Nutrition Module #1: Nutrition for Young Children Flashcards
During what life stage does the most rapid growth occur? What are 2 examples of this rapid growth?
Infancy
- Weight triples in year 1
- Length increases by 50% in year 1
- Brain triples in weight (linear growth)
What are the 5 necessary nutrients for brain development?
- Docosahexanoic acid (omega 3 eicosanoid FA): DHA
- Choline
- Iron
- Folate
- Taurine
During what life stage do nutrient needs peak?
Adolescence
How does the body composition change during early to late childhood?
Fat decreases
Muscles increase
How does the body composition change during adolescence for males and females?
Males: increase lean muscle mass
Females: increase body fat
When does an infant (0-36 mos) growth chart warrant further examination?
- Above 98th percentile
- Below 2nd percentile
- Changes across 2 percentile lines
When does a child (more than 36 mos) growth chart warrant further examination?
- Above 85th percentile
- Below 5th percentile
How to interpret BMI values?
- Above 95th percentile: obese
- Between 85th and 95th percentile: overweight
- Between 5th and 85th percentile: normal
- Below 5th percentile: underweight
What are the 3 most critical nutrients for children?
- DHA
- Calcium
- Iron
What are the 4 vitamins that are important for children fat development?
Vitamins A, D, E, and K
What are the 2 nutrients that are important for children muscle development?
- Protein
2. Vitamin C
What are the 3 nutrients that are important for children bone development?
- Calcium
- Phosphorus
- Vitamin D
What is the 1 nutrient that is important for children reproductive development?
Zinc
What are the 3 nutrients that are important for children circulatory system development?
- Iron
- Folate
- B12
How do the nutritional requirements of children compare to those of adults?
Kids have higher requirements PER KG than adults but adults have higher absolute requirements
How do calcium requirements change with age?
They increase until age 1 and then they decrease
What are 2 important nutrients in beef?
- Iron
2. Zinc
What are the 4 common nutrition-related problems in children?
- Anemia
- Overweight
- Poor dental health
- Growth retardation
What are 3 limitations of the BMI charts to screen for obesity?
- Data is from the 60s and 70s (more than 5% of the pop could be obese)
- May classify overweight children as normal
- Not sensitive enough for height, fat distribution, musculature
How much weight should an infant be gaining every day for the first 3 months?
~30 g/day once birth weight is regained
Do we have cutoff values to determine failure to thrive?
NOPE
How are weight and height affected with failure to thrive?
Weight gain slows first and then height
What are the 3 criteria to determine failure to thrive?
- Weight, length, or stature for age OR weight for stature below the 5th percentile
- Weight below 50th percentile
- Drop in weight or stature measurements across 2 or more major percentile lines
What are brain solids mostly made of?
Fats
What 3 nutrients are needed for choline synthesis?
- Folate
- B12
- Methionine
What is choline an important precursor for? 3 things
- Phosphatidyl choline
- Sphingomyelin
- ACh
What is taurine?
Sulfur containing conditionally essential AA
What are some important roles of taurine with regards to the developing brain and 2 other important functions?
- Brain osmoregulation
- Neuroprotection
- Neuromodulation
- Protects retinal photoreceptor
- Fat absorption
Where is choline obtained?
- Diet: milk, plant and animal foods (widely available)
2. Synthesis
In what foods is taurine obtained?
Milk, seafood, meat
What are the 3 main roles of iron?
- Cofactor for NT and hormone synthesis
- Myelin production
- Rate of mRNA translation
What is the most common nutrient deficiency?
Iron
What does iron deficiency in kids cause? 7 things
- Delayed speech
- Impaired growth
- Delayed cognitive development
- Anemia
- Increased cancer risk
- Altered hair/nail texture
- Impaired immune function
What are 2 groups at risk for iron deficiency?
- Poor
2. Older infants consuming mostly milk
What are 7 food sources of iron?
- Milks
- Cereal
- Meat
- Chichen
- Fish
- Legumes
- Spinach
When is iron uptake maximal?
Infancy
What are adverse reactions from high folate intake from foods?
None
How long does it take for the iron stores to deplete after birth?
6 months
Is milk a good source of vitamin D? Is cheese? Yoghurt?
Milk yes, but cheese and yoghurt are not
Where is DHA most abundant?
Brain cell membranes and photoreceptor rods
What are 3 food sources of DHA
- Omega-3 fish (salmon)
- Seafood
- Human milk
When should solid foods be introduced to infants?
Around 6 months
Describe the transition from liquid to solid foods.
- Birth: 100% liquid
- 6 mos: semi-solid foods
- 6-8 mos: strained fruits/veggies
- 1 yr: strained meats/dairy (70% liquid/30% solid)
What are 5 potential complications of introducing solid foods too soon?
- Allergies
- Diarrhea
- Renal overload
- Inadequate human milk production
- Disturbed dynamics around eating
What 2 nutrient deficiencies can be caused by delayed the introduction of solid foods?
- Iron
2. Zinc
What are the 5 signs of a food allergy?
- Rash
- Vomiting
- Diarrhea
- Irritability
- Wheezing
What are the 2 main differences between food allergies and intolerances?
- Immune vs metabolic responde
2. Permanent vs potentially transient
How is most water absorbed by cells?
Energy dependent Na+/Glc transporter (SGLT-1)
How does water leave cells?
Aquaporins
How much water is absorbed each day by the intestine?
4L
What causes diarrhea?
Inability of intestine to absorb water and electrolytes from stool
How to treat dehydration from diarrhea?
Oral Rehydration Therapy (ORT) = water + glucose + electrolytes = 245 mosm/L
What is the main cause of death of kids under 5?
Diarrhea
Should feedings be discontinued during ORT?
NOPE
If a certain digestive enzyme is compromised because of an intestinal infection, should the kid stop eating certain foods?
NOPE
What are the 2 ways to synthesize non-essential AAs?
- Transamination: N transfer from AA to alpha-ketoacid
2. Amination: N transfer to an alpha-ketoacid
What nutrient is needed for transamination? Why?
B6 bc precursor for pyridoxal-5-phosphate which is a cofactor for all enzymes that transfer N groups from 1 AA to the other
What are 2 symptoms of vitamin B6 deficiency?
- Slows growth
2. Neuron damage
What is a symptom of excess B6?
Sensory neuropathy
What is Marasmus? 3 symptoms?
Wasting disease caused by lack of protein and energy from diet
Symptoms: apathy, lower body temp, emaciated appearance
What is Kwashiorkor? 2 symptoms?
Caused by adequate energy intake, but insufficient protein
Symptoms: bloated belly, edematous limbs
Can all AAs be catabolized for energy?
YUP
What are the 2 types of AAs? Describe each.
- Glucogenic: generate pyruvate or TCA intermediates for gluconeogenesis
- Ketogenic: generate acetyl-CoA or ketone bodies
Which 2 AAs are neither glucogenic nor ketogenic?
Gly and Ser
What is phenylketonuria? Symptom? Treatment?
Defective Phe hydrolase = Phe cannot be converted to Tyr = excess Phe
Symptom: severe and irreversible dementia
Treatment: stop eating Phe
What is homocysteinemia? 4 symptoms? Treatment?
Defective cystathione B-synthase = homocysteine cannot be converted to Cys = excess homocysteine
Symptoms: eye abnormalities, mental retardation, CVD, osteoporosis
Treatment: reduce Met intake (homocysteine precursor) and take Cys supplement
What is maple syrup urine disease? Symptom? Treatment?
Defective alpha-ketoacid dehydrogenase complex for branches AAs = cannot be converted to acetyl CoA = excess Val/Leu/Ile
Symptom: severe mental retardation
Treatment: stop eating them and take thiamin supplement (cofactor)
What are 3 genetic defects in AA metabolism? Which is most common?
- phenylketonuria (most common)
- homocysteinemia
- maple syrup urine disease
What are the 4 factors to assess protein quality?
- AA composition
- Ability to sustain growth
- Effect on N retention
- Presence of antinutritive factors
What is an example of a protein with an antinutritive factor?
Some beans contain a trypsin inhibitor
What does a protein’s ability to sustain growth depend on? 3 factors.
- Consumed amount
- Bioavailability
- AA composition
Do all proteins contain all essential AAs?
YUP but amounts vary
What proteins have a high ability to sustain growth?
Animal and soy products
What proteins have a low ability to sustain growth?
Grains and legumes
Can complimentary vegetarian protein diets match the high quality of animal protein diets?
Yeah but they may need to eat 25% more in terms of quantity
What is the standard method to determine protein quality?
IOM’s Protein Digestibility Corrected AA Score (PDCAAS)
When should fat consumption be increased to 20-35% of energy intake?
Between 2 and 5
By what age should kids have made the full transition to an adult diet?
5
What kind of milk should be drank before 2?
Whole milk only
What are the 3 most common nutritional issues with preschoolers in the US?
- Iron deficiency
- Lack of fiber/fluids = constipation
- Cavities
What are the 8 foods that are choking hazards and should not be given until 4 or 6 yo?
- Popcorn
- Whole grapes
- Cherries with pits
- Hot dog slides
- Hard candies
- Nuts/seeds
- Celery
- Peanut butter spoon
What is the treatment for failure to thrive?
Catch-up growth with increased food intake
By how much are protein requirements increased during failure to thrive treatment?
1.5-2 x more
What is the most common cause of failure to thrive?
Improper diet
What are the 3 main roles of iron?
- O2 transport
- ROS defense
- Metabolism
What are the 4 symptoms of iron toxicity?
- Discolored skin
- Cirrhosis
- Hepatosplenomegaly
- Cardiomyopathy
What are the 4 proteins that increase iron uptake?
- Dcytb
- DMT1
3 Ferroportin - Tpr
What is the 1 protein that sequesters iron?
Ferritin
How do we loose iron?
Feces
What are the 2 mechanisms to avoid excess iron?
- Increase ferritin
2. Decrease ferroportin
What are the 5 main roles of copper?
- Cofactor for cyt C
- ROS defense
- Iron metabolism
- Catecholamine synthesis
- Collagen cross-linking
What are 3 symptoms of copper deficiency? Is this common?
- Impaired brain function
- Endangered vascular and bone integrity
- Decreased metabolic control
Very rare
What are 2 symptoms of copper toxicity?
Liver and DNA damage
What are the 3 proteins transporters of copper into intestinal cells?
- CTR-1
- DMT-1
- Copper-sensing ATPase
Which 2 trace minerals share a protein transporter?
Copper and iron: DMT-1
What are 10 functions of zinc?
- Growth/Cell division
- DNA replication
- Gene transcription
- RNA synthesis
- Metabolism
- Immune system
- Wound healing
- Folate absorption
- Insulin
What are 5 symptoms of zinc deficiency?
- Growth retardation
- Impaired immune system
- Anemia
- Cognitive impairment
- Decrease appetite/absorption
What are 4 symptoms of zinc toxicity? Is this common?
- Vomiting
- Anemia
- CNS disturbances
- Copper/Iron absorption issues
How can iron affect zinc absorption?
Excess iron decreases zinc absorption
What are the 2 proteins responsible for zinc absorption? What is the role of each?
- Zip: increases Zn in cytoplasm
2. ZnT: increases Zn in cells
What are the 3 roles of vitamin A and their form?
- Cell growth: retinol metabolites
- Vision: retinal
- Gene expression: retinoic acid
What are the 3 symptoms of vitamin A deficiency?
- Impaired vision
- Loss of appetite
- Infection susceptibility
What are 2 symptoms of vitamin A toxicity?
- Liver/bone damage
2. Dry mucous membranes
What are the precursors to vitamin A?
Carotenoids that contain a retinoid moiety at 1 or both ends (few of them) = 6 C ring with 1 double bond + 2 methyls at 1 end and 1 methyl at the other end of double bond
What can excess retinol cause during pregnancy?
Mutagenic issues
What are retinol activity equivalents?
They indicate how many micrograms of all trans retinol would give the same biological effect
What carotenoid has a very high RAE?
Beta-carotene
Where is retinol found in the body?
- Blood bound to retinol binding protein
2. Liver as retinyl ester
