Exam 4 Study Guide
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This 32 page Study Guide was uploaded by Bridget Ochuko on Friday October 23, 2015. The Study Guide belongs to FDNS 4050 at University of Georgia taught by Alex K. Anderson in Fall 2015. Since its upload, it has received 88 views.
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Date Created: 10/23/15
FDNS Exam 4 Study Guide 10242015 Child and Preadolescent Nutrition Needs and Requirements De nitions of the Life Cycle Stage 0 Middle childhood 510 years of age Preadolescence ages 911 years for girls ages 1012 years for boys 0 Also known as quotschoolage Introduction 0 We focus on growth and development of schoolage and pre adolescent children 0 Physical cognitive emotional social growth 0 Growth spurts 0 Modeling healthy eating and physical activity behaviors Importance of Nutrition 0 Establishing healthy eating habits helps prevent immediate and longterm health problems Adequate nutrition associated with improved academic performance 0 Tracking Child and Preadolescent Health 0 Disparities in nutrition status exist among different races and ethnic groups African American American Indian and Hispanic children more likely to live in poverty Odds of being obese signi cantly higher for non Hispanic Black children and Mexican American children Physiological Development in SchoolAge Children 0 In early childhood body fat reaches a minimum then increases in preparation for adolescent growth spurt Adiposity rebounds between ages 663 years Boys have more lean tissue than girls Body Image and Excessive Dieting The mother s concern of her own weight issues may increase her in uence over her daughter s food intake Young girls are preoccupied with weight and body size at an early age The normal increase in adiposity at this age may be interpreted as the beginning of obesity Imposing controls and restriction of quotforbidden foodsquot may increase desire and intake of the foods Energy and Nutrient Needs of SchoolAge Children Energy needs vary by activity level and body size The protein DRI is 095 gkg body weight Intakes of vitamins and minerals appear adequate for most US children Iron intake decreases from 10 to 8 mgd Zinc intake increases from 5 to 8mgd Calcium intake increases from 1000 to 1300 mgd Common Nutrition Problems Iron de ciency 0 Less common in children than in toddlers 0 Dietary recommendations to prevent encourage ironrich foods Meat sh poultry and forti ed cereals Vitamin C rich foods to help absorption Pediatric Overweight and Obesity 0 Experts recommend a 4stage approach to treatment Stage 1 Prevention Plus Stage 2 Structured Weight Management SWM Stage 3 Comprehensive Multidisciplinary Intervention CMI Stage 4 Tertiary Care Intervention reserved for severely obese adolescents 0 Treatment consists of a multicomponent familybased program consisting of Parent training Dietary counselingnutrition education Physical activityaddressing sedentary behaviors Behavioral counseling CVD in SchoolAge Children 0 Acceptable range for fat is 25 to 35 of energy for ages 4 18 years 0 Include sources of inoeic omega6 and alphainoeic omega3 fatty acids 0 Limit saturated fats cholesterol and trans fats 0 Increase soluble bers maintain weight and include ample physical activity 0 Diets should emphasize Fruits and vegetables Lowfat dairy products Wholegrain breads and cereals Seeds nuts sh and lean meats Dietary Supplements Supplements not needed for children who eat a varied diet If supplements are given do not exceed the Tolerable Upper Intake Levels Dietary Recommendations lron ironrich foods meats forti ed breakfast cereals dry beans and peas Fiber increase fresh fruits and vegetables whole grain breads and cereals Fat decrease saturated fat and trans fatty acids Calcium and Vitamin D 0 Bone formation occurs during puberty 0 Include dairy products and calciumforti ed foods 0 Vitamin D from exposure to sunlight and Vitamin D forti ed foods 0 If lactose intolerant do not completely eliminate dairy products but decrease only to point of tolerance Fluid and Soft Drinks 0 Provide plain water or sports drinks to prevent dehydration 0 Water is the best uid for children 0 Limit soft drinks because they provide empty calories displace milk consumption and promote tooth decays 0 Energy drinks should not be consumed by children Recommended versus Actual Food Intake 0 Saturated fat intake is 11 of calories recommended lt7 0 Total fat intake excessive in black and MexicanAmerican girls and black boys 0 Caffeine increasing because of soft drink consumption 0 Calcium intake falls short of RDA 0 Fast food 33 of children consume fast food each day Determinants of Physical Activity Determinants may include 0 Girls are less active than boys because girls over the years are expected to be playing with dolls o It was not a part of the social norm about 20 years ago girls were expected to act like ladies not boys 0 Physical activity decreases with age because academic and other social challenges take precedent over being physically active 0 Season and climate impacts during the winter months people tend to exercise less 0 Physical education classes are decreasing because schools want to focus on being the best academically Organized sports 0 Participation in organized sports linked to lower incidence of overweight AAP recommends 0 Participation in a variety of activities 0 Organized sports should not take the place of regular physical activity 0 Emphasis should be on having fun and non family participation rather than being competitive Nutrition Education Schoolage a prime time for learning about healthy lifestyles Schools can provide an appropriate environment for nutrition education and learning healthy lifestyles Education may be knowledgebased nutrition education or behavior based on reducing disease risk Nutrition Integrity in Schools 0 Federal funding is supposed to provide this in every school 0 Healthy Hunger Free Kids Act enacted to improve the nutritional environment of the school 0 Provides physical activity and nutritional education to the students o All foods available in school should be consistent with the US Dietary Guidelines and Dietary Reference Intakes Sound nutrition policies need community and school environment support 0 Community leaders should support the school s nutrition policy 0 The School Health Index SHI should be completed and implemented this index helps 0 Identify strengths and weaknesses in health promotion policies and strategies 0 Develop an action plan 0 Involve stakeholders teachers parents students community in improving school policies and programs Nutrition Intervention for Risk Reduction 0 Model programs 0 The National Fruit and Vegetable Program Formerly quot5 A Dayquot program Publicprivate partnership for the CDC and other health organizations 0 High 5 Alabama study to evaluate the effectiveness of a schoolbased dietary intervention Public Food and Nutrition Programs 0 Child nutrition programs 0 Began in 1946 0 Provide nutritious meals to all children 0 Reinforce nutrition education 0 Require schools to develop a wellness policy 0 Financial assistance provided by the federal gov t to schools participating in the National School Lunch Program 0 Five requirements Lunches based on nutrition standards No discrimination between those who can and cannot pay Operate on a nonpro t basis Programs must be accountable Must participate in commodity program 0 The National School Lunch Programs NSLP 0 Standards Both fruits and vegetables everyday increasing whole grains Only fatfree or low fat milk Limiting calories based on child s age Reduce saturated and trans fats and sodium 0 School Breakfast Program 0 Authorizes in 1966 0 States may require schools who serve needy populations to provide school breakfast 0 The NSLP rules apply to the School Breakfast Program 0 Breakfast must provide 14 the DRI o Other Nutrition Programs 0 Summer Food Service Program provides summer meals to areas with gt50 of students from lowincome families 0 Team Nutrition provides training technical assistance education or support to promote nutrition in schools Conditions and their Nutrition Management During Preadolescence Body Composition and Growth Health conditions may alter muscle size bone structure fat stores 0 Children with health conditions tend to be shorter o Reduces muscle tone affects caloric need o Down syndrome results in short stature low muscle tone and low weight o Cerebral palsy and spina bi da may reduce muscle tone 0 Spina bi da may impact muscles only in the lower extremities Methods of Meeting Nutritional Requirements 0 Most children will be able to eat and drink like everyone else 0 Gastrostomy feeding may be required for Kidney disease Some cancers Severe cerebral palsy Cystic brosis Vitamin and Mineral Supplements for Chronic Conditions Supplements may be bene cial for conditions to assure adequate intake 0 Supplements help avoid micronutrient de ciencies Conditions that require supplements o Chewing problems need liquid supplements 0 Diabetes or on ketogenic diets should avoid supplements with added CHO Ketogenic diets diets high in fat and very low in carbs nWorks well for children who have seizures o PKU should avoid supplements with certain arti cial sweeteners o Cystic brosis requires fatsoluble vitamins o Galactosemia restricts dairy requires calcium Fluids 0 Conditions that impact uid status and increase needs include o Uncontrollable drooling o Constipation from neuromuscular disorders 0 Multiple medication use Eating and Feeding Problems in Children with Special Health Care Needs Speci c Disorders Cystic Fibrosis One of the most common lethal genetic conditions 0 Not determined at birth lnterferes with lung function because they accumulate a lot of mucous GI tract compromised which causes decreased absorption of nutrients related to the excess mucous buildup Must have a supplement of uid form that helps absorb nutrients Malabsorption due to lack of pancreatic enzymes oDietary considerations 0 Calories and protein increase 2 to 4 fold o Enzymes taken with meals to aid in digestion o Frequent meals and snacks o Fatsoluble vitamin supplements o Gastrostomy feeding at night may be needed to boost energy intake Diabetes Mellitus Disorder in insulin and blood glucose regulation 0 Type 1 virtually no insulin production 0 Type 2 associated with obesity 0 Treatment includes 0 Timing and composition of meals and snacks o lnsulin injections for type 1 0 Exercise 0 Summer camps for diabetic children Seizures Uncontrolled electrical disturbances in brain Seizures epilepsy Results of a seizure range from mild blinking to severe jerking oChildren who are born oxygen de cient or have had a head injury are at risk of seizures Postictal state time after seizure of altered consciousness Can be caused by anything that disturbs the brain oTreatment o Important to wait 30 min1 hour after the recovery of a seizure to make sure not to feed during postictal state due to the chance of choking o Medications may impact growth andor appetite o Ketogenic diets severely lowCHO diet with increased calories from fat Cerebral Palsy Group of disorders resulting from brain damage with impaired muscle activity and coordination Spastic quadriplegia presents most nutritional problems Tend to have higher caloric and protein needs o They get so tired eating so must go outside three meals a day o Feed frequently at smaller portion sizes to ensure adequate nourishment 0 Nutrition concerns slow growth difficulty feeding and eating 0 Athetosis less common form of CP uncontrolled movement which increases energy expenditure Phenylketonuria PKU o lnborn error of metabolism 0 Body lacks enzyme needed to metabolize phenylalanine o Require intervention to manage breakdown of dietary proteins 0 Diet is adequate in vitamins minerals protein fat and calories 0 Nutrients are often provided in liquid rather than solid form 0 Dietary treatment includes avoiding meats eggs dairy products nuts and soy beans ADHD Most common neurobehavioral problem 5 to 8 of children Chaotic meals and snacks with difficulty staying seated oMay be given fewer opportunities in the kitchen due to impulsiveness o Nutritional concerns o Medications May decrease appetite and growth medications peak activity is aimed at school hours appetite returns to normal when meds are not given such as on weekends and school holidays 0 No evidence of nutrition as a cause and treatment Protein Energy Malnutrition When protein is used for energy instead of for growth 0 lnadequacy of calories coming from fats and carbohydrates eating disorders particularly anorexia o Malnutrition involves both undernutrition and over nutrition o Cyclicalthing 0 One thing triggers it o If not corrected will pass on from generation to generation 0 Indirect and direct causes 0 In America our problem is over nutrition because we have an abundance of food Adapted malnutrition adapt to severechronic lack of nutrients over a long period of time inadequacy of these nutrients allows the body to adapt to no nutrition being provided Characteristics 0 Reduced muscle mas 0 Reduced but constant body weight o Normal serum albumin o Reduced serum prealbumin Marasmus not enough protein fat or carbs all around malnourished Maladapted malnutrition severe protein undernutrition may be getting some calories from carbs and fat Characteristics 0 Reduced muscle mass 0 Reduced and falling body weight 0 Reduced serum albumin 0 Reduced serum prealbumin Introduction 0 WHO de nes malnutrition as quotthe cellular imbalance between the supply of nutrients and energy and the body s demand for them to ensure growth maintenance and speci c functionsquot PEM applies to a group of related disorders marasmus kwashiorkor marasmickwashiokor De cits in any of the energy and growth sources affects micronutrients 0 Patients with PEM also have de ciencies of vitamins essential fatty acids and trace elements all of which may contribute to their dermatosis PEM affects virtually every organ system in the body Marasmus o Withering or wasting lnvolves inadequate intake of calories to match the body s requirements and is characterized by emaciation o It is an adaptive response to starvation 0 Body draws on its own stores so it uses all the fat stores left Kwashiorkor Taken from the Ga language of Ghana which means quotthe sickness of the weaning or rst child when the second is bornquot Characterized by inadequate protein intake with reasonable caloric intake with associated edema o It is a maladaptive response to starvation o Begins with only feeding the child carbs with no other nutrients Lack of education is why this continues to be a problem Body unable to adapt to lack of nutrients because it is still receiving some nutrients carbohydrates and fats Results in swelling edema of certain body parts such as the belly hands and feet oEarly signs are lack of pigmentation in hair hair becomes very dark Adequate carbohydrate consumption and decreased protein intake lead to decreased synthesis of visceral proteins 0 Associated hypoalbuminemia contributes to extravascular uid accumulation o Impaired synthesis of Blipoprotein leading to fatty liver Effect of PEM Low serum Zn have been implicated as the cause of skin ulceration in PEM babies 0 Edema o Stunting of growth 0 Severe wasting lmpaired glucose clearance that relates to dysfunction of pancreatic betacells Classi cation of PEM Primary PEM solely due to lack of food nutrients Secondary PEM occurs as a result of underlying medical condition metabolic issues nutrientdrug interactions Treatment oThe rst step in the treatment of PEM is to correct uid and electrolyte abnormalities and to treat any infections 0 Most common electrolyte abnormalities oHypokaemia oHypophosphaternia o Hypomagnesemia o Macronutrient repletion should be commented within 48 hours oMilkbased formulas are the treatment of choice 0 Calorie 175 kcalkg body weight 0 Protein 4 gkg body weight 0 Multivitamin supplements should be given Types of feeding formulas oF75 starter formula used during stabilizing phase given because severely malnourished children can not tolerate high amounts of protein and fat at this stage F100 contains more calories than the other will cause refeeding syndrome if you start the child on this Nutrient Needs and Requirements during Adolescence Lecture Launcher True we need lots of milk and vitamin D 0 True this is possible because they are accessible for an onthego lifestyle Introduction o It is during adolescence that risks for laterlife noncommunicable diseases such as cancer obesity CVD o This transitional period is associated with incremental nutritional needs that must be met in order to optimize their capacity during adulthood and the health of future generations 0 Normal biological and psychosocial growth and development on adolescents 0 Effect on nutrient needs and eating behaviors o Common nutrition concerns o Effective methods for educating and counseling teens oFemales tend to gain more body fat and males more lean muscle mass o Females misinterpret this as being obese but it is a normal physiological phenomenon olmportant to treat supplements as medication and take them when you are supposed to Nutritional Needs in a Time of Change oHealthcompromising eating behaviors 0 Excessive dieting o Meal skipping o Use of unconventional nutritional and nonnutritional supplements o Fad diets o Healthenhancing eating behaviors o Healthful eating practices 0 Physical activity 0 Interest in a healthy lifestyle 0 812 and Folic acid are the only two supplements that we ingest better than the original food all the rest are better ingested through the food Normal Physical Growth and Development Puberty occurs during early adolescence Biological changes of puberty include 0 Sexual maturation o Increases in height and weight o Accumulation of skeletal mass 0 Changes in body composition 0 The sequence of maturation events is consistent but great individual variation in age of maturation 0 Variations in reaching sexual maturity affect nutrition requirements of adolescents Sexual maturation or biological age not chronological age should be used to assess growth and development and nutritional needs 0 Sexual Maturation Rating quotTanner Stagesquot 0 Scale of secondary sexual characteristics used to assess degree of pubertal maturation SMR 1 prepuburtal growth and development SMR 25 occurrences of puberty SMR 5 sexual maturation has concluded Maturation and Growth of 0 Females o Menarche onset of rst menstrual period occurs 24 years after initial development of breast buds 0 Age of menarche ranges from 917 years 0 Peak liner growth occurs 612 months prior to menarche 0 Highly competitive athletes severely restrictive diets may delay or slow growth Males 0 Show great deal of variation in chronological age at which sexual maturation takes place 0 Peak velocity of linear growth occurs during SMR 4 and ends with appearance of facial hair at age 144 0 Linear growth continues throughout adolescence ceasing at age 21 Changes in Weight Body Composition and Skeletal Muscle 0 Females 0 Peak weight gain follows linear growth spurt by 36 months gain of 183 pounds per year 0 Average lean body mass decreases 44 increase in lean body mass LBM 120 increase in body fat 0 17 body fat is required for menarche to occur 0 25 body fat needed to maintain normal menstrual cycles 0 Males 0 Peak weight gain at the same time as peak linear growth and peak muscle mass accumulation 0 Peak weight gain 20 lb per year 0 Body fat decreases to 12 o Half of bone mass is accrued in adolescence Normal Psychosocial Development 0 The need to t in can affect nutritional intake 0 Who they eat with 0 Where they eat 0 Peer in uences may be greater than family 0 May improve dietary intake 0 May lead to poor dietary intake Health and EatingRelated Behaviors Factors affecting eating behaviors 0 Peer in uence 0 Parental modeling 0 Food availability preferences cost convenience 0 Personal and cultural beliefs 0 Mass media 0 Body image Busy lives lead to different eating styles 0 Little time to sit down for a meal 0 Snacking and meal skipping common 0 Eating away from home and as fastfood restaurants 0 Consuming more soft drinks less nutrient dense drinks 0 Eating meals in front of the television Energy and Nutrient Requirements of Adolescents Increases in lean body mass skeletal mass and body fat Energy and nutrient needs during adolescence exceed those of any other point in life Needs correspond to physical maturation stage Energy needs in uenced by 0 Activity level more active more energy 0 Basal metabolic rate BMR minimal amount of energy required to maintain vital bodily functions Example sleeping o Puberta growth and development once puberty is hit energy needs increase Because males have greater increases in height weight and lean body mass they have higher caloric needs than females 0 Because lean body mass is more metabolically active than adipose tissue which requires more energy Level of physical activity declines during adolescence resulting in reduced energy requirements Protein Requirements 0 In uenced by protein need to maintain existing lean body mass and for growth of new lean body mass Quality protein needed for additional growth of new lean body mass 0 Recommendation is 085 gkg body weight shows the gradual decline needed from infancy When we become adults we ten to eat excess amounts of protein Adults don t need so much protein because after adolescence we are not building muscle anymore but simply maintain muscle 0 Low protein intake includes Reductions in linear growth likely to be stunted Delays in sexual maturation Reduced LBM Carbohydrates 130 gday or 4565 of calories 0 Majority should come from whole grains or complex carbohydrates 0 Most adolescents are getting most of their caloric intake from added sugars Dietary Fiber 0 DRI Recommends 26 gday for adolescent females 31 gday for males lt14 years of age 38 gday for older adolescent males 0 Fiber should come from fruits and vegetables 0 Fat 0 Required as dietary fat and essential fatty acids for growth and development 0 2535 of calorie from total fat 0 lt10 calories from saturated fat 0 Most adolescents get the wrong type of fat in their bodies fast food 0 Calcium 0 Adequate intake of calcium is critical to ensure linear growth and peak bone mass 0 Calcium absorption rate in females is highest around menarche 0 Calcium absorption rate in males is highest during early adolescence o 4 times more calcium retained during early adolescence compared to early adulthood Best time to build healthier bones o Adolescents who do not include dairy should consume calciumforti ed foods 0 Soft drink consumption displaces nutrientdense beverages such as milk and forti ed juices o DRI for ages 918 years is 1300 mgday 0 Average intake is 948 mg for females the result of females being at higher risk for osteoporosis 1260 mg for males 0 Weightbearing activities may lead to increased bone mineral dens y 0 Iron 0 Increased iron needs related to O O O Rapid rate of linear growth Increase in blood volume Menarche in females In females iron needs greatest after menarche In males iron needs greatest during the growth spurt Iron de ciency estimates 9 of 1215 yo females 5 of 1212 yo males 11 of 1519 yo females 2 of 1519 yo males n Females tend to be more iron de ciency than males n Athletes that sweat a lot are candidates for iron de ciency as well 0 With this de ciency athletes can become disoriented dizzy and tired Can ingest Vitamin C to help absorb iron 0 Vitamin D O OO 0 Essential role in facilitating absorption of calcium and phosphorous Essential role in immune function Essential for bone formation Synthesized by the body via skin exposure of ultraviolet B rays of sunlight In northern latitudes may require supplementation RDA 600 IUday Foa te O O O O O Folate required for DNA RNA and protein synthesis DRI 400 mcg Grilled vegetables forti ed cereals Severe folate de ciency leads to megaloblastic anemia Severe de ciency rare but inadequate folate status appears to be more common Folate added to forti ed foods synthetic version is better absorbed than folate from natural foods Adequate folate intake for female adolescents reduces incidence of birth defects like spina bi da It is imperative that women of reproductive age 15 to 44 years consume adequate folic acid Increased risk of folate de ciency if skipping breakfast or not consuming forti ed foods Some evidence is beginning to show that it could reduce dementia and Alzheimer s Nutrient Intakes of Adolescents US adolescents have inadequate intake of vitamins and minerals including 00000 O Folate Vitamins A B6 C and E Iron and zinc Magnesium Phosphorous and calcium Dietary ber Dietary Intake and Adequacy Many adolescents have diets that do not match the Dietary Guidelines for Americans or the MyPlate Recommendations 0 Most have inadequate consumption of 0 Dairy 0 Grains 0 Fruits and vegetables those consuming this are consuming it through fruit and vegetable drinks resulting in most of the ber being taken out and micronutrients lost 0 32 of calories from fat and 21 from added sugars Nutrition Education and Counseling 0 Use of technology to facilitate education and counseling text messaging podcasts YouTube Facebook Twitter 0 Technology can serve as a means to convey nutrition info in an engaging way Promoting Healthy Eating and Physical Activity Behaviors 0 Effective nutrition messages for youth O 0000 0 Teens are quotpresent orientedquot Concerned about appearance Achievingmaintaining a healthy weight Having lots of energy Optimizing sports performance Environmental or moral aspects of food 0 Pa rent involvement 0 O O 0 Target pa rents They are gatekeepers of foods Serve as role models Adolescents who eat at the table with their parents are more likely to consume healthy foods and correct portions Teenagers eat based on availability and convenience 0 Parents can capitalize on this 0 Stock a variety of nutritious readytoeat foods 0 School programs should be part of a comprehensive coordinated school health program that includes 0 Health instruction Physical education School food service Health services Health promotion for faculty and staff 0 Integrated community efforts Nutrition Environment of the School USDA sponsors the National School Nutrition Program and the School Breakfast Program 0 School lunches and breakfasts should complement and reinforce what is learned in class and help students develop healthy eating habts Chips candy or soft drinks sold in vending machines as fund raising events or offered as rewards by teachers send inconsistent nutrition messages to students 0 Commercial messages and advertisements easy access to highfat highsugar highsodium food products send con icting messages about nutrition Community Involvement 0 Promoting life long healthy eating and physical activity behaviors among adolescents requires attention to multiple in uences such as 0000 Theconvnun y Home School lWedm OOOO Model Nutrition Program 0 Numerous innovative nutrition programs exists that promote nutrition to youth 0 One example in CANFIT California Adolescent Nutrition and Fitness Weight and Weight Related Issues in the Athletic Population Weight and Performance ls weight sport speci c 0 All sports have different muscleweight requirements 0 Can have different muscleweight requirements within a sport as well Does more muscle always mean greater performance 0 Too much muscle can result in a decrease in speed exibility and agility 0 Too little muscle can result in decrease in strength and power Does lower body fat mean better performance 0 Some body fat is essential for health and performance Males 35 Females 1215 Optimal body weight for an athlete is determined by height weight body buildgenetics and size 0 Optimal body weight can be maintained without constant dieting allows physical activity and promotes healthy eating habits and takes into account genetic history of body weight and shape 0 Body shapes Ectomorph tall and lanky Mesomorph average normal muscle to height ratio Endomorph stalky and short lots of muscle What is Energy 0 Energy calories 0 Carbohydrates used during long duration andor low intensity endless supply 0 Protein spared during exercise used in recovery period to rebuild used in times of extreme endurance exercise 0 Fats used immediately small supply 0 During exercise energy breaks down Gaining Weight 0 Goal increase muscle mass to point of increased performance without an increase in excess body fat 0 Men 121 lbweek 0 Women 1434 lbweek Meal Plan 0 Increase overall calorie intake from carbs and fats Men 400500 kcals Women 300400 kcals 0 Extra protein does not equal muscle 0 Intake around workouts Resistance Training 0 Health Risks 0 Heart disease 0 Diabetes 0 Obesity 0 Sleep apnea 0 High blood pressure 0 High cholesterol Losing Weight 0 Goal decrease weight without losing strength power or endurance decrease body fat while protecting muscle mass 0 12 lbsweek with moderate energy de cit Via exercise andor decrease in calorie intake Not gt2 lbsweek Meal Plan 0 20 ess total calories than needed Men 300500 kcals Women 200300 k cas 0 Higher protein balance carbfat intake 0 Resistance Exercise 0 Health Risks o Injuryillness 0 Stress fracture which can lead to early osteoporosis o Disordered eating patterns 0 Amenorrhea Fad Diets and Athletic Performance Zone Diet 0 403030 CarbProteinFat 0 Philosophy lower carbohydrate less insulin secretion less fat storage 0 Truth any excess calorie intake leads to fat storage not just carbohydrate Atkins High fat high protein very lowno carbohydrate Philosophy lowno carbohydrate decreased insulin secretion decreased fat storage 0 Truth when carbohydrate intake is too low the body goes into ketosis body resorts to fueling brain with ketones breakdown of protein South Beach 0 Modi ed Atkins eliminates rice pasta bread and starch but includes fruits and veggies Philosophy low carbohydrates decreased insulin secretion decreased fat storage 0 Truth when carbohydrate intake is too low the body goes into ketosis Low Glycemic Index Glycemic index measures how fast and how much a food raises blood sugar levels 0 Philosophy foods with high GI are fattening because they cause rapid increase in blood sugar stimulating insulin release leading to fat storage 0 Truth GI does not take into account mixed diets athletes already have a reduced insulin response each person s reaction to carbohydrate foods is variable What do we know athletes need 0 The main fuel for exercise and brain functioning is carbohydrates 0 Without adequate carbohydrates this leads the athlete to have decreased performance and energy Overall 0 A sports quotstereotypical body typequot can differ from sport to sport and within a team 0 An ideal body type does not necessarily mean optimal performance 0 Weight gain and weight loss need to be done healthfully to avoid health consequences o What athletes do now nutrition wise affects their performance and health later in life Conditions and Interventions during Adolescence and Sports Overweight and Obesity Rapidly increasing in children 17 are obese based on BMI 0 Environmental factors epigenetics integrating these factors into what in uences genetics 0 2535 of people Caucasians are obese in Georgia Assessing Weight Status 0 In children look at BMI for age percentile not the raw score 0 Relative to weight and sex DXA Measure entire body composition as opposed to just assessing weight and height relative to age fat mass lean mass bone mass 0 Radiation is not a problem 0 Not given to pregnant women Health Implications of Adolescent Overweight Sleep apnea extra weight on chest make it difficult to breath while asleep very large concern 0 Orthopedic problems musculoskeletal complications due to extra weight on the body Bone Growth 0 Peak area where growth velocity is at its greatest 916 years 0 Greatest during adolescence 0 Optimizing bone growth is the greatest determinant for fractures later on in life 0 Bone Imaging o pQCT measures bone and muscle tissue 0 Important determinants of strength of bones Types 0 Trabecular matrix of bone tissue more surface area because of the spongy type resulting in more bone turnover 0 Cortical bone compact bone extremely resistant to bending and pressure 0 Bone marrow is where metabolic activity happens 0 Bone strength depends on size strength and density of bone 0 Boys have more size and strength while girls have more dense bones Muscle and Bone Growth 0 Peak height velocity measures the amount of height changing in a person s body over a period of time 0 Girls 12 years 0 Boys 135 years 0 Girls hit peak height velocity faster because girls physically mature faster 0 Peak height velocity is reached rst then peak muscle velocity then peak bone velocity 0 Bone always follows muscle because muscle needs to develop before bone continues to Obese kids have greater muscle than normal weight kids 0 Normal weight kids have larger and stronger bones than obese kids 0 Why do obese kids not have bene t of strong bones 0 Because they have so much extra fat surrounding the muscle and bones Positives adiposederived estrogens greater body weight really only bene ts the lower body Negatives chronic in ammation hyperglycemia insulin resistance 0 This increases their risk of fracture which is a problem 0 Why exactly are obese kids fracturing so easily 0 They aren t getting as much exercise 0 Their bones are weaker 0 Their tend to have lower muscle functioning Bonedependent bone size and strength contribute to fractures Boneindependent muscle function and quality are compromised IGF During adolescence when muscle and bone mass spike is greatest IGF is at its highest 0 Causes bone elongation and increase in diameter Assessment and Treatment of Adolescent Overweight and Obesity 0 Type 2 diabetes in children is a huge problem in the US 0 Prediabetes sign Blood glucose 100125 mgdL type 2 glucose greater than 126 mgdL
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