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
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
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
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
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
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 *
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
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
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
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
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
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
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
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
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
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
16
Q
Male Sexual Maturation
A
- 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)
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
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
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
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
Resonsibilites of Parent and Child
Parents - what foods are offered and when and where to eat
Children - whether or not they eat, how much they eat
25
Physical Acivity for Toddler and PreSchool
- 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
PA for School Aged and Adolesence
- 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
Consequences of Early age first Menses
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
WHy is first age of Menses decreasing?
- incrased BMI associated with earlier puberty in girls
29
Role of Leptin in Puberty
- 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
General Trends in Food Group Servings - 5-11 years (School Aged)
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
General Trends in Food Group servings 13-18 years (increases!)
```
females, males
veg/fruit - 6-7, 6-8
grains - 6, 6-7
milk - 3-4 for both
meats - 2, 2-3
```
32
Macronutrient (CHO, Fibre, Protein) intake for age 1-3
CHO - 130 g
Fibre - 19g
Protein - 1.05 g/kg
33
Macronutrient (CHO, Fibre, Protein) intake for age 4-8
CHO - 130 g (same)
Fibre - 25 g (increase)
Protein - 0.95 g/kg (decrease)
34
Macronutrient (CHO, Fibre, Protein) intake for age 9-13
CHO - 130g (same)
Fibre - 31 and 25 (increase, same)
Protein - 0.95 g/kg (same)
35
Macronutrient (CHO, Fibre, Protein) intake for age 14-18
CHO - 130g (same)
Fibre - 38g, 36g (increase) -- will decrease with age
Protein - 0.85 g/kg (decrease)
36
AMDR for 1-3 years
CHO - 45 - 65% (always)
Fats - 30-40% (brain development)
Protein - 5-20%
37
AMDR for 4-18 years
CHO - 45-65%
Fats - 25 - 35%
Protein - 10 - 30%
38
AMDR for >18
CHO - 45 - 65%
Fat - 20-35%
Protein - 10 - 35%
39
Nutrients of Conern for Toddler and PreSchooler
- iron
- calcium
- vitamin D
- sodium and potassion
40
Nutrients of Concern for School Aged
- iron
- calcium
- vitamin D
- vitamin A
- magnesium and Zinc for girls
- sodium and potassium
41
Nutrients of Concern for Adolescence
- 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
highest requirments for iron males and females
males - peak growth rte
| females - afrer first menses
43
Nutrition Concerns of Toddlers and PreSchoolers
- adequacy of diet
- iron deficiency
- vitamin and mineral supplementation
- vegetarian diets
- overweight and obesity
- dental carries - bacteria secrete acid
44
Nutrition Concerns of School Aged
- 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
Nutrition Concerns for Adolescence
- 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
Overweight and Obesity - trends and prevalence
- 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
Health Consequences of Obesity in Adolescence
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
Obesity Determinants - Individual, Environmental, and Social
"Obesgenic Environment"
Individual - unhealthy, PA, sedentary
Environmental - context for indiviual behaviour
social - Socio-Economic Status
- not as simple as energy in = energy out
49
School Based Health Promotion
- 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
