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HUNT 243 > Lecture 15 - Child Nutrition > Flashcards

Lecture 15 - Child Nutrition Flashcards

1
Q

what is the age of middle childhood

A

5-10 years

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2
Q

what is the age of pre-adolescence

A

girls = 9-11 years
boys = 10-12 years

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3
Q

what % of the total NZ population is 0-14 years

A

19.3%

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4
Q

what % of the NZ population is 0-4 years

A

6.2%

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5
Q

what % of the NZ is 5-9 years

A

6.7%

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6
Q

what % of the NZ population is 10-14 years

A

6.4%

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7
Q

how many children are aged :
0-14 =
0-4 =
5-9 =
10-14 =

A

0-14 = 946,400
0-4 = 305,030
5-9 = 327,910
10-14 = 313,510

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8
Q

how many days does it take for a child to develop into an adult

A

8,000 days

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9
Q

what are the three phases crucial to health during school age

A

middle childhood growth (5-9 years)

adolescent growth spurt (10-14 years)

adolescent growth phase (15-19 years)

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10
Q

what are a constraint on development (particularly in developing countries) in middle childhood growth

A

infection and malnutrition constraint on development

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11
Q

what happens at adolescent growth spurt (10-14 years)

A

BMI increases rapidly

substantial physiological and behavioural changes

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12
Q

what happens at adolescent growth phase (15-19 years)

A
  • further brain reconstructing (particularly the prefrontal cortex)
  • increase exploration, experimentation
  • increased behaviours that are lifelong determinants of health
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13
Q

a healthy diet facilitates

A
  • physical social / emotional and cognitive development
  • nutrients and health
  • steady growth
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14
Q

what is the physiological development in childhood

A
  • time of continued growth and development
  • muscular strength, motor coordination and stamina increase
  • lower nutrient needs in relation to body size than during early childhood
  • during middle childhood, boys have more lean body mass and height than girls
  • body fat reaches a minimum then increases in preparation for adolescent growth spurt
  • changes in body fat are normal
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15
Q

changes in cognitive development in childhood

A
  • self efficacy : knowledge of what to do and how to do
  • changes from magical thinking to concrete operations
  • develops a sense of self
  • more independent and learning family roles
  • peer relationships become more important
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16
Q

growth for both boys and girls is pretty linear until what age

A

until the age of 8 or 9

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17
Q

by age 8 what happens to growth in boys and girls

A

the rate of growth for boys begin to slow, but for girls it stays high

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18
Q

at age 11 girls are usually (height)

A

2cm taller than boys

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19
Q

from age 11 what happens to growth in boys and girls

A

girls growth slows and boys increases

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20
Q

bye age 13 boys are (height)

A

taller than girls

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21
Q

girls reach their finial adult height at around

A

16 years

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22
Q

boys reach their peak height at around

A

18, and are on average 13cm taller

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23
Q

why is periodic monitoring of growth important

A

early prevention / intervention of conditions that impact growth

24
Q

is there standard population monitoring of growth in childhood

A

no

25
Q

what are the WHO growth references for children aged 5-19

A
  • weight for age (5-10)
  • height for age (5-19)
  • BMI for age (5-19)
26
Q

what are the CDC growth reference data for 2-20 years

A
  • stature for age (2-20years)
  • weight for age (2-20 years)
  • BMI for age (2-20 years)
27
Q

WHO BMI for age growth charts are constructed using

A

historical data

28
Q

what is the most commonly used growth chart in NZ

A

WHO BMI for age growth chart

29
Q

WHO BMI for age growth charts are not

A

not a diagnostic tool, never use in isolation

30
Q

BMI is not a direct measure of …… but ..

A

not a direct measure of fatness but can be considered a proxy - good at identifying heavier kids

31
Q

BMI for age correlates with clinical risk factors for

A

CVD

32
Q

BMI differs by

A

age and gender

33
Q

can the same BMI cut offs be used for children and adults, why ?

A

no, because children are still growing so can not use the same cutoffs throughout every period of childhood

34
Q

what are the pros of BMI assessment in childhood

A
  • simple and appropriate field tool for screening for unhealthy weight
  • indirect measure of adiposity
  • appropriate age and sex specific reference data for children
  • WHO recommends use in all ethnic groups
  • a good tool for predicting later obesity
35
Q

what are the cons of BMI assessment in childhood

A
  • not a good measure of body fat in all individuals
  • single BMI measure does not show change in adiposity
  • reference data does not include Maori or Pacifika children - as used worlds reference data
36
Q

percentile indicates

A

the percentages of observations that fall below a certain value

37
Q

z score is the

A

distance and direction of an observation away from the population mean

38
Q

higher BMI trajectories in early childhood lead to

A

higher BMI in later childhood

39
Q

higher BMI trajectories lead to

A

higher BMI in adulthood

40
Q

what is the prevalence of obesity in New Zealand children

A

13.5%

41
Q

which subgroup have the highest prevalence of obesity

A

10-14 years (15.2%)

42
Q

main complications of obesity in childhood

A
  • type 2 diabetes
  • cardiovascular disease
  • increased risk of some types of cancers
  • physical disability
  • sleep apnoea orthopaedic pain
  • psychosocial problems
  • adult obesity
  • impaired fertility
43
Q

contributing factors to childhood obesity

A
  • genes
  • parental overweight / obesity
  • demographics
  • birth weight
  • infancy weight gain
  • nutrition
  • sleep
  • environmental
  • behavioural
44
Q

New Zealand data suggests what are the strongest predictors of childhood obesity

A
  • maternal pre-pregnancy BMI
  • paternal BMI
  • maternal smoking during pregnancy
  • infancy weight gain (high birth weight, rapid weight gain)
45
Q

there is a strong correlation between screen time and

A

obesity in children and adolescents

46
Q

what are the main mechanisms of the relationship between screentime and childhood obesity

A
  • increased eating while using screens
  • reduced energy expenditure
  • food advertising on screens
  • change to sleep routines
47
Q

satiety responsiveness / slowness in eating and food fussiness in children were

A

negatively associated with body weight

48
Q

food responsiveness, enjoyment of food, emotional overeating and desire to drink were

A

positively associated with weight

49
Q

children who are obese tend to eat

A

faster than their non obese counterparts

50
Q

what are the 4 steps of clinical guidelines for weight management in NZ children and young people

A
  1. monitor
  2. assess
  3. manage
  4. maintain
51
Q

what is the monitor step in clinical guidelines for weight management in NZ children and young people

A

measure and monitor height and weight and determine BMI. Brief intervention if over 91st centile, aim to act before it reaches 98th centile

52
Q

what is the assess step in clinical guidelines for weight management in NZ children and young people

A

collect full history and clinical exam and try to identify contributing factors so an appropriate intervention can be implemented

53
Q

what is the manage step in clinical guidelines for weight management in NZ children and young people

A

aim to slow weight gain so that children ‘grow into their weight’. involvement of whanau is key and focus on FAB

54
Q

what is the maintain step in clinical guidelines for weight management in NZ children and young people

A

long term follow up and monitoring of growth - contact and support

55
Q

a healthy weight for one child might

A

be quite different for another

HUNT 243 (17 decks)

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