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Clinical Nutrition > Nutrition Across the Lifespan - toddler to adolescence > Flashcards

Nutrition Across the Lifespan - toddler to adolescence Flashcards

0
Q

What are the Characteristics of Growth in a PreSchooler and How is Growth Monitored?

A

average growth = 2 kg and 7 cm / year
assess with weight and height for age, and weight for height
- BMI for age is used after 10 years and is used to assess body fatness
- growth declines in this age group

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1
Q

What are the Characteristics of Growth in a Toddler and How is Growth Monitored?

A

Average growth = 2.8 kg and 12 cm / year

assess with weight for age, length for age, and weight for length

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2
Q

What are the Characteristics of Growth in a School Aged and How is Growth Monitored?

A

average 3-3.5 kg and 6 cm / year
monitored using weight for age until age 10, then BMI for age is used
- there is fat gain at 6 years which is a normal increase in BMI after a dip in preschool
- greater increase in fat for girls
- rebound adiposity

middle childhood - 5-9 years
preadolescence - 9-11 years for girls, 10-12 years for boys

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3
Q

What are the BMI classifications for 2-5 years old, and how is this different from the BMI classifications for 5-19 years?

A 
2-5 years 
<3rd percentile = underweight
<85 = risk of overweight
<95 = overweight
<99.9 = obese
5-19 years
<3 = underweight
<85 = overweight
<95 = obese
<99.9 = severely obese
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4
Q

What are the Characteristics of Growth in Adolescence?

A

Females - peak weight gain is 3-6 months after linear growth spurt and all before menarche

  • there is an increase in lean and fat mass, fat mass is larger than lean mass gained
  • females will first gain the height and look thinner and then they will gain the fat mass

males - peak weight gain and linear growth occur at the same time

  • increase in lean body mass and decreased fat mass
  • increased proportion of ML and decreased proportion of FM
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5
Q

Motor Skills of Toddler and Preschooler

A
  • progression of ability to move
  • walking (1 year)
  • crawling up stairs (1.3 year)
  • running (1.5 year)
  • walking up stairs (2 years)
  • pedalling bike (3 years)
  • sit in chair, climb furniture (3 years)
  • expand ability for PA by age 5 - more energy expenditure *
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6
Q

Motor Skills of School Aged

A
  • more complex pattern movements
  • team sports - increasing motor coordination
  • increased muscular strength
  • PA contributes to more energy expenditure and it starts to be highly variable
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7
Q

Feeding Skills in Toddler

A
  • self-feeding and using cup
  • preference for hand feeeding - spoon and fork are not easy but developing
  • chewing ability is enhanced and tongue can move side to side and rotary
  • can handle more difficult textures
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8
Q

Feeding Skills of PreSchoolers

A
  • can use a spoon and fork, need help using a knife
  • able to participate in meal preparation
  • consider choking hazards
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9
Q

School Aged

A
  • full use of utensils
  • can be involved in food prep and chores related to meals
  • can learn about simple nutrition messages - not about body weight or disease
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10
Q

Cognitive and Social Development for Toddlers

A
  • new independence
  • more interactive
  • development of fears
  • expression of wills - negativism, temper tantrums
  • learn family customs
  • observe and copy others
  • language skills - 10 words at 18 months to >100 at 2 years
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11
Q

Cognitive and Social Development of PreSchoolers

A
  • egocentrism and magical thinking
  • increasing social interaction and cooperative play
  • external bhevaiour limits and internal limits
  • testing of limits - too much parental control will lower initiative and self-confidence, and too little parental control will lead to anxiety
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12
Q

Cognitive and Social Development of School Aged

A
  • decreased egocentrism
  • more rational cause/effect reasoning, but concrete thinking
  • development of sense of self and self efficacy
  • increasing importance of peer relationships
  • greater independence
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13
Q

Cognitive and Social Development of Adolescence

A
  • ~ 12 years and continues to 16
  • transition from concrete thinking to abstract thinking ~ black and white to debates, reasoning, more perspectives
  • early adolescence - all concrete, impulsive, egocentric
  • middle - still concrete but abstract starting
  • late - abstract thinking - change in delivery method of health messages
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14
Q

Psyschosocial Development of Adolescence

A
  • starts at 12 - 21 years
  • independence
  • self-identity
  • body image
  • relationships
  • beliefs and behaviours around lifestyle choices

early - body image and sexual awareness, strong peer influence
middle - emotional and soical independence, making self desisions, strongest peer influence but still need parental support (moody(
late - development of personal ID and beliefs, completion of dependence, social confidence, less influence from peers

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15
Q

Female Sexual Maturation

A
  • 8 - 13 years
    GnRH suppression is stopped and estrogen is released
  • amount of body fat is signal to release the supression on the hypothalamus
  • menarch 10.5 - 16.5 years of age
  • highest velocity of height growth is occuring at the same time and 2-3 of tanner stage
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16
Q

Male Sexual Maturation

A
  1. 5 - 13.5 years
    - release of GnRH hormone supression which then stimulates testosterone production
    - stages are samee but duration and timing are all varied with girls and boys and among themselves
    - secondary sex characteristics appear before rapid gain in height occur (stage 3-4 at max)
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17
Q

Eating Behaviours of Toddlers

A
  • desire to self feed
  • wants what others are having - family customs
  • easily distracted, less interest than infancy in food
  • expression of interests and wanting what is familiar
  • reluctance to try new foods
  • food jags
  • natural preference for sweet and salty foods
  • likes and dislikes are erratic and unpredictable
  • small appetites make snacks important
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18
Q

Eating Behaviours of PreSchoolers

A
  • growth occurs in spurts - highly variable appetite and energy intake
  • increase in appetite before spurt
  • preference for foods - dislikes mixed, touchhing, strong flavours or spicey foods
  • desire to please and be helpful - teaching opportunity, food selection, food preparation
  • limit their choices about foods to build confidence
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19
Q

Eating Behaviours of School Aged

A
  • eating more away from home
  • some independence on food choices
  • family still has greatest influence on food choics, but influence of peer and environment increases
  • marketing of foods
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20
Q

Eating Behaviours of Adolescence

A
  • individual - biological, attitudes, beliefs, preferences
  • environment - family, school
  • macrosystem - availability, media, policy
  • eating more awasy from home - schedule, fat increases, fibre decreases, soft drinks increase
  • snacking 1-7 a day - increasing in size
  • meal skipping
21
Q

Goals for how to feed toddlers and preschoolers

A
  • ensure adequate energy and nutrient intake but not excessive
  • enable normal development
  • encourage healthy eating patterns and behaviours - of family
  • encourage self-feeding - important for motor skill and self confidence
  • remove all distractions when eating and sit with family
  • role modeling - eating patterns, types, PA
  • follow schedule
  • offer new foods with preferred foods - may take 10-15 exposures
  • foods from food groups
  • limit beverages other than water - milk may cause iron deficiency, no more than half cup of juice a day
22
Q

Goals for How to Feed School Aged

A
  • ensure adequate nutrient energy intake but not excessive
  • enable normal development
  • encourage healthy eating patterns and behaviours - of family
  • family meals - higher micronutrient and fibre intake
  • role modelling
  • foods from food groups
  • still easily distracted
23
Q

How much to feed Toddler and PreSchooler

A
  • 1 tbsp per year age
  • innate ability to regulate intake
  • hypothalamus - control center for hunger and satiety
  • signals nervous system hormones, and blood nutrient levels
    hunger: low glucose, ghrelin, other hormones
    sateity: stretching GI, CCK. leptin, other hormones
  • external cues - sights, smells, tastes, advertising, habits social, portion size, rewards
24
Q

Resonsibilites of Parent and Child

A

Parents - what foods are offered and when and where to eat

Children - whether or not they eat, how much they eat

25
Q

Physical Acivity for Toddler and PreSchool

A
  • when able to walk, should be physicall active for at least 2 hours per day of normal acitivty
  • structured and unstructured
  • 40 minutes of moderate to vigorous activity each day
  • screen time limited to no more than 60 minutes per day
26
Q

PA for School Aged and Adolesence

A
  • 60 minutes of moderate to vigorous activity per day
  • vigorous activity at least 3 days a week
  • muscle and bone strenghtening at least 3 days a week
  • screen time should be limitted to no more than 2 hours per day
27
Q

Consequences of Early age first Menses

A

phychosocial and behavioural

  • usually related to overweight and obesity
  • vulnerable to be taken advantage of, hang out with older kids who look lioke them
  • don’t know how to fit in
  • don’t know how to handle the attention

Increased Risk of Metabolic Syndrome, breast cancer, PCOS

28
Q

WHy is first age of Menses decreasing?

A
  • incrased BMI associated with earlier puberty in girls
29
Q

Role of Leptin in Puberty

A
  • leptin releases the suppresion of GnRH stimulated the Anterior Pituitary
  • leptin is released from fat cells in the body, when energy is high enough - signals energy storage is adequate for puberty through the hypothalamic-pituitary-gonadal axis (HPG)
  • it is a permissive signal that removes the suppression
  • anterior pituitary then releass FSH/LH to stimulate production of Testosterone or estrogen
  • testosterone or estrogen lead to the production of growth hormone – which is anabolic for building tissue, and insulin-like growth factor which also has anabolic effects
  • girls increase leptin and 6 months later have menstruation
  • leptin causes puberty in boys but then levels decreases bc of the testosterone
30
Q

General Trends in Food Group Servings - 5-11 years (School Aged)

A

5-8 years, 9-11 years

fruit and vegetables - 5,6
grains - 4,6
milk and dairy - 2,3-4
meat - 1,1-2

offer 3 meals and 2-3 snacks each day

  • do not restrict how much fat is given
  • family meals *
31
Q

General Trends in Food Group servings 13-18 years (increases!)

A 
females, males 
veg/fruit - 6-7, 6-8
grains - 6, 6-7
milk - 3-4 for both
meats - 2, 2-3
32
Q

Macronutrient (CHO, Fibre, Protein) intake for age 1-3

A

CHO - 130 g
Fibre - 19g
Protein - 1.05 g/kg

33
Q

Macronutrient (CHO, Fibre, Protein) intake for age 4-8

A

CHO - 130 g (same)
Fibre - 25 g (increase)
Protein - 0.95 g/kg (decrease)

34
Q

Macronutrient (CHO, Fibre, Protein) intake for age 9-13

A

CHO - 130g (same)
Fibre - 31 and 25 (increase, same)
Protein - 0.95 g/kg (same)

35
Q

Macronutrient (CHO, Fibre, Protein) intake for age 14-18

A

CHO - 130g (same)
Fibre - 38g, 36g (increase) – will decrease with age
Protein - 0.85 g/kg (decrease)

36
Q

AMDR for 1-3 years

A

CHO - 45 - 65% (always)
Fats - 30-40% (brain development)
Protein - 5-20%

37
Q

AMDR for 4-18 years

A

CHO - 45-65%
Fats - 25 - 35%
Protein - 10 - 30%

38
Q

AMDR for >18

A

CHO - 45 - 65%
Fat - 20-35%
Protein - 10 - 35%

39
Q

Nutrients of Conern for Toddler and PreSchooler

A
  • iron
  • calcium
  • vitamin D
  • sodium and potassion
40
Q

Nutrients of Concern for School Aged

A
  • iron
  • calcium
  • vitamin D
  • vitamin A
  • magnesium and Zinc for girls
  • sodium and potassium
41
Q

Nutrients of Concern for Adolescence

A
  • iron (increased demands for growth including increased blood volume and red blood cell mass)
  • calcium – peak accrelation girls = 12.5 years and boys = 14 years - 40% of lifetime bone mass accumulated in adolescnece
  • vitamin D
  • vitamin A
  • Magnesium
  • folate, B12, zinc for girls
  • soium and potassium
42
Q

highest requirments for iron males and females

A

males - peak growth rte

females - afrer first menses

43
Q

Nutrition Concerns of Toddlers and PreSchoolers

A
  • adequacy of diet
  • iron deficiency
  • vitamin and mineral supplementation
  • vegetarian diets
  • overweight and obesity
  • dental carries - bacteria secrete acid
44
Q

Nutrition Concerns of School Aged

A
  • adequacy of diet
  • iron deficiency
  • vitamin and mineral supplementation
  • vegetarian diets
  • overweight and obesity
  • body image - rebound adiposity
  • parents attitudes has large impact on children - don’t restrict unhealthy foods
45
Q

Nutrition Concerns for Adolescence

A
  • body image and self esteem linked to eating
  • dieting behaviour, disordered and clinical disordered eating
  • pormoting positive body image is important
  • substance use - supress appetite, decrease funds, iron deficient anemia, decrease absorption and lower intake, higher requirements for some like vitamin C and B vitamins
  • pregnancy - low rates of BF, more complications and low birth weight, lifestyle factors are very important, iron and folate intake are concerning
  • low intake = impaired growth and delayed secxual maturation
46
Q

Overweight and Obesity - trends and prevalence

A
  • high prevalance in adolescence
  • sub-optimal nutrition intake
  • low levels of physical activity
  • has tripled in Canada since 1981
  • rapid rise in child overweight in genetically stable populations (obesity is not due to genetics)
47
Q

Health Consequences of Obesity in Adolescence

A

Psychological - poor self esteem, depression, eating disorders
GI - gallstones, steatohepatitis
Endocrine Problems - T2D, polycystic ovary,, hypogonadism, early puberty
flat feet
musculoskeletal disorders
neurological - headache
pulmonary - sleep apnea nad asthma
cardiovascular - dislipidemia, hypertension

48
Q

Obesity Determinants - Individual, Environmental, and Social

A

“Obesgenic Environment”
Individual - unhealthy, PA, sedentary
Environmental - context for indiviual behaviour
social - Socio-Economic Status

  • not as simple as energy in = energy out
49
Q

School Based Health Promotion

A
  • habits developed at early age can lead to lifelong patterns
  • benefits to learning and social development
  • children spend most time, children are educated here, environments can be changed, staff, parents, communities are connected

Clinical Nutrition (14 decks)

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