Nutrition Flashcards
Micronutrient deficiencies have ________ impacts during periods of ____ &______ as well as long-term effects on _________ _______.
Negative impacts
Growth & Development
Structural Integrity
T/F: Pediatric nutritional supplemental dietary recommendations are fairly well defined.
True
Early malnutrition may predispose us to an increased risk for ______ ________ later in life-specifically _______ _______
Chronic Diseases
Cardiovascular Disease
What is a supplement?
What forms can they come in?
Is a supplement a food or the sole item of a meal/diet?
A product that supplements the diet
Pill, Capsule, Tablet, Liquid
No
What are the most widely used types of dietary supplements?
Vitamins & Minerals
Supplement use is a/w what types of people/lifestyles?
- Higher income
- Smoke-free environment
- Lower BMI
- Less daily TV/Video time
Vitamin A is called?
Retinoid
Vit A is ___-soluble
Fat
Vit A is required for the transduction of light into neural signals necessary for vision. Therefore, intake in some forms have been associated w/decreased risk for:
Macular degeneration
Cataracts
Cancers
Cardiovascular events
Vit A plays an important role in?
Also in?
Vision
Vertebrae, spinal cord, limb development, formation of heart, eyes, ears.
T/F: Vit A increases macrophage phagocytic activity and increases cytokines that mediate T & B lymphocytic production.
True
What foods is Vit A found in?
Fish, Liver, Dairy, colorful Fruits and Vegies, some oily plants
What is the daily recommended intake of Vit A in infants based on?
Infants primarily fed breastmilk
Is Vit A common in the US?
No-rare. Cows milk, human milk (except preterm), and formulas are all good sources
Vit A deficiency might be an issue in children w/what disorder?
Fat-Malabsorption
Is preterm breastmilk low in Vit A?
Yes
A Cochrane review concluded that VLBW infants who were supplemented w/Vit A had a reduction in ______ or _______ requirement at 1 month of age and reduction of ______ requirement at 36 wks w/BW <1 kg
Death or Oxygen requirement
Oxygen
Vitamin A may prevent _____ ______ and promote ________.
Lung injury
Healing
Vit A reduced what lung Dz?
BPD
Low _____ levels has been shown to be a risk factor for Maternal-Child transmission of HIV
Vit A
Is there special recommendation concerning dietary supplementation w/Vit A?
No
Preterm infants fed breastmilk will need what?
Fortification of Vit A
There is some evidence that supplemental Vit A may be indicated for what type of preterm infants?
LBW
What is the other name for Vit D?
Calciferol
Vit D is essential for what?
Proper growth and development of skeletal system
Vit D works with ______ _____ to maintain serum ____ & ______ concentrations
Parathyroid Hormone
Ca++ & Phosphate
Where is Vit D synthesized?
Skin
The precursors of Vit D require what to convert to the Active form?
What is the common name for Vit D?
UVB light
the Sunshine Vitamin–deficiency is higher in areas where exposure to sunlight is limited
What sources is Vit D found?
Egg yolks, butter, whole milk, fatty fish, fish oils, mushrooms, liquid/dried milk, breakfast cereals
Is human milk low or high in Vit D?
Low–unless mom is receiving very high doses of the vitamin
Vit D deficiency leads to?
Characterized by?
Rickets
Impaired skeletal mineralization causing deformities and poorer linear growth of long bones
What are the clinical signs of Rickets in an infant?
Later in life?
Craniotables, Frontal skull bossing, Widened Ribs, Bowed legs, Muscle Weakness
Osteomalacia, various chronic Dz’s: CV, HTN, DM, inflammatory/autoimmune, CA
Hyper/Hypo-Calcemia and Hypervitaminosis D disrupts normal _____ function—>polydypsia & polyuria
Hypercalcemia
Kidney Function
The AAP recommends that all breastfed babies be supplemented with what vitamin?
Formula-fed infants need to consume at least ___ Liter/day Vit D fortified formula
Vitamin D
1 L/day
Vit E functions as a _____ breaking ___________ to prevent free radical damage–especially important for cells exposed to ________ like the lungs and RBC’s.
Chain-breaking
Antioxidant
Oxygen
Name dietary sources of Vit E
Whole grains, nuts, vegetable oils, meats, what germ, safflower oil, sunflower oil
Does breatmilk supply adequate amounts of Vit E in Term and Preterm infants?
Yes, both
T/F: Vit E deficiency is common in the US
What are signs of Vit E deficiency?
False, it’s rare except situations r/t fat-malabsorption
Peripheral neuropathy, Hemolytic Anemia, Abnormalities in Platelet Fxn
Does the AAP recommend pharmacologic doses of Vit E for prevention or treatment of ROP, BPD, or IVH?
NO
When is the only time Vit E supplementation will be required?
Situations of Fat-malabsorption
What Vitamin functions as the coenzyme for synthesis of proteins involved in blood coagulation and bone metabolism?
Vitamin K
Which proteins are dependent on Vit K?
Plasma Prothrombin (factor 2), 7, 9, 10 & Protein C and Protein S
Where is Vit K sourced from?
Diet
Intestinal Flora
What are dietary sources of vit K?
Green leafy vegetables, vegetable oil, margarine
Are there high or low levels of Vitamin K in human breastmilk?
Low
Are oral Vit K supplements licensed in the US?
No
Vit K deficiency is a/w bleeding during the first few ______s of life
Weeks
Vit K deficiency bleeding is categorized as?
Early
Classic
Late
Is Vit K toxicity rare or common?
Rare-and no adverse effects have been reported
Is there a relationship between Vit K at birth and childhood CA/Leukemia?
No
NB’s have __________ stores of Vit K at birth d/t ______ _________ transfer.
Inadequate
Poor Placental transfer
Serum Vit K level is ____ or ____________ in cord blood.
Low
Undetectable
Early Vit K deficiency happens when?
What are some sequellae?
Early Vit K deficiency is sometimes noted in which infant’s?
First 24 hrs life
ICH, Cephalic hematomas, intra-abdominal hemorrhages
Infants w/mom’s tx’d w/anti-hypertensives or anti-convulsants during pregnancy
When does Classic Vit K deficiency happen?
What signs might you see?
Day 2-7
Bleeding from umbilical stump, GI tract, or circ site
When does Late Vit K deficiency happen?
What often results?
Day7-3 months of age.
ICH and sometimes death
T/F: In babies w/ fat-malabsorption, Vit K supplement may be needed.
True
What might be an option of supplementation for families who do not want their infant to receive a dose of Vit K at birth?
Maternal Vit K supplement (although not seen in practice)
What is the most abundant mineral in the body?
Ca++
What mineral is the main structural component of the skeletal system?
Ca++
What mineral is regulated by several hormones including PTH,and Calcitonin?
Ca++
Low/High Ca++ concentrations generally imply abnormal _______ function or _____ failure
Low
Parathyroid
Kidney
In what foods is Ca+ found?
Dairy products
Dark green veggies
Legumes
Fortified food
___% Ca++ is found in bones and teeth. The other % is also crucial for health.
99%
Where is the remaining 1% Ca++ found?
How does it function?
Plasma & Soft tissues
Vasoconstriction, Vasodilation, Muscle contraction, Nerve impulse transmission, Hormone secretion
Intake of Ca++ from fromula may need to be ______ in order to achieve the same retention as infants who are fed human milk (term infants)
Greater
LBW infants are at risk for these biochemical abnormalities when deficiencies of Ca++ exist:
Rickets Low rates of bone mineralization Reduced linear growth Low net mineral retention Hypophosphatemia Reduced bone mass and subsequent Osteoporosis
T/F: Effects of excessive intake are not known in infants/children
True
In term infants, Human milk is thought to be a __________ source of Ca++ for the first ___ months of life.
Sufficient
6 months
Preterm infants have _______ Ca++ needs than Term infants
Higher
T/F: AAP recommends supplementation of Ca++ in preemies?
True
via: HMF, premature formulas, multivitamin preparations
In adults w/excessive Ca++ intake what might they have?
Poor muscle tone, Kidney stones, Hypercalcemia, Renal insufficiency, Constipation, Excessive urine loss, Nausea, Coma, Death
Iron is an essential _______
Mineral
Iron constitutes several classes of ______
Including:
Protein
- Heme proteins (hemoglobin)
- Iron-sulfur
- Nonheme enzymes (flavoproteins)
- Enzymes involved in iron storage and transport
Iron plays a role in _____ synthesis
DNA
___ proteins are required for the transport of oxygen from lungs to tissues
Heme proteins
____ deficiency is the best known nutritional deficiency in the world.
The best known consequence from it is_____.
Iron
Anemia
___% of the word’s Anemia is from Iron deficiency accounting for >840,000 deaths/year.
50%
__-__% of Full Term infants will develop iron deficiency Anemia.
Preemies are at higher/lower incidence.
3-30%
Higher
Iron deficiency anemia causes ______ & ______ developmental delays
Mental
Motor
Iron supplemented in kids >2y/o, resulted in what?
Increased cognition and enhanced physical performance
Homeostasis of Iron is primarily maintained through the coordinated _________ of absorption and __________.
regulation
transport
What are dietary sources of iron?
Heme-based: animal-based foods
None-heme based: grain, fruits, vegetables
Human milk: highly bioavailable source
Cow milk-based formula is less well absorbed, recommended >1 yr. age
AAP: healthy, full-term babies should receive Iron supplemented sources starting at ___-___ months from complimentary foods.
4-6 months
Preterm or LBW infants should begin iron supplementation at ___ month of age
1 month
in NICU- at 2 wks of age if on full feeds
What are adverse effects of Excess iron administration?
Promotion of cellular oxidation Impaired resistance to infection Interference w/absorption or metabolism of other nutrients GI abnormalities Behavioral disturbances
Zinc is an essential _____ ________.
trace mineral
Zinc has numerous ______ and ________ functions.
Physiologic
Biochemical
Zinc is a structural and/or regulatory component of nearly 300 _______ in which it maintains structural integrity and plays a role in regulation of gene ____________.
enzymes
expression
Like iron, Zinc is absorbed greater from a _____-based diet vs. _____-based.
Animal
Plant
Name some animal food sources of Zinc
Red meat
Oysters
Poultry
Liver
Name some plant food sources of Zinc
Beans Nuts Whole grains Fortified cereals Legumes
T/F: Zinc is highly bioavailable in human milk
True
Zinc concentrations ________ as lactation progresses
Decline
Zinc concentration is ______ in human milk vs. cow milk (just like iron)
Higher
Absorption of Zinc is _____ in Soy formulas compared to cow milk-based formulas and human milk
Less
Name some signs of Zinc deficiency
Growth retardation Alopecia Diarrhea Delayed sexual maturation and impotence Eye and skin lesions Loss of appetite Behavior (ADHD)
Excess Zinc intake causes:
Suppression of immune response
Decreased HDL cholesterol
Reduced Copper
Acute toxicity: epigastric pain, diarrhea, N&V
What does chronic, excessive intake of zinc induce?
Secondary Copper deficiency (by competitive interaction during intestinal absorption)
Infants fed human milk may benefit from zinc supplementation at what age?
6 months
During what age are zinc requirements high?
Second half of the first year (6-12 months)
True/False: Preterm formulas and HMF’s are a source of Zinc supplementation.
True
What are some food sources of zinc?
Lean beef, Legumes, Fortified cereals
Iodine is a ____ _______ essential for the synthesis of the Thyroid hormones T4 and T3.
trace mineral
Iodine is _______ absorbed and removed from the body
rapidly
T/F: Can iodine be absorbed through the skin from topical applications?
Yes (povidone iodine)
Iodine content in food depends on the iodine content of the _____ and _____ that were used to grow them.
soil
water
Name some sources of iodine
Ocean fish, mollusks
Iodized salt
Does human milk have iodine?
Yes, it is dependent on mother’s intake
Human milk, milk-based formulas and cow milk are all ______ sources of iodine
good
Thyroid hormones are essential for the regulation of:
Human growth, development, metabolism, & reproductive function
Most iodine is concentrated where?
the Thyroid gland
What are other target organs of iodine concentration?
Brain, Muscle, Heart, Pituitary, Kidney
T/F: Iodine deficiency is still a common world-wide deficiency.
True
What can inadequate Iodine intake result in?
Goiter Mental retardation Hypothyroidism Cretinism Growth and developmental abnormalities
Excessive Iodine intake has not been sufficiently _______.
It is recommended the only source during the 1st yr/life be from _______ & _______.
Studied
Food
Formula
What dietary mineral is a/w the prevention of dental caries and stimulation of new bone formation?
Fluoride
T/F: Fluoride enhances re-mineralization of enamel.
True
_______ is present in saliva and dental plaque.
Fluoride
In young children, as much as _____% Fluoride can be retained by developing skeleton and teeth.
80%
____ foods contain fluoride naturally.
What are they?
Few
Marine fish and some teas
What is our main source of Fluoride?
Artificially fluoridated water
T/F: the content of Fluoride in individuals varies greatly
True
The content of Fluoride in breastmilk depends on what?
Mother’s intake of Fluoride
The content of fluoride in formula depends on what?
The water used to reconstitute it
Inadequate intake of Fluoride places individuals at risk for?
Dental Carries.
The earlier children are exposed to Fluoridated water or dietary supplements, the greater _______ of carries in both primary and permanent teeth.
decrease
Dietary Fluoride supplements are intended to compensate for what?
Fluoride deficient drinking water
Excessive Fluoride intake can result in varying degrees of?
Fluorosis
Mild Fluorosis may render the _____ more resistant to carries.
Enamel
Moderate-severe forms of Fluorosis cause ______ issues due to increased porosity (causes the enamel to appear opaque and mottled)
Cosmetic
Omega-3 Fatty Acids are important for?
By providing?
Visual and Neurological development
Protection from inflammation
Optimal immune function
Decreasing risk of chronic, Dz’s: CV
Where are Omega-3 Fatty Acids found?
Oils (canola and flaxseed)
Meats
Eggs
The Content of Omega-3 Fatty Acids in human milk is dependent on what?
Mom’s diet
Formula content of Omega-3 Fatty Acids is usually ____.
Low–it is made w/corn, coconut, safflower, and soy oils.
Some evidence exists that intake of Omega-3 Fatty Acids benefits?
Cognitive and Behavioral performance
What would excessive Omega-3 Fatty Acid intake lead to?
Possible increased risk of conditions a/w oxidative damage (BPD, NEC)
