Lecture 24 Flashcards
What are the nutritional requirements in infancy influenced by?
- Demands of growth and development
- Organs have a funcitonal capacity which differs from adults
- Metabolic activities are more closly related to surface area
What happens to the ratio of surface area to weight or height as we age?
Decreases
What does high surface area put infants at risk of?
Dehydration
How much does a baby’s weight increase in the first year?
300%
How much does a baby’s length increase in the first year?
55%
How much does a baby’s head circumference increase in the first year?
40%
What happens to the brain weight of a baby within the first year?
Doubles
What can nutritional status in early life determine?
Dietary patterns and behaviours that last for life.
Growth trajectory and health later in life
What can SGA and LGA lead to?
Increased risk of cardiovascular disease
What does the MoH NZ and WHO recommended for infant nutrition?
Exclusively breast fed for 6 months (or formula)
What is the energy nutrient composition of breast milk?
Protein 6%
Fat 55%
Carbs 39%
Describe the foremilk of breastmilk and compare it to the hindmilk
Foremilk is very watery to quench thirst and the hindmilk is very high in fat to satisfy hunger.
Compare the protein content of breast and formula milk
Breast milk: - Whey:casein ratio low for early and 1 for mature - alpha-lactoalbumin Formula: - Variable whey:casein ratio - alpha-lactoglobulin - 50% more protein
When a baby is first born, what is the milk called?
Colostrum: sticky yellow substance high in immunoglobulins
Compare the fat content of breast and formula milk
Breast milk:
- Provides 50% energy
- High in long chain polyunsaturated fatty acids
- Arachiodonic acid and docosohexaenoic acid
Formula:
- Mixture of fatty acids different
Is the bioavailability for breast milk?
YES
What are the biologically active components in breast milk?
Immunoglobulins, enzymes, cytokines, growth factors
When is the risk of infection higher for feeding babies?
Infant formula as increased risk of contamination
Describe the ability of kidneys in newborns
Immature kidneys are inefficient at concentrating urine. High requirement of fluid and easily dehydrated.
Compare the renal solute load of human milk and other options
Human milk has lower renal solute load to prevent dehydration
What are the levels of digestive factors in infants compared to those of the adult?
Low levels of gastric acid and enzymes for breakdown of protein, fat, carbs.
What causes loose stools for breastfed babies?
Fermentation of undigested carbohydrates
Why do we need to eat solid foods?
- Nutrient requirements
- Physical development: oral motor development, gastrointestinal maturation
- Social development
- Antigen exposure
How can development of allergies be reduced?
If a baby is continued to be breastfed when antigens from solid foods are introduced
What methods are used to monitor growth and development?
Growth charts: WHO growth charts
What do centiles on growth charts indicate?
Normal growth. Swapping of centiles for weight is an issue. can be acute. Concerning if height also decreases.
What are the body shape changes that occur between the ages of 1 and 2?
- Loss of baby fat
- Muscles (especially, back, buttocks, and legs) become firmer and strengthen
- Leg bones lengthen
What are the recommended servings of fruit and vegetable for preschoolers (2-5) vs school children (5-12)?
Preschool: 2 servings of fruit and 2 servings of vegetables
School: 2 servings of fruit and 3 servings of vegetables
What percentage of children from 2-14 were obese in the NZ health survey of 2014/15
11%
What percentage of children 2-14 were overweight in 2014/15?
22%
What percentage of Maori and Pacific children were obese?
M: 15%
P: 30%
What is used to monitor weight in children?
BMI centile charts
What are the contributing factors to childhood obesity?
Increased energy due to bigger portion size
More fast food, junk food, sweetened drinks
Sedentary behaviour
Less physical activity
Genetic factors
What are the risks of childhood obesity?
- Early development of type 2 diabetes
- Early development of heart disease
- Atherosclerosis: plaque, fatty streaks
What are the differences in nutritional requirements for adolescents?
Increase protein, calcium, folate, iron requirements
When does maximal bone mass formation occur?
When is peak bone mass attained?
12 girls 13 boys
16-18
What is attainment of peak bone mass influenced by?
Dietary calcium intake and weight bearing exercise
When are nutrient requirements are their greatest?
Early childhood and adolescence
