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Nutrition > Diet and nutrition in childhood > Flashcards

Diet and nutrition in childhood Flashcards

1
Q

Babies: ideal food

A

Mammalian milk
-recommendation exclusive for first 6 months
Infant formula is alternative

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2
Q

Breast-feeding in UK

A

Infant Feeding Survey 2010: UK low
-only 34% at 6 months and <1% at 12 months
It is difficult, tiring, needs support; needs to be promote

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3
Q

Breast-feeding less likely to happen in UK if:

A

Breast-feeding less likely to happen if:

-white, young, routine/ manual professions, left education early

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4
Q

Maternal diet

A

Fat deposits - energy store for feeding
400-600kCal extra, 11g protein, plus fluid
Cabohydrate, fat, protein, vitamins, minerals
Anti-infective agents (e.g. immunoglobulins, lysozyme; long-lasting protection)

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5
Q

Contra-indications to breastfeeding

A 
Cleft palate (indirect feeding)
Inborn errors of metabolism (e.g. galactosaemia)
HIV infection (WHO 2009 antiretrovirals enabled them to breast-feed babies without passing on)
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6
Q

Infant formula

A

Kineys, liver enzyme systems immature to digest cow’s milk

Is modified

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7
Q

Weight gain (babies)

A

Controversy over charts

Put on weight at different intervals if they drink infant formula

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8
Q

Breast-feeding reduces

A
  • childhood obesity
  • diabetes
  • < infections (3mths –>year, long lasting, plus breast cancer
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9
Q

Babies/ infants: nutrient needs: 4-6 months

A

Rapid growth and development
Iron stores before birth, depleted
Breast milk or infant formula

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10
Q

Babies/ infants: nutrient needs: 6-12 months

A

Iron intake during weaning process

> protein uptake required, plus vitamins and minerals

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11
Q

Government help: healthy start scheme

A

Free milk, plain fresh and frozen fruit and vegetables plus infant formula, vitamins
Young children (birth - 4years) and pregnant mothers
Weekly, flexible voucher scheme
Early and close liaison with health professionals re:
-pregnancy, breastfeeding and healthy eating

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12
Q

Welfare Food Scheme

A 
Started during WWII re: food shortages
Vitamin supplements (drops)
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13
Q

Weaning

A

Expanding the diet (from 6 months)
GIT too immature to digest
Kidneys can’t regulate high solute load
Neuromuscular co-ordination to move food back in mouth and therefore swallow
Helps with developing chewing ability (teeth)

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14
Q

Toddlers and pre-school children

A

Eating is social occasion
Copy elder, enjoy
Food refusal may be for attention
Milk (1year): 500ml-litre
-Ca, riboflavin, 1/2 protein, 1/4 energy needs
-vit D: proprietary milks and fortified cereals
Variety, avoid unhealthy snacks as rewards
Teeth: fermentable carbohydrates
Water: intake encouraged, or weak cordials
Tea: tannins (+sugar?) so not main drink

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15
Q

Toddlers and pre-school children 1-4years: main nutrient needs

A

Energy requirements > as active, rapidly growing
Protein requirements slight >
Most vitamins, minerals >
2nd year need energy-dense diets (full-fat milk, watch NSP [fibre] amounts)

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16
Q

school children and adolescents: main nutrient needs

A

5 years+: semi-skimmed milk
Regular meals especially breakfast, not substitute with unhealthy snacks
Decline in family meals; 500,00 UK kids go to school hungry; 8 million families food poverty
< fat and sugar content will need and equivalent energy balance to avoid weight loss
Importance of healthy diet: ensure children understand as they gain more control over their choices

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17
Q

Main nutrient needs: school 4-6 years

A

Energy requirements still >, also protein (but vit D mainly via sunlight exposure)

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18
Q

Main nutrient needs: school 7-10 years

A

Energy requirements still >, also protein

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19
Q

Main nutrient needs: school 11-14 years

A

Energy requirements still >, also protein by ~50%

Higher iron requirement for girls

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20
Q

Main nutrient needs: school 15-18 years

A

Energy and protein requirements still >
Ca > in boys as rapid skeletal development
Higher iron requirement for girls

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21
Q

School meals

A

Set-price meal (primary schools), cafeteria (secondary)
Free hot dinner - infant 2014
Contribution to child’s nutrition, considerable impact: fat potential, e.g. chips
> fat: 5years+ should be 35% of energy intake

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22
Q

Children’s food trust

A

Eat Better Do Better
• advice, training and support to anyone
providing children`s food
• improving lunchtimes in early years
settings and schools
• helping schools with cooking skills
• providing independent, expert advice to
local and national government (and other
organisations working on children’s food)
• encouraging industry to help families make
better choices

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23
Q

Children’s food trust: Meet Sam

A

New campaign highlights how childhood food can shape health for life
-warn of how diet of today’s toddler could cripple health of tomorrow’s adults

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24
Q

Children’s food trust: preschool

A

Eat Better, Start Better

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25
Q

School Fruit and Vegetable Scheme

A

2004
Free piece of fruit or vegetable per day in infant schools
Lunches - at least 1 portion of both fruit and veg (or salad) every school day, and menus highlight in season fruit and veg
Fruit and/ or veg at school food outlets (e.g. breakfast clubs, tuck shops, and in vending machine)

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26
Q

National Healthy Schools Programme

A

2005
Schools achieve ‘Healthy Schools Status’
Includes learning about food as well as eating
From 2014 ‘school led’ ‘healthy schools’ status

27
Q

British Nutrition Foundation

A

Provide info on food and nutrition
Nurseries and schools
Promote healthy eating

28
Q

Schools: government standards

A

Ofsted monitored
Minimum national standards
Nutrient- and food-based

29
Q

Jamie Oliver

A

School dinners
‘Feed me better’ campaign, 2005
-Harder-to-reach poor communitites are suffering more
-easier for middle classes/ higher SES
Sugar campaign more recently (diabetes)-food industry
-‘Chocolate doesn’t lie’

30
Q

Adolescence

A

Transition from childhood to adulthood
Own choices and exert independence e.g. vegetarian and vegan diets
Weight and shape influences (girls and boys)
-may lead to eating disorders
Teenage growth spurt
-e.g. insatiable appetite (3000kCal+ if active)
-encourage carbohydrate > (bread, potatoes)
-avoid fatty/ sugar snacks

31
Q

Vegetarian and vegan diets for children

A

Lacto-or Lacto-ovovegetarian through weaning and childhood i.e. restriction in animal protein
Food stuffs can be bulky, not nutrient dense
-energy, protein and other nutrient levels<
-non-haem iron only in plants (+phytate inhibitor in nuts, legumes, wholegrain cereals)
-vit D many animal-based sources (e.g. oily fish, eggs, milk, liver)
May be smaller and lighter
Teenagers at risk:
-growth spurts, unconventional eating habits, family/ peer group isolation
-meat-eating family (cheese; non-haem iron absorption adaption takes time)

32
Q

Dietary intake: baby

A

Energy 515-920 kCal/day
Sugars 40% (lactose)
Protein 12-15 g/day
Minerals
-Fe from milk then need to create stores
- rickets; rise in Bradford 2007 (osteomalacia in adults), Southampton 2010
Vitamins
-D: Dietary up to 4 years then sun exposure; hypocalcaemia and hypomineralised enamel in Scotland re < UV radiation
-C: scurvy, poor wound healing and Fe absorption

33
Q

Pre-school dietary requirements

A

Energy 1200-1700 kCal/day
Sugar 25-30%
Protein 15-19 g/day
Minerals
-Fe from milk then need to create stores
- rickets; rise in Bradford 2007 (osteomalacia in adults), Southampton 2010
Vitamins
-D: Dietary up to 4 years then sun exposure; hypocalcaemia and hypomineralised enamel in Scotland re < UV radiation
-C: scurvy, poor wound healing and Fe absorption

34
Q

Older children/ adolescents dietary intake

A

Energy 1800-2750 kCal/day
Sugars 17-25% (85g)
Protein 28-55 g/day)
Minerals
-Fe from milk then need to create stores
- rickets; rise in Bradford 2007 (osteomalacia in adults), Southampton 2010
Vitamins
-D: Dietary up to 4 years then sun exposure; hypocalcaemia and hypomineralised enamel in Scotland re < UV radiation
-C: scurvy, poor wound healing and Fe absorption

35
Q

Ca/ Vit D/ Vit A and teeth

A

No link between diet high in Ca and Vit D improving strength of developing teeth, but adverse effects if mother poorly nourished
Vit A for enamel, Vit D for dentine

36
Q

Total fat

A

30-35% energy intake 2-3 years

25-35% 4-8 years

37
Q

Total salt

A

<1-6g, depending on age

38
Q

Free

A

<5-10% energy

39
Q

Food policies and capmaigns

A 
NHS 5 a day campaign
Change4Life
PHE Action on Childhood Obesity, 2016
Healthy Start
FSA: Saturated Fat Campaign 2009
Every Child Matters
-government initiative, leading to Children Act 2004
-health and wellbeing
Scotland, Wales, NI
40
Q

WHO and FAO 2003

A

• observational and experimental studies
• compromised or excessive nutrient supply during early
foetal and infant life – later health consequences
• long-term effects, risk of chronic disease in adulthood
• concern re dietary patterns of women and children
• improving nutritional status could improve health of future generations
• early life nutrition is important

41
Q

PHE

A

2 snack limit, Jan 2018
8-week plan with money-off vouchers
Challenge food industry <20% sugar by 2020
March 2018 - <20% in calorie content by 2024

42
Q

Change4Life: sugar

A 
“Around 30% of the sugar in
kids' diets comes from sugary
drinks, such as fizzy pop, juice
drinks, squashes, cordials,
energy drinks and juice.”
4-6 years: 5 cubes (19g)
7-10 years: 6 cubes (24 g)
11+ years: 7 cubes (30 g)
43
Q

Academy of Medical Royal Colleges

A

2013

  • tax on sugary drinks
  • less fast food outlets near schools
  • TV adverts after 9pm ‘watershed’
44
Q

Chief Medical Officer

A

2014

-sugar tax fizzy drinks and junkfood

45
Q

Denmark

A
  • saturated fat tax 2011, repealed in 2012

- sugar tak (proposed 2013 but not imposed)

46
Q

Mexico

A

-sugar tax drinks 2013

47
Q

UK 2016

A
  • tax on soft drinks 2018
  • reformulate
  • strong message sugar toxicity
48
Q

Food Standards Agency

A
  • encourage and facilitate healthy eating (eatwell guide)
  • improve diet and nutrition in UK
  • reduce diet-related disease (“eat well, be well”)
  • protect public`s health and consumer interest in relation to food
49
Q

Department of Health

A

Standard setting
Surveillance of nutrient intake and nutritional status of general population
Shared with FSA

50
Q

British Nutrition Foundation

A

Charity
Promote wellbeing of society - impartial interpretation/ dissemination of scientific knowledge
Advice on diet, physical activity and health

51
Q

British Dietetic Assocation

A

Food Facts about Sugar

52
Q

NHS live well

A

Healthy living for everyone

e.g. healthy food swaps

53
Q

National Diet and Nutrition Survey

A

Year 1 2008/2009
• Food consumption, nutrient intakes and nutritional
status 1.5yrs+ living in private UK households
• Commissioned by the FSA in 2006 (+DH/PHE funding)
• Socio-demographics, physical measurements, age and gender
• 3,000 individuals, cross-sectional
• Intake comparisons with government recommendations (Dietary Reference Values, COMA report 1991)
and previous surveys (see next)
(yr2 ‘09/’10 …… yr4 ‘11/’12 up to yr9 ‘16/’17)
Years 1-3 published 2012, years 1-4 2014 etc.
• Currently years 5-6 (‘12-’13 and ‘13-’14 data) Sept 2016

54
Q

National Diet and Nutrition Survey

A

Year 1 2008/2009
• Food consumption, nutrient intakes and nutritional
status 1.5yrs+ living in private UK households
• Commissioned by the FSA in 2006 (+DH/PHE funding)
• Socio-demographics, physical measurements, age and gender
• 3,000 individuals, cross-sectional
• Intake comparisons with government recommendations (Dietary Reference Values, COMA report 1991)
and previous surveys (see next)
(yr2 ‘09/’10 …… yr4 ‘11/’12 up to yr9 ‘16/’17)
Years 1-3 published 2012, years 1-4 2014 etc.
• Currently years 5-6 (‘12-’13 and ‘13-’14 data) Sept 2016

55
Q

1st food survey

A

1986/87 Dietary and Nutritional Survey of British Adults

56
Q

Stand alone food survey

A

1992/93 NDNS

• repeated 3 yearly until 2000/01

57
Q

Rolling programme food survey

A

NDNS (RP)
• interviews, diet-diary, main food provider (purchase, prepare),
nurse visits, blood, urine
• different data, but can compare previously
• continuous, cross-sectional data
• new in 11/12 - blood indices of nutritional status and 24 hr urinary
sodium in children and older adults

58
Q

2007

A

Health Survey for England

59
Q

2008

A

Scottish Health Survey

60
Q

National Diet and Nutrition Survey (yrs 1-6): results in children

A

• 8% children (11-18yrs) meet 5-a-day target (mean 2.8)
• Sugar-sweetened soft drinks reduced (4-10yrs);
from 130g (yrs 1+2) to 100g (yrs 5 and 6) (significantly)
(Ages 11-18yrs similar pattern but non-significant)
• Saturated fat: still exceeding recommendations
• Sugars (NMES) reduced (4-10yrs):
years 1 and 2 cf years 5 and 6
But 13.4% total food energy in 4-10yrs and 15.2% in 11-18yrs
• Vitamins and minerals: less than RNI (e.g. A, D, Fe)

61
Q

National Diet and Nutrition Survey: overall diet in children

A

Overall diet and nutrient intakes similar to previous
assessments
Indications of trends towards healthy recommendations
e.g.
• sat fat ↓ but still too much
• NMES ↓ but still too high (~13 and 15% for 4-10 and 11-18yrs)
• some↑ in fruit, lesser extent re: vegetables
Salt – above recommendations

62
Q

Diet and Nutrition Survey of Infants and Young Children key findings

A 
• varied diet • high proportion
(78%) ever been
breastfed, though
duration less • fruit and vegetable
consumption lower
in lower SEC •75% boys and 76%
girls exceeded EAR
for energy • protein above RNI • sodium 181% of
RNI for 12
-18mth grp
63
Q

Changing habits

A
  • How? Effectiveness?
  • Slowly
  • Consider effect of advertising
  • Knowledge, attitude, behaviour
  • Environment, access
  • Diet diaries
  • Family, not just child
64
Q

Are children eating the right things?

A 
1. We should make sure they are
(parent/carer, relative, healthcare
professional)
2. So that they can grow up
“big and strong” (develop and
grow properly, and be healthy,
including in later life)
3. And teach them about
nutrition (so they are able
to make healthy choices)

Nutrition (13 decks)

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