Lecture 24

Question 1

What occurs during the first year of life?

Answer 1

Infants grow really fast. Their growth directly reflects nutrient intake and is an important parameter in assessing neutron status of infants and children.

Question 2

What are the nutritional requirements of children?

Answer 2

1) Increased to meet the demands of Growth and Development.
2) Require more nutrients per kg of body weight than that of an adult.
3) Chronic malnutrition in childhood causes irreversible damage.
4) Organs have a functional capacity which differs from adults.
5) Metabolic activities are more closely related to the surface area.

Question 3

What are the measurement changes in the first year of babies growth?

Answer 3

1) Weight increases 300%
2) Length increases 55%
3) Head circumference increases 40%
4) Brain weight doubles.

Question 4

What are the diets for children?

Answer 4

1) Need to adapt to the physiological changes with age.
2) Need to meet the demands of Growth and Development.
3) Are provided by caregivers.
4) Set dietary patterns and behaviours’ that last for life.
5) Can impact on health and disease in adulthood.

Question 5

What are the options to feed a newborn?

Answer 5

• Breastfeeding: The MoH NZ, WHO exclusive breast feeding for 6 months.
• Formula feeding.

Question 6

What is the composition of breast milk?

Answer 6

Protein = 6%
Fat = 55%
Carbohydrate = 39%.

Question 7

What is the composition of recommended adult diets?

Answer 7

Protein = 15-25%
Fat = 20-35%
Carbohydrate = 45-65%

Question 8

What is the composition of breast milk?

Answer 8

Variable throughout lactation and during a single feed.

Question 9

What is the protein component of breast milk?

Answer 9

Whey : casein ratio
Early 20:80
Mature 50:50
alpha-lactoalbumin

Question 10

What is the fat content of breast milk?

Answer 10

Provides 50% of energy.
LCPUFA.
arachidonic acid and docosohexaenoic acid.

Question 11

What is the bioavailability of breast milk (e.g. iron, calcium and protein).

Answer 11

Higher.

Question 12

What is the biologically active components of breast milk?

Answer 12

Immunoglobulins, enzymes, cytokines and growth factors.

Question 13

What is the infection rate of breast milk?

Answer 13

Low risk.

Question 14

What is the composition of infant formula?

Answer 14

Constant.

Question 15

What is the protein component of infant formula?

Answer 15

Whey : casein ratio
18:82 - 60:40
alpha-lactoglobulin
50% more protein.

Question 16

What is the fat content of infant formula?

Answer 16

Mixture of fatty acids different.

Question 17

What is the bioavailability of infant formula?

Answer 17

Lower.

Question 18

What is the biologically active components of infant formula?

Answer 18

Cannot be reproduced.

Question 19

What is the infection rate of infant formula?

Answer 19

Increased risk of contamination.

Question 20

What are the fluid requirements of infants?

Answer 20

1 week = 80-100ml/kg/day of water.
2 week = 125-150ml/kg/day of water.
3 months = 140-160ml/kg/day of water.
6 months = 130-155ml/kg/day of water.
9 months = 125-145ml/kg/day of water.
1 year = 120-135ml/kg/day of water.

Question 21

What is the renal solute load for feeding?

Answer 21

Human milk = 93mOsm/L
Milk based formula = 135mOsm/L
isolates Soy protein based formula = 165mOsm/L
Evaporated milk formula = 260mOsm/L
Whole cow milk = 308mOsm/L.

Question 22

What is the level of gastric acid secretion in early infancy?

Answer 22

Low production. Rapid fall in pH after a meal. And low level of pancreatic enzyme secretion.

Question 23

What is the level of chymotrypsin, intestinal mucosal peptidases and pancreatic proteases in early infancy?

Answer 23

Low levels.

Question 24

What is the level of pancreatic lipase and bile acids in early infancy?

Answer 24

Low levels. The compensating mechanism is lingual, gastric and breast milk - BSSL (bile salt stimulated lipase - allows for lipase in the breast milk to be activated and allow to digest fat in breast milk).

Question 25

What is the salivary amylase, pancreatic amylase and disaccharidases in early infancy?

Answer 25

Low levels. The compensating mechanism is that salivary amylase stays active in the stomach. Breast milk amylase. And there is fermentation and absorption of disaccharides in the ht large intestine.

Question 26

Why do humans need to eat solid foods?

Answer 26

1) Nutrient requirements.
2) Physical development: oral motor development and gastrointestinal maturation.
3) Social development.
4) Antigen exposure.

Question 27

When do you introduce solids and how/why?

Answer 27

You introduce after 6 months, and try and introduce all types of foods, but mainly soft palate foods. It is dependent on the physical and physiological development of the baby. The choice of infant foods - texture, nutrient density, fat content, salt content and sugar content. You need to be consideration of food allergies.

Question 28

How do you monitor growth and development?

Answer 28

Growth charts. A number of different are available. NCHS charts most used and WHO growth charts.

Question 29

How does body shape change from infancy?

Answer 29

By the age of two years old, the child has lost much of its baby fat; the muscles (especially in the back, buttocks and legs) have firmed and strengthened; and the leg bones have lengthened.

Question 30

What happens after infancy and early childhood?

Answer 30

We are gaining weight and height but not as rapidly during infancy. During preschool years nutrition is still important. The next time our growth rate increases is during our pre-pubertal growth spurt. It starts at different ages depending on sex.

Question 31

What do we advise children to eat to stay healthy?

Answer 31

Use four core food groups. But serving sizes are slightly different. For pre-schoolers 2-5 serves, as they get older it increases.

Question 32

Describe childhood obesity?

Answer 32

Children are being born into a food environment where there is excess of food/energy. The concerning thing is that if you are overweight as a child and both parents are overweight, 90% likely to be obese as and adult.

Question 33

What are the stats for obesity in children (2-14) in NZ from 2014/2015?

Answer 33

1) 1 in 9 children were obese (11%).
2) A further 22% were children that were overweight but not obese.
3) 15% of Maori children were obese.
4) 30% of Pacific children were obese.
5) Children living in the most deprived areas were fine times as likely to be obese children living in the least deprived areas.
6) The child obesity rate increased from 8% in 2006/2007 to 11% in 2014/2015.

Question 34

What are the contributing factors to childhood obesity?

Answer 34

1) Genetic and environmental factors.
2) Growth.
3) Physical health - sedentary behaviour, so less physical activity.
4) Psychological developments.

Question 35

What can obesity lead to?

Answer 35

1) Early development of type 2 diabetes.
2) Early development of heart disease.
3) Atherosclerosis: plaque and fatty streaks.

Question 36

What is the nutritional requirement during adolescent growth spurt?

Answer 36

The requirements are significantly increased to meet the physiological demands of rapid growth and development.
Attain 15% of final adult height and 45% of maximal skeletal mass. Boys have higher peak velocity in height growth. Girls growth stature ceases 4.8years after onset menarche.

Question 37

Describe bone gain and bone loss in adolescents?

Answer 37

Peak bone mass attained at 16-18 years.
Maximal bone mass formation: 12 years for girls and 13 years of boys.
Attainment of PBM influenced by dietary calcium intake and weight bearing exercise.

Question 38

What is the dietary requirement and intake of calcium during adolescents?

Answer 38

Calcium requirements increase by 50% during adolescence. The current RDI:

1200-1000mg/d for 12-18yr Males.
1000-800mg/d for 12-18yr Females.

Teenagers need to consume 4-5 servings of calcium-rich foods daily to meet RDI.