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1) Nutrition & Health > Childhood Nutrition, Obesity, and Undernutrition > Flashcards

Childhood Nutrition, Obesity, and Undernutrition Flashcards

1
Q

Name the 3 challenge in childhood nutrition.

A

1) To provide energy and nutrients for
- maintenance needs
- proper growth and development
- long term health
2) To establish healthy eating and activity habits
3) To develop a health body image

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2
Q

When do girls stop growing in comparison to boys?

A

2 years before

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3
Q

How do infant and adult heart rate, respiration rate and energy needs compare?

A

Infants needs are all higher

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4
Q

How many kcals/pound of body weight does an infant need? Adult?

A

Infant: 45/lb
Adult: < 18/lb

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5
Q

How do the American Academy of Pediatrics and the Canadian Pediatric Society differ in terms of their recommendations for transitional diets in childhood?

A

USA: adopt low fat diet from age 2-3 is expected to decrease CVD in adults
Canada: childhood is a transition, priority is a healthy eating patern

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6
Q

What is the composition of breast milk?

A

High in fat: 55%
Protein: 6%
CHO: 39%

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7
Q

What % of children in Canada are overweight or obese?

A

31%

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8
Q

Has there been improvement in childhood obesity?

A

In the last year, o/w + obesity in 2-5 year olds has decreased

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9
Q

How does the treatment for childhood obesity differ from adult obesity?

A
  • Grow into the weight
  • Less aggressive
  • More positive approach
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10
Q

Why do we use percentiles for children?

A

Since body shape is different and percentiles can track growth

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11
Q

How do percentiles work?

A

If you are in the 75% percentile, that means that you are bigger than 75 children and smaller than 25 children

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12
Q

What does crossing percentile lines indicate?

A

That you are gaining weight more rapidly than height

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13
Q

How likely are kids below the 85th percentile to be obese in adulthood? Above 85?

A
  • Below 85th: 10-15% chance (low)

- Above 85th: 50-85%, chances increase as you increase the age

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14
Q

We don’t use the term obese in children. What does being in the 85th percentile mean? 95?

A

85: at risk of being overweight
95: overweight

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15
Q

According to the percentiles graph, 15% of children are obese, yet statistics show that 31% of children are overweight/obese. Why?

A

It is based on a different population (old data) from a healthier time.
The data from the past 2 surveys have been ignored

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16
Q

Name the 4 medical assessments of an overweight adolescent.

A

1) Personal and family history
2) Social/Psychological history
3) Physical Exam
4) Laboratory tests

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17
Q

What does personal and family history assess?

A

BMI changes

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18
Q

What does social/psychological history assess?

A

Tabacco use, depression, family disfunction, eating disorders

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19
Q

What does physical exam assess?

A

Anthropometrics, waist circumference, skinfolds, blood pressure

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20
Q

What do laboratory tests assess?

A

Fasting glucose, cholesterol, liver enzymes

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21
Q

How do you evaluate the readiness for a change in a child?

A
  • Dietary Assessment (foods, portions,eating patterns, beverages)
  • Physical Activity Assessment
  • Assess readiness to make changes
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22
Q

What is the primary goal of therapy?

A
  • Behavioural change
  • Patient is instrumental in treatment, commitment to
    goals and change is required
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23
Q

What is the secondary goal of therapy?

A
  • Weight maintenance (decrease BMI)

- Change the behavior, the numbers will follow

24
Q

What is the tertiary goal of therapy?

A
  • Resolve/Improve Medical Complications

- Reinforcement for behavioral change

25
Name skills to change current behaviour.
- Develop awareness of current eating and activity patterns (and parenting behaviour) - Identify problem behaviors - Modify current behaviour - Small changes, gradually - New behaviors become permanent - Continued awareness of behaviour
26
What is the appropriate goal for child weight loss?
- BMI below 85th percentile | - Maintain baseline weight (grow into weight)
27
How many pounds should you lose per unit of time?
1 pound/month
28
How should you increase activity level?
- Encourage fun social activities - Incorporate into usual daily routine - Incremental changes - Increase intensity gradually - Limit screen time
29
Why are breastfed infants less likely to be overweight?
- Baby is learning satiety signals, decides when to stop eating - Bottle: caregiver decides when the baby stops
30
What are the recommendations in terms of physical activity?
- Min. 60 min of moderate to vigorous activity - Play time - Physical activity (sports, activities) - Mostly aerobic - Vigorous at least 3 days a week - Muscle/bone strengthening 3 days/week
31
Name some complications of weight-management programs.
- Too severe restriction of calories, lean body mass may be lost and linear growth may slow - Preoccupation with weight may translate to self-esteem issues - Conflict between adolescent and family should be referred to therapist
32
Name some additional treatment options for high risk morbid obesity.
- Bariatric surgery and pharmacotherapy
33
Can children use pharmacotherapy?
Trials underway but currently not approved for pediatric use (<16 y.o.)
34
Can children undergo bariatric surgery?
- Minimal criteria: BMI>40 with co-morbidities, conservative treatments failed, psychosocial evaluation - Behavioural commitment
35
How could you decrease the risk of childhood obesity?
- Promote breastfeeding - Parents to provide, child to decide - Limit TV time
36
How many kids under the age of 5 have died in 2011? In 1990?
- 2011: 7 million | - 1990: 12 million
37
What are the main causes of death for young children?
- Neonatal - Pneumonia - Diarrhea - Malaria - Measles - HIV/AIDS - Injuries
38
What is acute protein energy undernutrition characterized by?
- short term - wasting - low weight for height
39
What is chronic protein energy undernutrition characterized by?
- long term - stunting - low weight + height for age
40
Define primary energy malnutrition. What is it due to?
- Inadquate intake - poverty - low food supply - poor quality of food - Armed conflicts - Political turbulence - Natural disasters
41
Define secondary energy malnutrition. What is it due to?
- Disease state - decreased intake - decreased absorption/utilization - increased losses - increased requirement
42
What is the successful adaptation to PEM? Unsuccessful?
Successful: Marasmus Unsuccessful: Kwashiorkor
43
How old are children with marasmus? Kwashiorkor?
Marasmus: infancy < 2 years Kwashiorkor: 1-3 year olds
44
What is marasmus? Does it develop slowly? What are the physical symptoms? What percentage of weight for age? Do they have a good appetite?
- Severe deprivation or impaired absorption of protein, energy, vitamins and minerals - Develops slowly - Severe weight loss and muscle wasting, including the heart - < 60% weight-for-age - Good appetite is possible
45
What is Kwashiorkor? Does it develop slowly? What are the physical symptoms? What percentage of weight for age? Do they have a good appetite?
- Inadequate protein intake or infection - Rapid onset - Some muscle wasting, some fat retention, edema and fatty liver - 60-80% weight-for age - Loss of appetite
46
Define edema. What causes it?
- Plasma proteins leave leaky blood vessels and move into tissues - Proteins attract water, causing swelling - When pressure is applied to the swollen tissue, it leaves an indentation
47
Name some long term consequences of PEM.
Decreased:  Development (physical, social, cognitive)  Adult productivity  Reproduction  Potential of the society as a whole
48
Describe a successful adaptation to PEM malnutrition.
 integrated metabolic response to a change in environmental conditions  maintains steady state within ‘preferred range”  fully reversible  no loss in overall function  Eg Marasmus
49
Describe an unsuccessful adaptation to PEM malnutrition.
 more severe metabolic adjustment  changes are outside “preferred range”  may not be reversible  loss of physiological function  Eg Kwashiorkor
50
What do infections cause?
```  Lack of antibodies  Hb no longer synthesized  Anemia  Dysentery – infection of the GI tract  Fever  Fluid imbalances  Heart failure, possible death ```
51
How do you rehabilitate a patient with Kwashiorkor?
1) Restore fluid and electrolyte imbalances 2) Treat infections 3) Nutrition intervention must be cautious, slowly increasing protein
52
Name some common infections with PEM.
 Diarrhea  Pneumonia and other respiratory tract infections  Urinary tract infections  Measles  Tuberculosis  Parasitic infections  Also parasitic infections are associated with Fe and Vitamin A deficiencies
53
What is cholera? What are the signs and symptoms? How many people does it affect? How many deaths? Which country has it started in recently?
 Bacterial infection of small intestine producing toxin  Vomiting, diarrhea, electrolyte imbalance, dehydration  3-5 million people per year  100,000 - 130,000 deaths per year - Haiti
54
What is the double burden of malnutrition?
- Undernutrition (child mortality) | - Overnutrition (chronic disease)
55
What percentage of health care is malnutrition?
34%

1) Nutrition & Health (21 decks)

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