Final Flashcards
1
Q
Define: Infancy
A
First year of life (birth-12 months)
2
Q
Infancy is sometimes broken down into:
A
- Early infancy (0-6 months)
- Later infancy (6-12 months)
3
Q
T or F: Newborns hear and move in response to familiar sounds.
A
True
4
Q
T or F: Newborns CNS is immature; subtle cues for hunger and satiety vs. stronger cues
A
True
5
Q
Define: Reflex
A
automatic response triggered by specific stimulus
6
Q
Define: Rooting Reflec
A
infant turns head toward the cheek that is touched
7
Q
Define: Suckle
A
reflex causing tongue to move forward and backward
8
Q
What are the domains of development (infants):
A
- Motor: voluntary muscle movement : gross and fine influenced by sensory system
- Sensory: information from the environment
- Cognitive / mental
- Language and Communication
- Social, adaptive, emotional
9
Q
Define: Intrinsic influence
A
child’s health (nutrition), brain function, temperament
10
Q
Define: extrinsic influence
A
family, environment, cultural norms
11
Q
Define: Motor development
A
the ability to control voluntary muscles
12
Q
T or F: Motor development is top down
A
True: the child first controls the head, and lastly controls the lower legs.
- central to extremities: shoulders are controlled before fingers
13
Q
In infancy: cognitive skills
A
- thumb sucking becomes intentional
- sensitivity to food texture helps develop speech skills
- feeding tubes in early infancy can interrupt development and have long-term negative consequences
14
Q
Infancy: Digestive System Development
A
- Gut is functional at birth (can digest fat, protein, simple sugars)
- ~ six months required for GI tract maturation
15
Q
Digestive system development: what happens as an infant ages?
A
- levels of digestive enzymes expand
- speed of stomach emptying increases
- Peristalsis becomes more consistent
16
Q
Feeding skills Development: What is happening at 4-6 weeks?
A
- reflexes fade
- infant begins to purposely signal wants and needs
17
Q
Feeding skills Development: What is happening at 4-6 months?
A
- tongue moves side to side
- teeth arrive
- can swallow pureed foods and hold a bottle
18
Q
Feeding skills Development: What is happening at 9-12 months?
A
- self-feeding with hands or spoon
- munching and biting skills
- lumpy and chopped foods
- drinking from an open cup
19
Q
T or F: Infants do not have an inherent preference for sweet taste.
A
False: Infants DO have an inherent preference for sweet taste.
20
Q
What are the energy needs of an infant?
A
108 kcal/kg/day from birth to 6 months
98 kcal/kg/day from 6-12 months
120 kcal/kg/day for babies born prematurely
How much is that?
Newborn weighing 4 kg (8.8 lbs) needs 108 x 4 = 432 kcal
6 month old weighing 8kg (17.6 lbs) needs 98 x 8 = 784 kcal
Absolute calorie needs are more from 6-12 months, but relative amounts are less
21
Q
What factors influence caloric needs of infants?
A
- Weight
- Growth rate
- Sleep/wake cycle
- temperature and climate
- metabolic response to food
- health status
22
Q
When do growth spurts typically occur for infants?
A
- 3 weeks
- 3 months
23
Q
What are the protein needs of an infant?
A
- 2 g/kg/day from birth to 6 months
- 6 g/kg/day from 6-12 months
Preemie Protein Needs
1.52 g/kg adequate if growth or digestion are not affected
3.0-3.5 g/kg required for preterm or recovery from illness
4.0 g/kg may be needed for extremely low birth weight (< 1000g)
Hydrolyzed protein or single amino acid formulas may be used for preemies or sick infants
24
Q
What are the fat needs for infants?
A
AI about 30 g/day; no change from birth- 6 mo and 6-12mo; restriction not recommended
Infants need cholesterol for brain development
Breast milk contains about 55% calories from fat
Breast milk contains short-chain and medium-chain fatty acids (in addition to the long-chain)
Short and medium-chain fatty acids are easier to digest and utilize
Preemies lack the bile required to digest long-chain fatty acids- can add MCT (medium-chain triglyceride) oil to boost energy
25
What are the carbohydrate needs for infants?
- 60 g/day from birth to 6 months
| - 95 g/day from 6-12 months
26
What is the metabolic rate of infants?
- Metabolic rate of infants is highest of any time after birth
- The higher rate is related to rapid growth and high proportion of muscle
- Low carbohydrate and/or energy intake results in protein catabolism which impact growth
- 6 weeks → 6 months
27
True or false: Infants need to be supplemented with fluoride at 6 months
True; unless they are provided with fluorinated water daily
28
What is fluoride important for? (infants)
- incorporated into enamel of forming teeth
29
T or F: Breastfed babies need Vitamin D supplement of 400 IU from birth until 1 year of age
True
30
T or F: Anemia is common in infants
False: anemia is uncommon in infants because of prenatal iron stores of the mother and high bioavailability in breastmilk
31
T or F: it is recommended that Iron-fortified cereals and other iron-rich foods are given to the infant starting at 6 months
True
32
T or F: Premature or sick infants may need additional vitamins and minerals to support "catch-up" growth or while recovering from illness
True
33
T or F: Human fortifiers provide additional calories and nutrients to infants (calcium, vitamin B12)
True
34
T or F: Formula composition is strictly regulated in Canada to match breast milk as closely as possible
true
35
What is the hierarchy of recommendations for milk for infants?
- Breast milk
- cow's milk formula
- soy based formula
36
T or F: Soy formula is recommended for managing colic
False; soy formula is NOT recommended for managing colic, not even recommended with milk-based allergies or intolerances
37
What do some of the specialized formulas include?
- higher energy
- hydrolyzed proteins
- lactose replaces with other sugars
- MCT added
- DHA added
- prebiotics
- decreased minerals
- fibre
38
How long does Health Canada support breast feeding for?
- Up to two years or beyond, as long as mother and child want to continue
39
Why should whole, reduced-fat or skim cow's milk not be used before 9 months of age?
- Iron-deficiency anemia linked to early introduction of cow's milk
- gastro-intestinal (GI) blood loss
- Displacement of iron-rich foods
40
When should complementary feeding start (infants)?
- Start at six months
41
What foods should be first presented to infants?
- Iron-rich foods (cereals and meats) then slowly progress (1 new food every 2-3 days) to a variety of foods that the family eats)
- Serve foods prepared without sugar
42
By 12 months, what is the recommended frequency of complementary feedings?
- 3 'meals' and 3'snacks' per day
43
Should honey be consumed before the age of 1?
No
44
What is the transition of textured foods for infants?
- pureed
- lumpy
- mashed
- diced
45
T or F: Lumpy foods should be offered no later than 9 months
True
46
T or F: After 6 months, there is no evidence that introducing any allergen has an increase risk of developing an allergy
True
47
How many allergens should you offer to an infant at once?
- Offer no more than 1 potential allergen at a time and wait at least two days before introducing another
48
What types of foods should be avoided when thinking about food safety for infants?
- hard, small, round , smooth, and sticky foods
49
What are some foods that could choke infants?
- popcorn
- peanuts
- raisins
- stringy meat
- gum and gummy textured candy, hard candy, or jelly beans
- hot dogs
- hard fruits or vegetables
50
What are the food recommendations for infants aged 6-9 months:
- texture: pureed, lumpy, mashed
- slowly increase amount based on infant's appetite
- by end of 9 months, eating 3 'meals' with breast/formula feeds
51
What are the food recommendations for infants aged 9-12 months:
- Texture: move towards diced soft foods
- foods need to increase in texture to encourage chewing
- encourage self-feeding and eating 'family foods'
52
What are the food expectations for infants aged 12 months?
- general pattern of 3 meals and 3 snacks
- slow self-weaning as increase solid food intake at nine months is 3-4 milk/feedings/day, 12 months is about 2 milk feedings/day
- texture: solids increase in amount progressing towards 'table' foods with some modification
53
What are some cues to tell if an infant is hungry?
- watches food being prepared
- reaches for food, spoon
- tight fists
- irritation is pace is too slow or stops
54
What are some cues to tell if an infant is full?
- Plays with food, utensils
- slows pace of eating
- turns away from spoon
- tries to get out of high chair
- stops eating
- spits out food
55
What does the physical growth assessment reflect for infants?
- nutritional adequacy
- health status
- economic and environmental adequacy
56
What is being measured in the physical growth assessment of infants?
- weight
- height / length
- head circumference
57
T or F: Infant / child height and weight must be interpreted in the context of age and gender
true
58
Who is the reference population for the WHO recommendations for infants?
- children from 6 countries worldwide (Brazil, Ghana, India, Norway, Oman, USA)
- based on standard measurements of babies
- Based on exclusively breastfed population that are 4 months old
59
T or F: Charts developed by WHO describe how children should grow
True
60
What is the difference between the CDC and the WHO in regards to infant growth?
CDC --> how children have grown, past patterns
WHO --> how children should grow, looking into the future
61
What are warning signs of a need for intervention for growth of infants?
- loss of weight or length gain
- plateau in weight or length for > 1
- Drop in weight without regain in a few weeks
- fast gain in weight
62
What is the process of correcting for gestational age?
1. Subtract gestational age at birth from 40 weeks
2. Divide by 4 to get months
3. subtract that amount from current age
Example: infant born at 30 weeks; assessing growth at 3 months
40-30 = 10 weeks
10/4 = 2.5 months
Current age = 3 months
3 months - 2.5 months = 0.5 months or two weeks
Therefore you will chart baby’s growth at two weeks to chart more accurately
63
T or F: Low birth weight infants are at a greater risk of dying during the first year of life, and of developing chronic health problems
true
64
Describe 'failure to thrive' in infants:
- Defined as when the infant is growing more slowly than other infants his/her own age; there is inadequate gain in weight or length
- Organic → diagnosed condition
Examples: chronic ear infections, developmental disability
- Non-organic → not based on medical diagnosis
Examples: maternal mental health, dilution of formula, general neglect
65
What are the nutrition interventions related to failure to thrive infants?
- May be complex and involve a team approach including the registered dietitian
- Nutrition interventions to establish energy and protein intake goals and feeding schedule
66
T or F: about 6-8% of children < 4 years old have allergies
true
67
What are the 'problems' with allergies for infants?
- diagnosis is challenging
- Families seeking testing is increasing → increased number of false positives (ie. incorrect diagnoses are common)
- Families determining ‘allergic’ without testing
- Self-diagnosis may lead to removal of foods/group that may decrease nutritional adequacy
68
What are some new thoughts on allergies for infants?
- Food avoidance /postponement may lead to decreased nutritional adequacy and limit variety
- Breast milk for infants at risk of allergies
- Oral Tolerance Induction:
Idea of slow sensitization especially for milk, soy, egg, wheat
Overcome risk of allergy by consuming tiny by increasing portions of the food
Train immature immune system
69
Discuss lactose intolerance in infants:
- Inability to digest the disaccharide lactose
- Characterized by cramps, nausea and pain and alternating diarrhea and constipation
- Treated with lactose-free cow’s milk or soybean-based formulas
- Many infants “outgrow” lactose intolerance
GI tract matures and produces the necessary enzymes
70
The development of motor control starts with:
a. Lower leg control, then arm control, and then head control
b. head and trunk control, then lower legs
c. trunk and arm control, then lower legs, then head
d. head and leg control that occur simultaneously, then neck control
e. finger and hand control, then lower legs, then head and neck control
b. Head and trunk control, then lower legs
71
Which of the following would NOT be a cue an infant might have given when signalling that s/he is hungry and ready to eat?
a. watching the food be opened
b. reaching for the spoon
c. showing irritation if the feeding pace is too slow
d. spitting out food on the floor
e. c and d
d. spitting out food on the floor
72
What is the gestational-adjusted age for a 9-month old infant born at 32 weeks of age?
a. 6.5 months
b. 7 months
c. 8 months
d. 8.5 months
b. 7 months
73
What percentage of children less than four years of age have a food allergy?
a. less than 10%
b. 10-30%
c. 30-40 %
d. over 50%
a. less than 10%
74
What is one of the signs associated with inadequate growth in infants?
a. weight loss within the first week after birth
b. weight remaining stable over 3 months
c. weight gain over 3 months
d. missing weights in the medical record
b. weight remaining stable over 3 months
75
On average, toddlers gain:
a. 4 oz per month
b. 8 oz per month
c. 1 lb per month
d. 2-3 lbs per month
b. 8 oz per month
76
On average, preschoolers gain:
a. 4lbs per year
b. 6 lbs per year
c. 8 lbs per year
d. 10 lbs per year
a. 4 lbs per year
77
What percentage of children aged 2-5 are overweight / obese?
a. 5%
b. 13%
c. 17%
d. 22%
b. 13%
78
Targeting behaviours in the prevention of overweight or obesity from birth would include all of the following except:
a. limiting sugary beverages
b. encouraging consumption of fruits and vegetables
c. skipping breakfast every day
d. limiting portion sizes
e. eating a fibre-rich diet
c. skipping breakfast every day
79
What is the recommended intake of total fibre for children aged 4-8 years?
a. 25 g/day
b. 29 g/day
c. 31 g/day
d. 35 g/day
a. 25 g/day
80
A child with a body mass index (BMI) equal or greater than the 85th percentile, but less than the 95th percentile, is:
a. at a normal weight
b. at risk of becoming overweight
c. overweight
d. obese
c. overweight
81
It is recommended that children engage in at least ____ minutes of physical activity every day.
a. 30
b. 45
c. 60
d. 90
e. > 90
c. 60
82
Females experience a ___ % increase in body fat during puberty.
a. 40%
b. 50%
c. 100%
d. 120%
d. 120%
83
During peak weight gain, adolescent males gain an average of ____ lb/year.
a. 10
b. 20
c. 30
d. 40
b. 20
84
It is difficult to meet vitamin and mineral needs at calorie levels below:
a. 1300 kcal
b. 1600 kcal
c. 1800 kcal
d. 2000 kcal
c. 1800 kcal
85
What is the life expectancy in Canada?
a. 73 years
b. 78 years
c. 82 years
d. 85 years
c. 82 years
86
Chronic conditions with modifiable risk factors include which of the following?
a. heart disease
b. cancer
c. stroke
d. type 2 diabetes
e. all of the above
e. all of the above
87
On average, lean body mass decreased by ____ per decade from age 30 to 70.
a. 2-3%
b. 5-7%
c. 8-10%
d. 12-13%
a. 2-3%
88
Toddlers can be defined as:
- between the ages of 1-3 years
| - toddler stage is characterized by rapid increase in gross and fine motor skills
89
Preschoolers can be characterized by:
- increasing autonomy
- broader social circumstances
- increasing language skills
- expanding self-control
90
Define: weaning
caloric needs met without bottle or breastfeedings
91
What might early weaning result in?
- impaired growth (due to reduced calories)
| - constipation (from low fluid intake)
92
What is the recommended age for weaning?
between 12 and 24 months
93
What might late weaning result in?
- later problems with feeding
| - problems with speech development
94
What are the recommendations for young children (Health Canada)?
1. Serve small nutritious meals and snacks each day
2. Do not restrict nutritious foods because of their potential allergen content. Offer a variety of foods from the four food groups
3. Satisfy their thirst with water
4. Respect your children's ability to determine how much food to eat
5. be patient
6. Be a good role model
7. Organize fun physical activities
95
T or F: Toddlers and preschoolers have large stomachs so they can consume more food less often
FALSE; toddlers and preschoolers have small stomachs, and so they need to eat small amounts of food more often throughout the day
96
T or F: You should offer a variety of nutritious foods, including some choices that contain different flavours, colours and textures such as 2% milk, peanut butter and avacados (toddlers and preschool)
True
97
What are some facts surrounding fluid intake for toddlers and infants?
- encourage young children to drink water to quench their thirst and replenish body fluids
- Canada's food guide recommends that children choose vegetables and fruit more often than juices
- children also need a total of 500 mL (2 cups) of milk everyday to help meet their requirement for vitamin D
98
If a toddler rejects a food the first time it is offered, should it be offered again?
Yes, the more often children are exposed to a new food the more likely they are to accept it
99
What are the energy needs for children ages 13-36 months?
[89 x child's weight (kg) - 100 + 20kcal]
- account for age, gender, height , weight, physical activity level
- range from approx 1100-2000kcal per day
- Most Canadian toddlers / preschoolers meet or exceed these recommendations
100
What is the RDA for protein for toddlers and preschoolers?
RDA for protein: 1.1g/kg/day (1-3 years)
0.9g/kg/day (4-8 years)
*Most Canadians meet these recommendations
101
Most toddlers and preschool-age children have adequate vitamin and mineral consumption except for:
- Iron
- Calcium
- Vitamin D
102
Approximately _____ % of children aged 1-5 years have iron-deficiency anemia in Canada
3.5-10.5%
103
Why is iron-deficiency anemia so prominent in First nations communities?
- high consumption of evaporated milk and cow's milk at 6 months of age; prolonged breastfeeding without sufficient supplementation
104
What can Iron-deficiency anemia lead to?
- May cause delays in cognitive development and behavioural disturbances
105
How can iron-deficiency anemia be prevented?
- Limit milk consumption to 2 cups per day since milk is a poor source of iron
- Provide iron-rich foods: fortified cereal, hamburger whole grain or enriched bread, beans, meat
- Canadian task force on the periodic health examination recommends that all high-risk infants should be screened at 6 and up to 12 months
106
How can Iron-deficiency anemia be treated?
- Iron supplements (typically flavoured drops)
- counseling with parents
- repeat screening
- Micronutrient powders: single dose sachets containing iron in a powder form, which are easily sprinkled onto any foods prepared in the household
107
What is the calcium RDA for children?
RDA for children 1-3 years is 700 mg/day
RDA for children 4-8 years is 1000mg/day
108
How can we ensure adequate intake of calcium?
- milk and milk alternatives
- dark green vegetables
- fish with soft bones that are eaten, such as canned salmon or sardines
109
What is the vitamin D RDA for children aged 1-8 years?
600 IU
110
Approximately ___% of Canadian children are deficient in vitamin D
20%
111
For toddlers: it may take up to ____ exposures to new foods before acceptance
8 to 10
112
What are some negative ways that parents get their children to eat vegetables?
- "Clean your plate" This reduces child's ability to listen to hunger cues
- "Instrumental feeding: using food as reward, child value the reward foods more, and healthful food less
- Heavy restriction of less healthy foods, may overindulge on the food when have access
113
What are some common pitfalls related to feeding toddlers and preschoolers?
- don't try to get food into child
don't expect child to be consistent
- avoid too much or too little hunger
- don't allow grazing
114
How can you overcome the pitfalls associated with feeding toddlers and preschoolers?
- prepare food that you and your family likes
- offer everyone the same meal
- provide 4-5 dishes including bread
- include familiar and unfamiliar foods
- teach and model aproppriate eating behaviours
- know children's needs
115
Beginning at age 3, the DRI equations for estimating a child's energy requirements are based on a child's:
a. age, height, weight, activity level and gender
b. age, weight, height, BMI, and activity level
c. activity level, age, height, and gender
d. activity level and BMI
a. age, height, weight, activity level and gender
116
At what percentile are children aged 2-5 years considered obese? (WHO)
Obese:
| BMI > 97th percentile for age and gender
117
At what percentile are children aged 2-5 years considered overweight? (WHO)
Overweight:
| BMI > 85th percentile for age and gender
118
How much physical activity should toddlers and preschoolers obtain daily?
- 180 minutes of physical activity per day, at any intensity
| - up to 60 minutes per day at high intensity
119
What are some interpersonal and environmental considerations for health of children? ****Short answer Question
- Child care (what is being fed to the children at the centre, if they follow activity guidelines
- Neighbourhood environment (playing outside with neighbours)
- Family influence- role model (parents need to be outside being active as well and eating healthy foods)
- Peers (what peers are eating)
- Parenting style
- Media (commercials on TV)
120
Discuss the four parenting styles in regard to feeding:
- Authoritarian: control child eating, restricting food, forcing food (low warmth/high demandingness)
- Indulgent: minimal guidance/structure, child eating whenever and whatever (high warmth, low demandingness)
- Neglectful: parenting is absent, foods available may be inadequate/inappropriate (low warmth, low demandingness)
- Authoritative: balances approach; parent determines what offered, child determines what is eaten (high warmth, high demandingness)
121
Compared to authoritative parenting, higher rates of obesity were shown with:
- Authoritarian: risk was 4 x higher
- Indulgent: risk was 2 x higher
- Neglectful: risk was 2 x higher
122
How much screen time is recommended for children ages 0-2 years?
No screen time is recommended
123
How much screen time is recommended for children ages 2-4 years?
Screen time should be limited to under 1 hour per day
124
According to a study of 3 yr old children, What was each one hour increment in TV viewing associated with?
- 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 fruits and vegetables, calcium and dietary fiber
125
What was television viewing associated with?
- Displacement of physical activity --> obesity
| - increased energy intake (snacking) --> obesity
126
To reduce risk of overweight and obesity: we should decrease what?
- sugar-sweetened beverages
- energy dense foods
- tv screen time
- fast foods
- portion sizes
127
To reduce risk of overweight and obesity: we should increase what?
- calcium rich diets
- diets high in fiber
- vegetables and fruits
- daily breakfast
- physical activity
128
What are the treatment guidelines for overweight and obesity?
Goal: maintaining weight while increasing height
| - weight loss typically not recommended; should not exceed 1 pound per month
129
What are the 3 stages of treatment for overweight and obese children?
Stage 1: Prevention Plus (behaviour change and more frequent follow-up
Stage 2: Structured weight management (planned diet/eating plan with RD, logs to monitor behaviour, monthly follow-up
Stage 3: Comprehensive Multidisciplinary intervention (more intensive intervention, multiple health professionals, weekly follow-up visits
130
What is nutrition screening?
- Process of identifying characteristics known to be associated with nutritional problem
- completed by dietitians or health care professionals in various settings
- determines the need for further nutritional assessment
131
Why should children have nutritional screening?
- early identification of problems
- to prevent serious consequences in the future
- to provide treatment when needed
- to identify who needs services, treatment and referrals
- to promote awareness and behaviour change
132
What are some nutrition screening tools??
- contain measures/questions focusing on known risk factors
- usually short checklists
- nutritional risk increases with increased presence of risk factors
- categorizes individuals based on needs for further assessment/follow-up
- must be followed up appropriately
133
What is NutriSTEP?
- developed here at UoG
- Nutrition screening tool for every preschooler
- screening tools for both toddlers and preschoolers
- 17 questions (each answer is associated with a risk level (1-4))
- valid and reliable measure of nutrition risk
- parent administered
- Determines 3 levels of risk: low, moderate, high
134
What does NutriSTEP provide?
- early identification of potential nutrition problems
- parent referral to community resources
- parental nutrition education
- support in evaluating preschool nutrition interventions
- a means of monitoring community nutrition programs
135
What are the results of the NutriSTEP?
- Approx 10-20% of the population of young children (18mo-5yrs) will be identified as high nutritional risk
- NutriSTEP items individually identified as high risk
(picky eating: grain, fruit/veg and meat consumption) (use of multivitamins- can result in toxicity)
- there is a questionnaire for toddlers (18-35 months) and one for preschoolers (3-5 years)
136
What age is considered 'middle childhood?
between the ages of 5 to 10 years
137
What age is considered preadolescence?
- Ages 9-11 for girls
| - Ages 10-12 for boys
138
What is unique about school aged children?
- preparation for the physical and emotional demands of the adolescent growth spurt
- Establishing healthy eating behaviours
- interventions help prevent immediate and long-term health problems
- adequate nutrition associated with improved growth and performance
139
What type of cognitive development happens to school aged children?
- Achievement of self-efficacy (the knowledge of what to do and the ability to do it
- developing a sense of self
- More independent, learning role in the family
- peer relationships become more important
- adequate nutrition associated with improved performance
140
Physical development in school aged children is characterized by:
- increases in muscular strength, motor coordination, and increased stamina overall
- boys generally have more lean tissue than girls
- adiposity rebound occurs at about 6 years
141
What is adiposity rebound?
- In early childhood, body fat reaches a minimum then increases in relation to the body's preparation for adolescent growth spurt
- percentage body fat reaches a minimum of 16% in females and 13% in males during this time
- adiposity rebound usually occurs before 6 years of age and is associated with increased obesity risk the earlier it occurs
- tends to be earlier and greater in females
142
Children aged 2-5 years that are in the 99th percentile can be considered:
Obese
143
Children aged 2-5 years that are in the 97th percentile can be considered:
Overweight
144
Children aged 2-5 years that are in the 85th percentile can be considered:
Risk of overweight
145
Children aged 2-5 years that are in the 3rd percentile can be considered:
Wasted
146
Children aged 5-19 years that are in the 99th percentile can be considered:
Severely obese
147
Children aged 5-19 years that are in the 85th percentile can be considered:
Overweight
148
Discuss the development of feeding skills in school aged children.
- increased motor coordination and improved feeding skills
- masters use of eating utensils
- involved in food preparation
- complexities of skills increase with age
149
Discuss the development of eating behaviours for school aged children.
- parents and older siblings influence food choices in early childhood with peer influences increasing in preadolescence
- parents should be positive role models
- family mealtimes should continue to be encouraged
- media has strong influence on food choices
150
What is the definition of Acceptable Macronutrient Distribution Range (AMDR)?
The range of intake for a particular macronutrient source (protein, fat or carbohydrate), expressed as a percentage of total energy (kcal), that is associated with reduced risk of chronic disease while providing sufficient amounts of essential nutrients
151
What are the AMDR ranges?
Carbohydrates: 45-65%
Protein: 10-30%
Fat: 25-35%
152
What is the AMDR range for carbohydrates?
45-65%
153
What is the AMDR range for protein?
10-30%
154
What is the AMDR range for fat?
25-35%
155
Why is fibre beneficial?
- provides fuel for beneficial bacteria within lower GI tract
- aids with waste removal from GI tract
156
How many grams of fibre are recommended per day for males aged 4-8?
25g/day
157
How many grams of fibre are recommended per day for males aged 9-13?
31 g/day
158
How many grams of fibre are recommended per day for females aged 4-8?
25g/day
159
How many grams of fibre are recommended per day for females aged 9-13?
26g/day
160
What are the nutrients of concern for school aged children?
- Fibre is low
- Calcium may be low
- Sodium is high
- Lower micronutrient intakes (less fruit and vegetables)
161
In school aged children, risks for iron deficiency include what?
- limited access to iron-rich foods
- a low-iron or other specialized diet (vegan or vegetarian)
- medical conditions that affect iron status
162
T or F: Vegetarian kids have normal growth and development from infancy through to adulthood
true
163
T or F: Vegan children and teens may be shorter and lighter, but are still within the range of normal height and weight.
True
164
In the Nova Scotia study, what percentage of children were meeting the Canada's food guide recommendations?
Milk: 42%
Fruit and veg: 49.9%
Grains: 54%
Meat and alternatives: 74%
165
What do Ontario children eat for breakfast?
- 4.9% ate no breakfast
- 27% had inadequate energy intakes
- main foods: milk, cereal, bread
- No differences in family income
166
Which demographic most commonly skips breakfast?
highschool girls
167
What do the numbers look like for children who skip breakfast in Canada?
- 1/4 of 4th grades
- 2/5 of 8th graders
= 2/3 of highschool girls
1/2 of highschool boys
168
Define: Food security
all people, at all times, have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life
169
How many children in Canada experience some level of food insecurity?
1.15 million children
| 1 in 6 children
170
Who is most at risk of being food insecure?
- families with children
- those families receiving government benefits
- single parent households
- indigenous families, especially in the north
171
How much does it cost to feed a family of 4 for one week in the Guelph region (following EWCFG)
```
$130.97 (2006)
$149.09 (2008)
$180.92 (2011)
$194.99 (2013)
$212.44 (2016)
```
172
A study of 10-14 year olds in Ontario found that ___% of girls were currently trying to lose weight and 10% engaged in disordered eating
29%
173
T or F: Parental controls and restriction of 'forbidden foods' may increase desire and intake of the foods
True
174
In what ways are weight based stigmatizations exhibited?
- biased attitudes, prejudice and behavioural intentions
- various forms of discrimination
- social marginalization, weight-related teasing
175
What are some psychosocial and behavioural consequences of weight-related teasing?
- increased frequent dieting
- increased extreme weight control behaviours
- increased binge eating
- increased depressive symptoms
- decreased self-esteem
- decreased body satisfaction
176
What are some preventative measures to take against childhood obesity and overweight? ** short answer question (3 examples)
- Limit sugar-sweetened beverages
- Limit TV
- Limit fast foods
- Limit energy dense foods
- have daily breakfasts
- encourage fruits and vegetables
- promote calcium rich diets
- promote diets high in fiber
- promote physical activity
177
What seems to work for decreasing overweight and obesity in school aged children?
- combination or clinical and school-based multicomponent programs
Componenets: physical activity, parent training/modeling, behavioural counseling, and nutrition education
178
What are the physical activity guidelines for children ages 5-17?
- 60+ minutes per day of moderate to intense exercise
- 3+ days per week, intense exercise
- 3+ days per week muscle building exercise
How are Canadian children doing --> ~8% of children active 60+ minutes 6+ days per week
179
Why are schools in a unique position to support health eating?
- Reach nearly all children
- captive audience
- venue for both nutrition and education
- role modeling and social norms: staff, peers
- May have positive influences on family
180
What are the 4 aspects of the school nutrition environment?
1. School food and beverage policy
2. Breakfast / snack programs
3. Access to off campus vendors
4. Health curriculum
181
When did the Ontario School Food and Beverage Policy come into effect?
September 2011
182
What is the Ontario School Food and Beverage Policy?
Nutrition standards for food and beverages sold in elementary and secondary schools
183
What does the Ontario School Food and Beverage Policy apply to?
All venues: cafeterias, vending machines, and tuck shops as well as events that happen on school property (bake sales and sports events)
184
What are the 3 categories of the Ontario School Food and Beverage Policy? **short answer question with examples
- Green (80%): Nutrient dense foods, low fat, sugar, and sodium. (extra-lean ground meat and whole grain bread)
- Yellow (20%): slightly higher fat, sugar, and sodium (white bagels and cheese).
- Red (0%): Low nutrients, high fat, sugar, and sodium. (candy, …)
185
How is the Ontario School Food and Beverage Policy doing?
- No monitoring strategy in place
- secondary school cafeteria sales down 25-45%
- vending machine sales up 70-80%
- Many food items are not compliant
- majority of students not receiving 20 minutes of daily physical activity
186
Does Canada have a national breakfast program?
No
187
What is an example of a local breakfast program?
Food and Friends:
Mission: Initiate, facilitate and support quality, sustainable student nutrition programs
Supports over 80 breakfast, lunch and snack programs for students in a supportive, nonjudgmental environment
Breakfast for Learning
Breakfast Clubs of Canada
Costs:
Snack program: $0.90 per child or $171 per school
Breakfast or Lunch: $1.45 per child or $418 per school
188
What the core principles of The Canadian Children's Food and Beverage Advertising Initiative?
- not advertising food or beverage products in elementary schools
(supposed to be regulating what is being sold in school settings but it is not very helpful. There is no middle ground organization that controls advertising and what is offered to students) **industry driven (conflict of interest for mcdonalds, pepsi, etc.)
189
What do children learn in each grade according to the Ontario Health Curriculum?
```
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 from food choices
Grade 8: Macro/Micronutrient functions
```
190
What age is considered early adolescence?
11 to 14 years
191
What age is considered middle adolescence?
15-17 years
192
What age is considered late adolescence?
18-21 years
193
What are the nutritional needs of adolescents?
- substantial physical, emotional and cognitive maturation
- rapid physical growth affects nutrient needs
- strong desire for independence: can influence food choices
194
Puberty begins during ______ adolescence
early
195
Biological changes of puberty include:
- Increases in height and weight
- sexual maturation
- changes in body composition
- accumulation of skeletal mass
196
Which should be used to asses nutritional needs; biological age or chronological age
Biological age/ sexual Maturation
197
What is sexual maturation rating (SMR/ tanner stages)?
scale to assess degree of sexual maturation
198
What are the stages of the sexual maturation rating?
Rated on a 5 point scale (SMR 1-5)
- SMR stage 1: pre-pubertal growth and development
- SMR stages 2-5: occurrences of puberty
- SMR stage 5: sexual maturation has concluded
199
Discuss menarche:
- Occurs 2-4 years after initial development of breasts (SMR 4)
- age of menarche ranges from 10-17 years (avg. 12.4)
- Peak velocity of linear growth occurs ~6-12 months prior to menarch
- In highly competitive athletes, severely restrictive diets may delay or slow growth
200
What are some body composition changes in adolescent females?
- Peak weight gain follows linear growth spurt by 3-6 months
- Increase in body fat
- decrease in lean body mass from 80% to 74% of body weight
201
Discuss body fat levels of female adolescents:
- Low <20% ; Moderate 28% ; High/Obese >35%
- 17% body fat is required for menarche to occur
- 25% body fat needed to maintain normal menstrual cycles (ovulation)
202
Discuss sexual maturation in adolescent males:
- Large variation in chronological age at which sexual maturation takes place
- peak velocity of linear growth occurs during SMR 4 and ends with the appearance of facial hair
- Linear growth continues throughout adolescence at a slower rate until~ 21 years
203
Body composition changes in adolescent males:
- Peak weight gain at the same time as peak linear growth
- peak weight gain ~ 20 lbs per year
- Body fat decreased to ~12%
204
Discuss skeletal mass of adolescents
~ half of bone mass is accrued in adolescence
| - by age 18: 90% of skeletal mass is formed
205
Given the growth and development during the adolescent life stage, what would be the key nutrients?
- Calcium
| - Iron
206
What are energy needs influenced by?
- activity level
- Basal metabolic rate (BMR)
- pubertal growth and development
207
What are the energy ranges for adolescent males and females?
Males: 220-3100 kcal/day
Females: 200-2400 kcal/day
208
Define: AMDR
Acceptable Macronutrient Distribution Range:
- The range of intake for a particular energy source (p, f, c), expressed as a % of total energy (kcal), that is associated with reduced risk of chronic disease while providing adequate intakes of essential nutrients
209
What are the protein requirements for adolescents?
- protein requirements influenced by amount needed to maintain existing and lean body mass and develops new muscle
- DRI: 0.85 g/kg body weight (AMDR; 10-30%)
210
What is low protein intake during adolescence linked to?
- reductions in linear growth
- Delays in sexual maturation
Reduced lean body mass
211
Carbohydrates in adolescence:
Carbohydrate: 130 g/day or 45-65% E
212
Dietary Fat in adolescence:
Required as dietary fat and essential fatty acids for growth and development
25-35% E from total fat
0.6-1.2% E from omega 3 fatty acids (LA, ALA)
< 10% E from saturated fat
213
Discuss adolescents and calcium:
AI is critical to ensure peak bone mass
Absorption highest for females around menarche, for males during early adolescence compared to adulthood
~4 times more calcium absorbed during early adolescence compared to adulthood
Adolescents who do not include dairy should consume calcium-fortified foods
Soft drink consumption displaces nutrient-dense beverages such as milk and fortified juices
RDA for ages 9-18 years is 1300 mg/d
214
Discuss adolescents and Vitamin D:
Facilitates intestinal absorption of calcium (and phosphorus)
Essential for bone formation
Synthesized by the body via skin exposure to (ultraviolet B rays of) sunlight
In northern latitudes, may require supplementation
DRI: 600 IU per day
215
Discuss adolescents and Iron:
Rapid rate of linear growth and increase in blood volume
For females, needs highest after menarche (15 mg/day), for males after growth spurt (11 mg/day)
Deficiencies in 9% of 12-15 year old females and 5% of 12-16 year old males
216
What is zinc important for in adolescence?
- Sexual maturation and growth, especially in males
217
What age is considered early adulthood and what is involved with this time?
- mid 20s- 30s
- involved in transitions to adulthood
- Planning, buying and preparing food may be newly developing skills
- may have renewed interest in nutrition 'for their kid's sake'
218
What age is considered middle adulthood and what is involved with this time?
- 40-64 years
- period of active family responsibilities
- Managing schedules and meals becomes a challenge
- Many are multigenerational caregivers
- Health concerns are frequently added (chronic disease, managing identified risk factors to prevent diseases)
219
What age is considered older age and what is involved with this time?
- 65+
- transition to retirement
- more leisure time- greater attention to physical activity and nutrition
- food choices and lifestyle factors, especially for those with chronic disease
220
What physiological changes happen in adulthood?
- growing stops by the 20s
- Bone density continues until 30 years of age
- Dexterity and flexibility decline
- Muscular strength peaks around 25 to 30 years
- Decline in size and mass of muscle and increased body fat
```
Hormonal Changes:
Women:
- decline of estrogen (menopause)
- increase in abdominal fat
- increase in risk of cardiovascular disease and accelerated loss of bone bass
```
Men: gradual decline in testosterone level and muscle mass
221
What are the body composition changes in adults?
- positive energy balance
- increase in weight and adiposity; decrease in muscle mass
- Fat redistribution- gains in the central and intra-abdominal space decrease in subcutaneous fat
Bone loss begins about age 40
222
Between the ages of 20-64, what is health and wellness greatly influenced by? **Exam Q; What are some modifiable risk factors, and what level of prevention strategies apply here
- Diet
- Body weight
- Physical activity level
- Smoking
223
What are some common health conditions for people ages 19-64?
- High blood pressure: 16.4%
- Diabetes Mellitus: 5.9%
- Heart disease: 4.8%
- Intestinal/ulcers: 2.9%
- Osteoporosis: 3.1%
224
What diseases are related to the top three health conditions of adults?
- high sodium intake
- overweight
- obesity
225
WHat age related changes occur to one's weight in adulthood?
- caloric intake declines
- Due to decreased metabolic rate and decrease in physical activity levels
- combination of nutrient dense/ lower energy food with increased physical activity recommended for long-term maintenance
226
What are the acceptable macronutrient distribution ranges for adults?
Fat 20-35% of E
Carbohydrate: 45-65% of E
Protein: 10-35% of E
227
discuss calcium and adults:
```
Needed for maintenance of body density
RDA is 1000 mg/day for 19-50 year olds
Requirement increases to 1200 mg/day for > 50
Age-related loss of calcium from bone
Inadequate dietary intake
Impaired absorption and utilization
```
228
What are three factors that put older adults at risk for vitamin D deficiency?
1. Limited exposure to sunlight
2. Institutionalization or long working hours
3. Certain medications
RDA: 51-70 is 400 IU/day, and 600 IU/day for 71+
Health Canada: all adults over age 50 should take a supplement with 400 IU of vitamin D
229
Discuss Iron in adults:
```
Needed for oxygen transport around body
Iron needs decrease after menopause
Most older adults are above adequate intake
Excess iron contributes to iron overload
Iron deficiency in some may be due to:
Iron loss from disease or medications
Poor diet ( decrease calorie intake)
Deficiency results in anemia
```
230
Supplements of multivitamins may be useful for adults who...
- Lack appetite
- Have diseases in digestive tract
- Have a poor diet
- Avoid specific food groups
- Take medications or other substances that affect absorption or metabolism
231
What are the recommendations for fluid intake for older adults
Total body water decreases with age
Smaller margin of safety for staying hydrated
6+ glasses of fluid/day will prevent dehydration in most older adults
To individualize fluid recommendations:
1mL of fluid/ 1 kcal consumed, with a minimum of 1500 mL
232
What are the four risk factors for health conditions for adults?
1. Overweight / obesity
- 61.3% of Canadian adults are overweight or obese
2. Weight Pattern
- Excessive abdominal fat associated with higher risk of:
High blood pressure
Type 2 diabetes
Heart disease
Stroke
3. Waist Circumference
- Gender specific cut-offs
Males > or equal to 102 cm
Females > or equal to 88 cm
Disease risk increases with both weight and WC
4. Physical Inactivity
- Recommendations for PA:
30-60 minutes per day, depending on type (intensity) of activity
150 minutes per week moderate to vigorous aerobic activity
Strength training twice / week
Start slowly 10 minutes at a time and build up tolerance
Short spurts of 10 minutes count toward daily goal
233
T or F: In adults and older adults, weight-bearing and resistance exercise increase lean muscle mass and bone density
true
234
What % of the population are older adults?
- 17/18% currently
| Expected to grow to about 23%
235
Which life stage is the fastest growing population in Canada?
Elderly people
| - by 2030, 1 in 5 Canadians will be 65+
236
What are the leading causes of death for older adults?
heart disease, stroke, type 2 diabetes, cancer, obesity, osteoporosis and arthritis
237
What does adequate nutrition lead to for older adults?
successful aging
238
What is Lean body mass (LBM) the sum of?
- sum of fat-free tissues, mineral as bone, and water
239
What is sarcopenia?
- term used for loss of LBM associated with aging
| - loss of muscle tissue as a natural part of the aging process
240
What are some nutritional considerations for older adults?
- Sensory changes
- Physical limitations
- Cognitive factors
241
T or f: Taste and smell senese decline with age
true
242
T or f: women retain their sense of smell better than men do
true
243
T or F: aging affects taste and smell more than diseases and medications
False; diseases and medications affect taste and smell more than aging
244
What are some examples of cognitive disorders that older adults may experience?
Alzheimer’s disease → causes dementia, physiological damages to the brain, degenerative disease
Vascular dementia
Parkinson’s disease → Degenerative disease
Alcohol-related and AIDS-related dementia
Dementia- a progressive cognitive decline, characterized by forgetfulness, memory decline, difficulty with decision-making, and mental ability (manifestation of physical changes in the brain- not directly a disease)
245
What are the effects of cognitive disorders?
```
Confusion
Anxiety
Agitation
Loss of oral muscular control
Impairment of hunger/appetite regulation
Changes in smell and taste
Dental, chewing and swallowing problems
```
246
What are some nutrition interventions for people with cognitive disorders?
- Ensure food safety
- Safe use of kitchen tools and equipment
- Dietary focus
- Nutrient-dense diet
- Maintain hydration
- Supply needed energy
247
What changes happen to the appetite of older adults?
- hunger and satiety cues weaken with age
| - Older adults may need to be more conscious of food intake levels since appetite-regulating mechanisms may be blunted
248
What changes happen to the thirst of older adults?
- Thirst-regulating mechanisms decrease with age
- studies support that dehydration occurs more quickly after fluid deprivation and rehydration is less effective in older men
249
What does meal intake impact for older adults?
- weight changes
- nutrient intake
- disease management
- Immunity
- risk of falls
- psychological health
250
What are some factors impacting nutritional intake of older adults?
- disease condition
- Inadequate Food Intake
- Poly-pharmacy → interaction of various medications can cause lack of appetite or drowsiness, or other severe side effects (3 or more prescriptions of medications can have a negative effect)
- Functional disability → activity of daily living is being impaired (not being able to cook for yourself, or feed yourself, or go grocery shopping)
- Swallowing difficulty
- Depression or anxiety → can dramatically affect one’s quality of life and ability to live on their own
251
What does oral health depend on?
Oral health depends on:
- GI secretions (saliva)
- Skeletal systems (teeth and jaw)
- Mucus membrane
- Muscles (tongue and jaw)
- Taste buds
- Olfactory nerves (taste and smell)
252
What is a disturbance that can affect oral health?
- losing teeth
| - having to get dentures
253
What are some strategies to promote intake of food for older adults?
- maintain focus on eating
- provide plenty of time to eat
- serve favourite foods
- encourage regular drinks between bites
254
What are the differences in Canada's food guide recommendations for older adults compared to adults?
```
Numbers are very similar to adults
Milk and alternatives increase
Fruits and veg decreases slightly
Meat and alternatives are similar
Grains are on the lower end, but still very similar
```
255
What are the nutrition concerns for older adults?
- poor intake of all four food groups
- A variety of nutrients consumed at low levels: Vitamin C, D, folate, B6, B12, calcium, magnesium, zinc
- protein and energy also low for certain population groups
256
What does osteoporosis result from?
Results from decreased bone mass and disruption of bone architecture ("porous bone')
257
What is the prevalence of osteoporosis?
- higher in women than in men
| - has no symptoms
258
Of older people who break a hip, _____% die within a year.
- 10-20%
- mobility is impacted, hard to recover after surgery, independence is impacted, may be unable to live on one's own
- 50% have permanent disabilities
259
~ ___% of vertebral fractures are asymptomatic
67%
| - results from compression and/or bone fracture in spine
260
What are some nutritional remedies for osteoporosis?
- Adequate calcium; increased absorption
- Calcium and vitamin D through diet or supplements
- don't take calcium with antacids
- Consume foods rich in: vitamins C, D, B6, and K, which help build bones
261
What are some determinants of eating behaviours that lead to a better diet?
- higher income
- higher education
- more social support
- better perceived health
- better vision
- adequate dentition
- belief that nutrition can affect health
262
What are some psycho-social factors in older Canadians?
- 7% of the elderly food insecure in Canada
- Many living alone
- Depend on fixed pensions or government benefits
- lack of social supports
263
What are some key issues for older adults that have low-income status?
- poorer living conditions
- restricted budget; medication costs
- Lower accessibility to assistance or care
- Isolated and/or eating alone
- More likely to suffer serious health problems related to poor nutrition
- have lower energy and overall nutrient intakes
264
Dietary management for a frail, elderly, undernourished person should consider what?
Calories → eat and exercise to build muscle mass and strength
Protein → 1 to 1.5 g/kg
Water → 1mL/kcal, rehydrate slowly
265
What are some nutritional interventions for dehydration?
- Beverages contribute nutrients and fluid
- Tea has flavonoids (antioxidants)
- Milk has calcium, protein, riboflavin, and vitamin D
- Cranberry juice may reduce chronic UTI
- Fruit and vegetable juices count toward fruit and vegetable servings (unless diabetic)
266
Discuss health promotion in older adults:
- Good nutrition habits make a greater impact when started early in life
- Many people are not motivated to make changes until later in life or when health problems occur
- The belief that a 70 year old is too old to learn and practice health promotion strategies is an outdated myth
267
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%
d. 55%
268
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
c. Exclusively or predominantly breastfed infants
269
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
c. overweight
270
T or F: Potential consequences of a weight loss program in childhood are slowed linear growth and the beginnings of an eating disorder
true
271
T or F: In older adults, BMI is an adequate indicator of excess body fat associated with morbidity and mortality.
False
272
What are the 3 categories of foods according to Ontario's food and beverage policy? Give two examples of each.
Green: nutrient dense foods, low fat, sugar and sodium (salad, whole grain bread, vegetable soup)
Yellow: slightly higher fat, sugar and sodium (white bagels and cheese, cheese pizza)
Red: Low nutrients, high fat, sugar and sodium (french fries, donuts, pop, energy drinks)
273
Give examples and briefly explain 3 of health Canada's recommendations for feeding toddlers or preschoolers: (know for other age groups as well)
- satisfy their thirst with water
- more frequent family meals, eating together
- Serving small nutritious snacks and meals throughout the day
- Offer a variety of foods from the 4 food groups
- encourage young children to drink water
- be patient when introducing new foods
- be a good role model
- don't be distracted by television or phone when eating
274
Give examples of how the socioeconomic model fits in each life stage.
??
275
Socio-ecological model: Society, Community, Organizational, Interpersonal, and
Individual
• Describe one factor from each level that would influence development of
eating disorders
Individual/intrapersonal – low self esteem, body dissatisfaction
o Interpersonal – bullying at school
o Organizational – time constraints, involved in competitive sport or
organization, food related policies at school level
o Community – weight norms in environment you live (beach
community?)
o Society – social media messages, advertisements
276
Infant mortality includes
a. Deaths that occur within first year of life
b. Deaths that occur from day of birth through the first 28 days of life
c. Deaths that occur at or after 20 weeks of gestation and through the
first 28 days of life
d. Deaths that occur in pre term babies
a. deaths that occur within the first year of life
277
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
e. a and c
278
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
e. all of the above
279
```
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%
```
d. 55%
280
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
c. overweight
281
. 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
282
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
c. inappropriately used coercion to control food intake
283
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
c. 9 to 11 for girls / 10-12 for boys
284
. 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
e. a and c only
285
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
c. parental obesity
286
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
e. all of the above
287
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
e. a and c only
288
During peak weight gain, adolescent males gain an average of ___ lb./year.
a. 10
b. 20
c. 30
d. 40
b. 20
289
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
b. a vitamin D supplement (400 IU/day)
290
Men and women continue to develop bone density until 40 years of age
a. True
b. False
False; only until age of 30; peak bone mass tends to occur during early 20s
291
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%
c. 20-35%
292
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
e. a and b
293
The two leading causes of death among elderly are heart disease and _______.
Cancer
294
In older adults, BMI is an adequate indicator of excess body fat associated
with morbidity and mortality.
a. True
b. False
b. False
295
Approximately ___ times more calcium is absorbed during early adolescence compared to adulthood
4
296
T or F: Adolescents who do not consume dairy should consume calcium-fortified foods
True
297
The RDA for calcium for people ages 9-18 years is ______ mg/d
1300
298
Vitamin D facilitates the intestinal absorption of ______
calcium (and phosphorus)
299
What is the adolescent DRI for Vitamin D?
600 IU per day
300
True or false: teens tend to live in the momen and have limited consideration of long-term consequences
true
301
What happens during early adolescence?
- 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
302
What happens during middle and late adolescence?
- Increased opportunities for employment and outside activities
- greater autonomy from parents
- continues need for social acceptance from peers
- Increased awareness of social and moral issues
303
About ___% of adolescents report following a vegetarian diet
4%
304
What are some reasons that adolescents adopt a vegetarian diet?
- Cultural or religious beliefs
- Moral of ethical concerns
- Health beliefs
- To restrict fat/calories
- A means of independence from family
305
Compared to non-vegetarians, vegetarians had:
- higher intake of fruits and vegetables
- less overweight / obesity
- more eating disorders
- more weight controlling behaviour
306
T or F: Lacto-ovo vegetarians can meet needs following EWCFG
True
307
What must vegans take as supplements?
- Calcium, zinc, Iron
| - Vitamins D, B6, and B12
308
What are the physical activity guidelines for children aged 5-17?
- 60+ minutes per day of moderate to intense exercise
- 3+ days per week of intense exercise
- 3+ days per week of muscle building exercise
309
T or F: 80% of adolescents not doing ANY daily physical activity
True
310
In adolescent females, what is lower body satisfaction associated with?
- Increased extreme weight control behaviours
- increased binge eating
- decreased physical activity
- decreased fruit and vegetable intake
311
In adolescent males, what is lower body satisfaction associated with?
- Increased extreme weight control behaviours
- increase binge eating
- decreased physical activity
312
List the four sections on the continuum of eating concerns and disorders:
1. Body dissatisfaction
2. dieting behaviours
3. disordered eating
4. clinically significant eating disorders
313
___ % of 15 year old girls dieting to lose weight
48%
314
___% of Ontario girls 12-18 years report disordered eating behaviours (vomiting, fasting, laxative use)
27%
315
Key features of Anorexia Nervosa include all of the following except:
a. Intense fear of gaining weight
b. Refusal to maintain body weight at normal weight for age
c. Amenorrhea
d. Distorted body image
e. All of the above are key features of AN
e. All of the above are key features of AN
316
Key features of Bulimia Nervosa include:
a. Recurrent episodes of rapid consumption of a large amount of food in a discrete period of time
b. Use of laxatives or diuetics
c. Feeling of control over eating
d. all of the above
e. a and b only
e. a and b only
317
For people with Binge Eating Disorder (BED), what is the role of food in their life?
- Comfort
- support
- deal with stress
- to feel numb
318
Define: Binge Eating Disorder
Binge eating, not followed by compensatory behaviours
319
Why do many eating disorders occur in adolescence?
- Life is overwhelming
- many changes (including physical)
- struggling for own identity and independence
- Increased pressure: socially, academically, emotionally
- Searching for control over stress
- food consumption and body weight can be controlled even when other things cannot
320
What are some factors associated with the development of eating disorders? (Socio-ecological model)
- Public Policy: National, provincial/territorial local laws and policy
- Community: design, access, connectedness, spaces
- Organizational: Organizations, schools, workplaces
- Interpersonal: family, friends, social networks
- Individual: Knowledge, attitudes, skills
