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by: Regan Dougherty

NHM201ch14and15.pdf NHM 201

Regan Dougherty
GPA 4.0

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chapter 14/15 lecture notes
Nutrition Through the Lifecycle
Denise DeSalvo
Class Notes
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This 9 page Class Notes was uploaded by Regan Dougherty on Thursday November 5, 2015. The Class Notes belongs to NHM 201 at University of Alabama - Tuscaloosa taught by Denise DeSalvo in Summer 2015. Since its upload, it has received 36 views. For similar materials see Nutrition Through the Lifecycle in Nutrition and Food Sciences at University of Alabama - Tuscaloosa.

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Date Created: 11/05/15
Tuesday, November 3, 2015 NHM 201 Chapters 14 & 15 Adolescent Nutrition - Ages 11 - 21 - Puberty occurs during adolescence. - Major changes in psychosocial development occur during this stage of the life cycle. - Normal Physical Growth and Development • The sequence of maturation events is consistent, but the events may occur at different ages. • increases in height and weight and changes in weight distribution - Sexual Maturation Rating (Tanner Stages) - scale of secondary sexual characteristics used to assess degree of pubertal maturation. • 1: prepubertal growth/development • 2 - 5: occurrences of puberty • 5: sexual maturation has concluded - Adolescent Height Changes • Females - begin gaining height between 9.5 and 14.5 years old. - Height growth peaks before menarche (onset of menstrual cycle). - The average increase at peak is 3.5” per year. • Males - begin gaining height between 10.5 and 17.5 years old. - Height growth peaks at 14.4 years. - The average increase at peak is 2.8 - 4.8” per year. - Girls reach peak height gain before peak weight gain (follows by 3 to 6 months) Lean body mass decreases. • 1 Tuesday, November 3, 2015 - Menarche • follows development of breast buds. • Average at about 12.5 years; range is 9 to 17 years • Delays may be caused by restrictive diets or athletics. - Maturation and Growth of Males • Peak linear growth is usually in SMR stage 4. ~14.5 - appearance of facial hair • • Peak weight gain occurs at the same time as peak height gain (about 14.4 years). - Peak weight gain: 20 lbs per year - Body fat decreases to about 12%. - Half of bone mass is accrued in adolescence. - Assessing Growth • Height (stature/standing height) • Weight • BMI for age - Factors that Impact Nutrition • Biological, psychosocial, and cognitive changes Rapid growth increases needs. • • The desire for independence may lead to the adoption of health-compromising eating behaviors. - Dietary Trends in Teens • Decrease: - dairy - grains/whole grains - fruits and vegetables - folate 2 Tuesday, November 3, 2015 - vitamins A, B6, C, and E - iron, zinc, magnesium, phosphorous, and calcium - fiber • Increase: - total fat and saturated fat - cholesterol - added sugars (primarily from sugar-sweetened beverages) - sodium • Most adolescents do not consume diets that do not match the Dietary Guidelines for Americans. - Energy and Nutrient Needs • Calorie needs are high to aid development. • Energy and nutrient needs during adolescence exceed those of any other point in life. • see Table 14.5 Energy needs are influenced by: • - activity level (about 35% of teens report moderate activity) • decline in physical activity of females - Basal metabolic rate (BMR) - pubertal growth and development • Males have greater increases in height, weight, and lean body mass (LBM), resulting in higher caloric needs than females. • Protein Needs - Protein in necessary for increasing LBM and to grow. - 0.85 g/kg - Low protein intake is linked to: reductions in linear growth, delays in sexual maturation, reduced LBM. 3 Tuesday, November 3, 2015 • Carbohydrate Needs - ~130 g/day or 45-65% of calories • Fat Needs - Teens consume more unhealthy than healthy fats. - Recommendations: • 25-35% total calories from fat <10% calories from saturated fat • • <300 mg cholesterol per day • Consume good sources of omega 3 and 6 fatty acids. • Fiber - 26 g for adolescent females - 31 g for males <14 years of age - 38 g for older adolescent males • Calcium - 1300 mg (ages 9 - 18) • Iron - 8 g (9 - 13); 15 g (14 - 18) - Iron needs increase for females because of the onset of menstruation. - also increases due to increase in blood volume. - In males, iron needs are greatest during the growth spurt. • Folate - 300 - 400 mcg - Promoting Healthy Eating and Physical Activity Behaviors • Parents should make healthy options more available to adolescents. - Chapter 15: Conditions and Interventions • Vegetarian Diets 4 Tuesday, November 3, 2015 - see Table 14.2 - Benefits: • high in fiber, vitamins, minerals • consume fewer salty snacks • consume less fat • Vegetarian diets are only beneficial if they are well-planned. - Pay attention to: protein, calcium, zinc, iron, vitamins D, B6, B12, and DHA - Concerns • Adolescent vegetarians are: - more likely to report binge eating. - twice as likely to report frequent or chronic dieting. - four times as likely to report purging. - eight times as likely to report laxative abuse. - Allow adolescent vegetarians to make their own decisions. But, be sure to give them the best information about making healthy decisions. • Overweight and Obesity - BMI for age and gender is used to assess weight status • BMI between 85th and 95th = overweight • BMI > 95th percentile = obese - Boys are more likely to be obese than girls. - There are significant differences in race and ethnicity. - Low-income populations in the U.S. are at an increased risk for overweight and obesity. - Assessing Weight Status • calculate BMI • plot BMI using appropriate BMI for age chart 5 Tuesday, November 3, 2015 • Healthy Behaviors - Nutritional Guidelines - 4 stages of treatment (pages 388 - 390) - Eat breakfast daily. - Limit restaurants and fast food. - Have family meals at least 5 times per week. - 5-2-1-0 consume at least 5 servings of fruits and vegetables • • limit screen time to less than 2 hours per day • recommend at least 1 hour of physical activity • 0 sugar-sweetened beverages • Adolescent Pregnancy - Possible nutrient deficiencies: calcium, iron, zinc, magnesium, folate, vitamins A, E, and B6 - Underweight increases the risk for LBW or SGA (small for gestational age). - Poor weight gain in first 24 weeks increases risk of SGA. - Poor weight gain after 24 weeks increases risk of pre-term delivery. • Iron Deficiency Anemia - risks: rapid growth, inadequate nutrition, vegetarian diets, meal skipping, strenuous sports, heavy menses • Hypertension - 140/89 for boys - 132/86 for girls • Adolescent Athletes - Nutrition Concerns: • fluid and hydration - body temperature regulation 6 Tuesday, November 3, 2015 - recommendations: 6-8 oz before; 4-6 oz every 15-20 minutes during activity; at least 8 oz following exercise; not more than 16 oz in 30 minutes (may cause nausea) - Water is the best fluid option. If they are going to have juice, dilute it (1:2) - Higher carb/glucose sports drinks can cause GI distress. • diet extremes (low or high carb // low or high protein) - Athletes may need 500-1500 additional calories per day. - Protein should supply no more than 30% of calories. - Carbohydrate Loading • used with endurance athletes • high-carb diet combined with resting to increase glycogen • days 1-3: low carb with high exercise // days 4-6: high carb with rest/ minimal activity to promote glycogen storage - High Protein Diet • may be 3 or 4 times to DRI • Should be discouraged because: - protein foods are typically high in total and saturated fats. - protein and fat may delay digestion and absorption, limiting total energy available for activity. - more water required for protein breakdown which increases dehydration risk. • If you’re eating mostly protein, you’re missing nutrients from fruits, vegetables, and other foods. • Eating Disorders - associated with self-esteem issues - can be the result of poor diet choices and unsuccessful dieting attempts. - can be mental health related. - 3 categories of eating disorders: 7 Tuesday, November 3, 2015 • Anorexia Nervosa (AN) - 2 subtypes: restrictive or binge-purge - extreme weight loss - fear of gaining weight - distorted image of body weight and shape - amenorrhea Bulimia Nervosa (BN) • - 2 subtypes: purging or non-purging - may be normal weight or slightly overweight - recurrent episode of rapid uncontrolled eating with compensatory behavior - at least twice a week for 3 months - associated with depression • Eating Disorder Not Otherwise Specified (EDNOS) - binge eating disorder • normal/overweight • binge eating at least twice a week for 6 months • not associated with compensatory behaviors eating more rapidly than normal, overeating to uncomfortably full, eating • large amounts when not hungry, eating alone or secretly, feeling disgusted/depressed/guilty after - Causes • social factors - cultural pressures, definition of beauty, societal norms that value appearance • biochemical/biological factors • psychological factors - low self-esteem/feelings of inadequacy or lack of control in life 8 Tuesday, November 3, 2015 • interpersonal relationships - history of being teased about weight, physical/sexual abuse - Problems Associated with Eating Disorders • disrupted blood sugar levels, ketoacidosis, diabetes, iron deficiency anemia, kidney infection and failure, osteoporosis/osteopenia, arthritis, amenorrhea, easy bruising, dental problems, depression, malnutrition, dehydration, electrolyte imbalance, lanugo (development of fine hairs on face), edema, hypo/hypertension, muscle atrophy, esophageal damage, insomnia, hair/skin/ nail problems, GI rupture/bleeding - Some athletes are at a higher risk for eating disorders. • sports that require weight control or thinness • pressure, perfectionist tendencies • Female Athlete Triad - disordered eating • weight loss/loss of body fat - amenorrhea • increase risk of infertility • primary amenorrhea: menarche delayed beyond 16 years • Secondary amenorrhea: absence of 3-6 consecutive menstrual cycles - osteoporosis • increased risk of stress fractures 9


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