exam 4

high food security

household had no problems, or anxiety about consistently accessing adequate food

marginal food security

households had problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of their food intake were not substantially reduced

low food security

households reduced the quality, variety, and desirability of their diets but the quantity of food intake and normal eating patterns were not substantially disrupted

very low food security

at times during the year, eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food

food insecurity definition

prolonged, involuntary lack of food, results in discomfort, illness, weakness, or pain that goes beyond the usual uneasy sensation

how food insecurity is measured

based on data collected by CPS survey

survey results

three positive = low food security, six or more positive = very low food security

food insecurity trends

* higher in households with children
* especially if single mother
* more common in black households

what food insecurity looks like

* irregular eating
* periods of underconsumption
* compensatory overconsumption
* food deprivation
* low food quality
* high calorie, low-cost foods

coping strategies for food insecurity

* physiological
* economical/food choice
* psychological/stress
* adaption to feast/famine cycle

chronic diseases often seen with food insecurity

* T2D
* obesity
* hypertension

childhood food insecurity impacts

* academic achievement
* health
* behavior outcomes

academic achievement of food insecure child

* lower scores in math and reading
* lower engagement in class
* loss of school days
* repeated grades

health of food insecure child

* lower health in general
* more stomach aches
* more headaches

behavior outcomes of food insecure child

* externalized → aggression, hyperactivity, inattentiveness
* internalization → depression, anxiety, substance abuse

consequences connected to transient state of food insecurity

externalized behavioral issues

consequences connected to long term food insecurity

* internalized behavioral issues
* academic achievement
* health

consequences of food insecure infants/toddlers

* developmental risk
* impairs child attachment
* mental proficiency
* impaired cognitive development

consequences of food insecure preschool child

* externalizing and internalizing behaviors
* interpersonal skills
* self-control
* mental health

consequences of food insecure school children

* impaired academic performance
* missing school
* hyperactivity, inattention
* borderline emotional problems
* interpersonal relations

consequences of food insecure adolescents

* anxiety, depression, suicidal thoughts
* suspension, difficulty getting along
* substance use disorder

impaired mother-child interaction mechanism

food insecurity reduces quality of interaction → lack of stimulation → impact on brain development and cognition

not impaired mother-child interaction mechanism

* hunger → less movement/lethargy → reduced development of gross motor skills → academic achievement and behavior
* less exploring and social interaction → reduced cognitive stimulation → academic achievement and behavior

steps to take

1. identify child development and behavioral issues
2. assessment of food security
3. evaluate development and behavior risks and caregiver’s psychological symptoms
4. refer to food assistance programs

hormone surge impacts

* reward processing
* emotional stimulation and processing
* social-cognitive reasoning

testosterone in boy and girls

* increased proactive aggression
* increased risk taking

hormonal surge can affect behavior by….

social environment

estrogen in girls

* decreased behavioral inhibition
* increased risk taking

when is the onset of eating disorders?

during adolescence, peak at age 21

eating disorders classified by DSM-5

* anorexia nervosa
* bulimia nervosa
* binge eating disorder
* OSFED

which is more at risk for developing an eating disorder?

females

trends in eating disorders

* increased for children ages 5-12
* increased in males
* increased in minorities

body fat % & FFM in females during development

increased fat mass until end of puberty, increased FFM until mid-puberty

body fat % & FFM in males during development

fat mass increase during adiposity rebound until puberty, steep increase of FFM during puberty while fat mass slightly increases

emotional development during development

* increase emotional reactivity
* decreased inhibition
* increased social bonding
* increased awareness
* increased reward orientation

physiological development during development

* secondary sex characteristic growth
* increased fat mass
* increased muscle

changes affecting body image

heightened experience of negative emotions → discovering sense of self-concept → impacted body image

body image definition

how you see yourself in the mirror or when you picture yourself in your mind, encompasses perception of body characteristics, body-related behavior, cognitions and attitudes towards one’s body

body dissatisfaction definition

the negative thoughts and feelings about one’s body

predictor for development of eating disorders

body dissatisfaction

the thin-idealthe musc

exposure to social media &increased social reward seeking behavior → internalized thin-ideal → depreciation of body fat & comparison to ideal → risk for eating disorders

the muscular-ideal

exposure to social media &increased social reward seeking behavior → internalized muscular-ideal → depreciation of body fat & comparison to ideal → risk for eating disorders and muscle dysmorphia

eating disorder composition

body dissatisfaction + restrictive eating + global psychological functioning

anorexia nervosa definition

self-starvation, weight loss/sufficient weight gain, distorted body image, intense fear of gaining weight and restrict caloric intake

anorexia nervosa complications

* heart disease like myocardial atrophy
* marked bone mineral density leading to osteopenia and osteoporosis
* pulmonary problems
* cognitive deficits
* 5% mortality

bulimia nervosa definition

loss of control eating large amounts of food in one sitting followed by strategies to get rid of excessive calories such as self-induced vomiting, misuse laxatives/diuretics, excessive exercising, or fasting for at least once a week for 3 months

bulimia nervosa complications

* dehydration leading to kidney failure
* heart problems like arrhythmia
* severe tooth decay
* absent or irregular periods
* digestive problems

binge eating disorder definition

recurrent episodes when they eat large quantities of food to the point of discomfort with no reduced ingested calories, at least once a week for 3 months

most common eating disorder in the US

binge eating disorder

binge eating disorder complications

* association with obesity
* depression and anxiety

body dysmorphic disorder (BDD)

fixation of non-existing or slight physical flaw associated with self-hatred, shame, or overcritical thoughts

muscle dysmorphia

subcategory of BDD when the fixation in on being too small or not muscular enough

BDD complications

* interference with school and work due to time-consuming behaviors
* low quality of life
* higher rates of suicide and substance use disorders

orthorexia definition

not recognized by DSM-5, characterized as a desire to eat healthy eventually to the point of obsession damaging health and lower quality of life

orthorexia complications

* nutrient deficiencies
* malnutrition
* anxiety and depression

criteria for athletes

* training in sports aiming to improve performance/results
* actively participating in sport competitions
* formally registered in a sport organization/team/league that participates in competitions
* sports training and competition is majority of activity or focus; devoting several hours most days for these activities

average teen energy needs

* due to growing body
* additional 20-30 kcal per day
* males have an RMR increase due to increasing lean mass

teen athlete energy needs

* larger increase due to increasing RMR from muscle growth
* competing in sports increases energy needs to support energy expenditure

insulin activity

insulin-bound receptor stimulates GLUT4 to open more channels to allow exocytosis of glucose into the cell

insulin sensitivity

* higher sensitivity means cells remove glucose quickly from the blood stream
* increased with higher energy expenditure and more lean mass

insulin resistance

lack of insulin receptors, reduced signaling or translocation of the insulin receptor redirecting glucose to specific tissues

insulin and adolescents

adolescents have increased insulin resistance

effects of insulin resistance in sports

1. less ability to convert glucose into muscle or liver glycogen
2. a muscle will use less glucose and more fat as an energy source

plate for easy training/weight management

reflects MyPlate recommendations

plate for moderate training

increased carb intake through grains and fruit to fuel additional energy expenditure

plate for hard training/competition

large increase of carbs for exercise and for depleted muscle glycogen post exercise

relative energy deficiency in sport (RED-S)

due to chronic under-fueling which may lead to nutrient deficiencies

RED-S complications

* increased risk of injury
* irritability and depression
* irregular/loss of menstrual cycle
* impaired muscle growth and strength
* decreased training response

before exercise hydration recommendation

* 16-20 oz water/sports drink at least 4 hours before
* 8-12 oz 10-15 minutes before exercise

during exercise hydration recommendation

* drink every 15-20 minutes
* 3-8 oz water if < 60 minutes
* 3-8 oz sports drink if > 60 minutes

after exercise hydration recommendation

* 16-24 oz for every pound lost within 2 hours of exercise
* chocolate milk, sports beverage, water, etc

dehydration syndrome

when body has lost 2% of its weight due to seat loss, worsen if lost weight through sweat fluids containing electrolytes

nutrients of concern for deficiencies in athletes

* calcium
* vitamin D
* iron

calcium recommendation

1300 mg, deficiency associated with bone breaks

vitamin D recommendation

eating eggs yolks & fortified milk/juice

iron deficiency

anemia, frequency injury, poor immune system, fatigue, high HR during exercise

how long does it take to reverse iron-deficiency anemia?

3 months

risk of keto diet while exercising

inadequate for high-energy sports/training because lacks quick fuel source found in carbs

risk of vegan diet while exercising

iron deficiency decreases performance and calcium deficiency increases risk of energy

risk of paleo diet

decreased calcium increases risk for injury

why dieting is not effective while training?

all restrictive diets eliminate food groups increasing risk for sub-optimal nutrient intake or nutrient deficiency negatively impacting performance

why supplements are not needed

* most protein powders and creatine are not made for teens
* supplements are not regulated by FDA and not enough research is needed to show efficacy of supplements for adolescents
* consumption of supplements may not be effective but actually dangerous

why is life expectancy increasing?

* food safety
* antibiotics
* vaccines
* improved nutrition

trends in aging

* women > men
* white > black
* hispanic > white

adulthood definition

* heaving reached physical maturity
* growth mostly completed
* sexual maturity reached

stages of adulthood

young = 19-30

middle = 31-50

older = 51-70

aging definition

all physiological functions lose efficiency throughout life, progressive loss of function, capacity to endure slowly decreases, increased susceptibility to disease and injury, and adaptability to environment declines

aging is…

individualized

chronic disease and aging

* risk increases with age
* accelerates aging process

effective age

risk factors for age-related diseases and compares to risk for an average healthy adult

osteoporosis

medical condition in which the bones become brittle and fragile from loss of bone mass

non-modifiable risk factors for osteoporosis

* age
* female gender
* white or asian race
* small boned
* low BMI
* early menopause

modifiable risk factors of osteoporosis

* low peak bone mass at age 20
* inadequate calcium intake
* inadequate vit D intake
* low BMI
* smoking and excessive alcohol consumption

osteopenia

low bone mass and low bone density

sources of calcium

* milk
* dairy
* fortified plant milks

sources of vitamin D

* fatty fish
* cod liver
* eggs
* fortified foods
* sunshine

bone remodeling

removal of mineralized bone by osteoclasts followed by formation of bone matrix by osteoblasts

when does peak bone mass occur?

early 20s

two phases most critical to limit osteoporosis

1. adolescence
2. menopause in women

factors affecting peak bone mass

* genetic predisposition
* calcium and vit D intake during adolescence
* lifestyle choices
* estrogen levels during menopause (low = bad)
* BMI (low = bad)