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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
Q

What are some risks of becoming obese in kids

A
  • 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
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26
Q

Prevention and treatment of childhood obesity

A
  • Early treatment before the adolescence
  • Permanent lifestyle changes, successful approaches
  • Promote positive body image, not diets and cal
  • Goal:improve BMI
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27
Q

Dietary recommendations for children

A

Variety of foods and maintain healthy weight(limit fat,sugar, drink water, fun movement )

  • Moderation, nit deprivation
  • Avoid extremes, positive messages
28
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
29
Q

What is the primary goal of therapy

A

Behavioural change - Patient is instrumental in treatment, commitment to goals and change is required

30
Q

What is the secondary goal of therapy?

A
  • Weight maintenance (decrease BMI) - Change the behavior, the numbers will follow
31
Q

What is the tertiary goal of therapy?

A
  • Resolve/Improve Medical Complications - Reinforcement for behavioral change
32
Q

Name skills to change current behaviour.

A
  • 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
Q

What is the appropriate goal for child weight loss?

A
  • BMI below 85th percentile - Maintain baseline weight (grow into weight)
34
Q

How many pounds should you lose per unit of time?

A

1 pound/month

35
Q

How should you increase activity level?

A
  • Encourage fun social activities - Incorporate into usual daily routine - Incremental changes - Increase intensity gradually - Limit screen time
36
Q

Why are breastfed infants less likely to be overweight?

A
  • Baby is learning satiety signals, decides when to stop eating - Bottle: caregiver decides when the baby stops
37
Q

What are the recommendations in terms of physical activity?

A
  • 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
Q

Name some complications of weight-management programs.

A
  • 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
Q

Name some additional treatment options for high risk morbid obesity.

A
  • Bariatric surgery and pharmacotherapy
40
Q

Can children use pharmacotherapy

A

Trials underway but currently not approved for pediatric use (<16 y.o.)

41
Q

Can children undergo bariatric surgery?

A
  • Minimal criteria: BMI>40 with co-morbidities, conservative treatments failed, psychosocial evaluation - Behavioural commitment
42
Q

How could you decrease the risk of childhood obesity?

A
  • Promote breastfeeding - Parents to provide, child to decide, family meals - Limit TV time
43
Q

What are the main causes of death for young children?

A
  • Neonatal - Pneumonia - Diarrhea - Malaria - Measles - HIV/AIDS - Injuries
44
Q

The malnutrition-lead connection

A

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
Q

How many children in Canada are in food insecure households

A

1 in 6

46
Q

What is acute protein energy undernutrition characterized by?

A
  • short term - wasting - low weight for height
47
Q

Hunger “spots” in the world

A

South east Asia
Africa
South America

48
Q

Primary cause of hunger in the world is

A

Poverty

49
Q

Who are the most influenced by food insecurity

A

Women and children

50
Q

What is chronic protein energy undernutrition characterized by?

A
  • long term - stunting - low weight + height for age
51
Q

Define primary energy malnutrition. What is it due to?

A
  • Inadquate intake - poverty - low food supply - poor quality of food - Armed conflicts - Political turbulence - Natural disasters
52
Q

How many people in the world are iron deficient, zinc, vitamin A, iodine

A

Iron -30%
Zinc-20%
Vitamin A- 1/3 of children have symptoms
-Iodine a lot of -cretinism, mental retardation

53
Q

Define secondary energy malnutrition. What is it due to?

A
  • Disease state - decreased intake - decreased absorption/utilization - increased losses - increased requirement
54
Q

What is the successful adaptation to PEM? Unsuccessful?

A

Successful: Marasmus Unsuccessful: Kwashiorkor

55
Q

How old are children with marasmus? Kwashiorkor?

A

Marasmus: infancy < 2 years Kwashiorkor: 1-3 year olds

56
Q

What is marasmus? Does it develop slowly? What are the physical symptoms? What percentage of weight for age? Do they have a good appetite?

A
  • 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
Q

What is Kwashiorkor? Does it develop slowly? What are the physical symptoms? What percentage of weight for age? Do they have a good appetite?

A
  • 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
Q

Define edema. What causes it?

A
  • 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
Q

Name some long term consequences of PEM.

A

Decreased:  Development (physical, social, cognitive)  Adult productivity  Reproduction  Potential of the society as a whole

60
Q

Describe a successful adaptation to PEM malnutrition.

A

 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
Q

Describe an unsuccessful adaptation to PEM malnutrition.

A

 more severe metabolic adjustment  changes are outside “preferred range”  may not be reversible  loss of physiological function  Eg Kwashiorkor

62
Q

What do infections cause?

A

 Lack of antibodies  Hb no longer synthesized  Anemia  Dysentery – infection of the GI tract  Fever  Fluid imbalances  Heart failure, possible death

63
Q

How do you rehabilitate a patient with Kwashiorkor?

A

1) Restore fluid and electrolyte imbalances 2) Treat infections 3) Nutrition intervention must be cautious, slowly increasing protein

64
Q

Name some common infections with PEM.

A

 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
Q

What is the double burden of malnutrition?

A
  • Undernutrition (child mortality) - Overnutrition (chronic disease)

Nutrition 207 (17 decks)

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