Answer questions

profilepeekaboo
chapter_12_child_and_preadolescent_nutrition.ppt
Home>Applied Sciences homework help>Answer questions

Chapter 12

Child and Preadolescent Nutrition

*

Definitions of the Life Cycle Stage

  • Middle childhood—between the ages of 5 and 10 years
  • Preadolescence—ages 9 to 11 years for girls; ages 10 to 12 years for boys
  • may also be termed “school-age”

*

Introduction

  • Focuses on growth and development of school-age and pre-adolescent children
  • Physical, cognitive, emotional, social growth
  • Growth spurts
  • Modeling healthy eating and physical activity behaviors

Importance of Nutrition

  • Establishing healthy eating habits helps prevent immediate & long-term health problems

  • Adequate nutrition associated with improved academic performance

*

Tracking Child and Preadolescent Health

  • Data on U.S. children in 2010
  • Children under 18 were nearly 10% of population
  • 7.5 million had no health insurance
  • Disparities in nutrition status exist among different races & ethnic groups

*

Tracking Child and Preadolescent Health

  • Disparities in nutrition status exist among different races & ethnic groups.
  • African American, American Indian, and Hispanic children more likely to live in poverty
  • Odds of being obese significantly higher for non-Hispanic Black children and Mexican American children

*

Normal Growth and Development

  • Measurement techniques
  • Growth velocity will slow down during the school-age years
  • Should continue to monitor growth periodically
  • Weight and height should be plotted on the appropriate growth chart

*

Normal Growth and Development

  • 2000 CDC growth charts
  • Tools to monitor the growth of a child for the following parameters
  • Weight-for-age
  • Stature-for-age
  • Body mass index (BMI)-for-age
  • Can be downloaded from CDC website: www.cdc.gov/growthcharts/cdc_charts.htm

*

Normal Growth and Development

  • 2000 CDC growth charts
  • Based on data from cycles 2 & 3 of the National Health & Examination Survey (NHES) & the National Health & Nutrition Examination Surveys (NHANES) I, II, & III
  • WHO Growth References
  • Available at www.who.int/childgrowth

*

Normal Growth and Development

*

Physiological Development in School-Age Children

  • Muscular strength, motor coordination, & stamina increase
  • In early childhood, body fat reaches a minimum then increases in preparation for adolescent growth spurt
  • Adiposity rebounds between ages 6 to 6.3 years
  • Boys have more lean tissue than girls

*

Cognitive Development in School-Age Children

  • Self-efficacy…the knowledge of what to do and the ability to do it
  • Change from preoperational period to concrete operations
  • Develops sense of self
  • More independent & learn family roles
  • Peer relationships become important

*

Development of Feeding Skills

  •  motor coordination & improved feeding skills
  • Masters use of eating utensils
  • Involved in food preparation
  • Complexities of skills  with age
  • Learning about different foods, simple food prep and basic nutrition facts

*

Eating Behaviors

  • Parents & older siblings influence food choices in early childhood with peer influences increasing in preadolescence
  • Parents should be positive role models
  • Family meal-times should be encouraged
  • Media has strong influence on food choices

*

Body Image and Excessive Dieting

  • The mother’s concern of her own weight issues may increase her influence over her daughter’s food intake

  • Young girls are preoccupied with weight & body size at an early age

*

Body Image and Excessive Dieting

  • The normal increase in adiposity at this age may be interpreted as the beginning of obesity

  • Imposing controls & restriction of ”forbidden foods” may increase desire & intake of the foods

*

Energy and Nutrient Needs of School-Age Children

  • Energy needs vary by activity level & body size

  • The protein DRI is 0.95 g/kg body wt

  • Intakes of vitamins & minerals appear adequate for most U.S. children

*

DRI for Iron, Zinc and Calcium for School-Age Children

*

Common Nutrition Problems

  • Iron deficiency
  • Less common in children than in toddlers
  • Dietary recommendations to prevent: encourage iron-rich foods
  • Meat, fish, poultry and fortified cereals
  • Vitamin C rich foods to help absorption

*

Common Nutrition Problems

  • Dental caries
  • Seen in half of children aged 6 to 9
  • Reduce dental caries by limiting sugary snacks & providing fluoride
  • Choose fruits, vegetables, and grains
  • Regular meal and snack times
  • Rinse (or better yet, brush the teeth) after eating

*

Prevention of Nutrition-Related Disorders

  • Prevalence of overweight among children is increasing
  • Data from NHANES I, II, & III suggest weight gain linked to inactivity rather than increases in energy intake
  • Excessive body weight increases risk of cardiovascular disease & type 2 diabetes mellitus

*

Prevalence of Overweight and Obesity

  • Definitions:
  • Obese = BMI-for-age ≥95th%
  • Overweight = BMI-for-age from 85th to 95th% (Discuss meaning of “to”)
  • Obesity more common in Hispanic and non-Hispanic black children and adolescents
  • Heaviest children are getting heavier

*

Characteristics of Overweight Children

  • Compared to normal weight peers, overweight children:
  • Are taller
  • Have advanced bone ages
  • Experience earlier sexual maturity
  • Look older
  • Are at higher risk for obesity-related chronic diseases

*

Predictors of Childhood Obesity

  • Age at onset of BMI rebound
  • Normal increase in BMI after decline
  • Early BMI rebound, higher BMIs in children later

  • Home environment
  • Maternal and/or Parental obesity most significant predictor of childhood obesity

*

Effects of Television Viewing Time

  • Obesity related to hours of television viewing
  • Resting energy expenditure decreases while viewing TV
  • Healthy People 2020 objective:
  • Increase proportion of children who view 2 hours or less of TV per day from 78.9% to 86.8%

*

Television Viewing Time

*

Addressing the Problem of Pediatric Overweight and Obesity

“An ounce of prevention is worth a pound of cure”

*

Prevention and Treatment of Overweight and Obesity

  • Expert’s recommend a 4-stage approach:
  • The four stages:
  • Stage 1: Prevention Plus
  • Stage 2: Structured Weigh Management (SWM)
  • Stage 3: Comprehensive Multidisciplinary Intervention (CMI)
  • Stage 4: Tertiary Care Intervention (reserved for severely obese adolescents)

*

Prevention and Treatment of Overweight and Obesity

*

Prevention and Treatment of Overweight and Obesity

  • Treatment consists of a multi-component, family-based program consisting of:
  • Parent training
  • Dietary counseling/nutrition education
  • Physical activity/addressing sedentary behaviors
  • Behavioral counseling

*

Nutrition and Prevention of CVD in School-Age Children

  • Acceptable range for fat is 25% to 35% of energy for ages 4 to 18 year
  • Include sources of linoleic (omega-6) and alpha-linolenic (omega-3) fatty acids
  • Limit saturated fats, cholesterol & trans fats

*

Nutrition and Prevention of CVD in School-Age Children

  • Increase soluble fibers, maintain weight, & include ample physical activity
  • Diet should emphasize:
  • Fruits and vegetables
  • Low-fat dairy products
  • Whole-grain breads and cereals
  • Seeds, nuts, fish, and lean meats

*

Dietary Supplements

  • Supplements not needed for children who eat a varied diet & get ample physical activity

  • If supplements are given, do not exceed the Tolerable Upper Intake levels

*

Dietary Recommendations

  • Iron
  • Iron-rich foods: meats, fortified breakfast cereals, dry beans, & peas
  • Fiber
  • Increase fresh fruits and vegetables, whole grain breads, and cereals
  • Fat
  • Decrease saturated fat and trans fatty acids

*

Dietary Recommendations

  • Calcium & Vitamin D
  • Bone formation occurs during puberty
  • Include dairy products and calcium-fortified foods
  • Vitamin D from exposure to sunlight and Vitamin D fortified foods
  • If lactose intolerant:
  • Do not completely eliminate dairy products but decrease only to point of tolerance

*

Fluid and Soft Drinks

  • Provide plain water or sports drinks to prevent dehydration
  • Cold water is the best fluid for children
  • Limit soft drinks because they provide empty calories, displace milk consumption & promote tooth decay
  • Energy drinks should not be consumed by children

*

Recommended versus Actual Food Intake

  • Saturated fat—intake is 11% of calories (recommend <7%)
  • Total fat—intake excessive in Black & Mexican-American girls and Black boys
  • Caffeine—increasing because of soft drink consumption
  • Calcium intake falls short of RDA
  • Fast food—33% of children consume fast food each day

*

Other Considerations

  • Cross-cultural Considerations
  • Healthy People 2020-a major goal-eliminate health disparities among different segments of the population

  • Health care professionals should learn about cultural dietary practices

*

Other Considerations

  • Vegetarian Diets
  • Suggested daily food guides for vegetarians are available
  • Vegetarian diets should be planned to provide adequate calories, protein, calcium, zinc, iron, omega-3 fatty acids, Vitamin B12, riboflavin and Vitamin D

*

Physical Activity Recommendations

  • Recommendations:
  • Children should engage in at least 60 minutes of physical activity each day
  • Parents should set a good example, encourage physical activity, and limit media & computer use
  • Actual:
  • Only 7.9% of middle & junior high schools require daily physical activity

*

Determinants of Physical Activity

  • Determinants may include:
  • Girls are less active than boys
  • Physical activity decreases with age
  • Season & climate impact level of physical activity
  • Physical education classes are decreasing

*

Organized Sports

  • Participation in organized sports linked to lower incidence of overweight
  • AAP recommends:
  • Participation in a variety of activities
  • Organized sports should not take the place of regular physical activity
  • Emphasis should be on having fun and on family participation rather than being competitive

*

Organized Sports

  • Participation in organized sports linked to lower incidence of overweight
  • AAP recommends:
  • Use of proper equipment such as mouth guards, pads, helmets, etc.
  • Should not include intensive, specialized training

*

Nutrition Education

  • School-age: a prime time for learning about healthy lifestyles
  • Schools can provide an appropriate environment for nutrition education & learning healthy lifestyles
  • Education may be knowledge-based nutrition education or behavior based on reducing disease risk

*

Nutrition Education

*

Nutrition Integrity in Schools

  • All foods available in schools should be consistent with the U.S. Dietary Guidelines & Dietary Reference Intakes
  • Sound nutrition policies need community & school environment support
  • Community leaders should support the school’s nutrition policy
  • The School Health Index (SHI) should be completed & implemented

*

Nutrition Integrity in Schools

  • The SHI (School Health Index) helps:
  • Identify strengths and weaknesses in health promotion policies and strategies
  • Develop an action plan
  • Involve stakeholders (teachers, parents, students, community) in improving school policies and programs

*

School Health Index

*

Public Food and Nutrition Programs

  • Child nutrition programs
  • Began in 1946
  • Provide nutritious meals to all children
  • Reinforce nutrition education
  • Require schools to develop a wellness policy

*

Public Food and Nutrition Programs

  • Financial assistance provided by the federal gov’t to schools participating in the National School Lunch Program
  • Five requirements
  • Lunches based on nutrition standards
  • No discrimination between those who can and cannot pay
  • Operate on a non-profit basis
  • Programs must be accountable
  • Must participate in commodity program

*

Public Food and Nutrition Programs

  • The National School Lunch Program (NSLP) Standards:

1. Both fruits and vegetables every day; increasing whole grains

2. Only fat-free or low fat milk

3. Limiting calories based on child’ age

4. Reduce saturated and trans fats, and sodium

*

School Breakfast Program

  • Authorized in 1966
  • States may require schools who serve needy populations to provide school breakfast
  • The NSLP rules apply to the School Breakfast Program
  • Breakfast must provide ¼ the DRI

*

Other Nutrition Programs

  • Summer Food Service Program
  • Provides summer meals to areas with >50% of students from low-income families
  • Team Nutrition
  • Provides training, technical assistance, education, or support to promote nutrition in schools

*