Child and Preadolescent Nutrition Needs; Conditions and their Nutrition Management during Preadolescence
Child and Preadolescent Nutrition Needs; Conditions and their Nutrition Management during Preadolescence FDNS 4050
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This 11 page Class Notes was uploaded by Bridget Ochuko on Monday October 19, 2015. The Class Notes belongs to FDNS 4050 at University of Georgia taught by Alex K. Anderson in Fall 2015. Since its upload, it has received 20 views.
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Date Created: 10/19/15
FDNS Test 4 Notes 10122015 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 Feed frequently at smaller portion sizes to ensure adequate nourishment Nutrition concerns slow growth difficulty feeding and eating Athetosis less common form of CP uncontrolled movement which increases energy expenditure 0 Phenylketonuria PKU AD lnborn error of metabolism Body lacks enzyme needed to metabolize phenylalanine Require intervention to manage breakdown of dietary proteins Diet is adequate in vitamins minerals protein fat and calories Nutrients are often provided in liquid rather than solid form Dietary treatment includes avoiding meats eggs dairy products nuts and soy beans HD Most common neurobehavioral problem 5 to 8 of children Chaotic meals and snacks with difficulty staying seated May be given fewer opportunities in the kitchen due to impulsiveness 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
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