Nutrition

Question 1

What leads growth in infancy, childhood and puberty respectively?

Answer 1

infant - nutrient
childhood - growth hormone
puberty - sex steroids

Question 2

What is the reference nutrient intake for vitamin A and where is it obtained?

Answer 2

RNI - 350-400 micrograms/day

Cheese, eggs and yogurt

Question 3

What is the reference nutrient intake for vitamin C and where is it obtained?

Answer 3

RNI 25-30mg/day

Oranges, blackcurrants and potatoes

Question 4

What is the reference nutrient intake for vitamin D and where is it obtained?

Answer 4

RNI 7-8.5 micrograms/day

Oily fish and eggs but main source is the sun

Question 5

If an infant has <500ml/day of formula milk what supplements do they need?

Answer 5

Vitamins A,C and D

Question 6

By 2 weeks if a baby is breastfed what supplements should they be taking?

Answer 6

8.5-10micrograms/day vitamin D

Question 7

What supplement should breastfeeding mothers take?

Answer 7

10 micrograms/day of vitamin D

Question 8

When should weaning start?

Answer 8

About 6 months

Question 9

At what age should a bottle no longer be used?

Answer 9

1 year old

Question 10

Describe weaning

Answer 10

Foods should be gradually introduced and potential allergens should be introduced one at a time. Full fat cows milk can be used as a drink but introduced gradually

Question 11

When should a child start to brush their teeth?

Answer 11

As soon as they have their first tooth

Question 12

What are some risk factors for childhood obesity?

Answer 12

• deprivation
• parental obesity
• black ethnicity
• smoking in pregnancy
• lone motherhood
• pre pregnancy overweight
• solid foods before 4 months
• maternal employment

Question 13

How will a child with Prader Willi present at birth?

Answer 13

Floppy, weak/absent ability to suck, commonly have feeding problems

Question 14

What causes Prader Willi syndrome?

Answer 14

Mutations lead to problems in the hypothalamus and inappropriate hormone regulation of growth and appetite

Question 15

How will a child with Prader Willi present?

Answer 15

Hyperphagia (food seeking/lack of satiety)
Reduced energy requirements due to low muscle tone
Often have learning difficulties, hypogonadism and short stature

Question 16

How is Prader Willi treated?

Answer 16

Lifestyle management

Question 17

How are obese children managed?

Answer 17

Clinical Assessment
Aim to maintain weight (unless severely obese then aim is to lose 0.5-1kg/month)
Smaller portion sizes
Increase physical activity (60mins/day)

Question 18

What are the five key steps to reaching a target BMI?

Answer 18

Self monitoring 
Goal setting 
Contracting 
Stimulus control 
Relapse prevention

Question 19

Describe Orlistat

Answer 19

Inhibits gastric and pancreatic lipase to reduce fat absorption, only used in severe paediatric cases

Question 20

Describe surgery as a means to control obesity

Answer 20

Difficult when children are still growing, only used in exceptional circumstances and must be post pubertal