notes: Flashcards
Puberty in females
ages
10.5 - 14
puberty in males
ages
12 - 16.5
cognitive maturation
ages
12 - 16
early psychosocial maturation
ages
12 - 14
middle psychosocial matration
ages
14 - 17
late psychosocial maturation
17 - 21
what changes affect nutritional status?
biological/physical
psychosocial
cognitive changes
biological changes of puberty include:
- sexual maturation
- increases in height and weight
- accumulation of skeletal mass
- changes in body composition
variations in reaching ____ maturity affect nutrition requirements of adolescents
sexual
____ should be used to assess growth and development and nutrition needs of adolescents
sexual maturation
or biological age
what is menarche?
the first menstrual cycle
girls peak weight gain ____ linear growth spurt by ____
follows linear growth spurt by 3-6 months
boys peak weight gain ____ as peak linear growth & peak ____ mass accumulation
at the same time as peak linear growth and peak muscle mass accumulation
what is the % body fat required for menarche to occur
17%
what is the % body fat required to maintain normal mestrual cycles
25%
what psychosocial characteristics do adolescents develop?
and what can be effective at decreasing unhealthy eating habits?
- sesne of personal identity
- moral and ethical value system
- feelings of self esteem or self worth
- a vision of occupational aspirations
- heightened sensitivity to peer influences
social norm messages can be effective at decreasing unhealthy eating
why does healthy eating matter during adolescence?
- pormotes growth and development in children and adolescents
- minimizes the risk of nutrient-related chronic diseases (such as: type 2 diabetes mellitus, obesity, rickets, osteoporosis, hypertension, cardiovascular disease (CVD) and certain cancers)
- promotes appetite control
- promotes better performance at school and work
- promotes and maintains a healthy weight when combined with active living
- reduces the risk of health concerns (such as : iron deficiency anemia, dental decay, dyslipidemia and viral infections)
factors of macrosystems that affect eating behaviours of adolescents
- socioeconomic-political systems
- food-production and distribution systems
- food availability
- mass media
environmental factors that influence eating behaviour of adolescents
2 main groups
microenvironmental:
- cultural group
- social/cultural norms and values
- food trends and fads
- school meals
Immediate social environmental:
- family unit characteristics
- parenting practices
- parent modeling
- home environment
- family meal patterns
- peer norms and influences
personal factors that influence eating behaviours of adolescents
3 main groups
Cognitive-affective:
- personal health values and beliefs
- functional meanings of food
- body image
- self-concept
Behavioural:
- food preferences
- self-efficacy
- food-related skills
- eating practices
Biologic:
- pubertal status
- growth
- physiologic needs
- genetic predisposition
- health status
lifestyle and individual food behaviour influence ___
nutritional status
energy and nutrient requirements of adolescents
- dramatic growth and development + high nutritional needs
- with the exception of infancy, energy and nutrient needs during adolescence exceed those of any other point in life
-
DRI’s provide the best estimate of nutrient requirements for adolescents but are based on chronological rather than biological development
(professional judgement therefore needs to be used
note, changes for energy, protein, iron and calcium)
calcium requirements for adolescents
- adequate intake of calcium is critical to ensure peak bone mass
- calcium absorption rate in females is highest around menarche and during early adolescence in males
- ~4x more calcium absorbed during early adolescence compared to early adulthood
what age is peak bone mass achieved in females?
24 years
what age is peak bone mass achieved in males?
26 years
adolescence who dont include dairy should consume ___
calcium fortified foods
are adolescents meeting calcium requirements?
not usually
many adolescents have inadequate intakes of:
magnesium, vitamin A, Vitamin D, calcium, phosphorus
and iron among girls 14-18
when assessing nutritional status and risk for adolescents, what are the recommended health assessment and screenign tools?
- dietary behaviours
- physical/sedentary activity
- anthropometric measures
- family history
- blood pressure
- blood lipids
- diabetes
what are the divisions of responsibility for:
- children 3-8,
- pre adolescents 9-12 and
- adolescents 12-17
children 3-8:
Parent: when, when, where. Table manners, no grazing
child: how much, whether
Preadolescence 9-12:
parent: what, when, where. after-school snacking rules
child: how much, whether. contribute to meal planning
adolescence 12-17:
parent: what, when, where. keep family meals priority. teach simple meal planning
child: how much, whether. manage snack schedule
moderate dose of alcohol increased consumption, liking and wanting of ____ but not ____ snacks
savoury but not sweet
what is the impact of energy drinks on children?
- increased risk of excess intakes
- increased risk of dependency
nutrition guidelines for adolescents:
- choosing variety of foods from CFG daily
- eating at least 3 regular meals per day, including breakfast and 2-3 healthy snacks
- aiming to include food from all four food groups at meals
- snacks should include foods that might be missed during meals
- ensuring adequate intake of specific nutrients (such as: iron, calcium and vitamin D, fluoride and fibre)
- choosing high fibre foods
- limiting salt intake
- avoiding caffeine
- preparing and serving healthy protions to meet the CFG recs
- being physically active on a daily basis
what is the method for assessing and treating of adolescent overweight and obesity?
think 5 A’s
- ask for permissionto discuss weight
- assess obesity related risk and potential ‘root causes’ of weight gain
- advise on obesity risks, discuss benefits and options
- agree on realistic SMART plan to achieve healthbehaviour outcomes
- assist in addressing drivers & barriers, offer educatioin & resources, refer to provider and arrange follow up
what stressors trigger emotional eating?
- bullying
- neglect, maltreatment
- living situation where consistency, limit-setting and supervision are lacking
approaches to treating eating behaviour issues in adolescents
- encourage parents to be more sensitive and non-judgmental
- focus helping an entire family become healthier
- two key strategies: to determine
- (1. whether changingfamily behaviour is a priority, 2. how confident the parent (and teen) is about acheiving the necessary changes)
- motivational interviewing
obesity risks are more related to _____ than to BMI
obesity stage
providing obesity advise
3 steps
Explaining benefits of health behaviours:
- first goal is to stabalize BMI (substantial benefits, improvement in quality of life)
**Explain need for long-term strategy: **
- relapse is part of this chronic condition
Advise on management options:
- focus of management should be on IMPROVING HEALTH and WELLBEING rather than simply loosing
when is bariatric surgery considered for adolescents?
may be considered for adolescents who have reached their final adult height, with BMI >40, and with obesity related health complications.
- candidates and their families are required to have completed a multidisciplinary 6-month presurgial intervention
what are the risk factors for hyperlipidemia in adolescents?
- family history of cardiovascular disease or high blood cholesterol levels
- smoking
- overweight
- hypertension
- diabetes
- physically inactive
screening procedures for overweight and obesity in adolescents:
- routine screening is not recommended
- youth with family risk factors or overweight should be screened
- recommended at age 10 or after age 17
cholesterol levels ____ by 10-20% in puberty
drop
diet for management of overweight and obesity in adolescents:
DASH Diet
what age range is considered adulthood
20 - 64
adulthood is considered the ____ developmental phase
longest
44 years
what age range is considered early adulthood?
20-39 years
emerging adult
living at home longer for a number of factors
what typically happens to adults in their 20s
- some become independent and move out of their family home
- planning, buying and preparing food are newly developing skills
what typically happens to adults in their 30s?
- many have children: gain a renewed interest in nutrition for their kids sake
- building careers, increased responsibility
dietary implications for parents?
juggling acts
might eat childs left overs
only eat convenience foods
less variety in the diet
what is ages are considered adult “midlife” and what does this period usually entail?
40-64 years
- period of active family responsibilites
- managing schedules and meals continue to be a challenge
this is where we see muscle and joint issues occuring / hyperkalemia
- significant changes for those who are diagnosed with diseases
what is the sandwich generation?
people in their 50s
- multigenerational caregivers (juggle roles of caring for children and aging parents/ inlaws, while maintaining a career)
physiological changes of adulthood
- growth stops by the 20s
- bone density continues to increase until 30
- muscular strength peaks around 25 to 30 years of age
- decline in size and mass of muscle and increase in body fat
- dexterity and flexibility decline
- hormonal changes
bone loss begins around what age?
40
why and what diseases are more common with increased age?
fat re-distribution is associated with increased risk of chronic disease (because of more intra-abdominal fat)
Disease:
- hypertension
- insulin resistance
- diabetes
- stroke
- gallbladder disease
- coronary artery disease
explain the nonspecific signs and symptoms on the continumm of nutritional health and intervention
dietary guidance
- visible changes associated with insufficient or excessive intakes
- recognized risk factors for chronic disease
dietary guidance:
- target specific risk factors and observable signs and symptoms
- measure and monitor for progress to halt or reserve risk factors for disease
could have more than 1 disease (might see signs themself)
explain clinical condition on the continumm of nutritional health and intervention
guidance
- genetic predisposition, interacting with dietary components and environmental factors these influence whether and when the clinical condition develops
- intensive intervention may be needed (e.g. medical nutrition therapy or therapeutic behaviour change programs)
explain chronic condition on the continumm of nutritional health and intervention
interventions
- altered metabolism and structural changes in tissues become permananet and irreversable
(examples. structural damage to coronary arteries, invasive and metastatic cancer, loss of kidney function, or blindness) - intervention is aimed at managing the condition
what are the nutrients of concerns for adults?
- fibre
- vitamin D, E, A, B12
- folic acid
- magnesium
- potassium
- calcium
(sodium often exceed recommendations)
dietary recommendations for adults
eating competence model
- eating attitudes
- food acceptance
- regulation of food intake
- eating context
in nutrition intervention for risk reduction, adults need:
- access to. a variety of healthful food
- knowledge to guide food choices
- positive attitudes about food and eating
- to follow the principles of variety, moderation, and balance in choosing a diet
what was the most googled diet of 2018?
keto
what is the difference between the low carb diet and the true keto diet?
low carb:
- 50% fat
- 40% protein
- 10% carb
Keto:
- 65-80% fat
- 20-30% protein
- 0-10% carb
what are the concerns of the keto diet from cardiologist perspective?
- high in saturated fat
- may impact LDL cholesterol (causing inflammation)
