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NUTR 2050 > Final > Flashcards

Final Flashcards

1
Q

Infancy

A

First year of life (birth-12 months)

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2
Q

Early infancy

A

0-6 months

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3
Q

Later infancy

A

6-12 months

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4
Q

Newborn development

A
  • hear and move in response to familiar sounds (exposed to mothers voice in utero)
  • subtle cues for hunger and satiety
  • strong reflexes, especially suckle and root, within hrs. after birth
  • reflexes replaced by purposeful movement
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5
Q

CNS development in newborns

A
  • begins in utero
  • CNS immature when first born
  • evolves in complexity in first year
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6
Q

Reflex

A

automatic response triggered by specific stimulus

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7
Q

Rooting reflex

A

infant turns head toward the cheek that is touched

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8
Q

Suckle

A

reflex causing tongue to move forward and backward

- sometimes triggered by smell of breast milk

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9
Q

5 domains of development

A
  1. Motor
  2. Sensory
  3. Cognitive/mental
  4. Language and communication
  5. Social, adaptive, emotional
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10
Q

Motor development

A

refers to ability to control voluntary muscle movement

  • influenced by sensory system
  • gross and fine
  • crawl/turn over
  • ability to focus
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11
Q

Sensory development

A

refers to responding to information from environment

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12
Q

Cognitive/mental development

A

refers to development of brain through interaction with environment

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13
Q

Language and communication

A

refers to development of ability to communicate

- can’t express but can communicate very early

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14
Q

Social, adaptive, and emotional development

A

refers to development of responding to other people, gaining a sense of their own abilities and relationships

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15
Q

Development occurs…

A

in a predictable sequence like building blocks

- stages are interrelatable

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16
Q

Intrinsic influence

A

refers to development of things you can’t necessarily see

  • child’s health (nutrition)
  • brain function
  • temperament
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17
Q

Extrinsic influence

A

factors such as family, environment, cultural norms

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18
Q

The development of motor control starts with?

A

Head and trunk control then lower legs

  • top down
  • central to extremities
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19
Q

Motor control development influences?

A

Ability to be fed, feed self and amount of energy expended

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20
Q

Sensorimotor

A

refers to knowledge of world limited to sensory perception and motor activity

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21
Q

For infants, the _____ is an important source of stimulation and pleasure

A

mouth

  • allows development of cognitive skill
  • sensorimotor skills
  • develop ability to speak
  • move tongue properly
  • say words
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22
Q

Feeding tubes in early infancy can interrupt…

A

Development and have long term negative consequences

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23
Q

Digestive system development

A
  • gut functional at birth (can digest fat, protein, simple sugars)
  • 6 months required for GI tract maturation
  • as infant ages levels of digestive enzymes expand
  • speed of stomach emptying increases
  • peristalsis becomes more consistent
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24
Q

Feeding skills development

A
  • infants born with reflexes and food intake regulatory mechanism
  • inherent preference for sweet taste
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25
Q

Reflexes fade and infant begins to purposely signal wants and needs at?

A

4-6 weeks

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26
Q

Tongue moves side to side, teeth arrive, and can swallow pureed foods and hold bottle at?

A

4-6 months

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27
Q

Self feeding with hands or spoon, munching and biting skills, lumpy and chopped foods, drinking from open cup at?

A

9-12 months

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28
Q

Energy needs from birth to 6 months

A

108 kcal/kg/day

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29
Q

Energy needs from 6 to 12 months

A

98 kcal/kg/day

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30
Q

Energy needs for babies born prematurely

A

120 kcal/kg/day

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31
Q

Energy needs in first 6 months of life are…

A

higher per pound than any other time of life

- supports so much growth and development

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32
Q

Factors that influence caloric needs for infant

A
  • weight
  • growth rate
  • sleep/wake cycle
  • temperature and climate
  • metabolic response to food
  • health status
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33
Q

Warmer climates nurse…

A

more

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34
Q

Growth spurts typically happen at

A

3 weeks and 3 months

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35
Q

Growth spurts does NOT signal…

A

a need for solid foods or formula if breastfeeding

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36
Q

Protein needs from birth to 6 months

A

2.2g/kg/day

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37
Q

Protein needs from 6 to 12 months

A

1.6g/kg/day

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38
Q

Premie protein needs if growth or digestion are not affected

A

1.52 g/kg

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39
Q

Premie protein needs required for preterm or recovery from illness

A

3.0 - 3.5 g/kg

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40
Q

Premie protein needs for extremely low birth weight

A

4.0 g/kg

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41
Q

Hydrolyzed protein or single amino acid formulas may be used for

A

preemies or sick infants

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42
Q

Fat needs from birth to 12 months

A

AI about 30 g/day

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43
Q

Infants need ____ for _____ development

A

cholesterol; brain

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44
Q

Breastmilk contains about ___% calories from fat

A

55

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45
Q

CHO needs from birth to 6 months

A

60 g/day

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46
Q

CHO needs from 6-12 months

A

95 g/day

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47
Q

Metabolic rate of infants is…

A

highest of any time after birth

- related to rapid growth and high proportion of muscle

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48
Q

Fluoride for infants

A

supplement at 6 months unless provided with fluoridated water

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49
Q

Vitamin D for infants

A

breastfed babies need supplement of 400IU from birth until 1 year of age

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50
Q

Iron requirements for birth to 6 months

A

0.27 mg/day

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51
Q

Iron requirements for 6 months to 12 months

A

11 mg/day

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52
Q

Anemia is uncommon in infants because of:

A
  • prenatal iron stores of mother

- high bioavailability in breastmilk

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53
Q

Whole, reduced fat or skim cow’s milk should not be used before…WHY?

A

9 months of age

- iron deficiency anemia linked to early introduction of cow’s milk

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54
Q

Health Canada infant recommendations

A
  1. support breastfeed up to 2 years and beyond
  2. no cow’s milk before 9 months (unless whole milk)
  3. complementary feeding to start at 6 months
  4. gradually increase frequency of complementary feedings
  5. no honey before 1 year
  6. progress in textures gradually
  7. allergens
  8. consider food safety and choking hazards
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55
Q

Progress in textures

A

pureed –> lumpy –>mashed –> diced

- lumpy foods offered no later than 9 months

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56
Q

No evidence that introducing any allergen has an increased risk of developing an allergy after

A

6 months

- offer no more than 1 potential allergen at time and wait at least 2 days before introducing another

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57
Q

Foods that could choke infants

A
  • popcorn
  • peanuts
  • raisins
  • stringy meats
  • gum and gummy textured candies
  • hot dogs
  • hard fruits or vegetables
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58
Q

Recommendations for 6 to 9 months

A
  • increasing textured foods
  • slowly increase amount based on infant’s appetite
  • should be eating 3 meals with breast/formula feeds
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59
Q

Recommendations for 9 to 12 months

A
  • move towards diced soft foods
  • increase texture to encourage chewing
  • encourage self feeding and eating family foods
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60
Q

Expectations for 12 months

A
  • general pattern of 3 meals and 3 snacks
  • slow self weaning as increase solid food intake (about 2 milk feedings/day)
  • solids increase in amount progressing towards table foods with some modification
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61
Q

Hungry feedings cues

A
  • watches food being prepared
  • reaches for food, spoon
  • tight fists
  • irritation if pace too slow or stops
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62
Q

Full feedings cues

A
  • plays with food, utensils
  • slows pace of eating
  • turns away from spoon
  • tries to get out of high chair
  • stops eating
  • spits out food
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63
Q

Why assess physical growth in infants?

A

Reflects:

  • nutritional adequacy
  • health status
  • economic and environmental adequacy
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64
Q

How do we assess physical growth in infants?

A
  • weight
  • height/length
  • head circumference
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65
Q

Infant/child weight and height must be interpreted in context of

A

age and gender

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66
Q

How do we interpret growth in infants?

A

percentile rankings

  • child weighs the same or more than 95% of reference population
  • child weighs less than 5% of reference population
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67
Q

Who is reference population when referring to percentiles?

A

WHO studied children from 6 countries:
Brazil, Ghana, India, Norway, Oman, USA
- based on standard measurements of babies
- based on an exclusively breastfed population

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68
Q

Difference between infant growth charts used in CA (WHO) and USA (CDC)

A
  • CDC based charts describe how children have grown in past

- WHO describe how children should grow

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69
Q

Interpretation of growth data

A

Measures over time identify change in growth progress and whether there is a need for an intervention

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70
Q

Warning signs for infant intervention

A
  • loss of weight or length gain
  • plateau in weight or length for > 1 month
  • drop in weight without regain in a few weeks
  • fast gain in weight
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71
Q

concern for underweight in infants

A

less than 3rd percentile for weight for age

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72
Q

concern of stunting in infant

A

less than 3rd percentile for height for age

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73
Q

concern of wasting in infant

A

less than 3rd percentile for weight for length

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74
Q

risk of overweight in infant

A

weight for length greater than 85th percentile

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75
Q

overweight infant

A

weight for length greater than 97th percentile

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76
Q

obese infant

A

weight for length greater than 99.9th percentile

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77
Q

small or large head for infant

A

head circumference less than 3rd or greater than 97th percentile

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78
Q

WHO charts can be used as growth indicator for premies only if…

A

infant’s body weight is greater than 2500 g

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79
Q

For premies, catch up growth can take…

A

1-3 years

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80
Q

Using growth chart for premies need to correct

A

for gestational age

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81
Q

Correcting for gestational age

A
  1. subtract gestational age from 40 weeks
  2. divide by 4 to get months
  3. subtract that amount from current age
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82
Q

What is the gestational adjusted age for a 9 month old infant born at 32 weeks of age

A

7 months

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83
Q

Low birth weight is…

A
  • an indicator of general health of newborns

- a key determinant of growth, health and development

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84
Q

Low birth weight infants are at…

A

greater risk of dying during the first year of life, and of developing chronic health problems

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85
Q

What percentage children less than 4 years of age have a food allergy?

A

6-8%

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86
Q

Common allergy symptoms in infants

A

respiratory or skin rashes

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87
Q

Treating allergies in infants

A

may consist of baby formula with hydrolyzed proteins

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88
Q

Food avoidance/postponement may lead to…

A

decreased nutritional adequacy and limit variety

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89
Q

___________ for infants at risk of allergies

A

Breastmilk

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90
Q

Oral tolerance induction

A

The idea of slow sensitization especially for milk, soy, egg and wheat

  • overcome risk of allergy by consuming tiny but increasing portions of the food
  • train immature immune system
  • shown to help prevent certain allergies
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91
Q

Between the ages of 1 to 3 years

A

toddlers

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92
Q

Between the ages of 3 to 5

A

preschoolers

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93
Q

Toddler stage characterized by

A

rapid increase in gross and fine motor skills

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94
Q

Preschool stage characterized by

A
  • increasing autonomy
  • broader social circumstances
  • increasing language skills
  • expanding self control
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95
Q

Health Canada recommendations for young children

A
  1. serve small nutritious meals and snacks each day
  2. do not restrict nutritious foods because of allergen potential
  3. offer variety form all 4 food groups
  4. satisfy thirst with water
  5. respect children’s ability to determine how much food to eat
  6. be patient
  7. be a good role model
  8. organize fun physical activities
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96
Q

Toddlers and preschoolers have small stomachs so

A

they need to eat small amounts of food more often throughout the day

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97
Q

Children need a total of ___ of milk every day to help meet their requirement of vit. D

A

2 cups

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98
Q

Equation for estimating energy requirements for 13 to 36 months

A 
89 x (child weight in kg) - 100 + 20 kcal
- account for age, gender, height, weight, physical activity level
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99
Q

Most Canadian toddlers/preschoolers _______ recommendations

A

Meet or exceed

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100
Q

RDA for protein for children 1 to 3 years

A

1.1 g/kg/day

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101
Q

RDA for protein for children 4 to 8 years

A

0.9 g/kg/day

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102
Q

Most toddlers and preschool-age children have adequate vitamin and mineral consumption except for

A
  • iron
  • calcium
  • vit. D
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103
Q

What nutritional factors put preschoolers at risk for iron deficiency

A
  • high milk consumption

- low iron diet

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104
Q

RDA for iron for children 1 to 3 years

A

7 mg/day

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105
Q

RDA for iron for children 4 to 8 years

A

10 mg/day

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106
Q

Approximately ____% of children aged 1 to 5 years have iron deficiency anemia in Canada

A

3.5 to 10.5%

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107
Q

Much higher iron deficiency anemia where in Canada and why?

A

Northern Ontario First Nation communities

  • due to high consumption of evaporated milk and cow’s milk at 6 months of age an prolonged breastfeeding without sufficient supplementation
  • don’t necessarily have access to good dietary sources
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108
Q

Iron deficiency anemia in children may cause

A

delays in cognitive development and behavioural disturbances

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109
Q

Preventing iron deficiency anemia in children

A
  • limit milk consumption to 2 cups per day
  • provide iron rich foods
  • Canadian Task Force on Periodic Health Examination recommends that all high risk infants be screened at 6 and up to 12 months
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110
Q

Treating iron deficiency anemia

A
  • iron supplements
  • counselling with parents
  • repeat screening
  • micronutrient powders (sprinkles)
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111
Q

RDA for calcium for children 1 to 3 years

A

700 mg/day

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112
Q

RDA for calcium for children 4 to 8 years

A

1000 mg/day

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113
Q

Ensure adequate calcium intake in children through:

A
  • milk and milk alternatives
  • dark green vegetables
  • fish with soft bones that are eaten
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114
Q

RDA for vitamin D for 1 to 8 years

A

600 IU

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115
Q

Approximately ___% of Canadian children deficient in vit. D

A

20

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116
Q

Feeding behaviours of toddlers

A
  • rituals are common
  • may have strong preferences and dislikes
  • food jags are common
  • imitate parents and siblings
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117
Q

May take up to how many exposures before toddler accepts food?

A

8 to 10

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118
Q

What is not a good way to get kids to eat vegetables?

A
  • clean your plate
  • using food as reward
  • heavy restriction of less healthy
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119
Q

Development of feedings skills of preschool aged children

A
  • can use fork, spoon, and cup
  • temper tantrums occur less frequently
  • foods should be cut into bite sized pieces
  • adult supervision required
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120
Q

Beginning at age 3, DRI equations for estimating a child’s energy requirements are based on child’s:

A
  • age
  • height
  • weight
  • activity level
  • gender
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121
Q

On average toddlers gain?

A

8 oz. per month

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122
Q

What percentage of children aged 2-5 are overweight/obese?

A

13%

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123
Q

On average preschoolers gain?

A

4 lbs. per year

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124
Q

WHO definition of obese children aged 2 to 5

A

BMI greater than 97th percentile for age and gender

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125
Q

WHO definition of overweight children aged 2 to 5

A

BMI greater than 85th percentile for age and gender

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126
Q

Toddlers and preschoolers should obtain ___ minutes of any intensity physical activity per day

A

180

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127
Q

Interpersonal and environmental considerations for toddlers and preschoolers

A
  • child care
  • neighbourhood environment
  • family influence
  • peers
  • parenting style
  • media
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128
Q

Parenting and feeding styles

A
  • authoritarian
  • indulgent
  • neglectful
  • authoritative
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129
Q

Authoritarian

A

control child eating, restricting food, forcing other food

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130
Q

Indulgent

A

minimal guidance/structure, child eats whenever and whatever

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131
Q

Neglectful

A

parenting is absent, foods available may be inadequate/inappropriate

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132
Q

Authoritative

A

balanced approach

  • parent determines what is offered
  • child determines what is eaten
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133
Q

Low warmth and high demandingness

A

Authoritarian

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134
Q

High warmth and low demandingness

A

Indulgent

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135
Q

Low warmth and demandingness

A

Neglectful

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136
Q

High warmth and demandingness

A

Authoritative

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137
Q

Authoritarian style parenting ___ times more likely to obese compared to authoritative

A

4

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138
Q

Indulgent and neglectful style parenting __ times more likely to be obese compared to authoritative

A

2

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139
Q

Canadian guidelines for screen time for children 0 to 2 years

A

No screen time

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140
Q

Canadian guidelines for screen time for children 2 to 4 years

A

under 1 hour per day

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141
Q

Each 1 hour increment in TV viewing associated with

A
  • higher intakes of sugar-sweetened beverages, fast food, red and processed meat, total energy intake, and percent energy intake from trans fat
  • lower intakes of fruit, vegetables, calcium, and dietary fiber
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142
Q

Marketing influence on child nutrition

A
  • commercials during child programming
  • fast food predominates sponsorship, even for ad free television
  • characters, give aways
  • child oriented food products
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143
Q

Goal for overweight and obesity in toddlers and preschoolers

A

maintain weight while increasing height

  • weight loss typically not recommended (don’t exceed 1 pound per month)
  • not time to restrict food
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144
Q

Treatment guidelines for overweight and obesity in toddlers and preschoolers

A

Stage 1: prevention plus
- behaviour change and more frequent follow up
Stage 2: structured weight management
- planned diet/eating, logs to monitor behaviour, monthly follow up
Stage 3: comprehensive multidisciplinary intervention
- more intensive intervention, multiple health professionals, weekly follow up visits

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145
Q

What is nutrition screening?

A
  • process of identifying characteristics known to be associated with nutrition problem
  • completed by dietitians OR health care professionals in various settings
  • determines the need for further nutritional assessment
146
Q

Why nutrition screen?

A
  • early identification of problems
  • to prevent serious consequences in future
  • to provide treatment when needed
  • to identify who needs services, treatment and referrals
  • to promote awareness and behaviour change
147
Q

Nutrition screening tools

A
  • contain measures/questions focusing on known risk factors
  • usually short check lists
  • nutritional risk increases with increased presence of risk factors
  • categorizes individuals based on needs for further assessment
  • MUST be followed up appropriately
148
Q

What is NutriSTEP?

A

Nutrition Screening Tool for Every Preschooler

  • 17 question screening tool for both toddlers and preschoolers
  • each answer associated with a Risk Level
  • parent administered
  • determines 3 levels of risk
149
Q

NutriSTEP provides:

A
  • early identification of potential nutrition problems
  • parent referral to community resources
  • parental nutrition education
  • support in evaluating preschool nutrition interventions
  • means of monitoring community nutrition programs
150
Q

Target behaviours in the prevention of overweight or obesity from birth would include:

A
  • limiting sugary beverages
  • encouraging consumption of fruits and vegetables
  • limiting portion sizes
  • eating a fibre-rich diet
151
Q

Middle childhood

A

children between the ages of 5 to 10

152
Q

Preadolescence for girls

A

ages 9 to 11

153
Q

Preadolescence for boys

A

ages 10 to 12

154
Q

Unique characteristics for school-aged life stage

A
  • preparation for physical and emotional demands of adolescent growth spurt
  • adequate nutrition associated with improved growth and performance
  • girls develop earlier than boys
155
Q

Cognitive development of school-aged life stage

A
  • achievement of self efficacy
  • developing sense of self
  • more independent, learning role in family
  • peer relationships become more important
  • adequate nutrition associated with improved academic performance
156
Q

Self-efficacy

A

knowledge of what to do and ability to do it

157
Q

Physiological development of school aged life stage

A
  • increases in muscular strength, motor coordination, and increased overall stamina
158
Q

Boys general have more ______ ______ than girls

A

lean tissue

159
Q

Adiposity rebound

A

In early childhood when body fat reaches a minimum then increases in relation to the body’s preparation for adolescent growth spurt

160
Q

When does adiposity rebound occur?

A

At about 6 years of age

161
Q

Percent body fat reaches a minimum of __% in females

A

16

162
Q

Percent body fat reaches a minimum of __% in males

A

13

163
Q

Early adiposity rebound is associated with

A

increased obesity risk

164
Q

Adiposity rebound tends to be ___ in females than males

A

earlier and greater

165
Q

BMI considerations for school aged children

A
  • BMI is not consistent because there is so much growth (weight and height) during this time
  • plotting BMI for age intervals is really the only way to know where children stand
  • goal is not to strive for certain BMI but to be in reasonable percentile based on age and gender
166
Q

Protein DRI for children 4 to 13 years old

A

0.95 g/kg/day

167
Q

AMDR

A

Acceptable Macronutrient Distribution Range
- the range of intake for a particular macronutrient source, expressed as a percent of total energy, that is associated with reduced risk of chronic diseases while providing sufficient amounts of essential nutrients

168
Q

Wiggle room

A

AMDRs for children aged 4 to 18 years is not static there is 20% of wiggle room

169
Q

Benefits of fibre

A
  • provides fuel for beneficial bacteria within lower GI tract
  • aids with waste removal
  • slows digestion
  • makes you feel fuller longer
170
Q

Fibre is indigestible

A
  • we cannot breakdown plant components ourselves
  • cannot obtain energy
  • no AMDR
171
Q

Fibre recommendations for children aged 4 to 13

A

Between 25 and 31 based on age and gender

172
Q

Canadian health survey for children aged 9-13 suggests…

A
  • fat consumption is too high
  • fibre intake is too low which is related to low fruit and veg intake
  • calcium levels are low
  • sodium is way too high
173
Q

During childhood dietary iron and iron status are usually _______

A

adequate

174
Q

Children at risk for iron deficiency

A
  • limited access to iron-rich foods
  • low iron or specialized diet (vegetarian)
  • medical conditions that affect iron status
175
Q

A child with a BMI equal to or greater than the 85th percentile but less than the 95th percentile is…

A

overweight

176
Q

Toxic media environment

A

Kids these days are exposed to way too much screen time

177
Q

Influences as you get into school age

A
  • self esteem and body image in media
  • more peer influences
  • friends telling the truth
  • anatomic toys
178
Q

Weight based stigmatization exhibits as

A
  • biased attitudes, prejudice and behavioural intentions
  • various forms of discrimination
  • social marginalization, weight-related teasing
179
Q

Normal increase in body fat during school aged children may be interpreted as…

A

beginning of obesity before girls have growth spurt

180
Q

Parental controls and restriction of forbidden foods may…

A

increase intake of these foods

181
Q

Weight-related teasing associated with:

A
  • increased frequent dieting
  • increased extreme weight control behaviours
  • increased binge eating
  • increased depressive symptoms
  • decreased self esteem
  • decreased body satisfaction
182
Q

Measures to prevent childhood obesity

A
  • limit sugar sweetened beverages
  • limit TV
  • limit fast foods
  • limit portions
  • limit energy dense foods
  • have daily breakfasts
  • encourage fruits and veg
  • promote calcium rich diets
  • promotes diets high in fiber
  • promote physical activity
183
Q

What works for preventing childhood obesity?

A

Combination of clinical and school based multi-component programs

  • physical activity
  • parent training/modelling
  • behavioural counselling
  • nutrition education
184
Q

Physical activity guide for children aged 5 to 17

A
  • 60+ mins/day of moderate to intense exercise
  • 3+ days/week, intense exercise
  • 3+ days/week, muscle building exercise
185
Q

Approximately what percent of Canadian children achieve 60+ minutes 6+ days/week

A

7%

186
Q

_____ level of activity in school aged children compared to preadolescents

A

HIGHER

187
Q

Schools are in a unique position to support healthy eating…why?

A
  • reach nearly all children
  • captive audience
  • venue for both nutrition and education
  • role modelling/social norms
  • may have positive influences on parents
188
Q

4 aspects of school nutrition environment

A
  1. School food and beverage policy
  2. Breakfast/snack programs
  3. Access to off campus vendors
  4. Health Curriculum
189
Q

Ontario School food and beverage policy

A
  • Nutrition standards for food and beverages sold in elementary and secondary schools
  • Took effect in September 2011
  • Applies to all venues and events on school property
  • 10 “event” days per year where any food is limited
  • 20 minutes of daily physical activity
190
Q

Ontario School food and beverage policy nutrition standards

A

3 categories

  • green
  • yellow
  • red
191
Q

Green category

A

Sell most (at least 80%):

  • healthier options
  • higher levels of essential nutrients and lower amounts of fat, sugar and sodium
192
Q

Yellow category

A 
Sell less (less than 20%)
- may have slightly higher amounts of fat, sugar and sodium than food in green category
193
Q

Red category

A

Not permitted

  • foods contain few or no essential nutrients
  • contain high amounts of fat, sugar and sodium
194
Q

Green food examples

A
  • extra lean ground meat

- whole grain bread

195
Q

Yellow food examples

A
  • white bagels

- cheese

196
Q

Red food examples

A
  • candy
  • energy drinks
  • fried foods
197
Q

Chocolate milk controversy

A
  • 250 mL has approximately 26 g of sugar and policy states that schools are not allowed to sell milk-based drinks with more than 28 g
  • children like it!
  • good source of calcium, vitamin D, protein
  • 2 x the sugar of white milk
  • no added health benefits
  • normalization of sugary foods
198
Q

How is the policy doing?

A

Not very well

199
Q

Food breakfast programs

A
  • Canada has no national breakfast program; education is the jurisdiction of provincial governments
  • district school/level programs may provide “universal” breakfast, lunch, or snacks to children
200
Q

Breakfast programs in Guelph

A
  • Food and Friends
  • Breakfast for Learning
  • Breakfast clubs of Canada
201
Q

Number of breakfast programs are _______

A

increasing

202
Q

Canadian Children’s food and beverage advertising initiative

A
  • voluntary industry driven program

- core principles include not advertising food or beverage products in elementary schools

203
Q

Ontario Health Curriculum

A

Incorporates healthy eating component

  • grade 1: Food groups, hunger
  • grade 2: food choices, food guide
  • grade 3: nutrition value, local and cultural foods, environmental impact
  • grade 4: nutrients, healthy eating
  • grade 5: food labels, media effect on choices
  • grade 6: benefits of healthy food
  • grade 7: health issues form food choices
  • grade 8: macro/micro nutrient functions
204
Q

How many minutes of physical activity per day are recommended for school aged children?

A

60 minutes

205
Q

Early adolescence

A

11 to 14 years old

206
Q

Middle adolescence

A

15 to 17 years

207
Q

Late adolescence

A

18 to 21 years

- crosses over with early adulthood

208
Q

Adolescent nutritional needs

A
  • substantial physical, emotional and cognitive maturation
  • rapid physical growth affects nutrient needs
  • strong desire for independence can influence food choices
209
Q

Puberty begins during…

A

early adolescence

210
Q

Biological changes of puberty include

A
  • increases in height and weight
  • sexual maturation
  • changes in body composition
  • accumulation of skeletal mass
211
Q

___ of changes is consistent but ___ of changes is not

A

Order; timing

212
Q

Sexual maturation

A

Biological age not chronological age

213
Q

Sexual maturation should be used to

A

assess nutritional needs

214
Q

Sexual maturation rating

A

scale to assess degree of sexual maturation

215
Q

SMR stage 1

A

pre puburtal growth and development

216
Q

SMR stages 2-5

A

occurrences of puberty

217
Q

SMR stage 5

A

sexual maturation has concluded

218
Q

Sexual maturation in boys

A

genital development and pubic hair growth

219
Q

Sexual maturation in girls

A

breast development and pubic hair growth

220
Q

Menarche

A

onset of first menstrual period

221
Q

Menarche in girls occurs

A

2-4 years after initial development of breasts

- SMR 4

222
Q

Age of menarche in girls

A

ranges from 10 to 17 years

- earlier now than in previous generations

223
Q

Peak velocity of linear growth in girls occurs

A

approximately 6 to 12 months prior to menarche

- SMR 3

224
Q

Slow or delayed growth occurs

A
  • in highly competitive athletes

- severely restricted diets

225
Q

___ tend to develop earlier than ___

A

Girls; boys

226
Q

Peak weight gain in girls follows

A

linear growth spurt by 3 to 6 months

227
Q

Girls decrease in lean body mass from __% to __% of body weight

A

80; 74

228
Q

Girls gain approximately __ cm and stop growing around __ years of age

A

8; 16

229
Q

Females experience a __% increase in body fat during puberty

A

120

230
Q

Body fat levels in females

A

low: less than 20%
medium: 28%
high/obesity: greater than 35%

231
Q

__% body fat is required for menarche to occur

A

17

232
Q

__% body fat is needed to maintain normal menstrual cycles

A

25

233
Q

In males there is a ______ variation in chronological age at which sexual maturation takes place

A

large

234
Q

Peak velocity of linear growth in males occurs ____ and ends ___

A

during SMR 4; with the appearance of facial hair

- can be as early as 10 years and as late as 14

235
Q

Boys can gain between ____ cm/year in height

A

7 and 12

236
Q

In males linear growth continues throughout adolescence at a slower rate until about

A

21 years

237
Q

In males peak weight gain occurs

A

at the same time as peak linear growth

238
Q

Peak weight gain for males is approximately ___ lbs. per year

A

20

239
Q

In males body fat decreases to approximately __%

A

12

240
Q

___ of bone mass is accrued in adolescence

A

Half

241
Q

By 18 __% of skeletal mass is formed

A

90

242
Q

Given growth and development during adolescence, what are the key nutrients?

A
  • Calcium
  • Iron
  • Vit. D
  • Protein
243
Q

Energy requirements for adolescents are influenced by

A
  • activity level
  • BMR
  • Pubertal growth and development
244
Q

Level of activity ______ during adolescence

A

Declines

245
Q

Energy ranges for male and female adolescents

A

Males: 2200 - 3100 kcal/day
Females: 2000 - 2400 kcal/day

246
Q

Protein requirements for adolescents influenced by

A

amount needed to maintain existing and lean body mass and develops new muscle

247
Q

DRI protein requirements for adolescents

A

0.85 g/kg (AMDR 10-30%)

248
Q

Low protein intakes during adolescence linked to

A
  • reductions in linear growth
  • delays in sexual maturation
  • reduced lean body mass
249
Q

Carbohydrate intake for adolescents

A

130 g/day or 45-65%E

250
Q

Dietary fibre recommendations for males and females age 9 to 18 are between

A

26 and 38

251
Q

Fat required during adolescence

A
  • required as dietary fat and essential fatty acids for growth and development
252
Q

What is the AMDR for total fat and omega 3 fatty acids during adolescence?

A

25 to 35%, and 0.6 to 1.2%

253
Q

Less than __% E from saturated fat

A

10

254
Q

During peak weight gain, adolescent males gain an average of __ lbs. /year

A

20

255
Q

Calcium AI during adolescence is critical why?

A

to ensure peak bone mass

256
Q

Calcium absorption highest for females and males when?

A

around menarche and during early adolescence

257
Q

Approximately how many times more calcium is absorbed during adolescence compared to adulthood?

A

4x

258
Q

Adolescents who do not include dairy should consume…

A

Calcium fortified foods

259
Q

RDA for calcium for ages 9 to 18?

A

1300 mg/d

260
Q

Vitamin D important because?

A
  • facilitates intestinal absorption of calcium (and phosphorus)
  • essential for bone formation
261
Q

Northern latitudes may require supplementation of what?

A

Vitamin D

- synthesized by body via skin exposure to sunlight

262
Q

DRI for vitamin D during adolescence

A

600 IU per day

263
Q

Iron critical during adolescence because

A
  • rapid rate of linear growth and increase in blood volume
264
Q

Female iron needs highest _____

A

after menarche

- 15 mg/day

265
Q

Male iron needs highest ____

A

after growth spurt

- 11 mg/day

266
Q

Other key nutrients during adolescence?

A
  • zinc

- B vitamins

267
Q

Why is zinc important during adolescence?

A

for sexual maturation and growth especially in males

268
Q

Why are B vitamins important during adolescence?

A

for protein synthesis and cofactor properties

269
Q

“teen” brain refers to

A
  • ability to reason although rational thought may be limited
  • living in the moment so limited consideration of long-term consequences
  • reward benefits much more important than possible risk
270
Q

Social and emotional development during early adolescence

A
  • strong need for social acceptance from peers
  • body image may change as a result of changes in body shape
  • increased awareness of sexuality
  • strong sense of impulsivity
271
Q

Social and emotional development during middle and late adolescence

A
  • increased opportunities for employment and outside activities
  • greater autonomy from parents
  • continued need for social acceptance from peers
  • increased awareness of social and moral issues
272
Q

About __% of adolescents report following a vegetarian diet

A

4

273
Q

Reasons adolescents adopt a vegetarian diet include:

A
  • cultural or religious beliefs
  • moral or ethical concerns
  • health beliefs
  • to restrict fat/calories
  • a means of independence from family
274
Q

Compared to non vegetarians, vegetarians tend to have:

A
  • higher intake of fruits and veggies
  • less overweigh/obesity
  • more eating disorders
  • more weight controlling behaviour
275
Q

Position of dieticians of Canada on vegetarian diets

A
  • depends on level of restriction (high = concerns with adequacy)
  • can be associated with eating disorders
  • fortification and supplements will help vegans to achieve adequate nutrition
276
Q

Teen eating challenges

A
  • nutrition knowledge may be limited

- may be motivated by weight loss

277
Q

Physical activity guide for children aged 5 to 17

A
  • 60+ minutes/day of moderate to intense exercise
  • 3+ days/week, intense exercise
  • 3+ days/week muscle building exercise
278
Q

Rates of physical activity tend to ______ as children get older

A

decrease

279
Q

Association between body satisfaction and weight related behaviours in females

A

Lower body satisfaction associated with:

  • increased extreme weight control behaviours
  • increased binge eating
  • decreased physical activity
  • decreased fruit and veg intake
280
Q

Association between body satisfaction and weight related behaviours in males

A

Lower body satisfaction associated with:

  • increased extreme weight control behaviours
  • increased binge eating
  • decreased physical activity
281
Q

Continuum of eating concerns and disorders

A

Body dissatisfaction > dieting behaviours > disordered eating > clinically significant eating disorder

282
Q

Key features of anorexia nervosa include

A
  • refusal to maintain body weight at normal weight for age
  • intense fear of gaining weight
  • amenorrhea
  • distorted body image
283
Q

Key features of bulimia nervosa include

A
  • recurrent episodes of rapid consumption of a large amount of food in a discrete period of time
  • use of laxatives or diuretics
284
Q

Binge eating disorder

A

Binge eating not followed by compensatory behaviours caused by dietary restrictions leading to uncontrolled hunger

285
Q

Why are eating disorders so common in adolescence?

A
  • life is overwhelming
  • so many changes
  • struggling for independence and identity
  • increased pressure
  • source of control over stress
286
Q

Early adulthood

A

Mid 20s to 30s

287
Q

Characteristics of early adulthood

A
  • involved in transitions to adulthood
  • planning, buying and preparing food may be newly developing skills
  • may have renewed interest in nutrition
288
Q

Midlife

A

40 to 64 years

289
Q

Characteristics of midlife

A
  • period of active family responsibilities
  • managing schedules and meals becomes a challenge
  • multigenerational caregivers
  • health concerns are frequently added
290
Q

Older age

A

65+ years

291
Q

Characteristics of older adult

A
  • transition to retirement
  • more leisure time
  • greater attention to physical activity and nutrition
  • food choices and lifestyle factors especially for those with chronic disease
292
Q

Physiological changes of adulthood

A
  • growing stops by 20s
  • bone density continues until 30 yrs. of age
  • dexterity and flexibility decline
  • muscular strength peaks around 25 to 30 yrs.
  • decline in size and mass of muscle and increase in body fat
293
Q

Hormonal changes in adult women

A
  • decline in estrogen
  • increase in abdominal fat
  • increase in risk of CVD and accelerated loss of bone mass
294
Q

Hormonal changes in adult men

A
  • gradual decline in testosterone level and muscle mass
295
Q

Body composition changes in adults

A
  • positive energy balance
  • increase in weight and adiposity
  • decrease in muscle mass
  • fat redistribution
  • bone loss begins about age 40
296
Q

Fat redistribution

A
  • gains in central and intra-abdominal space

- decrease in subcutaneous fat

297
Q

Between ages 20 and 64, health and wellness greatly influenced by:

A
  • diet
  • PA level
  • body weight
  • smoking
298
Q

Caloric intake declines by approximately __% per decade during early adulthood…due to?

A

2; decreased metabolic rate and decrease in physical activity

299
Q

To maintain a healthy weight into adulthood

A
  • consume nutrient-dense/lower energy foods

- increase physical activity

300
Q

It is difficult to meet vitamin and mineral needs at calorie levels below

A

1800

301
Q

AMDR ranges for adults

A

Fat: 20-35%
Carb: 45-65%
Protein: 10-35%

302
Q

Fibre helps:

A
  • prevent against certain types of cancer and heart disease
  • allows us to eat a lot more food
  • helps rid body of cholesterol
303
Q

Calcium RDA ___ to ___ mg/day for adults

A

increases; 1200

304
Q

All adults over age 50 should take a supplement with ____ because:

A

400 IU of Vit. D

  • limited exposure to sunlight
  • institutionalization or long working hours
  • certain medications
305
Q

Most older adults are above adequate intake of what micronutrient?

A

Iron

306
Q

Total body water ____ with age

A

decreases

307
Q

____ glasses of fluid/day will prevent dehydration in most older adults

A

6+

308
Q

Risk factors for health conditions in adults and older

A
  1. overweight/obesity
  2. weight pattern
  3. waist circumference
  4. Physical inactivity
309
Q

Recommendations for PA in adults

A
  • 30 to 60 minutes per day
  • 150 minutes per week
  • strength training twice per week
  • start slowly 10 minutes at a time and build up tolerance
310
Q

In adults and older adults weight bearing and resistance exercises increase

A

lean muscle mass and bone density

311
Q

Chronic conditions with modifiable risk factors include:

A
  • heart disease
  • cancer
  • stroke
  • type II diabetes
312
Q

What is the life expectancy in Canada?

A

82 years

313
Q

Fastest growing population group in Canada?

A

Elderly

314
Q

2 main causes of death

A

Cancer and heart disease

315
Q

Lean body mass

A

sum of fat-free tissues, mineral as bone and water

316
Q

Sarcopenia

A

term used for loss of LBM associated with aging

- can begin as early as 40 years old

317
Q

LBM decreases ___ from age 30 to 70

A

2-3% per decade

318
Q

3 nutritional considerations for older adults

A
  1. Sensory changes
  2. Physical limitations
  3. Cognitive factors
319
Q

Taste and smell ___ with age

A

decline

320
Q

_____ retain their sense of smell better than _____

A

Women; men

321
Q

What affects taste and smell more than aging?

A

Disease and medications

322
Q

Cognitive disorders

A
  • Alzheimer’s
  • Vascular dementia
  • Parkinson’s disease
  • Alcohol-related and AIDS-related dementia
  • Dementia
323
Q

Dementia

A

a progressive cognitive decline, characterized by forgetfulness, memory decline, difficulty with decision-making and mental ability
- ranks 5 in cause of death of older people

324
Q

Effects of cognitive disorders

A
  • confusion
  • anxiety
  • agitation
  • loss of oral muscular control
  • impairment of hunger/appetite regulation
  • changes in smell and taste
  • dental, chewing and swallowing problems
325
Q

Nutrition interventions for cognitive disorders must:

A
  • ensure food safety
  • safe use of kitchen tools and equipment
  • dietary focus
  • nutrient-dense diet
  • maintain hydration
  • supply needed energy
326
Q

Change in eating patterns that comes with aging

A
  • meal prep
  • decreased appetite
  • smaller less frequent meals
327
Q

Changes in sensual awareness related to appetite

A

hunger and satiety cues weaken

- need to be more conscious of food intake levels since appetite regulating mechanisms may be blunted

328
Q

Changes in sensual awareness related to thirst

A

thirst regulating mechanisms decrease with age

329
Q

Older adult meal intake impacts:

A
  • weight changes
  • nutrient intake
  • disease management
  • immunity
  • risk of falls
  • psychological health
330
Q

Factors impacting nutritional intake of older adults:

A
  • disease condition
  • functional disability
  • inadequate food intake
  • swallowing difficulty
  • depression or anxiety
  • poly pharmacy
331
Q

Poly-pharmacy

A
  • taking too many medications

- certain medications limit absorption

332
Q

Oral health depends on and determines?

A 
Depends on:
- GI secretions
- Skeletal systems
- mucus membrane
- muscles
- taste buds
- olfactory nerves
Determines what we can eat
333
Q

Strategies to promote food intake in older adults:

A
  • maintain focus on eating
  • provide plenty of time to eat
  • serve favourite foods
  • encourage regular drinks between bites
334
Q

As adults get older milk and alternatives ____, fruits, veggies, and grains ____ and meat and alternatives ____

A

increases; decreases; remains the same

335
Q

Nutrition concerns for older adults

A
  • poor intake of all four food groups
  • variety of nutrients consumed at low levels (vitamin C, D, folate, B6, B12, calcium, magnesium, and zinc)
  • protein and energy also low
336
Q

Osteoporosis

A

Porous bone

- results from decreased bone mass and disruption of bone architecture

337
Q

Osteoporosis ___ in women than in men

A

higher

  • mostly due to hormonal changes
  • decrease in estrogen for women
  • men testosterone tapers more slowly
338
Q

Osteoporosis symptoms

A

Osteoporosis has no symptoms

339
Q

Of older people who break a hip:

A
  • 10 to 20% die within a year

- 50% have permanent disabilities

340
Q

Kyphosis

A

shrinking height

- results from compression or bone fracture in spine

341
Q

Nutritional remedies for osteoporosis

A
  • increase calcium and vitamin D through diet or supplements
  • don’t take calcium with antacids
  • consume foods rich in vitamins C, D, B6 and K
342
Q

Promise of Prevention and Health Promotion:

A
  • good nutrition habits make a greater impact when started early in life
  • never too old to practice health promotion strategies
343
Q

Infant mortality includes

A

deaths that occur within first year of life

344
Q

Which of the following statements best describes motor development in infants?

a. Voluntary control of muscles starts from head and moves down legs
b. Voluntary control of muscles starts from being able to fan toes out at birth to blinking eyes in response to loud noise or light
c. Voluntary muscle control develops with central muscles first and then moves out to hand muscles
d. Voluntary muscle control develops with rooting reflex and then moves out to hand muscles
e. a and c

A

e. a and c

345
Q

Which of the following is a warning sign indicating growth problems in infants

a. Plateau in head circumference gain for more than one month
b. Lack of height gain
c. Plateau in gain for more than one month
d. Drop in weight without regain within a few weeks
e. All of the above

A

e. All of the above

346
Q

Infants need a high fat diet compared to older people; therefore up to _____ of calories from fat may be recommended?

a. 25%
b. 32%
c. 40%
d. 55%
e. 60%

A

d. 55%

347
Q

The 2006 WHO growth charts are based on longitudinal and cross sectional data of ________________.

a. Preterm and full term infants
b. Low birth weight and normal birth weight infants
c. Exclusively or predominantly breastfed infants
d. Formula fed infants
e. Infants fed equal amounts of formula and breast milk

A

c. Exclusively or predominantly breastfed infants

348
Q

BMI in the 90th percentile would indicate that a 3 year old was:

a. Underweight
b. Normal weight
c. Overweight
d. At risk of overweight
e. Obese

A

c. overweight

349
Q

Potential consequences of a weight loss program in childhood are slowed linear growth and the beginnings of an eating disorder

a. True
b. False

A

True

350
Q

At daycare a small chocolate candy bar was given only to three year olds who ate everything at mealtime. Choose the best description of the feeding relationship problem between daycare center staff and 3 year olds:

a. Inappropriate portion sizes for toddlers
b. Served severely restricted junk foods
c. Inappropriately used coercion to control food intake
d. Taught children to like sweets

A

c. Inappropriately used coercion to control food intake

351
Q

Preadolescence is generally defined as ages:

a. 5-10 for girls/7-9 for boys
b. 7 to 9 for girls/9 to 11 for boys
c. 9 to 11 for girls/10-12 for boys
d. 10-12 for girls/11 to 13 for boys
e. 11 to 13 for girls/12 to 14 for boys

A

c. 9 to 11 for girls/10-12 for boys

352
Q

What are the proposed mechanisms by which television viewing contributes to obesity?

a. Reduced energy expenditure
b. More commercials advertising appropriate foods
c. Increased intake while watching television
d. All of the above
e. a and c only

A

e. a and c only

353
Q

The most significant predictor of childhood obesity has been found to be:

a. Low family income
b. Food insecurity
c. Parental obesity
d. Lower cognitive simulation
e. Use of formula instead of breastfeeding

A

c. Parental obesity

354
Q

The struggle for independence that characterizes adolescent psychosocial development may lead to development of health compromising eating behaviours, including:

a. Excessive dieting
b. Meal skipping
c. Use of unconventional nutritional supplements
d. Adoption of fad diets
e. All of the above

A

e. All of the above

355
Q

Health advantages for an adolescent consuming a vegetarian diet include:

a. High intake of fiber
b. High intakes of B vitamins, especially B12
c. High intakes of vitamins and minerals found in plant foods
d. All of the above
e. a and c only

A

e. a and c only

356
Q

During peak weight gain, adolescent males gain an average of ___ lb./year.

a. 10
b. 20
c. 30
d. 40

A

b. 20

357
Q

Susan is a 15 year old who likes fruits some vegetables and breads but refuses to consume milk, seafood and eggs. A recent doctor visit revealed normal hemoglobin and plasma ferritin levels…what would you advise?

a. A folate supplement (400mg/day)
b. A vitamin D supplement (400 IU/day)
c. An iron supplement (10mg/day)
d. No changes in nutrient intake

A

b. A vitamin D supplement (400 IU/day)

358
Q

Men and women continue to develop bone density until 40 years of age

a. True
b. False

A

b. False

359
Q

Among adults, the AMDR for total fat intake is ____ of calories.

a. 10-15%
b. 15-20%
c. 20-35%
d. 35-40%
e. 40-50%

A

c. 20 to 35%

360
Q

Which type of fiber is helpful in decreasing absorption of cholesterol?

a. Oatmeal
b. Viscous fiber
i. Soluble
c. Fermentable fiber
i. Insoluble
d. Potato skin
e. a and b

A

e. a and b

361
Q

In older adults, BMI is an adequate indicator of excess body fat associated with morbidity and mortality.

a. True
b. False

A

b. False

NUTR 2050 (2 decks)

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