Nutrition and Growth

Question 1

What are essential nutrients needed for?

Answer 1

Replace losses and to grow new tissue

Question 2

Why is nutrition important?

Answer 2

Energy needed to permit metabolic functions
Maintenance, growth ad development
Develop immunity

Question 3

What are the phases of child growth?

Answer 3

Infant = nutrient led
Child = growth hormone led
Pubertal = sex steroid led

Question 4

Are the phases of child growth clear cut?

Answer 4

No = they merge gradually over time

Question 5

What is the lower reference nutrient intake (LRNI)?

Answer 5

Nutrient intake sufficient for the 3% of the population with the lowest needs

Question 6

What is the estimated average requirement (EAR)?

Answer 6

Used to calculate energy requirements for population = about 50% of population will need more than EAR and 50% will need less

Question 7

What is the reference nutrient intake (RNI)?

Answer 7

Nutrient intake sufficient for 97% of the population

Question 8

As a population, is the RNI being met?

Answer 8

Yes = the mean protein intake for each age group is above the RNI

Question 9

What is the RNI for protein?

Answer 9

Age 4-6 months = 12.7g/day
Age 7-9 months = 13.7g/day
Age 10-11 months = 14.9g/day
Age 12-18 months = 14.5g/day

Question 10

How is the energy reference value calculated for children aged 0-12 months?

Answer 10

Energy deposited in new tissue + total energy expenditure

Question 11

What is an energy deposit classed as in a child aged between 1-18 years?

Answer 11

1% increase in physical activity level

Question 12

How is healthy body weight decided in children aged 1-18 years old?

Answer 12

EAR calculated at median activity level values

Calculated for less or more active children by the 25th and 75th centile physical activity levels respectively

Question 13

What is the RNI of vitamin A and what are some dietary sources of it?

Answer 13

RNI = 350-400 micrograms/day

Found in cheese, eggs and yogurt

Question 14

What is the RNI of vitamin C and what is it found in?

Answer 14

RNI = 25-30mg/day

Found in oranges, blackcurrants and potatoes

Question 15

What is the RNI of vitamin D and what are some sources of it?

Answer 15

RNI = 7-8.5 micrograms/day

Gained from sunlight and small amounts from oily fish

Question 16

Is the RNI being met for vitamin D?

Answer 16

No = deficiency was reported in all age groups on both breastfed and non-breastfed children

Question 17

What supplements are recommended in 6 month children consuming less than 500ml/day of formula milk?

Answer 17

Vitamins A, C and D

Question 18

When should breastfeeding babies start taking vitamin D supplements?

Answer 18

Should take 8.5-10mg a day by two weeks of age

Question 19

How much vitamin D supplementation should breastfeeding mothers take?

Answer 19

10 micrograms per day

Question 20

Is the RNI for sodium being met?

Answer 20

Yes = it is being exceeded in all age groups apart from children aged from 4-6 months

Question 21

What is the RNI for sodium?

Answer 21

Age 4-6 months = 280mg
Age 7-9 months = 320mg
Age 10-11 months = 350mg
Age 12-18 months = 500mg

Question 22

How much sodium is contained in 1g of salt?

Answer 22

393mg

Question 23

How much sodium is recommended in children aged between 0-12 months overall?

Answer 23

Less than 400mg per day (less than 1g)

Question 24

How much sodium is recommended in children aged between 1-3 years old?

Answer 24

Less than 800mg per day (less than 2g)

Question 25

What are the revised dietary goals for Scotland?

Answer 25

At least 5 fruit and veg a day I portion of oily fish a week Total fat accounts for no more than 35% of food energy Saturated fatty acids no more than 11% of food energy Free sugars amount to no more than 5% of food energy At least 25g per day of fibre

Question 26

What nutrition is recommended for the first 6 months of an infant's life?

Answer 26

Exclusive breastfeeding

Question 27

What are some types of infant formula?

Answer 27

Modified cows milk, whey or casein based formula

Question 28

What are some negative features of formula milk?

Answer 28

Don't provide antimicrobial or bioactive substances that are present in breastmilk Change in brand isn't recommended so have to stick to one kind

Question 29

What kind of formula milk is recommended for the first year of an infant's life?

Answer 29

Whey based formula milk

Question 30

What age group is follow-on milk intended for?

Answer 30

For infants aged over 6 months

Question 31

Why is follow-on milk not recommended?

Answer 31

Provides no advantage to standard infant formula milk

Question 32

When should the transition from exclusive milk diet to family foods begin?

Answer 32

At about 6 months = baby not getting adequate nutrition from breastmilk alone, can start earlier but never before 4 months old

Question 33

What should be the main milk consumed in a baby transitioning to solid foods?

Answer 33

Breastmilk

Question 34

What is weaning defined as?

Answer 34

Process of introducing foods with an increase in variety of texture, flavour, aroma and appearance

Question 35

Why must the average density of food not be less than 1 kcal/g when a baby is weaning?

Answer 35

Low energy foods can limit energy intake = only exception is if meals are going to be offered more frequently

Question 36

When can full fat cows milk be introduced to a baby's diet?

Answer 36

Used in small amounts in cooking from 6-9 months | Gradually introduced as drink from 12 months

Question 37

When can semi-skimmed and skimmed milk be introduced to a child's diet?

Answer 37

``` Semi-skimmed = never before 2 years old Skimmed = never before 5 years old ```

Question 38

What are some features of the first foods a baby is given?

Answer 38

Should be gluten free, salty foods should be avoided, sugar and salt shouldn't be added, give foods rich in absorbable iron early

Question 39

How should food that may cause allergies be introduced?

Answer 39

One at a time

Question 40

When can children start to consume whole nuts and seeds?

Answer 40

Once they are five years old

Question 41

How should teeth be cleaned in children?

Answer 41

Cleaned gently twice a day as soon as they appear

Question 42

How often should solid foods be eaten in children aged between 6-8 months old?

Answer 42

2-3 times daily

Question 43

When should solid foods be increased to 3-4 times a day in children?

Answer 43

Between 9-11 months | From age 12-24 months also include nutritious snacks

Question 44

What may impact nutrition in young children?

Answer 44

Still depend on carers for food so vulnerable to parenting and to acute illness

Question 45

What starts to develop in school age children?

Answer 45

Eating patterns and behaviour patterns (activity)

Question 46

What may impact the nutrition of a school age child?

Answer 46

Chronic disease, disordered eating patterns (ie faddism), supply/demand imbalance (obesity)

Question 47

Why do teenagers have increased nutritional demands?

Answer 47

Because they have accelerated growth

Question 48

What tends to affect the nutritional status of teenagers?

Answer 48

Obesity, eating disorders, early pregnancy

Question 49

What are some agents passed from mother to her child via the breastmilk?

Answer 49

Immunological factors, anti-infective agents, growth factors

Question 50

What are the benefits of breast feeding?

Answer 50

Reduces diarrhoea and respiratory infections Lowers risk of atopic disease, obesity and breast cancer Associated with higher IQ

Question 51

When should children be introduced to beakers/drinking cups?

Answer 51

From 6 months old

Question 52

What factors have been associated with an increase in dental caries in children?

Answer 52

Amount of free sugars in diet and the frequency of free sugar consumption

Question 53

What are some factors that may cause someone to start a baby on solid food too early?

Answer 53

Living in a deprived area Opinion of infant's maternal grandmother Personal disagreement with recommendations Lack of encouragement from peers to wait Receiving free samples of manufactured food

Question 54

What are some public health interventions aimed at improving nutrition in children?

Answer 54

Healthy start = welfare food scheme Childsmile = dental programme Child healthy weight and physical activity programmes Community food and health programmes