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Flashcards in Under Nutrition in Infants and Children Deck (36)
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1

What is primary malnutrition?

Lack of or poor quality of food

2

What is secondary malnutrition?

accompanies a disease which disturbs appetite or food digestion/absorption/utilization

3

Consequences in developing countries, of malnutrition, include a major cause of death and stunts _______ and ________ development.

physical and mental development

4

In developed countries, malnutrition, accompanies a wide variety of ______, _____, _______ , _______ conditions.

Social, psychiatric, medical and surgical conditions

5

Undernutrition is due to a combination of what?

disease and dietary inadequacies which are mutually reinforcing

6

Inadequate dietary intake or disease leads to appetite loss and malabsorption, decreased immunity, mucosal damage and nutrient loss., which leads to what?

Faltering of growth and weight loss

7

Malnutrition can result in stunting or wasting. what is the difference between the two?

Wasting: low weight:height ratio
Stunting: low height:age ratio (more common than wasting) (develops post weaning; catch-up growth may or may not occur)

8

How is growth regulated?

1. Bone growth: is a genetic and nutritional component. length growth primary driver of whole body growth
2. Skeletal Muscle: Growth rate and target weight controlled by bone length growth due to passive stretch physiological stimulus for growth
3. Visceral Organ Growth: growth driven by functional demand (food intake and metabolic work)

9

Continued growth in infancy and childhood is regulated by what endocrine hormones?

Infant: IGF-1 mediated with insulin main driver of IGF-1)
Childhood: growth hormone is main driver of IGF-1 (dwarfism can be seen here)

10

Continued growth during puberty is regulated by what?

primarily sex-steroid driven

11

Bone lengths by endochondral ossification, what is the process?

recruitment of stem cells, via GH and IGF-1 and T3, which proliferate into chondrocytes

12

Stunting reduces psychosocial IQ development. What is a way to help increase the child's IQ?

Physical stimulation
--attention from the mother and dietary supplementation have a positive effect on improving the development of stunted growth

13

Infant lengthening reflects the maternal-intrauterine status and is independent of what?

Protein intake

14

In breast fed babies, protein intake was not associated with ______ or _____ gain during the first year of life

weight or length gain

15

Infection and inflammation produce what hormones and cytokines?

Cortisol
IL-1
IL-6
TNF
which all inhibit chondrogenesis (and lead to stunting)

16

What are the activators of chondrogenesis?

TGFbeta and BMP

17

Childhood height growth is sensitive to what?

1. Nutrition (type 2 nutrients): protein, zinc, potassium, sodium, magnesium, phosphorus and water -- you can't take a biochemical measurements and show a child is deficient in one of these nutrients
2. Environmental Stress

18

Type 2 nutrients are more likely to influence length growth and have what characteristics?

1. Ubiquitous with fixed tissue levels and lack of storage in the body.
2. No characteristic physical signs of deficiency
3. Immediate growth response
4. Responds to daily input with high degree of interdependence (control) on each other's balance
5. Sensitive to physiologic control (Through absorption or excretion)

19

What nutrients influence height growth?

Animal Source Food: milk, meat, fish, and eggs that are rick in bioavailable micronutrients and minerals
Type two nutrients: protein and zinc
Type one nutrient: iodine

20

During intervention studies in the 30s, 50s, and 70s, it was shown that giving school children, what food source, promoted what?

Skimmed milk supplements increased protein content in diet and height improved
--children were stunted on the low protein diet

21

In Uganda it was shown that what food sources showed faster height growth?

Milk and meat eating children are taller and thinner than those eating mainly starchy foods.

22

Therefore more milk and meat (protein) leads to what kind of school children?

Taller and thinner

23

We know that it is milk not meat that influence serum ________ and thus the height for children

IGF-1
--this was shown in preschool Danish children

24

For children on vegan diets, what were the results in terms of height?

Girls: able to maintain normal height growth
Boys: growth was slightly lower than average

25

Mineral supply, ______ and ______, does not seem to affect bone length, however deficiences can lead to bone deformities such as Rickett's.

Calcium and Phosphate
---phosphate alone may be relevant to length
---calcium does not affect long bone growth

26

Zinc, in animal studies, have been shown to stimulate bone ____ ______ and bone _____.

bone protein synthesis and bone formation
--to enable the anabolic effect of IGF-1 in the growth plate

27

Zinc augments the anabolic effects of IGF-1 on osteoblasts and inhibit _______ activity.

Osteoclast

28

A diet that was zinc-free showed what?

growth cessation and body weight cycling

29

Meta-anaylsis shows that zinc increases height but not _______??

weight in children

30

Zinc supplementation increases bone length/height growth in what situations?

In utero
In children
-global prevalence of inadequate zinc intake is correlated with the prevalence of stunting in children under 5 years of age