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GI/Nutrition > Nutrition Through the Lifespan > Flashcards

Nutrition Through the Lifespan Flashcards

1
Q

How are macronutrient requirements different for pregnant women?

A
  • Follow similar macronutrient distribution as non-pregnant women (50-60% CHO, 15-20% protein, 25-30% fat) with increased calorie level:
    • Normal body weight = 30 kcal / kg
    • >120% IBW = 24 kcal / kg
    • <90% IBW = 36 – 40 kcal / kg
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2
Q

When are prenatal vitamins recommended for a pregnant woman?

A

Prenatal vitamins always recommended!

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3
Q

What micronutrients are recommmended for pregnancy?

A
  1. Iron: Prevent anemia; Support fetal growth; Produce additional blood
    • Lean beef/pork, whole grains, dark leafy greens
    • Vitamin C improves absorption; Calcium can block absorption
  2. Folic acid: Decrease risk of birth defects
    • deficiency can cause spina bifida
    • Fortified grains, beans, dark leafy greens
  3. Calcium: Prevent bone loss/Improve fetal bone growth
    • Dairy products, fortified OJ, fish with bones
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4
Q
  • Maternal weight gain recommendations:
  • Problems related to overwieght or obesity in pregnancy:
A
  • Maternal weight gain recommendations:
    1. BMI = < 18.5 ⇒ 28 – 40 lb gain
    2. BMI = 18.5 – 24.9 ⇒ 25 – 35 lb gain
    3. BMI = 25 -29.9 ⇒ 15 – 25 lb gain
    4. BMI = > 30 ⇒ 15 lb gain
  • Problems related to overweight or obesity in pregnancy:
    1. Gestational diabetes
    2. Macrosomia
    3. Eclampsia
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5
Q

Diet Precautions in Pregnancy:

A
  1. Cravings: Pica
  2. Fish consumption: Limit shark, swordfish, king mackerel, tilefish, albacore tuna due to mercury levels
  3. Listeriosis: Limit soft cheeses, raw fish (sushi), deli meats, unpasteurized milk, smoked seafood
  4. Specific disease states: PKU, Renal disease, Diabetes
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6
Q

What are the benefits of breastfeeding?

A
  1. Better for baby’s immune system due to antibodies in milk
  2. Better digested, less gas and constipation
  3. Linked to decreased risk of ovarian & breast cancer
  4. Less expensive
  5. Improves mother/child bonding
  6. Burns calories for mother
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7
Q

Breastfeeding: Macronutrient Management

A
  • Mom is burning additional 200-500 kcal/day
  • Eat wide variety of foods
    • Focus on protein sources
    • Watch signs from baby for fussiness, rashes – potential food allergy concern
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8
Q

What is a breastfeeding mother at risk for?

A

Higher risk for dehydration – additional fluids are necessary

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9
Q

Breastfeeding: Micronutrient Management

A
  • Continue prenatal vitamin!
  • Calcium = additional 1,000 mg/day
  • Folic acid = 500 mcg/day
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10
Q

Growth Charts:

  1. Premature Infants
  2. Birth to 24 months
  3. 2-20 years old
  4. Specialty Growth Charts:
    • Down Syndrome:
    • Cerebal Palsy:
A
  1. Premature Infants = Fenton 2003
  2. Birth to 24 months = WHO growth charts
  3. 2-20 years old = CDC growth charts
    • BMI plotted on chart
    • Overweight: 85-95%ile BMI-for-age
    • Obese: >95%ile BMI-for-age
  4. Specialty Growth Charts:
    1. Down Syndrome: Not recommended for use
    2. Cerebal Palsy: Use Brooks growth charts
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11
Q

**Infancy Macronutrient Needs: **

  • Breastmilk:
  • What is the point of infant formula?
A
  • Breastmilk:
    • ~40-50% Fat
    • 40-50% Carbs
    • 10% Protein (very bioavailable)
  • Infant formula: Made to mimic components of breastmilk
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12
Q

**Infancy Micronutrient Needs: **

  • Vitamin K:
  • Iron:
  • **Vitamin D: **
A
  • Vitamin K:
    • Single intramuscular prophylactic dose given at birth to infants
  • Iron:
    • Breastfed infants - supplement by 6 months of age (can be in the form of food vs supplement)
  • Vitamin D:
    • Breastfed infants - start supplement shortly after birth
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13
Q

Protein Energy Malnutrition (PEM) in Infants:

  • **Kwashiorkor: **
  • **Marasmus: **
  • **Cachexia: **
A
  • Kwashiorkor:
    • Edema that masks muscle wasting
    • Caused by lack of adequate protein in diet
  • Marasmus:
    • Wasted appearance and diminished subcutaneous fat stores
    • Caused by overall lack of adequate energy intake
  • Cachexia:
    • Wasting in the presence of a chronic disease
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14
Q
  • How long should an infant be breast/formula fed?
  • What is dental caries?
A
  • Breast milk and/or formula should be the sole source of nutrition for the first 6 months of life
  • Dental caries:
    • Result of use of a bottle or sippy cup while sleeping or ad lib intake while awake with liquids other than water
    • Flouride supplementation is not recommended until 6 months of age
      • Only required if water supply does not contain enough fluoride
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15
Q

GER vs GERD:

A
  1. Gastroesophageal reflux (GER):“happy puker”
    • Common in newborns
    • Usually resolves with lower volume/more frequent feedings, position changes, and maturation of the infants GI tract
    • Painless and not affecting the infant’s growth
  2. Gastroesophageal reflux disease (GERD):
    • Reflux accompanied by symptoms and complications (i.e. inadequate growth)
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16
Q

Infancy Recommendations:

  • First Foods:
  • Food Allergies:
  • Juice:
  • Milk:
  • Water:
A
  • First Foods:
    • Introduce around 6 months of age
    • Choose first foods that help meet micronutrient and energy needs (i.e. Iron-fortified cereals and pureed meats)
  • Food allergies:
    • Introduce new, single-ingredient foods no sooner than every 2-3 days to watch for possible allergic reactions
  • Juice:
    • Never introduce before 6 months
    • Only in an open cup
    • Limit to ≤4 oz per day
  • Milk:
    • Cow’s milk is not recommended until 12 months of age
    • Only whole cow’s milk should be offered
  • Water: No specific recommendations
17
Q

Stooling Patterns for

  • Breastfed infants:
  • Formula-fed infants:
  • How does the pattern change with age?
A
  • Breastfed infants:
    • 3-4 soft, medium-sized yellow stools per day
  • Formula-fed infants:
    • firmer, less-frequent, tan-colored stools
  • With age, volume of stools increases but frequency decreases
18
Q

What are some red flags for infant feeding problems?

A
  • Consuming too little or too much
  • Feeding too quickly or too long
  • Feeding not on a typical schedule
  • Not advancing to appropriate textures
  • Having difficulty successfully transitioning to new textures
19
Q

What are the macronutrient recommendations toddlers - adolescents?

A
  • Carbohydrate: 50-60% of total intake
  • Protein: 10-15% of total intake
    • Populations at risk: dieters, athletes who restrict intake, vegetarians, food allergies
  • Fat: 25-30% of total intake
  • Fiber:
    • Prevents constipation, protects against heart disease
20
Q

Fiber Needs:

  • Ages 6-12 months
  • Children older than 2 years of age
A
  • Ages 6-12 months→ gradually increase to 5g/day by 1st birthday
  • Children older than 2 years of age→ child’s age + 5g/day (age +10g/day found to be safe)
21
Q
  • Why is calcium important for adolescents?
  • What increases risk for low calcium levels?
A
  • Calcium – adolescence is a critical period to achieve peak bone mass, especially in females
  • At risk: low milk intake, high soda intake, low vitamin D
22
Q
  • What is the daily recommendation for Vitamin D?
  • What are the benefits of vitamin D?
A
  • Vitamin D – 600 IU/day needed, starting with the first day of life
  • Benefits: bone health, prevention of cancer, autoimmune and infectious diseases
23
Q

Iron:

  • Deficiency:
  • At risk:
  • Heme iron sources vs. non-heme iron sources
A
  • Deficiency: poorer cognitive performance, delayed psychomotor development
  • At risk: high milk volume, poor intake of solids, dieting
  • Heme iron sources (meat, fish, poultry) are better absorbed than non-heme sources (vegetables, grains)
    • Ascorbic acid and heme iron sources help with absorption
24
Q

Who is at risk for vitamin/mineral deficiency?

A

At risk populations:

  1. Anorexia, poor appetite, fad diets
  2. Chronic disease (CF, IBD, liver dz)
  3. Deprived, abused, neglected children
  4. Diet restriction to manage obesity
  5. FTT
  6. Food allergies
  7. Omit food groups
25
Q

What is the recommended food intake pattern for toddlers/preschoolers?

A
  • Modeling behavior, positive feeding environment very important
    • Rule of thumb: Offer 1 tablespoon of each food for every year of age for preschool children
    • Be cautious about choking hazards under age 4 (hot dogs, grapes, nuts, hard candy)
  • May need to eat 4-6 times/day
  • Juice should be limited to 4 oz. or less/day
26
Q

How does the food intake pattern change for school-aged children (6-12 years of age)?

A
  • After-school snacks
  • Fewer family meals
  • Meals at friend’s houses
  • Start of skipping breakfast
  • Preparing their own convenience foods
27
Q

What are some adolescent eating patterns?

A
  • Frequent meal skipping (breakfast, lunch)
  • Regular snacking
  • High fast food intake
  • Potential for disordered eating:
    • Vegetarianism
    • Athletes
    • Eating disorders
28
Q

Describe vegetarianism:

  • Vegetarian diet pattern:
  • Restrcitve vegetarian diet:
  • Infants:
  • Adolescents:
A
  • Vegetarian diet patterns vary:
    • Lacto-ovo (includes dairy, egg)
    • Vegan (excludes all animal products)
  • Restrictive vegetarian diets:
    • Monitor intake of vitamin B12, calcium, vitamin D, zinc, long chain omega-3 fatty acids, iron, riboflavin
    • Assess for unhealthful weight control behaviors
  • Infants: Can be breastfed or receive soy formula
  • Adolescents: Consider vitamin and/or mineral supplements
29
Q

Anorexia nervosa:

  • Defintion:
  • **Medical complications: **
  • Treatment Concerns?
A
  • Voluntarily-restricted caloric intake resulting in weight loss
    • Fear of gaining weight
  • Medical complications include: amenorrhea, bradycardia, abnormal EKG, fatigue, dizziness, hypercholesterolemia
  • Refeeding is a concern: monitor K, Mg, Phos
30
Q

**Bulimia nervosa: **

  • **Definition: **
  • **Medical complications: **
  • GI complications
A
  • Binge eating + compensatory behavior to prevent weight gain
    • Over concern with body shape and weight, although typically normal weight or overweight
  • Medical complications include: constipation and laxative dependency, dehydration, electrolyte abnormalities
  • GI complications from frequent vomiting – esophagitis, reflux, gastritis
31
Q

Requirements for adolescent athletes:

  • Calories
  • Carbohydrates
  • Proteins
  • Water
  • Vitamin/Mineral Supplementation
A
  • Calories: likely need more than the average adolescent
  • Carbohydrates: encourage breakfast intake, within 15-30 minutes after workouts
  • Protein: may require 50-150% more than the RDA
    • Discourage protein supplements –
      • dehydration, weight gain, Ca loss, stress on kidneys/liver
  • Water: 16 oz. water needed for each pound of weight lost
    • Sports drinks – not needed for workouts less than 60 mins
  • Vitamin/mineral Supplementation: RDA meets needs for the majority of healthy individuals, even athletes

GI/Nutrition (36 decks)

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