spotlight F; Childhood Nutrition

Question 1

the hygiene hypothesis posits that reduced exposure to childhood infections in developed countries can help explain drastic increases in the rates of allergies and other immune disorders, such asthma, type 1 diabetes, celiac disease, and multiple sclerosis, in these regions

Answer 1

only about 3-8% if individuals in developing countries report suffering from asthma, for instance, as many as 30% of those in developed countries

Question 2

One way for parents and pediatricians to check that children are consuming an adequate diet is by assessing if their rate of growth is appropriate when compared with growth rates expected for U.S. children and adolescents
(one way is through the CDC’s growth charts)

Question 3

the CDC’s growth charts include sex-specific plots of weight-for-age, height-for-age, and body mass index (BMI)-for-age curves for children and adolescents from ages 2 to 20 years
(the growth charts present these data as a series of percentile curves that allow one to assess if body size and growth of a child are appropriate for his or her age or if the child is at risk of undernutrition or obesity

Question 4

a child whose body weight or height falls at or under the [..] percentile for his or her age is considered at risk of undernutrition, whereas those who exceed the [..] or [..] percentile of BMI-for age- are considered at risk of being overweight and obese, respectively

Answer 4

5th
85th or 95th

Question 5

growth is extremely [..] in infancy, but it [..] in preschool children aged 2-5 years. still, in preschool children, growth continues at an impressive rate, with an average weight gain of [..]-[..] pounds and an average growth of [..]-[..] inches each year.

Answer 5

rapid
slows
4.5-6.6
3-4

Question 6

school aged children 6-11 years still continue to grow at a steady pace and have occasional growth [..], periods of accelerated physical development with associated changes in height and weight.

Answer 6

spurts

Question 7

children can vary drastically in height, weight, and build during the school years because of [..], [..], and [..] patterns.

Answer 7

genetics
nutrition
exercise

Question 8

(6-11); on average, children in this age range grow a little more than [..] inches and gain [..] pounds per year

Answer 8

2
6.5

Question 9

the end of elementary school years generally marks the beginning of puberty, a dynamic time of development with periodic growth spurts that result in changes body size, shape, composition, and sex specific maturation

Question 10

growth and development vary widely during puberty, but the period is almost always associated with significant [..] gain - in fact, [..]% of adult body weight is typically gained during puberty.

Answer 10

weight
50%

Question 11

in bodys, puberty typically begins at age [..] or [..] with an average of [..] inches of growth in height and weight gain of a little more than [..] pounds a year for a span of about 4 years,

Answer 11

12, 13
2.5
11

Question 12

in girls, puberty usually begins earlier, at age [..] or [..], and girls gain an average of about [..] inches in height and [..] pounds of fat and lean mass each year.

Answer 12

10, 11
2
9

Question 13

body and girls often have different [..] needs during puberty in part because of their different [..] trajectories.

Answer 13

nutritional
growth

Question 14

studies suggest that on average, US children [..]-consume energy-dense, nutrition poor foods at the expense of nutrient dense foods

Answer 14

over
for instance, up to 90% of children aged 4-13 years do not consume the recommended number of servings of vegetables, and only about 1% consumed the recommended servings of whole grains per day

Question 15

according to the 2020 Dietary Guidelines for Americans, about [..]% of children and adolescents aged 5 to 18 exceeded recommended intake limits for added sugars and saturated fats, and [..]% or more exceeded limits for sodium intake. according to NHANES data, half of the calories from added sugars and saturated fat come from six sources, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk

Answer 15

80%
95%

Question 16

what types of foods are children commonly eating?
1. sugar sweetened beverages,
2. grain based desserts (cakes, cookies, pies, doughnuts)
3. milk
4. sweet snacks and candy
5. daily desserts
6. cheese
7. pizza
8. processed meats
9 .ready to eat cereals

Answer 16

yes

Question 17

children are eating so poorly because they are now eating more meals [close or away] from home, particularly at fast food restaurants, which tend to serve energy dense and nutrient poor foods in large portion sizes.

Answer 17

away

Question 18

studies suggest that children who eat the most fast foods have diets with [higher or lower] total intakes of total energy, saturated fat, and sodium.

Answer 18

higher

Question 19

children tend to eat less when they can serve themselves, as they might do at home; children eating at home also tend to eat more nutrient rich foods.
( family mealtimes at home can also do a great deal to affect nutrition beliefs and attitudes, which typically translates to healthier food choices, reducing kid’s future riskier overweight and obesity.

Question 20

beverage consumption has also shifted in children and adolescents in recent decades, which is probably driving weight [..]. children aged 2-18 years drink [more or less] milk but [more or less] sugar sweetened beverages (SSB) than did the same age group in the past

Answer 20

gain
less, more

Question 21

Not only do SSB (sugar sweetened beverages) contribute significantly to overall added sugar intake, but they also are a source of calories that do not help meet food group or nutrient needs.

Answer 21

yes, are not nutritious

Question 22

average intake of added sugars is 11% of total calorie intake among young children, increasing to around [..]% during adolescence. this high added sugar consumption could be a primary reason that a whopping [..]% of children aged 6-11 years have had cavities in their primary teeth and [..]% of adolescents age 12-19 on their permanent teeth

Answer 22

15%
51% , 54%

Question 23

millions of children are participating in the National School Lunch Program, a federally assisted meal program operating in public and nonprofit private schools and residential child care institution that provides nutritionally balanced, low cost (or free) lunches to children, nationwide.

Answer 23

e

Question 24

the new standards in (National School Lunch Program) increases the number of fruits and vegetables included in these meals, emphasize whole grain-rich foods, serve only low fat and nonfat milk, limit calories, and reduce saturated fat and sodium content to ensure the meals are in line with US dietary guidelines for Americans.

Question 25

after 1 year of age, children learn to feed themselves and consume new and different foods. although their growth is [..] than it was during infancy, it continues steadily through the toddler and preschool years and in periodic "[..]" during the elementary school years and early adolescence.

Answer 25

slower spurts

Question 26

some parents get concerned because their children's interest in food [..] during periods of [..] growth, but the trend usually reverses itself during accelerated growth periods. energy requirements in children, as in adults, are based on age, sex, and activity level.

Answer 26

declines, slower

Question 27

the energy required to support growth is significant only during the first [..] months of life

Answer 27

6

Question 28

total daily estimated energy requirements (EER) depend on [.] and [..], and from [..] years of age and up, EER also depend on [..] levels. the EER are shown for children and adolescents with average levels of physical activity.

Answer 28

sex, age, 3, activity

Question 29

although children's nutrient needs are generally [higher or lower] than those of adults (because of their smaller size), nutrients are no less vital to optimal growth, development, and health.

Answer 29

lower

Question 30

recommended nutrient intakes do not differ for Boys and girls until about age [..] years, when maturation and sexual development influence dietary needs. by adolescence, micronutrients needs are [..] to those in adulthood

Answer 30

9, similar

Question 31

According to the AMDRs set by the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine, [..] should be children’s primary source of energy, composing [..]–[..]% of total calories (the same range recommended for adults).

Answer 31

carbohydrates 45-65%

Question 32

children need sufficient protein, too - for growth, tissue maintenance and repair, and other essential functions. for children aged 1-3 years, protein should make up [..]-[..]% of total calories and fat should make up [..]-[..]% of their total calories.

Answer 32

5-20% 30-40%

Question 33

for older children aged 4-18 years, protein should compose [..]-[..]% of total calories and fat should make up [..]-[..]% of total calories . these amounts reflect the transition from the higher fat intakes of infancy to the lower recommended fat intakes of adulthood. they also account for the fact that diets too low in fat may not provide sufficient intake of essential fatty acids as well as certain vitamins. dietary fat also provides energy, which may be particularly important for younger children during the transition from a primarily breast milk or formula based diet to a mixed diet

Answer 33

10-30% 25-35

Question 34

AMDRs for children; ages 1-3 years ages 4-18 carbs protein fat

Answer 34

ages; 1-3 carbs 45-65 protein 5-20 fat 30-40 ages; 4-18 carbs 45-65 protein 10-30 fat 25-35

Question 35

parents also play an important role in shaping their children's eating behaviors by establishing the eating environment and modeling food related behaviors and attitudes.

Answer 35

yes, children learn from parents

Question 36

decades of research have consistently shown that children's eating patterns are strongly influenced by their [..] and [..] environment- and the factors that influence this environment, such as parental education, time constraints, and ethnicity - and children, like adults, are likely to eat foods that are available and easily accessible

Answer 36

physical, social

Question 37

parents can affect children's dietary practices by determining what foods are offered and when, the [..] and [..] of meals, and the [..] in which they are provided. they model food choices and intake and socialization practices surrounding food.

Answer 37

timing, location environment

Question 38

how parents interact with their children in relation to eating during mealtimes can influence how children relate to food in general, which can have an impact not only on nutritional choices but also on lifelong food preferences and eating habits.

Answer 38

yes, when eating dinner during mealtime is very important affects food relationships

Question 39

studies demonstrate that that although specific parenting styles are not strongly linked to negative eating behaviors and nutrient poor food choices, a [..] between parental authority and permissiveness within an appropriate eating environment helps guide children toward making healthier choices on their own as personal responsibility an independence increase

Answer 39

balance

Question 40

to encourage healthy eating habits, parents should provide their children with a [..] of nutritious foods and [..]-but not force or bribe- their children to taste them.

Answer 40

variety encourage

Question 41

food preferences are in large part learned through repeated [..]

Answer 41

exposure

Question 42

the more a parent offers a food, the more likely a child will accept and try it; and the more a child tries it, the more likely he or she is to like it. studies suggest that children may need to try a new food at least [..] times before they develop a taste for it.

Answer 42

10

Question 43

involving children in food shopping and meal preparation also helps to expose them to different foods, educate them about nutrition, and engage them in the process of feeding the family.

Answer 43

yes

Question 44

when trying to encourage the consumption of health foods, one thing that doesn't seem to work is parental [..]. can lead to learned dislikes

Answer 44

pressure

Question 45

Birch and her colleagues found that children who were pressured to finish their soup ultimately ate less of it than when they were not pressured to finish it.

Answer 45

yes

Question 46

ultimately, nutritionists suggest that parents should consider themselves responsible for the quality (type) of food and the frequency of feeding (when food is offered), but children as young as age 2 years should be permitted to gauge the quantity they consume. ex.

Answer 46

serving children adult size portions or forcing hem to "clean" their plates can result in excess intake and make it difficult for children to determine when they have had enough to satisfy their hunger and avoid habitual overeating

Question 47

sometimes children develop particular ways of eating - for instance, they might not eat foods if they are touching other foods, only eat sandwiches if they're cut into triangles, or only eat one food item meal after meal. these behaviors, called food jags, are developmentally "normal" as children strive for more independence and control. children generally outgrow them with patience and guidance

Question 48

In addition to a varied and balanced diet, children should also engage in regular physical activity. Yet research suggests that more than 75% of all U.S. youth between ages 6 and 19 do not meet the physical activity guidelines set forth by the U.S. Department of Health and Human Services (HHS).

Answer 48

These recommend that children and adolescents older than 6 years participate in 60 minutes or more of developmentally appropriate and enjoyable physical activity per day. Ideally, this should encompass activities that are aerobic in nature (such as running, biking, or dancing) as well as muscle-strengthening activities (such as using playground equipment, lifting weights, or climbing trees) and bone-strengthening activities (such as hiking, running, or jumping rope).

Question 49

Younger children should engage in periods of active play [..] times a day, such as running, jumping, or dancing. It’s fine for children to be active for short bursts of time rather than sustained periods, as long as these bursts [..] up to at least recommended levels.

Answer 49

several add

Question 50

The Advisory Committee for the 2018 Physical Activity Guidelines for Americans reported several health benefits for children that include lower risk of excessive weight gain as well as improved bone health and weight status for children aged 3–5 and improved cognitive function for children aged 6–13.

Question 51

And as in adults, regular moderate to vigorous activity improves quality of sleep and reduces symptoms associated with depression and anxiety.

Question 52

Unfortunately, children who don’t meet the physical activity guidelines also tend to have [greater or lower] diet quality—they eat fewer fruits and vegetables and more energy-dense snacks, drinks, and fast foods—which compounds their risk of obesity and chronic disease.

Answer 52

lower

Question 53

American children consume low levels of several important nutrients, deemed select nutrients of cancer.

Answer 53

yes

Question 54

calcium is a select nutrient of concern. due to older children and adolescents in the United States not meeting the recommended calcium intakes, which is problematic as calcium is necessary for bone health and the development of peak bone mass, both of which prevent fractures and osteoporosis later in life.

Answer 54

yes

Question 55

optimal calcium intake is particularly important during [..], when most bone mineralization occurs and calcium requirements are [higher or lower] than during any other period of life. one way to help children obtain a range of healthful nutrients is to provide nutrients-dense snack options in pleasant eating environment

Answer 55

adolescence higher

Question 56

(building healthy eating habits), making the eating environment pleasant; - children can help [..] meals, [..] for ingredients, and [..] the food - turn [..] electronic devices and televisions, and avoid other distractions at mealtime - resist eating in the [..] to make mealtimes and snacks rushed - eat meals together as a [..] when possible - when you introduce a new food, serve it with food your child already [..] - include a [..] or [..] at each meal and snack

Answer 56

plan, shop, prepare off car together vegetable, fruit

Question 57

(building healthy eating habits), choosing nutrient rich snacks; grains vegetables fruits protein beverages

Question 58

many children under the age of 3 years also have inadequate dietary intakes of iron, because they often consume a great deal of cow's milk, which is [high or low] in iron, in place of iron-rich foods. this can lead to iron deficiency anemia, a form of anemia that can, during infancy and childhood, affect short term and long term [..] development

Answer 58

low neurological

Question 59

iron is also important for adolescents and older teens as it supports accelerated [..] and, in females, helps to replace iron lost through [..]. the DRIs recommend that adolescents (14-18 years of age) consume [..] mg of iron per day, more than 8 mg recommended for younger boys and men older than 19.

Answer 59

growth menstruation 11

Question 60

in teenage girls, iron needs to increase from 8 mg to [..] mg during adolescence. because few teenage girls consume enough iron to meet this increased need, approximately [..]% of adolescent girls are iron-deficient

Answer 60

15 10%

Question 61

fiber is another nutrient of concern, as [..] out of every 10 U.S. children particularly those with low-income and minority backgrounds-fail to meet the recommendations

Answer 61

9

Question 62

recent surveys suggest that children and adolescents only consume about [..] of fiber they should; teens are particularly deficient. fiber plays an important role in the health of children and adults and has been shown to reduce the risk of several chronic diseases. it also alleviates [..], which many children experience

Answer 62

half constipation

Question 63

adequate intake of vitamin D is crucial for [..] health and optimal [..] growth and development in children, but few children and adolescents get enough of this vitamin. this is in part because eo fat slow levels of vitamin D naturally found in most foods.

Answer 63

skeletal , bone (milk is almost always fortified with vitamin D, but as noted, many children opt for soda or other beverages at mealtimes. also, sunlight exposure, which can help meet all or part of vitamin D needs, has decreased in recent decades as children spend more time indoors)

Question 64

the health and medicine division increased its recommended intake of vitamin D by 50% to [..] micrograms (600 IU) for children and adolescents. healthcare providers may recommend vitamin D [..] for some children to meet these recommended levels.

Answer 64

15 supplementation

Question 65

approximately 18.5% of American children and adolescents aged 2-19 are currently obese, a prevalence that has more than tripled since 1980. obese children are more likely than normal weight children to have the high blood pressure and high cholesterol , type 2 diabetes, asthma, joint problems, fatty liver disease, and psychological problems.

Answer 65

yes

Question 66

obese children often become obese adults and are at a higher risk of a number of serious chronic [..]

Answer 66

diseases

Question 67

diet is one of the causes of childhood obesity due to eating more [..] dense foods, bigger [..] sizes, and more meals [..] from home.

Answer 67

energy, portion, away

Question 68

cause of childhood obesity; most children are too sedentary. screen time, and in particular TV viewing, is associated with an increased risk of overweight and obesity.

Answer 68

yes

Question 69

a recent study found that teens who watch more than [..] hours per day of TV without advertisements and junk food consumption.

Answer 69

three

Question 70

the American academy of pediatrics recommends that children and adolescents spend no more than [..] to [..] hours a day watching television, playing electronic games, or using the computer (other than for homework). yet children tend to spend far more time than is recommended in these sedentary pursuits. in addition to being a sedentary behavior, television viewing also appears to have a negative impact on [..] quality.

Answer 70

one to two diet

Question 71

increased duration of television viewing by adolescents in grades 7 through 10 was associated with [increased or decreased] fruit and vegetable intake and [higher or lower] intakes of candy and fast food.

Answer 71

decreased higher

Question 72

studies demonstrate that 1 in every 18 US children has a food allergy, a reproducible, adverse reaction to food that is caused by an [..] response to an allergen in food

Answer 72

immune allergen

Question 73

usually a food allergen is a small fragment of protein from the food that in susceptible individuals is identified by the body as harmful and that elicits an allergic reaction by the immune system.

Question 74

interestingly, the [..] exposure to a food does not cause an allergic response, but it sensitizes susceptible individuals to the food by causing the immune system to produce [..] (immunoglobulin E, or IgE) that are specific to the food allergen. when the food is consumed again, the allergen binds to these antibodies, which stimulates immune cells to release [..] and other chemical substances that trigger an allergic reaction

Answer 74

first antibodies histamine

Question 75

symptoms of an allergic reaction; depending on the tissue in which they are released, these chemicals will cause various symptoms of food allergy. the symptoms can range from mild to severe. a severe allergic reaction can include a potentially life-threatening airway obstruction called anaphylaxis.

Answer 75

skin reactions: hives, swelling, itchiness, flushing respiratory problems, wheezing, coughing, breathing gastrointestinal reactions; "itchy" mouth, nausea, vomiting, abdominal cramps, diarrhea

Question 76

The most common food allergies are to cow’s milk, eggs, peanuts, tree nuts, wheat, soy, fish, and crustacean shellfish. For individuals allergic to one or more of these foods, consuming even minute amounts can be immediately life-threatening.

Answer 76

yes

Question 77

food allergy; anaphylaxis and anaphylactic shock are massive immune reactions that can result in death if not treated immediately with injected epinephrine ([..]). although symptoms typically appear within [..] hours of exposure to a food allergen, allergic reactions can also be [..].

Answer 77

adrenaline two , delayed

Question 78

younger children with delayed allergic reactions most commonly experience heartburn, vomiting, bloody stools, and poor growth

Answer 78

yes

Question 79

although most adverse reactions or sensitivities to food are attributed to allergies, many food induced symptoms are not allergic in nature and instead may be caused by a food intolerance, a reproducible adverse reaction to a food that is not a direct result of an antibody (IgE)-dependent immune response.

Answer 79

basically; not all bodily reactions are reactions to allergies where antibodies are produced in reaction to the sensitivity. antibodies release histamine in reaction to eating. however, some people are just sensitive and not allergic to foods like lactose intolerant individuals

Question 80

food intolerances can induce allergy like gastrointestinal and respiratory symptoms and often appear within a few hours of eating the food, but they are not life threatening and are the result of different bodily mechanisms. lactose intolerance, for example, is caused by reduced levels of the digestive enzyme lactase in the gastrointestinal tract, but there are other potential causes for food intolerance.

Answer 80

basically; food intolerance are not life threatening unlike allergic reactions

Question 81

celiac disease is also classified as a food intolerance and not a food allergy because it does not involve the production of allergen specific [..]. rather it is caused when immune cells directly attack the [..] of the small intestine in the presence of gluten, a protein found in wheat, rye, barley, and many processed foods.

Answer 81

antibodies lining

Question 82

the best way to diagnose mild food allergies is through immunologist-led, double-blind, placebo-controlled oral food challenges in which children are exposed to suspected food allergens and to "fake" allergens at alternating times, without knowing which is which, while being closely monitored

Answer 82

yes

Question 83

some allergies naturally [..] over time. about 80% of children, for instance, outgrow cow's milk allergies, and most outgrow egg allergies. this could be because the gastrointestinal tract matures to become less [..] with age, making it less likely that an allergen will be able to penetrated the lining of the intestine and initiate an [..] response.

Answer 83

resolve permeable immune

Question 84

other scientists contend that food allergy risks go down with increased exposures to allergens

Answer 84

yes.

Question 85

some food allergies are diagnosed in children and persist into adulthood. allergies to peanuts and tree nuts, e.g.

Question 86

allergies common in adults; seafood (can develop at any points a person's life)

Question 87

why are allergies becoming more common? heightened [..] among the public and healthcare providers translates to increased recognition and diagnosis of allergies.

Answer 87

awareness

Question 88

why are allergies becoming more common? the hygiene hypothesis theory - the idea that [more or less] exposure to dirt and germs interferes with the normal [..] and [..] of the immune system. changes in food manufacturing and processing could also play a role, in that foods are prepared differently in today than they were in the past.

Answer 88

less maturation, regulation e.g. peanuts used to be boiled, but now they are roasted. some scientists also theorize that inadequate intake of certain nutrients, such as vitamin D, omega-3 fatty acids, and folate, may contribute to the rise of food allergies in children.

Question 89

why are allergies becoming more common; the timing at which foods are [..] to children could be important: many parents delay the introduction of allergenic foods to their children, but research suggests that delaying introduction beyond a certain point may actually be [..].

Answer 89

introduced detrimental

Question 90

since food allergies have no "cure", it is easier in present times to avoid foods that are harmful to the individual thanks to the food manufacturers and packagers must declare all major food allergens on food packages

Answer 90

yes

Question 91

the academy of nutrition and dietetics has tips for parents who want to minimize the risk of food allergies in their children; - exclusive [..] compared with the use of cow's milk based formula for at least four months during infancy, which decreases the risk of atopic dermatitis, cow's milk allergy, and wheezing. (soy formula does not seem to affect allergy risk) - to not introduce solid foods before [..]-[..] months of age

Answer 91

breastfeeding 4-6

Question 92

avoiding common allergens such as fish, eggs, and peanuts during pregnancy, during breastfeeding, or beyond the age of [..]–[..] months in infants does not seem to be [..]. In fact, there is growing evidence that the introduction of potentially allergenic foods while the infant is still receiving the majority of calories from breast milk [..] the risk of subsequent allergies.

Answer 92

4-6 protective reduces

Question 93

They recommend that infants deemed at high risk for peanut allergy (those who have already had a severe case of the skin condition eczema, egg allergy, or both) have peanut-containing foods introduced into their diet as early as [..]–[..] months of age to reduce the risk of that child developing peanut allergy.

Answer 93

4-6

Question 93

The LEAP study demonstrated that introducing peanut-containing foods to infants at high risk of developing a peanut allergy was [..] and led to an 81% [..] in subsequent peanut allergy.

Answer 93

safe reduction

Question 94

For infants with mild to moderate eczema, the panel recommended introduction of peanut-containing foods around [..] months of age. For infants without eczema or any food allergy, peanut-containing foods may be freely introduced in to the diet. In each situation, infants should have begun eating other solid foods [..] introduction of peanut-containing foods.

Answer 94

6 before

Question 95

Kondrashova suggests for kids to be closer to nature to reduce food allergies; don't avoid contact with pets, grass, soil, ,and farms.