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Nutri Sci 431 > Exam 4- Childhood/Adolescence > Flashcards

Exam 4- Childhood/Adolescence Flashcards

1
Q

Toddlers (1-3 years)

A

Growth rate slows down
- appetite/food intake compared to infancy
Transition to independent feeding
- can still choke
-small stomach= frequent snacks
Strong likes & dislikes; distinct food preference
- food jags (eat same food all the time)
- neophobia (fear of new foods)
Wide variation in physical activity (PA)

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2
Q

Early Childhood (4-8 years)

A

Period of lowest growth rate

Transition from feeding skills to eating habit

Knowledge/belief of food influenced by
- parents, siblings, teachers
- media
Wide variation in PA (screen time)

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3
Q

Growth:

toddlers thru adolescence

A

Influence of genetic potential ↑
Gender difference becomes apparent
- boys slightly taller and heavier than girls
Adolescent growth spurt
- girls begin and end earlier than boys
- peak height velocity (PHV) girls-12, boys-14
- total height gain: boys>girls
Body composition:
- pre-puberty % body fat: boys-15%, girls-19%
- during puberty: girls gain proportionately more fat due to estrogen & progestrone
- after puberty % body fat: boys-15% girls-23%

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4
Q

Growth (BMI)

toddlers thru adolescence

A

Normal BMI change with age

  - 50th %tile values for boys:
    16. 5 at age 2, 15.5 at age 6, ~20 at age 15

BMI curve: U-shape
- decreased at age 2-5, lowest (nadir) at 4-8, increases (rebound) afterwards, continue to increase thru adolescence

BMI nadir and rebound

  - girls earlier than boys
  - heavy children earlier than light children
  - earlier rebound  linked to increased risk of obesity

Overweight/obesity definition

  - based on percentiles, not absolute BMI (kg/m2) 
  - relationship to adult definitions

   At age 20                               Boys      Girls    Adult
   50th percentile BMI                 23           21.8    
   85th percentile BMI (OW)        27          26.5         25
   95th percentile BMI (OB)        30.5         31.8          30
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5
Q

Categories of BMI status

A

< 5th percentile: underweight
5-84th percentile: healthy weight
85-94th percentile: overweight
≥95th percentile: obesity

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6
Q

DRI: Energy and Macronutrients

toddlers (1-3)

A 
Same EER equation as infants’
but +20 kcal for growth
Fat: 30-40%
CHO: 45-65%
Protein:   5-20%
Protein RDA: 1.05 g/kg BW
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7
Q 
DRI: Energy and Macronutrients
Early Childhood (4-8 years)
A 
girls:
EER = 135.3 – 30.8 x age + PA x
           [(10.0 x wt) + (934 x ht) + 20
boys:
EER = 88.5 – 61.9 x age + PA x
           [(26.7 x wt) + (903 x ht) + 20
age 4-18 yr
       Fat: 25-35%
      CHO: 45-65%
      Protein: 10-30%
Protein RDA (4-8):   0.95  g/kg BW
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8
Q

DRI: Micronutrients (RDA/AI)

Calcium

A

toddlers: 700

4-30: 1000

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9
Q

DRI: Micronutrients (RDA/AI)

Iron

A

infants: 11
toddlers: 7
early childhood: 10
adults: M:8 and W: 18

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10
Q

Nutrients of concern

A 
Vitamin A
iron
calcium 
zinc
Vitamin D 
(40% of toddlers take supplement but not really recommended)
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11
Q

Actual intake from NHANES Survey

A

% of children drinking milk decreased from 85% (1976-80) to 77% (2001-06)
- intake of milk decreased while fruit juice increased

Juice consumption increased from 30% (1976-80) to >50% (2001-06)
- AAP and DGA recommends 4-6 oz/day for 1 y.o. (actual is 10-12 oz/day)

Soft drink increased from 7 oz/day (1976-80) to ~8 oz/day (2001-06)

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12
Q

Eating Patterns of Children

A

Meals at home decrease, Meals away from home increase

 - meals with families at home have higher diet quality 
 - calorie intake away from home increase from 23% in 1977 to 34% in 2006
 - fast food was the largest contributor, 13% of calories

Meal patterns and meal frequency

 - of children skip breakfast (NHANES 1999-2006)
 - snacking  from 4x per day (1977-78) to 5x per day (2006-10) 
 - of calories come from snacks; largest increases in salty snacks &amp; candy

Portion sizes
- when larger entrée portions are offered, children age 3-5 y consume more of the entrees and less of “other” (e.g., F & V)

Beverage consumption

Development of eating habits food preference lecture

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13
Q

Growth and Feeding/Eating Characteristics: Adolescence

A

Adolescence (9-13 & 14-18)
Growth spurt; sexual maturation
- appetite increases during growth spurt
↑ Meals/snacks away from home
- skipping breakfast
-decreased milk, increased sweetened beverages
Eating habit strongly influenced by peers
-maybe sudden/dramatic (e.g. vegetarian)
Wide variation in PA (screen time & sports)

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14
Q

Puberty

A

process of physically developing from child to adult, physical growth and sexual maturation
F: 10.5 -14
M:12-16.5
Timing of growth spurt correlate closely to stages of sexual maturation
Progression of puberty: sequence of pubertal events is consistent, but age of onset, magnitude and duration vary greatly among individuals - “early”, “average” and “late” maturers

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15
Q

Tanner stages

A

A scale to assess the characteristics & degree of sexual maturation of adolescents, regardless of chronological age.
Girls: based on breast development and pubic hair
Boys: based on genital and pubic hair development
- Separate stage established for each of the 2 characteristics

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16
Q

Tanner stage categories

A 
Stage ranges from 1 to 5     
Girls: B1 to B5 and PH1 to PH5 
Boys: G1 to G5 and PH1 to PH5     
- Stage 1: pre-pubertal
- Stage 2: onset: earliest visible signs
- Stage 5: mature, adult development
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17
Q

Tanner stages - girls - common characteristics

A

Earliest sign of puberty
- breast budding, usually obvious; onset of B2
- average age 10½ y.o. (age range 9-13 y.o)
Breast development- B2 to B5 takes ~4 years
Peak Height Velocity
- occurs before menarche
- usually during stages 2-3
Menarche
- average age 12½ y.o.
- usually during stages 3-4
Other signs of puberty e.g., acne

18
Q

Tanner stages - boys - common characteristics

A 
Earliest sign of puberty
- testes enlarges, usually subtle; onset of G2      
- average age: no data
Genital development
- G2 to G5 about 3 y
PHV    
- usually during stages 3-4
Other signs of puberty: voice deepening, mustache, etc
19
Q

DRI: Energy and Macronutrients- adolescence

A 
Energy: same as 3-8 but +25 kcal for growth 
Protein RDA: 
9-13: 0.95 g/kg 
14-18: 0.85 g/kg 
AMDR: 
Fat: 25-35%
CHO: 45-65%
Pro: 10-30%
20
Q

DRI: Micronutrients (RDA/AI)- calcium

A

9-18: B:1300 G:1300

18+: 1000

21
Q

DRI: Micronutrients (RDA/AI)- iron

A

9-13: 8
14-18: B: 11, G:15
Adults: B:8, G: 18

22
Q

Energy & nutrient requirement influenced by growth rate and physical activity level

A
  • chronological age is a poor indicator of requirement
    2 girls of the same age have very different requirement if one is pre-pubertal and the other is during puberty - adolescence: high risk of developing obesity and eating disorder
23
Q

Adolescence - a critical stage of bone Ca accretion

A
  • ½ of adult boss mass accrued, peak bone mass reached 20-25 years of age
  • Ca absorption rate highest
  • average Ca intake: 800-1200 mg in adolescent boys, 500-800 mg in girls
24
Q

Adolescence and Fe

A
  • high requirement during growth spurt (Increased LBM and blood volume)
  • highest requirement: PHV in boys and after menarche in girls
  • iron intake: 32% adolescent boys and 83% adolescent girls are below RDA
  • Fe-deficiency anemia higher in adolescents than pre-pubertal children
25
Q

Nutrients of concern- adolescence

A 
Vitamin A, D, E
Folate
Iron
Zinc
Magnesium
Calcium
overnutrition: too much sodium and sat fat, 1 in 5 overweight/obese
26
Q

Tips to Promote Healthy Eating in Adolescence

A

Parents can:
-have healthy snacks readily available
◦Help them learn more about nutrition in a peer-oriented fashion
-take their suggestions when preparing foods at home
◦Try to have an least 1 family meal at home per day
-will adopt if they know how it will affect sports, academic performance and body look

27
Q

Genetic Predisposition for food preferences

A

Unlearned ( innate ) Taste Preferences

28
Q

Newborns-children food preference

A

Newborns have a preference for sweet taste
and an aversion for bitter tastes
-preference for salty foods at 4 mo
-energy dense foods
-accept familiar foods and reject new flavors (neophobia)

29
Q

Impact of Innate Taste Preferences

A

Advantageous from an evolutionary standpoint
- energy-dense food ↑ chance for survival
- potential toxins are often bitter/sour and unfamiliar
Potential obstacle for promoting healthy eating in the current obesogenic environment
- unfamiliar sweet/salty/energy-dense foods readily accepted; prone to over-consumption when large portions offered
Aversion to bitter/sour and neophobia
- intro of certain foods (e.g., vegetables) difficult; acceptance/preference for novel flavors need to be learned

30
Q

Flavor Learning Early in Life: Acceptance of new foods promoted by

A

Prenatal exposure to flavors in amniotic fluid
- taste and smell functional in fetus
- fetus regularly swallows amniotic fluid
Postnatal exposure to flavors in breast milk
- many flavors of maternal diet appear in breast milk, e.g. garlic
- breast milk provides a “flavor bridge” that familiarize infants with a variety of flavors

31
Q

Breastfed infants more likely to

A
  • accept new food at first exposure

- prefer & consume more new food when introduced repeatedly

32
Q

Carrot Flavor Study: hypothesis

A

prenatal and early postnatal exposure affects food acceptance

33
Q

Carrot Flavor Study: Study design

A

Treatment: exposure to carrot flavor
- carrot juice 300 ml/day given to mothers during pregnancy and/or lactation
- pregnancy: during the last 3 wk of the 3rd
- lactation: during the first 2 mo of lactation
Control: water
3 groups total: WC, CW, WW
Outcome measure: infants acceptance of carrot flavored cereal at weaning (5 mo)

34
Q

Results- Carrot Flavor Study

A
  • significantly less negative faces in WC and CW groups vs WW
  • mothers perception: increased in WC and CW
  • intake greatest in CW, lowest in WW
  • Food Acceptance Can be Changed by Repeated Exposure
35
Q

Acceptance of foods with less intrinsic appeal to children (e.g., veges ) are

A
  • affected by their experience to those foods
  • enhanced by repeated exposure (10-16 times) in a non-coercive setting
  • Simply offering new foods are not enough, having children “taste” the food is necessary
36
Q

Vegetable Intervention Study: hypothesis

A

repeated exposure changes acceptance

37
Q

Vegetable Intervention Study: treatment

A

Treatment: repeated exposure to a disliked vegetable - offer a disliked veg (“target veg”) to 2-6 y.o. children daily for 14 days
- target veg chosen from: carrot, cucumber, tomato, celery, green pepper, red pepper
A 2nd “treatment” group: the “information” group
- nutrition advice & nutritional education leaflet to parents
Control: receives nothing

38
Q

Vegetable Intervention Study: outcome measure

A

taste test on target vegetable pre and post intervention

39
Q

Vegetable Intervention Study: results

A

p<0.05 and **p<0.001 comparing pre- and post-

vege intake: exposure=significant increase in target vege consumed, info and control didn’t change much

40
Q

Repeated Exposure Works -Personal Experiences

A 
Brown rice
Degree of sweetness and saltiness
Works in adults too!
-Immigrants
-Tomato (a NS431 student!)
41
Q

environmental impact to food preference

A
  • advertising

- foods available in the home/school

Nutri Sci 431 (8 decks)

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