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HUNT243 Exam > Lecture 15: Child Nutrition Part 1 > Flashcards

Lecture 15: Child Nutrition Part 1 Flashcards

1
Q

What age are middle-aged children?

A

5-10 years

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2
Q

What age is pre-adolescence?

A

Girls = 9-11 years
Boys = 10-12 years

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3
Q

How many NZ’ers are 0-14 years?

A

19.3% (946,400)

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4
Q

How many NZ children are aged 0-4 years?

A

6.2% (305,030)

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5
Q

How many NZ children are aged 5-9 years?

A

6.7% (327,910)

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6
Q

How many NZ children are aged 10-14 years?

A

6.4% (315,510)

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7
Q

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

A

8,000

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8
Q

What are the three phases crucial to health during school age?

A
  • Middle Childhood Growth (5-9)
  • Adolescent Growth Spurt (10-14)
  • Adolescent Growth Phase (15-19)
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9
Q

What is happening during middle childhood growth (5-9 years)?

A
  • Infection and malnutrition constraint on development
  • Mortality higher than previously thought
  • Commonly micronutrient deficiencies
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10
Q

What is happening during the adolescent growth spurt (10-14 years)?

A
  • BMI increases rapidly
  • Substantial physiological and behavioural changes
  • Adequate energy intake is crucial for growth
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11
Q

What is happening during the adolescent growth phase (15-19 years)?

A
  • Further brain restructuring
  • Increase exploration, experimentation
  • Increased behaviours that are lifelong determinants of health
  • More focused on brain growth
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12
Q

What does a healthy diet facilitate?

A
  • Physical social/emotional and cognitive development
  • Nutrients and health
  • Steady growth
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13
Q

Physiological development is a time of…

A

Continued growth and development

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14
Q

What 3 things increase during physiological development?

A
  • Muscular strength
  • Motor co-ordination (more complex pattern movements)
  • Stamina
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15
Q

Nutrient needs: Middle childhood vs. Early childhood

A

Lower nutrient needs in relation to body size than during early childhood

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16
Q

Boys vs. Girls: Body composition during middle childhood

A

Boys have more lean body mass and height than girls

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17
Q

What happens to body fat in preparation for adolescent growth spurt?

A

Increases! Changes in body fat are normal

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18
Q

What is self-efficacy?

A

Knowledge of what to do and ability to do it

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19
Q

When does self-efficacy development occur?

A

In the middle childhood period

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20
Q

Self-efficacy is changes from magical thinking to…

A

Concrete operations

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21
Q

What does concrete operations compared to magical thinking refer to?

A
  • Focusing on multiple things at once
  • More rational reasoning
  • Able to clarify, generalise
  • Decrease in egocentrism
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22
Q

What are key aspects of cognitive development that we see?

A
  • Develop a sense of self
  • More independent and learning family roles
  • Peer relationships become important
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23
Q

What does linear growth look like for boys and girls at age 8?

A

The rate of growth for boys begins to slow, but for girls it stays high

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24
Q

Girls vs. Boys Height at Age 11

A

Girls are typically 2cm taller than boys

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25
Q

From age 11…

A

Growth rate for girls slows and for boys increases

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26
Q

Girls vs. Boys Height at Age 13

A

Boys are taller

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27
Q

When do girls reach their final adult height? (Plateau)

A

Around 16 years

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28
Q

When do boys reach their final adult height? (Plateau)

A

Around 18 years

29
Q

How much taller on average are boys compared to girls?

A

13cm taller

30
Q

Why is periodic monitoring of growth important during school age?

A

For early prevention/intervention of conditions that impact growth

31
Q

What is the standard population monitoring of growth in childhood?

A

There is none
- Just assessed when attending health checks (e.g. GP)

32
Q

How is weight, height and BMI assessed during school age?

A

By using WHO growth reference curves

33
Q

For what ages does WHO have reference data for weight-for-age?

A

5-10 years

34
Q

For what ages does WHO have reference data for height-for-age?

A

5-19 years

35
Q

For what ages does WHO have reference data for BMI-for-age?

A

5-19 years

36
Q

Overall, what growth reference data does WHO have for children aged 5-19 years?

A
  • Weight for age (5-10y)
  • Height for age (5-19y)
  • BMI for age (5-19y)
37
Q

What are WHO BMI-for-age growth charts constructed using?

A

Historical data

38
Q

What is the most commonly used growth chart in NZ?

A

BMI-for-age

39
Q

Growth charts are not a…

A

Diagnostic tool

40
Q

BMI differs by…

A

Age and gender

41
Q

BMI is not direct measure of fatness but can be considered a….

A

Proxy
- a good way to identify whether a child is heavier

42
Q

What does BMI-for-age correlate with?

A

Clinical risk factors for CVD

43
Q

Why can we not use the same cut-offs for children as adults?

A

Because adults do not grow and children do

44
Q

What are the PROs of BMI assessment in childhood?

A
  • Simple screening tool
  • Indirect measure of adiposity
  • Appropriate age- and sex-specific reference data
  • Tool for predicting later obesity
45
Q

What are the CONSs of BMI assessment in childhood?

A
  • Not a good measure of body fat for all individuals
  • Single BMI measure foes not show change in adiposity
  • Data does not include Maori or Pacifica children
46
Q

What does percentile indicate?

A

The percentage of observations that fall below a certain value

47
Q

What is z-score?

A

The distance and direction of an observation away from the population mean

48
Q

Higher BMI trajectories in early childhood lead to…

A

Higher BMI in later childhood

49
Q

When is the largest BMI increase?

A

2-4 years

50
Q

Higher BMI trajectories lead to….

A

Higher BMI in adulthood

51
Q

During adulthood, higher BMI is more concerning because?

A

You are at risk of more health problems

52
Q

What is the prevalence of obesity in NZ children?

A

13.5%

53
Q

Which subgroup of children (0-14 years) have the highest prevalence of obesity?

A

10-14 (15.2%)

54
Q

What are complications of obesity in childhood?

A
  • TD2
  • CVD
  • Physical Disability
  • Influence on puberty (fertility)
  • Sleep apnoea
  • Orthopaedic pain
55
Q

What are contributing factors for childhood obesity?

A
  • Genes
  • Parental weight (particularly maternal BMI)
  • Birth Weight
  • Infancy weight gain
  • Environment (SES, physical etc.)
56
Q

What are the 4 strongest risk factors for childhood obesity?

A
  • Maternal pre-pregnancy BMI
  • Paternal BMI
  • Maternal smoking during pregnancy
  • Infancy weight gain (high BW, rapid weight gain)
57
Q

There is a strong correlation between screen time and…

A

Obesity in children and adolescents
- High screen use compared to less screen use = greater body fatness

58
Q

What are the main mechanisms of screen time increasing weight?

A
  • Increased eating while using screens
  • Reduced energy expenditure
  • Food advertising
  • Changed sleep routines
59
Q

What is the association between satiety responsiveness/slowness in eating and food fussiness with body weight?

A

Negatively associated with body weight
- Body weight is lower

60
Q

What is the association between food responsiveness, enjoyment of food, emotional overeating and desire to drink with weight?

A

Positively associated with weight
- Body weight is higher

61
Q

Children who are obese tend to eat…

A

Faster than their non-obese counterparts

62
Q

In a study of 5-17 year old children who are obese what were the 3 most prominent behaviours?

A
  • Hyperphagia (increased appeitite)
  • Not satiated after food
  • Comfort eater
63
Q

What are the 4 steps of clinical guidelines to manage weight in NZ children and young people?

A
  1. Monitor
  2. Assess
  3. Manage
  4. Maintain
64
Q

How do you monitor weight?

A

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

65
Q

How do we assess weight?

A

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

66
Q

How do we manage weight?

A

Aim to slow weight gain so that children can ‘grow into their height’. Involvement of whanau is key and focus on Food activity and Behaviour (FAB)

67
Q

How do we maintain weight?

A

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

68
Q

Health cannot be judged solely on…

A

Body shape or size

69
Q

What is a healthy body?

A

One that is, whatever shape, size or weight, is in a state of wellbeing and has enough energy and strength to do the things that the person loves

HUNT243 Exam (18 decks)

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