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NUTR451 > EXAM 3 > Flashcards

EXAM 3 Flashcards

1
Q

Healthy People 2020 for toddlers/preschool goals (6)

A
  1. decrease childhood deaths
  2. increase parents that use positive parenting and communicate with doctors about positive parenting
  3. increase Americans 2 yrs and older who follow the dietary guidelines
  4. Reduce iron def. by 10% among young children
  5. Eliminate very low food security among children
  6. Concern for overweight and obesity in children
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2
Q

Typical growth for toddler and preschooler

A

toddler 6 lb/yr

preschooler 4.4 lb/yr

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3
Q

CDC 2-20 years BMI underweight

A
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4
Q

CDC 2-20 years BMI

risk for overweight

A

> 85th percentile but less than 95th percentile

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5
Q

CDC 2-20 years BMI overweight

A

> 95th percentile

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6
Q

Ideas to promote healthy eating in a picky eater

A

Don’t pressure

  • give choices
  • don’t bribe
  • mix foods
  • repeated food exposure
  • fav food next to new food
  • help with food prep
  • pick out veggies in store
  • same food as fam
  • don’t short order cook
  • child chooses how much or whether to eat
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7
Q

What are the nutrients of concern in the FITS study?

A
  • not enough fruits and veggies
  • too much sodium
  • too much Sat. fat
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8
Q

Define responsive parenting

A

involves prompt, emotionally supportive and developmentally appropriate responses that promote the infant’s developing ability to move between states of arousal

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9
Q

During a responsive feeding the parent is…(3)

A

Aware of cues.. Is child full?

Accurate interpretation…of those vocal, behavioral, and affective cues accurate

Prompt, developmentally appropriate response… portion sizes, type of foods served, use of controlling feeding practices

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10
Q

Protein RDA for 1-3 years

A

1.1 g/kg or 13g/day

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11
Q

Protein RDA for 4-8 years

A

0.95 g/kg or 19 g/day

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12
Q

American Heart Association fat recommendation for 2-3 yrs

A

30-35%

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13
Q

AI for fiber 1-3 years old

A

19 g/d

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14
Q

AI for fiber 4-8 years

A

25 g/d

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15
Q

What are the micronutrients of concern in toddlers and preschoolers? (3)

A

iron, zinc, calcium

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16
Q

How to prevent iron deficiency in toddlers and preschoolers?

A

recommend

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17
Q

How to prevent Ca deficiency in toddlers and preschoolers (5)

A
  • serve milk or fortified calcium drinks
  • use heated milk to make foods ex. hot cocoa
  • add cheese to foods
  • desserts made with milk
  • add dried milk power to mixed dishes
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18
Q

How to prevent Vit D def in preschoolers and toddlers

A

full clothed: 2 hrs/wk in sunlight

dark children need longer exposure

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19
Q

RDA for iron for 1-3 yrs and 4-8 yr

A

5 mg/d

10 mg/d

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20
Q

RDA for zinc for 1-3 yr and 4-8 yr

A

3 mg/d

5 mg/d

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21
Q

RDA for Ca for 1-3 yr and 4-8 yr

A

700 mg/d

1000 mg/d

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22
Q

How to prevent dental caries in toddlers/preschoolers

A
  • Fluoridated water

- If

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23
Q

How to prevent lead poisoning in toddlers/preschoolers (5)

A

Eliminate Lead Sources

-Pb pipes, Pb-based paint (Homes

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24
Q

Food security

A

access at all times to sufficient supply of safe, nutritious foods

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25
Q

Food insecurity is more common in ______ populations. It is a concern for growing children since food insecurity may hinder _____ and ______.

A
  1. minority

2. growth and development

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26
Q

How to handle food safely (4)

A
  1. Clean: wash hands and surfaces
  2. Separate: don’t cross contaminate
  3. Cook to proper temperatures
  4. Chill: refrigerate promptly
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27
Q

Prevention of overweight and obesity in toddlers and obesity (10)

A 
-Limit sugar-sweet beverages
•Encourage fruits & vegetables
•Limit TV
•Daily breakfast
•Limit fast foods
•Calcium rich diets
•Diets high in fiber
•Follow the DRI for carbs, pro & fat
•Promote physical activity
•Limit energy-dense foods
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28
Q

Prevention of CVD in toddlers/preschoolers

A

Limit dietary saturated fats, trans fat & cholesterol

For children at high risk limit Sat fat to

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29
Q

Fat intake for 4-18 years

A

25-35% of kcals

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30
Q

AAP recommens supplements for certain groups of children: (6)

A
  • from deprived families
  • anorexia, poor appetites, or diet for weight management
  • consume only a few types of food
  • vegetarians w/o dairy products
  • chronic disease
  • classify as failure to thrive
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31
Q

AAP rules to follow for supplement for children (2)

A
  • Doses should not exceed the DRI for age

* Pay careful attention to avoid high doses of VitA and VitD

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32
Q

Herb supplement recommendations for toddlers/preschoolers (2)

A
  • advise parents of potential risk and to closely monitor children
  • consult with pediatrician before giving
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33
Q

middle childhood

A

5-10 yr

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34
Q

preadolescence

A

girls: 9-11
boys: 10-12

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35
Q

adolescence

A

11-21 years

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36
Q

Puberty

A

girls: 10.5-14 yr
boys: 12-16.5 yr

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37
Q

Physical changes in childhood and preadolescence stages (3)

A

-steady growth, growth spurts, appetite increases(7/lb/yr; 2.5 lb/yr)
–↑ Muscle strength, motor coordination, stamina
–Body composition –↑ body fat
•greater ↑ in body fat in females vs. males during early puberty

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38
Q

Cognitive changes in childhood and preadolescence (4)

A

–↑ self-efficacy, develop sense of self, independent
–Focus on many aspects of a situation at a time
–Can see “another’s” point of view
–Enjoy playing strategy games

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39
Q

Energy needs for middle childhood and preadolescence (2)

A

–Reflects child’s activity level and body size

–↓ in kcals/kg compared to toddlers & preschoolers

40
Q

Protein needs for middle childhood and preadolescence

A

4-13 y/o girls and boys: 0.95 g/kg/bwper day

41
Q

Vitamins and minerals of concern for middle childhood and preadolescence (3)

A

calcium, zinc, iron

42
Q

Fluid recommendation for middle childhood and preadolescence

A

use thirst as a guide except with exercise

43
Q

Milk or calcium fortified soy,almond milk recommendation for 4-8 yrs and 9+ yrs

A

2.5 c/d

3 c/d

44
Q

Juice recommendation for middle childhood and preadolescence

A

100% juice

no more than 1 c. per day

45
Q

True or false sports drinks or diluted juices are appropriate during prolonged vigorous exercise for middle childhood and preadolescence

A

true

46
Q

middle childhood and preadolescence groups that are at risk for iron deficiency (2)

A
  • vegetarian or strict vegan diets

- children with known risk factors for iron-def anemia

47
Q

Treatment for iron def in middle childhood and preadolescence (2)

A
  • Iron supplements, iron drops (3mg/kg)

- Iron rich foods with Vit C to enhance abosprtion

48
Q

Risk factors for iron def (5)

A
  • Low household income
  • Lack of consistent medical care
  • Poor diet quality
  • Parents with low education level
  • African American and Mexican-American children
49
Q

Weight and body composition changes in female adolescence (4)

A
  • Peak velocity weight gain at 12.5 years
  • weight gain slows around menarche and continues into late adolescnece
  • body composition changes compared to childhood (increase lean mass 44%, increase body fat 120%)
  • Changes in proprtion of fat mass and lean mass relative to body weight (decrease lean mass, increase fat mass (16-26%)
50
Q

Males weight and body composition changes in adolescence (3)

A
  • Increased body wt compared to childhood, peak wt gain: 14.4 years
  • Increase lean mass (2x more than females)
  • changes in proportion of fat mass relative to body wt (increase fat mass (15-18% bw)
51
Q

Fmeales and males skeletal mass changes in adolescence.
Bone density ______.
____ adult peak bone mass accrued.
By age ____, 95% of people have acheived peak bone mass.

A
  1. increases
  2. 1/2
  3. 20
52
Q

What are energy needs based on in adolescence?

A

velocity of growth (not age)

-influenced by activity level, BMR, and increase requirements to support pubertal growth and developemt

53
Q

Protein intake for adolescence

A

0.85 g/kg BW

54
Q

Chronically low intake of protein during adolescence can lead to…. (2)

A

–↓linear growth and lean mass accumulation

–Delayed sexual maturation

55
Q

At risk groups for low protein intake during adolescence are…(3)

A

–Food insecure households
–Those severely restricting kcals
–Those following vegetarian diets (esp. vegan diets)

56
Q

Why is calcium/Vit D important during adolescence? (3)

A
  • Low Vit D levels are inversely related to BP, fasting BG, hypertriglyceridemia, and metabolic syndrome
  • Ca absorption rates peak for both males and females in adolescnece
  • Vit D recommendation: 400IU/d
57
Q

Why is iron important during adolescence? (4)

A 
Iron requirement increases
–Support rapid linear growth
–Expanding blood volume
–Losses with menstruation (females)
–Males: 11 mg/d and Females: 18 mg/d
58
Q

How are teens meeting myplate fruits recommendations?

A

males: 25%
females: 20%

59
Q

How are teen meeting myplate vegetable recommendations?

A

males: 17%
females: 14%

60
Q

How are teens meeting myplate grains recommendations?

A

males: 64%
females: 48%

61
Q

How are teens meeting myplate protein recommendations?

A

males: 50%
females: 17%

62
Q

How are teens meeting myplate dairy recommendations?

A

males: 20%
females: 9%

63
Q

Reasons for poor dietary adequacy in adolescence (5)

A
  • irregular meals
  • poor food choices
  • overconsumption of carbonated beverages and fruit drinks
  • fewer meals with family
  • external influences (peers, tv)
64
Q

Risk factors for overweight and obesity in adolescence (6)

A
  • Having at least one parent who is overweight or obese
  • Coming from a low-income family
  • African American, Hispanic, or American Indian/Native Alaska descendent
  • Limited mobility
  • Low physical activity/sedentary lifestyle
  • Excessive kcal, added sugar, and fat intake
65
Q

Treatment Stage 1: Prevention

Obesity in adolescence

A 
•60 min of physical activity per day
•Help develop and sustain healthful eating habits
–5 servings F/V per day
–Limit sweetened beverages
–Limit screen time (
66
Q

Treatment Stage 2: Weight Management

Obesity in Adolescence

A

-Parental and adolescent monitoring of behaviors
-Reinforce stage 1-goals
(Limit screen time,
Structured meal plan,
journal to monitor behaviors, non-food reward system for motivation)
-Best to have trained professional involved

67
Q

Treatment Stage 3: Multidisciplinary intervention

Obesity in Adolescence

A

–More structured and involves healthcare team specializing in pediatric obesity management
–Structured behavior modification program with weekly visits for 8-12 weeks initially

68
Q

Treatment Stage 4: Tertiary Care

Obesity in Adolescence

A

–Severely obese youth or have serious comorbid conditions
–Adolescent needs to be emotionally mature for this stage
–Attend a pediatric weight management center

69
Q

Semi or particial vegetarians exclude

A

red meat

70
Q

lacto-ovo vegetarians exclude

A

all meat

71
Q

lacto- vegetarians exclude

A

meat and eggs

72
Q

macrobiotic vegetarians exclude

A

meat, eggs, dairy, seafood, fish (some may eat fish)

73
Q

Health affects on growth and development of adolescences consuming vegetarian diets (3)

A
  • shorter and leaner prior to puberty
  • later onset of puberty (final adult height may occur later)
  • taller and leaner after puberty
74
Q

Nutrient concerns for vegetarians/ vegans (9)

A

protein, iron, zinc, calcium, Vit D, Vit B12, Vit B6, total fat, omega-3-FA

75
Q

Anorexia Nervosa

A

Persistent restriction of energy intake leading to significantly low body weight (due to intense fear of gaining weight or disturbance in one’s body weight)

76
Q

Typical Anorexia profile (6)

A
  • Female
  • Middle and upper class
  • Competitive, obsessive
  • Evaluate self-worth in terms of self-control
  • Refuse to eat
  • Conflicting family structures
77
Q

Health affects of anorexia (12)

A
  • ↓ body temperature
  • Slower metabolic rate
  • heart rate
  • Iron-deficiency anemia
  • Rough, dry, scaly skin
  • Weakened immune system
  • Hair loss
  • Constipation
  • Low blood potassium
  • Amenorrhea
  • Tooth decay
  • Osteoporosis
78
Q

Treatment of Anorexia nervosa (5)

A
  • Correct consequences of malnutrition
  • Stop further weight loss
  • Increase food intake and restore appropriate food habits
  • Slow weight gain, set small attainable goals
  • Provide reassurance during the refeeding process
79
Q

Bulimia Nervosa criteria (4)

A
  • recurrent episodes of binge eating (during discrete time, larger portions, lack of control)
  • recurrent inappropriate compensatory behavior (vomiting, laxatives, excessive exercise, diurectics)
  • occurs at least once a week for 3 months
  • The disturbance does not occur exclusively during episodes of anorexia nervosa
80
Q

Typical bulimia profile (5)

A
  • Successful, perfectionist
  • White, middle-class women
  • Weight maintenance or extreme weight fluctuations
  • Use food to cope
  • Low self-esteem, depression
81
Q

Health affect of bulimia (5)

A
  • Enamel damage and demineralization
  • Hypokalemia
  • Swollen salivary glands
  • Stomach ulcers, bleeding and esophageal tears
  • GI distress from frequent laxative use
82
Q

Binge eating disorder episodes are associated with 3 ore more of the following: (5)

A

– eating much more rapidly than normal
– eating until feeling uncomfortably full
– eating large amounts of food when not feeling physically hungry
– eating alone because of feeling embarrassed by how much one is
eating
– feeling disgusted with oneself, depressed or very guilty afterward

83
Q

Binge Eating disorder defined

A
  • Binge eating episode
  • marked distress regarding binge eating is present
  • occurs 2x per wk for 3 months
84
Q

Bulimia nervosa treatment (4)

A
  • Correct misconceptions about food
  • Emphasize regular eating habits
  • Psychotherapy for more realistic body and self image
  • Treatment groups
85
Q

12 months development

A 
Walk independently (drink from a cup, pincer
	 grasp to put food into mouth, can hold spoon)
86
Q

15 months development

A

: Crawl upstairs (handle chopped or soft food)

87
Q

18 months development

A

Run, rapid increase in language skills from

10-15 words to lots of words

88
Q

24 months development

A

Walk up + down stairs, jump (more mature chewing, meat + raw f + v, etc., “No”)

89
Q

36 months development

A

3 word sentences (I do it. No, no, no.)

90
Q

Toddlers and feeding (4)

A

• No sense of danger:
Everything into mouth.
But also developing fears
• Develop rituals and routines in daily activities
Regular meals and snacks, gives sense of security
• Increased determination to express their own will.
Give choices.
• Social development: imitation of others
Now learning about family cultural.
Parents and peers as role models.

91
Q

Preschoolers development and feeding behavior: Typical development (4)

A

-Continue with gross and fine motor skills
- Magical thinking, egocentrism
-More cooperative
-Parents need to strike an appropriate balance for setting limits:
not too tight – undermine sense of initiative
not too loose – may feel anxious, no one in control

92
Q

Feeding behavior and appetite of preschooler (4)

A

Similar to toddler
Can use a fork and spoon, and cup, still lots of spills
Growth in spurts so appetite varies
Wants to be helpful and imitate parents/adults

93
Q

Both toddlers and preschooler should…

A

eat together as a family, sit down snack

94
Q

Concerns about juice intake for toddlers/preschoolers (3)

A
  • displaces nutrient dense food (ex. milk)
  • suppress appetite
  • may increase calorie intake
95
Q

Fruit juice should be limited to…

A

1-6 yr: 4-6 oz

7-18 yr 8-18 oz

96
Q

What are the energy requirements for 1-3 years based on?

A

EER formulas

based on weight

97
Q

What are the energy requirements for 3 years old and up based on?

A

EER formulas

based on age, gender, ht, wt, and PAL

NUTR451 (3 decks)

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