastfeeding women and young children are at risk of vitamin D deficiency

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20
Q

Vegetarians diets

A

Complementary proteins mixing grains and pulses for example results in high quality protein

One or two sources of protein at each meal

Input from dietician

Know what to remove from diet

Know which nutrients to replace

Essential amino acids maintaining adequate amounts

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21
Q

An optimum healthy diet

A

Is balanced in quantity and quality

Meets the daily recommended needs

Maintained health and well-being

Facilitates growth and development

Illness and disease affects bioavailability and cellular utilisation of food

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22
Q

The eat well plate

A

Fruit and veg

Potatoes bread rice and pasta

Milk and dairy foods

Fat and sugar

Non-dairy source protein

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23
Q

Preschool children and school age children

A

Set foundations for life long healthy eating

1-6 year age group do not get enough fruit and veg

Need a diet low in fat

Diet high in fruit and veg and finer and starchy foods

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24
Q

Nutritional deficiencies in uk

A

Vitamin D

Iron

Calcium

Zinc

Vitamin B12

Protein

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25
Q

Early nutrition is critical

A

Lower plasma cholesterol levels

Enhanced growth, body composition and body fat deposition

Improved hormonal secretion

Improved efficiency of enzyme activities

Improved vision

Positive effects on behaviour, learning and memory

Lifelong healthy eating practices

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26
Q

Current paediatric nutritional clinical concerns

A

Infant nutrition

Childhood obesity

Vitamin D deficiency

Bone density

Iron deficiency

Tooth decay

Effects of childhood diet on adult health

27
Q

Summary

A

Maternal nutrition impacts on the unborn baby

Infant nurtritio. Is important for growth and part of eastblishing good eating hanits

There are biological rationales underpinning uk nutritional guidelines through childhood

A vegetarian diet in childhood can be healthy

28
Q

Humans are mostly made up of water

A

Premature infant 90%

Newborn 70-80%

12-24 months 64%

Adults 60%

29
Q

Where is all this fluid

A

Inside the cells - intracellular fluid 67%-50%

Outside the cells - extracellular fluid

Around the cells in the tissue space - interstitial fluid 10%-30%

In the circulation- intravascular fluid (plasma) 23%-20%

Distinct locations bladder, GI tract

30
Q

Children need more water

A

Higher volume of extracellular fluid

Faster metabolic rate

Large surface area:volume ratio

Water turnover high 15% vs 9% in adults

Immature homeostatic mechanisms

31
Q

Daily oral fluid requirements

A

New bone- 30 ml/kg

Day 2- 60

Day 3- 90

Day 4 - 120

Day 5 - 150

1 wk to 8 m - 150

9-12m 120

Child <100

Adolescent - 1-2 L per day

32
Q

Daily normal I’ve maintenance fluid requirements

A

100 ml/kg/day - first 10kg

50 ml/kg/day second 10kg

25 ml/kg/ day each kg above 20kg

33
Q

Normal urinary out by age

A

Neonate 2-3 ml/kg/hr

Infant 1-2 ml/kg/hr

Child 1-2 ml/kg/hr

Adolescences 0.5-1 ml/kg/hr

34
Q

What are electrolytes

A

Substances which develop an electrical charge when dissolved in water for example NaCI, KCI, NaHCO3

35
Q

Some examples

A

Positive change Negative
Sodium ion: Na+ Chloride ion CI-
Potassium ion: K+ Bicrbonate ion: HCO3

36
Q

Sodium

A

Most sodium is found in the extracellular fluid

Sodium is removed out of cells by a sodium pump

Sodium is a major player in the control of fluid distribution between extracellular fluid and intracellular fluid

High sodium levels in the extracellular fluid leads to water movement out of cells, low sodium levels in the extracellular fluid leads to water entering the cells

Sodium levels are mainly maintained by the kidney in response to hormone release

37
Q

Sodium ions

A

Normal plasma levels 135-145 mmol/l

38
Q

Potassium

A

Potassium is ingested in the diet from meat, fruit and some veg

Potassium is the major intracellular electrolyte

Only 2% of our potassium is present in the extracellular fluid

Potassium is vital for nerve, muscles and cardiac function. Potassium set up the membrane potential of these cells

Excess potassium is excreted mainly from the kidneys

Severe hypo or hyper jalapeños can be fatal

39
Q

Potassium ions

A

Plasma levels 3.5-5.5 mmol/l

40
Q

Major body electrolytes

A

Extracellular

  • sodium
  • chloride
  • bicarbonate

Intracellular

  • potassium
  • magnesium
  • phosphate
  • proteins with negative charge
41
Q

How do water and electrolytes move in the body

A

Water and electrolytes can pass freely between the capillaries and the interstitial fluid through tiny gaps

gates called ion channels - electrolytes

Semi permeable membrane - water

42
Q

Osmosis

A

Osmotic pressure pulls water to the concentrated solution

It’s the movement of water from an area of low solute concentration to an area of high volume

Water follows salt

43
Q

Hydrostatic pressure

A

There is the pressure in the closed system of the circulation produced due to the pumping action of the heart

This pressure dissipates the farther away from the heart

At some point across the capillary bed and wham in the veins, the hydrostatic pressure is generally below that of the surrounding tissue

44
Q

Hydrostatic pressure

A

Hydrostatic pressure in the vessels is slightly higher than the tissues around it

Hydrostatic pressure in the vessels is slightly lower than the tissues around it

Fluid moves from areas of higher hydrostatic pressure to areas of lower hydrostatic pressure.

45
Q

Oncotic pressure

A

The pressure exerted by the small, non diffusible particles suspended in a solution or fluid

These non disable particles, also called Colloids, are unable to pass through the semipermeable membrane of the endothelial cells and so remain in the circulation

46
Q

Oncotic pressure

A

Is the ability of proteins to hold on to water

If the level of plasma protein falls. Where might some of the water go

47
Q

Plasma pro times

A

The main plasma protein is albumin

Plasma - 55% of whole blood

Buddy coat
Leukocyte and platelets - 1% of whole blood

Erythrocytes - 45% of whole blood

48
Q

Water movement

A

Whenever hydrostatic pressure is greater than oncotic pressure, water containing electrolytes will leave the capillaries

Whenever the oncotic pressure is greater than the hydrostatic pressure water containing electrolytes will enter the capillaries

49
Q

Fluid and electrolyte regulation

A

Detection
•hypothalamus- osmoreceptors> release of ADH

  • aorta and carotid sinuses - baroreceptors> signal to the medulla oblongata
  • kidney- detects local fall in perfusion > renin
  • right atrium - detects increases in aerial volume> ANP
  • adrenal gland - high levels of k+ and angiotensin > aldosterone

Hormonal effects

Renin-aldosterone-angiotensin system- Na and water retention/k excretion and vasoconstriction

Antidiuretic hormone (ADH) water retention

Atrial natriuretic peptide - increases Na and water excretion

50
Q

Imbalances

A

Over hydration

Oedema

Dehydration

Hypo/hypernatraemia

Hypo/hyperkalemia

Metabolic acidosis

51
Q

Tonicity

A

Is the osmotic pressure exerted on a cell by the extracellular fluid

I’ve fluid are classed by their tonicity

52
Q

Tonicity of IV fluids

A

Isotonic

  1. 9% NaCI
  2. 5% dextrose/ 0.45% saline

Hypotonic

Hypertonic

53
Q

Summary of fluids

A

There are three zones of fluid distribution

Intravascular space
Interstitial space
Intercellular space

Fluid movement and distribution depends largely upon osmosis, hydrostatic pressure and oncotic pressure

Fluid flows freely between the circulation and interstitial fluid though gaps in the capillary walls
Water enters or leaves cells mainly by osmosis

54
Q

Summary of electrolytes

A

Electrolytes such as sodium and potassium are changed particles dissolve in body fluid

All electrolytes have a specific distribution between plasma, interstial fluid and intracellular fluid

Electrolytes and their correct distribution are essential to life as they are required for the normal functioning of all organs and tissues

55
Q

Oncotic pressure

A

Is the ability of proteins to hold on to water

If the level of plasma protein falls. Where might some of the water go

56
Q

Plasma pro times

A

The main plasma protein is albumin

Plasma - 55% of whole blood

Buddy coat
Leukocyte and platelets - 1% of whole blood

Erythrocytes - 45% of whole blood

57
Q

Water movement

A

Whenever hydrostatic pressure is greater than oncotic pressure, water containing electrolytes will leave the capillaries

Whenever the oncotic pressure is greater than the hydrostatic pressure water containing electrolytes will enter the capillaries

58
Q

Fluid and electrolyte regulation

A

Detection
•hypothalamus- osmoreceptors> release of ADH

  • aorta and carotid sinuses - baroreceptors> signal to the medulla oblongata
  • kidney- detects local fall in perfusion > renin
  • right atrium - detects increases in aerial volume> ANP
  • adrenal gland - high levels of k+ and angiotensin > aldosterone

Hormonal effects

Renin-aldosterone-angiotensin system- Na and water retention/k excretion and vasoconstriction

Antidiuretic hormone (ADH) water retention

Atrial natriuretic peptide - increases Na and water excretion

59
Q

Imbalances

A

Over hydration

Oedema

Dehydration

Hypo/hypernatraemia

Hypo/hyperkalemia

Metabolic acidosis

60
Q

Tonicity

A

Is the osmotic pressure exerted on a cell by the extracellular fluid

I’ve fluid are classed by their tonicity

61
Q

Tonicity of IV fluids

A

Isotonic

  1. 9% NaCI
  2. 5% dextrose/ 0.45% saline

Hypotonic

Hypertonic

62
Q

Summary of fluids

A

There are three zones of fluid distribution

Intravascular space
Interstitial space
Intercellular space

Fluid movement and distribution depends largely upon osmosis, hydrostatic pressure and oncotic pressure

Fluid flows freely between the circulation and interstitial fluid though gaps in the capillary walls
Water enters or leaves cells mainly by osmosis

63
Q

Summary of electrolytes

A

Electrolytes such as sodium and potassium are changed particles dissolve in body fluid

All electrolytes have a specific distribution between plasma, interstial fluid and intracellular fluid

Electrolytes and their correct distribution are essential to life as they are required for the normal functioning of all organs and tissues

Exam In January (11 decks)

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