Lecture 16-Child nutrition Part 1 Flashcards
Child nutrition part 1
what is the age of middle childhood
5-10 years
what is the age of pre-adolescence
girls = 9-11 years
boys = 10-12 years
what % of the total NZ population is 0-14 years
19.3%
what % of the NZ population is 0-4 years
6.2%
what % of the NZ is 5-9 years
6.7%
what % of the NZ population is 10-14 years
6.4%
how many children are aged :
0-14 =
0-4 =
5-9 =
10-14 =
0-14 = 946,400
0-4 = 305,030
5-9 = 327,910
10-14 = 313,510
how many days does it take for a child to develop into an adult
8,000 days
what are the three phases crucial to health during school age
middle childhood growth (5-9 years)
adolescent growth spurt (10-14 years)
adolescent growth phase (15-19 years)
what are a constraint on development (particularly in developing countries) in middle childhood growth
- infection and malnutrition constraint on development
- Mortality higher than previously thought
what happens at adolescent growth spurt (10-14 years)
BMI increases rapidly
substantial physiological and behavioural changes
what happens at adolescent growth phase (15-19 years)
- further brain reconstructing (particularly the prefrontal cortex)
- increase exploration, experimentation
- increased behaviours that are lifelong determinants of health
a healthy diet facilitates
- physical social / emotional and cognitive development
- nutrients and health
- steady growth
what is the physiological development in childhood
- 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
changes in cognitive development in childhood
- 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
growth for both boys and girls is pretty linear until what age
until the age of 8 or 9
by age 8 what happens to growth in boys and girls
the rate of growth for boys begin to slow, but for girls it stays high
at age 11 girls are usually (height)
2cm taller than boys
from age 11 what happens to growth in boys and girls
girls growth slows and boys increases
by age 13 boys are (height)
taller than girls
girls reach their finial adult height at around
16 years
boys reach their peak height at around
18, and are on average 13cm taller
why is periodic monitoring of growth important
early prevention / intervention of conditions that impact growth
is there standard population monitoring of growth in childhood
no
what are the WHO growth references for children aged 5-19
weight for age (5-10)
height for age (5-19)
BMI for age (5-19)
what are the CDC growth reference data for 2-20 years
stature for age (2-20years)
weight for age (2-20 years)
BMI for age (2-20 years)
WHO BMI for age growth charts are constructed using
historical data
what is the most commonly used growth chart in NZ
WHO BMI for age growth chart
WHO BMI for age growth charts are not
not a diagnostic tool, never use in isolation
BMI is not a direct measure of …… but ..
not a direct measure of fatness but can be considered a proxy - good at identifying heavier kids
BMI for age correlates with clinical risk factors for
CVD
BMI differs by
age and gender
can the same BMI cut offs be used for children and adults, why ?
no, because children are still growing so can not use the same cutoffs throughout every period of childhood
what are the pros of BMI assessment in childhood
- 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
what are the cons of BMI assessment in childhood
- 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
percentile indicates
the percentages of observations that fall below a certain value
z score is the
distance and direction of an observation away from the population mean
higher BMI trajectories in early childhood lead to
higher BMI in later childhood
higher BMI trajectories lead to
higher BMI in adulthood
what is the prevalence of obesity in New Zealand children
13.5%
which subgroup have the highest prevalence of obesity
10-14 years (15.2%)
This would be higher if we add the overweight category into this
main complications of obesity in childhood
- type 2 diabetes
- cardiovascular disease
- increased risk of some types of cancers
- physical disability
- sleep apnoea orthopaedic pain
- psychosocial problems
- adult obesity
- impaired fertility
contributing factors to childhood obesity
- genes
- parental overweight / obesity
- demographics
- birth weight
- infancy weight gain
- nutrition
- sleep
- environmental
- behavioural
New Zealand data suggests what are the strongest predictors of childhood obesity
- maternal pre-pregnancy BMI
- paternal BMI
- maternal smoking during pregnancy
- infancy weight gain (high birth weight, rapid weight gain)
there is a strong correlation between screen time and
obesity in children and adolescents
what are the main mechanisms of the relationship between screentime and childhood obesity
- increased eating while using screens
- reduced energy expenditure
- food advertising on screens
- change to sleep routines
satiety responsiveness / slowness in eating and food fussiness in children were
negatively associated with body weight
food responsiveness, enjoyment of food, emotional overeating and desire to drink were
positively associated with weight
children who are obese tend to eat
faster than their non obese counterparts
what are the 4 steps of clinical guidelines for weight management in NZ children and young people
- monitor
- assess
- manage
- maintain
what is the monitor step in clinical guidelines for weight management in NZ children and young people
measure and monitor height and weight and determine BMI. Brief intervention if over 91st centile, aim to act before it reaches 98th centile
what is the assess step in clinical guidelines for weight management in NZ children and young people
collect full history and clinical exam and try to identify contributing factors so an appropriate intervention can be implemented
what is the manage step in clinical guidelines for weight management in NZ children and young people
aim to slow weight gain so that children ‘grow into their weight’. involvement of whanau is key and focus on FAB
what is the maintain step in clinical guidelines for weight management in NZ children and young people
long term follow up and monitoring of growth - contact and support
a healthy weight for one child might
be quite different for another
It is common to think that dieting and loosing weight will
Help a person to be healthy, but dieting is never healthy for children
