Nutrition Flashcards
Overweight
Obesity
It is the measurement of the body weight of a person above the population norm
Obesity is the measurement of the fatness of a person above the population norm
Double burden of disease
According to WHO there is a double burden of disease
- countries that are still developing have issues of under nutrition and infectious diseases
- whilst in urban places there is an increase in chronic disease related to obesity
Causes of childhood obesity
- inadequate prenatal care,
-poor infant and child nutrition( eating high fat and high sugar foods- children are more likely to choose healthier foods if offered to them at an early age in the house)
-physical inactivity,
-genetic basis (80% risk if both parents are obese), - epi genetic factors,
- maternal smoking,
-effect of non breastfeeding, - environment (in homes where healthy foods are not offered to the children) also there has been a global shift in how we eat. Foods are more of western diet of processed food with high sugar, fat and calories. Less nutrients and reduced intake of vitamins and minerals
An Obolo child is on a ticking time bomb
Obese children and adolescents become obese adults
This has also increased the number of newly diagnosed diabetes type 2 patients
Body mass index
BMI= BW/H2
Less than 18.5— underweight
18.5-24.9 —- normal
25-29.9 —- overweight
30-34.5 —- obesity Class I
35-39.9 —- obesity Class II
40-49.9 —- obesity Class III
50 and above—- Super obesity
How poor prenatal care and breastfeeding can predispose a child to obesity
- Mothers who engage in good prenatal care by having a normal BMI during pregnancy, eat well and exercise moderately. They gain weight of 11.5- 16 kg
- Children who are weaned before age 4 months gain more weight than those who are breastfed for more than 6months
Treatment of pediatric obesity
- Multidisplinary: involves dietician, pediatrician, cardiologist ,psychologist, support group
- formal behaviour modification
- family based change
Effect of childhood obesity
- premature death
- developing heart disease at a younger age
- developing type 2 DM at a younger age
Contributors to weight gain
- socioeconomic status (high or middle income)
- smoking cessation
- hormonal
- Inactivity
- psychosocial or emotions
- medications
In Type 2 DM seen in overweight patients treatment involves
- weight loss being the cornerstone of treatment
Medical complications of Obesity
- pulmonary disease
- obstructive sleep apnea
- hypoventilation syndrome
- NASH
- steatohepatitis
- cirrhosis
- gall bladder disease
- Gynaecological abnormalities
- abnormal menses
- infertility
- osteoarthritis
- cancer of the breast, uterus, cervix, colon, esophagus, pancreas, kidney and prostate
- CHD
- diabetes
- dyslipidemia
A hypertension - severe pancreatitis
- cataract
- stroke
- venous status
- phlebitis
Weight loss strategies
- diet therapy
- increased physical activity
- pharmacotherapy
- behavourial therapy
- surgery
- any of the above combination
How much fruit and vegetables each day
WHO recommends 400g of food and vegetable each day
Hunger ?
Hunger is a physiological state when food is not able to meet the energy needs of a person
Malnutrition
Refers to impaired development linked to both deficient and excessive nutrient intake
Undernutrition
Most common form of malnutrition in developing countries, there is a lack of energy, proteins and micronutrients
Hunger?
It is a physiological state when food is not able to meet the energy needs of an individual
Malnutrition
Refers to impaired development linked to both deficient and excessive nutrient intake
Undernutrition?
The most common form of malnutrition in developing countries; provides the body with energy, protein and micronutrients
Undernutrition is a complex condition that involves that involves multiple, overlapping deficiencies of protein, energy and micronutrient- rarely do these occur in isolation
Primary cause of Undernutrition
- Inadequate food intake, but is compounded by illness (congenital heart disease, childhood cancers)and malabsorption (structural - IBD, gastroectomy, or loss of appetite, disease process- celiac disease,)
Insufficient access to food
Poor health services
Lack of safe water and sanitation
Inadequate child and maternal care
Poverty
Anthropometric indicators for accessing nutritional status
- wasting (low weight- for- height)
Stunting ( low height- for- age)
Underweight ( low weight - for- age)
Classification based on International Growth Reference
When one is undernourished
- it leads to reduced productivity
- it reduces economic growth and effectiveness of investments in health and education
Micronutrient are needed by the body for
Micronutrient is needed by the body in minute amount and are critical for:
- regulation of growth, activity and development
- needed for immune and reproductive function
Three primary micronutrient deficiencies include: iodine, vitamin A, iron
Iodine deficiency disorders preventable cause?
IDD (Iodine deficiency disorder) single most important cause of preventable brain damage and mental retardation
The primary intervention for IDD is salt iodization
Vitamin A deficiency causes
- irreversible corneal damage, leading to partial or total blindness
Prevention of Vitamin A deficiency
- Giving of Vitamin A supplements
Iron
Iron deficiency lowers the resistance to disease and weakens a child’s learning ability and physical stamina
- it significantly causes maternal mortality, increases the risk of hemorrhage and infection during childbirth
Intervention for iron:
Supplementation and fortification are primary interventions to improve iron intake
Main factors contributing to anaemia
- poor bioavailability of consumed iron
- insufficient dietary iron intake
- chronic and recurrent infections that interfere with food intake and absorption or utilization of iron. These include
a)?helminth infestation, primarily hookworm
? Chronic diarrheal disease
? Hiv
? Malaria
Interventions to control anaemia
- depends on the etiology
- for iron deficiency: supplementation and fortification
- for parasitic disease control: appropriate measures for prevention and treatment
Folate deficiency
Needed to prevent neural tube defects (brain and spinal cord)
Ideally should be taken by women before getting pregnant
Nutrition is important for
- energy of daily living
- maintenance of all body functions
- vital to growth and development
- therapeutic benefits of healing and prevention
Growth in infants
It is rapid during the first year
- weight increases by 200%
- body length increases by 55%
- head circumference increases by 40%
- brain weight doubles
Feeding of a newborn
- breastfeeding : exclusive breastfeeding for the first six months
- formula feeding
Advantages of breastfeeding
- immunologic benefits by decreasing the incidence of ear infections, UTI, gastroenteritis, respiratory illness, bacteremia
- convienent and ready to eat
- reduced chance of over feeding
- fosters mother- infant bonding
- May delay return of ovulation (FP lactation amenorrhea method)
- loss of pregnancy associated adipose tissue and weight gain
- suppresses postpartum bleeding
- decreased breast cancer rate
In poverty and malnutrition
Poor nutrition and congnitive function:
- decreases growth of the brain and or CNS development
- poor performance on measures of congnitive ability
- malnourished children are unprepared to benefit from age- appropriate educational experiences
Complementary feeds?
- Are energy containing feeds that displace breastfeeding and reduce the intake of breast milk
OR - Are any foods or liquids other than human milk or formula that are fed during the first 12 months of life
OR - are any nutrient containing feeds or liquid other than breast milk given to young children during periods of complementary feeding when other foods or liquids are provided along with breast milk
Complementary feeds should contain
- zinc
- iron
- energy
