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Nutrition 207 > Childhood obesity > Flashcards

Childhood obesity 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
Girls-15 years
Boys-17 years

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3
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 pattern

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4
Q

What is the composition of breast milk?

A

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

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5
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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6
Q

Energy requirement s for boys and girls 2-3 years and 4-5 years

A

2-3 years 1000 kcal
4-5 boys 1200
4-7 girls 1200

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7
Q

Why do we use percentiles for children

A

Since body shape is different and percentiles can track growth

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8
Q

Should children eat as their parents?

A

No, because they have little stomach, less portion size

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9
Q

How the eating patterns of the child should be controlled not to lead to obesity?

A

Children regulate the fullness and hunger by their own otherwise can lead to obesity

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10
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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11
Q

What does crossing percentile lines indicate?

A

That you are gaining weight more rapidly than height

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12
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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13
Q

What does being in the 85th percentile mean? 97? for children 5-19

A

> 85: overweight >97: obesity >99.9 severe obesity

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14
Q

Energy and nutrient needs during adolescence

A
  • Needs are great and they vary with the physical activity level and the gender ( boys have higher requirements than girls)
  • RDA and AI are higher for most vitamins
  • Caffeine,smoking should be avoided
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15
Q

Consequences of skipping the meals

A

Leads to overeating after and in general

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16
Q

Why girls are more at risk of calcium deficiency?

A

Because they stop drinking milk because of the acne(myth) and cutting of calories

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17
Q

What is the risk of obesity of none of the parents is obese, if one?

A

None- 10%

One or more - 80%

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18
Q

What does personal and family history assess?

A

BMI changes

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19
Q

What does social/psychological history assess?

A

Tabacco use, depression, family disfunction, eating disorders

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20
Q

What does physical exam assess?

A

Anthropometrics, waist circumference, skinfolds, blood pressure

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21
Q

What do laboratory tests assess?

A

Fasting glucose, cholesterol, liver enzymes

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22
Q

What are the guidelines for optimal children health

A

Sweat
Step
Sleep
Sit less( No more than 2 hours a day)

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23
Q

How much sleep should children get and what are the risk of not having enough

A

5-13 years 9 to 11 hours
14-17 8 to 10 hours
If not enough will compensate with snacking

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24
Q

What do you need to look at the percentile graph

A

At the overall trend

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25
What are some risks of becoming obese in kids
- Begin puberty earlier, may stop growth at a shorter height, greater bone and muscle mass - Emotional and social problems, bullying - Blood lipid profile,T2DM and respiratory diseases
26
Prevention and treatment of childhood obesity
- Early treatment before the adolescence - Permanent lifestyle changes, successful approaches - Promote positive body image, not diets and cal - Goal:improve BMI
27
Dietary recommendations for children
Variety of foods and maintain healthy weight(limit fat,sugar, drink water, fun movement ) - Moderation, nit deprivation - Avoid extremes, positive messages
28
How do you evaluate the readiness for a change in a child?
- Dietary Assessment (foods, portions,eating patterns, beverages) - Physical Activity Assessment - Assess readiness to make changes
29
What is the primary goal of therapy
Behavioural change - Patient is instrumental in treatment, commitment to goals and change is required
30
What is the secondary goal of therapy?
- Weight maintenance (decrease BMI) - Change the behavior, the numbers will follow
31
What is the tertiary goal of therapy?
- Resolve/Improve Medical Complications - Reinforcement for behavioral change
32
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
33
What is the appropriate goal for child weight loss?
- BMI below 85th percentile - Maintain baseline weight (grow into weight)
34
How many pounds should you lose per unit of time?
1 pound/month
35
How should you increase activity level?
- Encourage fun social activities - Incorporate into usual daily routine - Incremental changes - Increase intensity gradually - Limit screen time
36
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
37
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
38
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
39
Name some additional treatment options for high risk morbid obesity.
- Bariatric surgery and pharmacotherapy
40
Can children use pharmacotherapy
Trials underway but currently not approved for pediatric use (<16 y.o.)
41
Can children undergo bariatric surgery?
- Minimal criteria: BMI>40 with co-morbidities, conservative treatments failed, psychosocial evaluation - Behavioural commitment
42
How could you decrease the risk of childhood obesity?
- Promote breastfeeding - Parents to provide, child to decide, family meals - Limit TV time
43
What are the main causes of death for young children?
- Neonatal - Pneumonia - Diarrhea - Malaria - Measles - HIV/AIDS - Injuries
44
The malnutrition-lead connection
Low intakes of CA,Zn,vit C and D, Fe increase risk of lead poisoning - Commonalities between iron deficiency and lead poisoning - Malnourished children eat paint
45
How many children in Canada are in food insecure households
1 in 6
46
What is acute protein energy undernutrition characterized by?
- short term - wasting - low weight for height
47
Hunger "spots" in the world
South east Asia Africa South America
48
Primary cause of hunger in the world is
Poverty
49
Who are the most influenced by food insecurity
Women and children
50
What is chronic protein energy undernutrition characterized by?
- long term - stunting - low weight + height for age
51
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
52
How many people in the world are iron deficient, zinc, vitamin A, iodine
Iron -30% Zinc-20% Vitamin A- 1/3 of children have symptoms -Iodine a lot of -cretinism, mental retardation
53
Define secondary energy malnutrition. What is it due to?
- Disease state - decreased intake - decreased absorption/utilization - increased losses - increased requirement
54
What is the successful adaptation to PEM? Unsuccessful?
Successful: Marasmus Unsuccessful: Kwashiorkor
55
How old are children with marasmus? Kwashiorkor?
Marasmus: infancy < 2 years Kwashiorkor: 1-3 year olds
56
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
57
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
58
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
59
Name some long term consequences of PEM.
Decreased:  Development (physical, social, cognitive)  Adult productivity  Reproduction  Potential of the society as a whole
60
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
61
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
62
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
63
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
64
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
65
What is the double burden of malnutrition?
- Undernutrition (child mortality) - Overnutrition (chronic disease)

Nutrition 207 (17 decks)

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