Toddler & Preschooler Nutrition Ch 10

Question 1

Key terms: middle childhood, preadolescence

Answer 1

Middle childhood
-Between the ages of 5 and 10 years
Preadolescence
-Between ages 9 to 11 years for girls
-Between ages 10 to 12 years for boys
(Both phases may also be termed “school-age”)

Question 2

How do you assess growth in school-age children using CDC growth chart?

Answer 2

2000 CDC growth charts
§  Tools to monitor the growth of a child for the following
parameters
² Weight-for-age ² Stature-for-age
² Body mass index (BMI)-for-age

Focuses on growth and development of school-age and pre-adolescent children

• Physical, cogniBve, emoBonal, social growth
• Growth spurts
• Modeling healthy eaBng and physical acBvity behaviors

Question 3

Describe physiological development changes in school-age children

Answer 3

Muscular strength, motor coordinaBon, & stamina increase

• In early childhood, body fat reaches a minimum then increases in preparaBon for adolescent growth spurt
• Adiposity rebounds between ages 6 to 6.3 years ¤ Boys have more lean Bssue than girls

Question 4

What are the consequences of early BMI rebound?

Answer 4

Age at onset of BMI rebound
§ Normal increase in BMI aner decline
§ Early BMI rebound, higher BMIs in children later ² Before 5.5 years

Question 5

What are the % range recommendations for macronutrients intake (AMDR)?

Answer 5

Carbs
45-65% 
Protein:
1-3yo: 5-20%
4-18yo: 10-30%
>19yo: 10-35%
Fat:
1-3yo: 30-40%
4-18yo: 25-35%
>19yo: 20-35%

Question 6

What is the recommendation for protein (g/kg/d)?

Answer 6

Protein: g/kg/day
Birth -> 6 mo: 2.2
6-12mo: 1.6
1-3yo: 1.1
4-13yo: 0.95
14-18yo: 0.85
>19yo: 0.80

Question 7

Describe eating behaviors in school-age children

Answer 7

Eating Behaviors
¤ Parents & older siblings influence food choices in early childhood with peer influences increasing in preadolescence
¤ Parents should be posiBve role models ¤ Family meal-Bmes should be encouraged ¤ Media has strong influence on food choices

Question 8

What factors influence energy needs of school-age children?

Answer 8

Energy and Nutrient Needs of School- Age Children
¤ Energy needs vary by activity level & body size
¤ The protein DRI is 0.95 g/kg body wt
¤ Intakes of vitamins & minerals appear adequate for most U.S. children

Question 9

Discuss common nutrition problems and prevention strategies: iron deficiency and cavities

Answer 9

Iron deficiency

• Less common in children than in toddlers
• Dietary recommendaBons to prevent: encourage iron-rich foods
• Meat, fish, poultry and forBfied cereals ² Vitamin C rich foods to help absorption

Question 10

Describe body image in school-age children

Answer 10

The mother’s concern of her own weight issues may increase her influence over her daughter’s food intake
¤ Young girls are preoccupied with weight & body size at an early age
¤ The normal increase in adiposity at this age may be interpreted as the beginning of obesity
¤ Imposing controls & restricBon of ”forbidden foods” may increase desire & intake of the foods

Question 11

What are the predictors of childhood obesity

Answer 11

¤ Age at onset of BMI rebound
§ Normal increase in BMI aner decline
§ Early BMI rebound, higher BMIs in children later ² Before 5.5 years
¤ Home environment
§ Maternal and/or Parental obesity is a predictor of
childhood obesity
² Parental obesity doubles the risk of adult obesity
TV time

Question 12

Discuss common nutrition problems and prevention strategies: cavities

Answer 12

Dental caries
§ Seen in half of children aged 6 to 9
§ Reduce dental caries by limiBng sugary snacks & providing fluoride
§ Choose fruits, vegetables, and grains
§ Regular meal and snack Bmes
§ Rinse (or better yet, brush the teeth) after brushing

Question 13

Describe overweight/obesity

Answer 13

DefiniBons:
§ Obese = BMI-for-age ≥95th%
§ Overweight = BMI-for-age from 85th to 94th%
¤ Prevalence of overweight among children is increasing
§ Children & adolescent ≥ 95th percentile

Question 14

Prevention and Treatment of Overweight and Obesity

Answer 14

¤ Expert’s recommend a 4-stage approach:
¤ The four stages:
§ Stage 1: PrevenBon Plus
§ Stage 2: Structured Weigh Management (SWM)
§ Stage 3: Comprehensive MulBdisciplinary IntervenBon (CMI)
§ Stage 4: TerBary Care IntervenBon (reserved for severely obese adolescents)

¤ Treatment consists of a mulB-component, family-based program consisBng of:
§ Parent training
§ Dietary counseling/nutriBon educaBon
§ Physical acBvity/addressing sedentary behaviors
§ Behavioral counseling

Question 15

What are the components of a healthy diet?

Answer 15

Nutrition and Prevention of CVD in School-Age Children
¤ Increase soluble fibers, maintain weight, & include ample physical acBvity
¤ Diet should emphasize:
§ Fruits and vegetables
§ Low-fat dairy products
§ Whole-grain breads and cereals
§ Seeds, nuts, fish, and lean meats

Dietary Recommendations
¤ Iron
§ Iron-rich foods: meats, forBfied breakfast cereals, dry
beans, & peas ¤ Fiber
§ Increase fresh fruits and vegetables, whole grain breads, and cereals
¤ Fat
§ Decrease saturated fat and trans fa]y acids
Dietary Recommendations
¤ Calcium & Vitamin D
§ Bone formaBon occurs during puberty
§ Include dairy products and calcium-forBfied foods
§ Vitamin D from exposure to sunlight and Vitamin D forBfied foods
§ If lactose intolerant:
² Do not completely eliminate dairy products but decrease only to point of tolerance

Fluid and Soft Drinks
¤ Provide plain water or sports drinks (during prolonged vigorous PA) to prevent dehydraBon
¤ Cold water is the best fluid for children
¤ Limit son drinks because they provide empty calories,
displace milk consumpBon & promote tooth decay ¤ Energy drinks should not be consumed by children

Question 16

Describe strategies to encourage physical activity?

Answer 16

¤ RecommendaBons:
§ Children should engage in at least 60 minutes of physical
activity each day
§ Parents should set a good example, encourage physical acBvity, and limit media & computer use
¤ Actual:
§ Only 7.9% of middle & junior high schools require daily physical activity

Organized Sports
¤ ParBcipaBon in organized sports linked to lower incidence of overweight
¤ AAP recommends:
§ Participation in a variety of acBviBes
§ Organized sports should not take the place of regular physical acBvity
² Emphasis should be on having fun and on family parBcipaBon rather than being compeBBve
§ Use of proper equipment such as mouth guards, pads, helmets, etc.
§ Should not include intensive, specialized training