Nutrition

Question 1

Which is the phase of growth that is dependent on nutrients?

Answer 1

the first stage of growth

Question 2

What does Vitamin A do and where is it found?

Answer 2

• strengthens the immune system, helps vision and maintains healthy skin
• cheese, eggs and yoghurt

Question 3

What does Vitamin C do and where is it found?

Answer 3

• immune system and helps body to absorb iron

- oranges, strawberries and potatoes

Question 4

Where is Vitamin D found?

Answer 4

• sunlight mostly

- oily fish and eggs is small amounts

Question 5

What supplements should children be given?

Answer 5

• babies being breastfed should get vit D from 2 weeks

- mothers who are breastfeeding should supplement vit D

Question 6

When should a baby start to eat normal foods?

Answer 6

• weaning should begin at 6 months
• this should not occur before 4 months
• normal cows milk not allowed before 2y for semi-skimmed or 5y for skimmed

Question 7

What are the rules for weaning children off breastmilk?

Answer 7

• give foods rich in iron
• low sugar
• give foods with allergens one at a time and in small amounts

Question 8

What are the negatives of late weaning?

Answer 8

• growth faltering

- deficiency as breast milk can no longer meet requirements

Question 9

What are some of the positives of breastfeeding?

Answer 9

• Higher IQ for child
• Lower obesity risk
• Lower maternal cancer risk
• Reduction in diarrhoea
• Reduction in respiratory infections
• Growth factors
• Colonic function
• Reduction in atopic disease

Question 10

What are the dental recommendations for children?

Answer 10

• use cups and beakers from 6 months of age

- teeth should be brushed as soon as they appear

Question 11

How is BMI plotted on charts for children?

Answer 11

BMI against age on relevant gender chart

only effective over 2 when height can be measured so otherwise use a BMI conversion chart

Question 12

What are the risk factors for being overweight?

Answer 12

• Parental overweight
• Black ethnicity
• Greater birthweight
• Smoking during pregnancy
• Lone motherhood
• Prepregnancy overweight
• Maternal employment over a certain limit
• Solids before 4 months

Question 13

What are the features of Prader-Willi syndrome?

Answer 13

• at birth they are floppy, can’t suck and may need NG feeding
• hyperplasia so lots of eating, lack of satiety and reduced energy requirements
• learning difficulties
• hypogonadism
• short stature

Question 14

What are the main comorbidities to childhood obesity?

Answer 14

• metabolic syndrome
• respiratory problems
• hip and knee problems
• diabetes
• CHD
• sleep apnoea
• hypertension

Question 15

What are the treatment goals for overweight and obese children?

Answer 15

• weight maintenance for overweight and obese

- for severely obese, the maximum weight loss should be 0.5-1kg per month

Question 16

What are the physical activity requirements?

Answer 16

• under 5s walking should be active for at least 180 minutes
• 5-18 year olds should aim for at least 60 minutes per day
• minimise screen and sedentary time

Question 17

When is orlistat prescribed?

Answer 17

• only to those with severe obesity or when there are severe comorbidities
• only for those above 12 years
• needs regular review

Question 18

What does orlistat do?

Answer 18

inhibits gastric and pancreatic lipase to reduce absorption of dietary fat

Question 19

When is bariatric surgery used?

Answer 19

• in post-pubertal adolescents with extreme obesity
• when there are severe comorbidities
• rarely used

Question 20

Does bariatric surgery work?

Answer 20

• very effective

- can resolve many comorbidities such as hypertension, sleep apnoea and type 2 diabetes