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HUNT 243 > Unit 2 lectures 15-18 > Flashcards

Unit 2 lectures 15-18 Flashcards

1
Q

Three phases crucial to health (during school age)

A

1) Middle childhood (5-9)
-malnutrition and infection constrains on development
-high mortality
2) Adolescent growth spurt (10-14)
-BMI increases rapidly
-Adequate energy intake is important for substantial physiological and behavioural changes
3) Adolescent growth phase (15-19)
- Brain restructuring (pre-frontal cortex)

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1
Q

NZ food and nutrition guideline statements
9 key recommendations to ensure optimal growth and prevent nutritional deficiencies, obesity and diet related chronic diseases.

A
  1. Eat a variety of foods from the 4 food groups.
    - Vege & fruit
    - Bread/cereals (increase wholegrains with age)
    - Milk products
    - Lean meat, poultry, fish, eggs, legumes, nuts/seeds
  2. Eat enough for activity, growth and to maintain a healthy body size
  3. Prepare/chose foods low in saturated fat, sugar and salt (use iodized)
  4. Adequate water intake throughout the day (incl low fat milk)
  5. Alcohol is not recommended
  6. Eat meals with family as often as possible
  7. Encourage children and adolescents to be involved in shopping, growing and cooking
  8. Purchase, prepare, cook and store food in ways to ensure food safety
  9. Be physically active
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2
Q

Fruit serves / day

A

1-2

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3
Q

Vege serves / day

A

3 -5

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4
Q

Bread/cereal serves / day

A

4 - 6

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5
Q

Milk/milk products serves / day

A

2-4

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6
Q

Complications of obesity in childhood

A

-Adult obesity
-Insulin resistance -> type 2 diabetes
- hypertenson/dyslipidemia -> CVD
- Increased mechanical load -> orthotic pain or sleep apnoea
- Low self-esteem -> psychological issues
- Puberty -> Impaired fertility

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7
Q

Satiety responsiveness / slowness and food fussiness in children

A

Negatively associated with body weight
:. if fussy, eat slow and respond to food satiety then less likely to have larger bodyweight

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8
Q

Higher food responsiveness, enjoyment of food, emotional overeating and desire to drink

A

Positivley associated with body weight

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9
Q

Strongest childhood obesity risk factors

A

Maternal pre-pregnancy BMI
Parental BMI
Maternal smoking during pregnancy
Infancy weight gain (high BW, rapid weight gain)

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10
Q

Effects of screen time

A
  1. Increased eating while using screens
  2. Reduced energy expenditure
  3. Food advertising on screens
  4. Change in sleep routines
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11
Q

Are RCTS which include programmes to reduce screen effective in reducing weight gain?

A

yes
suggests a casual relationship between screen time and obesity

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12
Q

Clinical guidelines for weight management in NZ children and adolescence

A
  1. Monitor: height, weight, BMI (if over 91st centile = brief intervention)
  2. Assess: collect full history and clinical exam to identify contributing factors for implementation of appropriate intervention.
  3. Manage: Aim to slow weight gain so can ‘grow into their weight’ (FAB)
  4. Maintain: LT follow up and monitor growth (i.e. contact and suppourt)
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13
Q

WHat is “Ka Ora Ka Ako School Lunch Programme” and “Feed the Need”

A

School lunch programmes implemeted to provide free and healthy food to children and to reduce food insecurity by ensuring they have access to nutritous meals.

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14
Q

Are children meeting the recommended guidelines for fruit and vege?

A

Data from surveys indicates that a significant percentage of children in New Zealand may NOT be meeting the recommended guidelines for fruit and vegetable intake.

Fruit: Two-thirds (68.6%) MET the guidelines
Vege: 39.7% MET the guidelines

*Boys are less likely to meet these guidelines compared to girls.

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15
Q

What percentage of children drink milk products at leaast once a week?

A

64%

*21% never consume milk

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16
Q

Snacks contribute significantly to children’s dietary intake.
They are NEEDED to meet the nutritional requirements.

A

True

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17
Q

Family influence on children’s eating behaviours

A

Two most dominant factors which influence children’s eating behaviours

  1. Parents Food Habits
    -what is available in house: only have nutritious food available
    -family meals: aim for 3/week -> inc consumption of nutritious food
    -portion size: Children guage appropriate portions from observing parents
    *common for toddlers to eat more than parents
  2. Feeding strategies
    -pressure to eat: results in higher avoidance = lower consumption of core foods :. Reduce food pressure = less picky eating, and more accepting of food.
    -Responsibility: self-regulation skills
    -focus on nutrition: positive food talk
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18
Q

Factors influencing dietary choices in children

A
  • Family income (avalibilty, i.e. full time working parents)
  • Education (nutrition knowledg)
  • Housing (appropriate equipment to prepare food)
  • Culture (food preferences, i.e. preception of food)
    Food marketing (promoting)
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19
Q

Relationship between food marketing and childhood obesity

A

Strong links between childhood obesity and food marketing.

  • Targeted around low decile schools (within 500m)
    where families have low socioeconomic status - twice as much as high decile schools
  • 50% marketing is for unhealthy food & bev
    78% were marketed to children

Current government policies - not adequate to protect children from unhealthy advertising of food and drinks
*Voluntary laws (not mandatory)

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20
Q

How can the food industry help to reduce childhood obesity

A
  • Reducing the fat, sugar, and salt content of processed foods is recommended.
  • Ensuring that healthy and nutritious food options are available and affordable to all consumers.
  • Encouraging responsible marketing, especially to children and teenagers.
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21
Q

What is the recommendation for sugar sweetened beverages?

A
  • Consume LESS than 1 glass per week
  • WITH meals (not between, to give teeth break from cho exposure)

fruit juice and sports drinks are not needed - just water and milk are recommended

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22
Q

What is the primary source of energy for NZ children?

A

Carbohydrates - mostly refined cereals and added sugars with low fibre which do not meet the reccomendations.

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23
Q

Are NZ children meeting the requirements for micronutrient intakes?

A

No
Particularly Calcium, Iron, Selenium, Zinc and Vitamin D

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24
Q

Risk for food insecurity

A
  • Deprived neighbourhood
  • low income
  • living in a rental property
  • Maori/pasifika populations
25
Q

Effects of childhood poverty

A
  • Reduced access to healthy food
  • little oppourtunity for PA
  • Potential adverse affects to health and development
  • poorer housing
26
Q

Children from socioeconomically deprived areas are more likely to be obese.

A

true
1 in 8 children are obese

27
Q

Factors Contributing to Childhood Obesity

A

energy intake imbalances
genetics
birth weight
maternal health
unhealthy diets
sedentary lifestyles
poor sleep, and environmental factors.

Screen time is significantly correlated with obesity in children, partly due to increased eating while on screens, reduced energy expenditure, and food advertising.

28
Q

Nutrition Care Process

A

includes monitoring, assessment, and management of children’s weight and nutritional needs.
Holistic approach and involving the child’s family in their care.

29
Q

Supporting Healthy Growth in Children

A

Focus on overall health - regardless of weight/size
Prommote healthy lifestyle i.e. PA, sleep, limiting screen time and healthy eating
*Not reccomended to diet

30
Q

What role do key nutrients play in the growth and development of children?

A
  • Facilitate physical, social, cognitive and emotional growth
  • provide energy and strength for daily activity
  • ensure steady growth and align appetite changes with growth spurts, supporting a healthy body composition.
31
Q

How does the pace of growth during adolescence affect nutritional needs?

A

Rapid growth increases energy and protien and micronutrient requirments.

Independent food choices and social pressure impact diet habitts -> over/under nutrition conerns

32
Q

What are some social pressures that adolescents face regarding nutrition and body image?

A
  • Exposure to FAD diets and misinformation
  • Desire for an ideal body shape
  • Societal beauty standards
  • Influence of peers on food choices
33
Q

A 16-year-old girl visits a nutritionist due to concerns about her energy levels and frequent fatigue. She recently started a fad diet to lose weight, influenced by social media trends. Her dietary intake lacks iron-rich foods, which raises concern for potential deficiencies.

A

Her current eating habits, particularly the lack of iron-rich foods, increase the risk of iron deficiency anemia. This condition can lead to fatigue, decreased energy levels, and hinder overall growth and development during adolescence.

33
Q

What dietary changes should be recommended to address iron deficiency anemia?

A

Increasing intake of iron-rich foods with vitamin C sources can enhance absorption.

34
Q

Describe the differences in body composition changes between males and females during adolescence.

A

Females: gain more body fat
need 17% for menarche, and 25% for normal menstruation. Body fat peaks at 15-16 years.

Males: Gain more lean mass (average 9 kg/year), end puberty with about 12% body fat.

*Girls mature earlier than boys.

35
Q

Strategies to prevent LEA

A
  • Ensure adequate energy intake for exercise requiremnts
  • Provide regular snacks and meals
  • Adjust intake based on training
  • Avoid long periods without eating
36
Q

Intentional LEA vs UN-intentional LEA

A

intentional: restricting energy intake
UN-intentional: failing to increase energy intake for higher training demand

37
Q

The Tanner stages

A

How puberty is evaluated
5-point scale that assesses characteristics such as pubic hair, breast development, menarche (females), genitalia development, and pubic hair (males).

38
Q

Adolescent snacking behaviours

A

Adolescents often snack, skip meals, or consume cheap foods. Skipping meals, especially breakfast, is common.

Influenced by dieting, screen time, activity level

39
Q

Meeting Adolescent Nutrient Needs

A

Adolescents have unique nutrient needs based on their stage of growth and activity levels.
Determining optimal energy intake can be challenging, but it is influenced by factors like
basal metabolic rate (BMR) and physical activity level (PAL).

Adequate intake of macronutrients (carbohydrates, fats, and protein) is essential for growth and development.

40
Q

Nutrient Concerns in Adolescence

A

iron deficiency anemia (especially during periods of rapid growth and menarche)

Nutritional needs vary by gender and development stage.

Adequate calcium and vitamin D intake is crucial for bone health.

41
Q

Adolescent bone health

A

over 90% of peak skeletal mass is reached by age 18.

Weight-bearing exercise plays a significant role in bone development.

Adolescents with obesity may have complex associations with bone mineral density.

Oestrogen, oestrogen deficiency, and oral contraception can impact bone health.

42
Q

Influencing Factors on Bone Health

A

Caffeine
Alcohol
cigarette smoking
dietary factors like sufficient energy, protein, calcium, and vitamin D can influence bone health.
Some medical conditions
dietary choices
lactose intolerance
dieting practices can affect bone mass.

43
Q

What is the primary neurotransmitter that promotes sleep drive?

A

Adenosine
- increases the need for sleep

It accumulates in the brain during wakefulness, leading to deeper sleep and helping regulate the sleep-wake cycle.

44
Q

How does sleep impact children’s behavior?

A

Sleep deprivation leads to increased irritability and difficulty coping.

negatively affecting their behavior and overall well-being.
Adequate sleep is crucial for their physical and psychological health, as well as their ability to function in school.

45
Q

What evidence is presented regarding the relationship between sleep and obesity in children?

A

Evidence shows that short sleep duration increases obesity risk and that sleep interventions may help prevent and treat obesity in children.

46
Q

Importance of sleep

A

Less tantrums
Better at listening
Concentration at school
More energy for activities
More patient
Happier
Growth and development
Less battles at bedtime

47
Q

What steps can be taken to improve sleep in children based on the DREAM intervention methods?

A
  • Establish a consistent bedtime routine
    Limit screen time before bed
  • Create a calming sleep environment
  • Encourage physical activity during the day
  • Monitor nutrition and eating habits
  • Educate parents on the importance of sleep for health and wellbeing
48
Q

children in her practice are experiencing behavioral issues and obesity. She suspects that inadequate sleep may be a contributing factor. The doctor decides to investigate the relationship between sleep duration and children’s eating habits.

How does sleep health impact children’s nutrition?

A

Inadequate sleep can lead to poor eating behaviors in children.
i.e. Increased consumption of unhealthy foods and difficulty regulating hunger.

This can contribute to obesity and negatively impact their overall health and well-being

49
Q

How might improving sleep duration impact childhood obesity rates?

A
  • Increases energy for physical activity
  • Enhance apetite regulation and make healthier food choices
50
Q

What are some behavioral changes in children that can result from insufficient sleep?

A
  • lack of concentration
  • irritability
  • increased tantrums
  • decreased patience
    *impacting children’s overall behavior and mood.
51
Q

How might circadian rhythms be contributing to sleep problems?

A

Circadian rhythms regulate the sleep-wake cycle.
Disruptions due to irregular sleep schedules or excessive screen time = impaired ability to fall asleep at night -> leading to insufficient rest and daytime fatigue.

52
Q

What key aspect of sleep health should be assessed to determine if a child is experiencing adequate sleep quality?

A
  • Assessing satisfaction with sleep
  • including how long it takes to fall asleep
  • if feels rested upon waking
53
Q

What is sleep ‘health’ ?

A
  • Ability to function day to day activities
  • Sustained alertness during waking hours
  • Satisfaction
  • Adequate duration and quality
54
Q

What did the Poi study (intervention) show?

A

Increasing sleep, reduced obesity risk in 5 year olds

55
Q

Possible mechanisms for short sleep increasing risk of obesity

A
  1. Sleep less = dietary changes which promoted weight
  2. Increase in sedentary behavior and decrease in PA
  3. Hormonal and metabolic changes
  4. other factors
56
Q

DREAM study

A

Randomised control trial, within subjects with a cross-over design
Aimed: To determine if mild sleep deprivation increased eating in the absence of hunger (EAH)

57
Q

Sleep interventions potentially prevent and treat obesity and problematic eating in middle childhood

A

Sleep hygiene recommendations:
Daylight exposure
PA
Don’t dine late
Restrict in bed activity
Have a fixed wake-up time
Don’t exercise before bed
Cool (but comfortable) room temp

58
Q

What is the most commonly skipped meal among adolescents? How does this affect overall nutrient intake?

A

Breakfast
- increases snacking behaviour: increases consumption of HFSS foods (20%) and lower consumption of fruit/vege and increased overall energy intake

59
Q

Why is vitamin D important in the body? Generally, who is at risk for low levels of vitamin D?

A

Bone Development, growth and repair, Enhances calcium absorption

Comes from sunlight exposure, those who live south of nelson
Old people =

HUNT 243 (7 decks)

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