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NU FS 356 > School Age Children > Flashcards

School Age Children Flashcards

1
Q

Age of school children

A
  • Middle Childhood: 5 to 9 year olds
    Preadolescence: 9 to 11 year old girls & 10 to 12 year old boys
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2
Q

Growth of school aged children

A

growth is lower than earlier stages and occurs in spurts
* gain average 3 to 3.5 kg and 6 cm per year

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3
Q

What is the gain in fat mass called and when does it occur?

A

rebound adiposity around ~6-7 years
* normal increase in BMI
* greater increase in fat mass for girls
* early rebound adiposity associated with obesity

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4
Q

How is growth monitored?

A

WHO growth charts
monitor using weight for age (until 10 years of age) and height for age; BMI for age

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5
Q

What factors would be considered optimal for growth in these age groups?

A
  • physical activity/ movement
  • Sleep
  • Quality nutrition
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6
Q

Motor Skill Development

A
  • improved motor coordination
  • ability to perform more complex pattern movements
  • increasing muscular strength
  • physical activity contributing more to energy expenditur (highly variable)
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7
Q

Feeding and Food Skills

A
  • mastered the use of utensils
  • should be involved with food preparation and chores related to meals
  • ready to learn about simple nutrition facts and relate to food they are eating
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8
Q

How should this aged learn about nutrition?

A

“this food helps make you strong”
* Not complex
* not related to chronic disease or body weight
* not “good” or “bad” foods

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9
Q

Cognitive and Social Development

A
  • decreased engocentricism
  • more rational cause/effect reasoning, but concrete thinking (Can relate consequences to action)
  • development of sense of self and self- efficacy
  • increasing importance of peer relationships
  • greater independence
  • promotion of autonomy
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10
Q

Eating Behaviours

A
  • eat more away from home
  • some independance on food choice
  • influence of family vs. peers
  • environmental influences (culture of school, activites, what is available)
  • marketing of foods (beyond advertising too)
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11
Q

Diet Quality

A

Based on following recommendations in Eating Well with Canada’s Food Guide most require improvement or have a poor quality diet.

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12
Q

How are energy intakes determined?

A

Energy needs for maintenance, growth and activity
Estimated Energy Expenditure:
* separate formula boys and girls
* different formula for 3-8 years and 9-18 years
* weight, height, age, and physical activity level (variable)

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13
Q

Stats of obesity

A

Canadian Health Measures Survey (2009 to 2011):
* 5 to 11 year olds: 19.7% overweight
* 13.1% obese
* ~1.5% underweight

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14
Q

Canadian 24-hr movement guidelines for 5-17 years

A

SIT
* Limit sitting for extended period
* No more than 2 hours of recreational screen time

UNINTERRUPTED SLEEP
* 5 to 13 years: 9 to 11 hours
* Consistent bed and wake-up times

STEP (LIGHT ACTIVITY)
* Several hours, structured and unstructured

SWEAT (MODERATE TO VIGOROUS)
* At least 60 mins
* Vigorous activities, muscle and bone strengthening at least 3 days/week

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15
Q

Macronutrient Recommendations

A
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16
Q

fibre intake

A

Median intake fibre: below AI boys and girls 4-13yrs

Canadian Community Health Survey (CCHS) 2.2 (2011)

17
Q

AMDRs

A
18
Q

fat intake stats

A
  • 9-13 years female: 6.5% fat intake below, 11% above
  • 9-13 years male: 12% fat intake above
19
Q

Micronutrients of Concern

A

Reflects intake of ultra-processed foods
Intake less than EAR 9 to 13 year olds:
* Iron: <3%
* Calcium: 44-67%
* Vitamin D: 84-93%%
* Vitamin A: 12-22%
* Magnesium and Zinc: 10-25% girls

  • Sodium: 80-97% had intake above UL
  • Potassium: median intake below AI

Lower range: males; Higher range: females

20
Q

Goals for School-Age Children

A
  • adequate, but not excessive, energy and nutrient intake
  • support normal development (growth, motor, cognitive and social)
  • encourage healthy eating patterns and behaviors (family strongest influence still)
  • support self-regulation of energy intake
21
Q

Division of Responsibility in Feeding

A
  • Parents decide: What foods are offered & when and where to eat
  • Children decide: Whether or not they eat & how much they eat
22
Q

How to Feed a School-Age Child

A
  • role modeling
  • foods available and accessible (chopped up veg and fruit)
  • food preparation
  • consistent eating schedule (Need to know when they can expect to eat)
  • meals at table without distractions
  • selecting foods and serving size from what
    is offered themselves (encourage internal cues)
23
Q

What parental control practices that can have negative impact?

A
  • pressure to eat
  • restriction for weight
  • threats and bribes
  • intrusive control ⤄ permissive feeding
  • prompt to eat
  • rules and limits
  • redirection and negotiation
24
Q

Body Image

A

Children senstive to cues from parents and friends so rebound adopisty can be misconstrued and may start to trigger negative body images.
* severe restriction of ‘unhealthy’ foods and/or focus on weight can increase risk of disordered eating in children

25
Q

Healthy Foods to feed school aged children

A
  • variety (all food groups, different foods within groups)
  • unprocessed or minimally processed emphasized
  • processed in moderation; ultra-processed not needed
26
Q

What regulates energy intake?

A

INTERNAL CUES: The hypothalamus is the control centre of hunger and satiety via signals from the nervous system, hormones, and blood nutrient levels
* hunger: low glucose, ghrelin, other hormones
* satiety: stretching in GI tract, CCK, leptin, other hormones

27
Q

What are External Cues?

A

Anything that can influence consumption other than feelings of hunger and satiety and can interfere with internal cues
* sight, smell, taste of foods
* Advertising
* Habits, social situations
* Portion sizes
* Parental and peer modeling
* Pressure or incentives to eat more
* Using food as a reward
* Food often equates with love or acceptance

28
Q

Regulation of Energy Intake in Toddlers and Pre-schoolers

A

6 day food records in 2 to 5 years reveal large
variability in energy from individual meals (33%),
lower variability in daily energy (10%)
* responsive to internal cues: energy intake variability, eat more if lower energy density
* but sensitive to external cues: praise, rewards, portion sizes, peers

29
Q

Fat Substitution Study in 2-5 year olds

A

Ate more CHO to compensate for calories they weren’t getting in fat
* meals can be variable but children are good at regulating overall intake

30
Q

Influence of internal vs. external cues

A

Children will rely on internal cues but can be overrun by external cues which can lead to more food consumption
* yogurt study - encouraging taste
* drink study - praise/ reward
* peer modelling

31
Q

Yogurt study

A

external cues ate more high density

Based on study: Adjustments with different energy density and use of internal vs external cues (convo about fullness vs. food)
* yogurt – same amount with one high kcal and the other low kcal
* offered an ad lib snack (unlimited amount) after yogurt
* influence of internal vs external cues

32
Q

Praise and reward (Drink study) on energy intake regulation

A

Reward does not always encourage to eat more food creates an inadvertent side effect it seems like

Children (3 to 5 years) offered novel drink
* Praise if drink +/- offered more and encouraged
* Movie ticket if drink +/- offered more and encouraged
* Controls – got drink and movie ticket

Offered drink again Consume less second time if praise or movie with or without encouragement to drink more the first time

33
Q

How does modelling as an external cue effect regulation?

A

Food preferences determined – children who didn’t like vegetable (target) mixed with peers who did and saw that peers influenced each other in both ways, so will accept and try new foods with peers
* Evaluated frequency of choosing non-preferred food, and overall consumption of non-preferred food and children who did not like vegetables increased intake of that vegetables

34
Q

Why is assessing appetite important?

A

assessment of appetite important in understanding regulation of food intake
* appetite: subjective sensations of hunger, satiety, motivation to eat

35
Q

Appetite Assessment in Older Children and Adults

A

visual analog scales are most commonly used to assess appetite for these ages

36
Q

Assessing appetite in young children

A

Developed a picture-based assessment for
use in young children where they can point to pictures where they feel most hungry (board games, video games, walking dog etc.)
* Before the age of ~8 years, not able to complete visual analog scales usually either starving or extremely hungry so hard to assess level of hunger and satiety.

Around peri-willer syndrome - part of this is ravenous hunger

37
Q

Reccomendations around exposure to allergenic foods

A

Introduce “allergenic” food earlier
* Purposeful early feeding of peanut is a reversal from the 2000 AAP recommendations that suggested high-risk infants avoid peanut to age 3 years.

NU FS 356 (21 decks)

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