Chapters 12 and 13

Energy needs vary depending on

special health care condition

children with slow growth increases or decreased muscles have …. calorie needs

lower

…. calorie needs in children that have activity increases like ADHD and ASD

higher

Protein needs increase for recovery from burns and Cf by ….% of the DRI

150

PKU and other protein based inborn errors of metabolism require

decreased protein needs

Some conditions require …. for digestion of protein

hydrolyzed or specific amino acids

warning signs for growth problems

\-plateau in weight

\-pattern of weight gain and then loss

\-failure to regain weight loss during an illness

\-unexplained/ unintentional weight gain

Spina bifida impacts muscles only in the

lower extremities

Health conditions may alter

muscle size, bone structure, fat stores

down syndrome results in

short stature, low muscle tone, and low weight

cerebral palsy and spina bifida may reduce

muscle tone

gastrostomy feeding is required for

kidney disease

some cancers

severe cerebral palsy

conditions that require nutritional supplements

chewing problems

diabetes or on ketogenic diet

PKU

CF

galactosemia

chewing problems require

liquid supplements

diabetes or ketogenic diet reuquire

supplements with added CHP

PKU needs to avoid supplements with

artificial sweeteners

CF requires

fat soluble vitamins

galactosemia requires

calcium supplements

conditions that require increased fluids

those with uncontrollable drooling

constipation

multiple medication use

eating and feeding problems are diagnosed when children have difficulty with

\-accepting foods

\-chewing them safely

\-ingesting enough foods and beverages

…. % of children with developmental delays have feeding difficulties

70%

CF is one of the most common …. genetic conditions

lethal

CF interferes with

lung function

dietary considerations for CF

\-Calories and protein increase

\-enzymes taken with meals to aid in digestion

\-frequent meals and snacks

\-fat soluble vitamin supplements

\-gastrostomy feeding at night

diabetes mellitus disorders in … and … … regulation

insulin and blood glucose

type 1 diabetes has

virtually no insulin production

type 2 diabetes associated with

obesity

treatment for type 1 diabetes

timing and composition of meals and snacks

insulin injections for type 1 exercise

epilepsy

uncontrolled electrical distributions in the brain

\-results in a range of mild blinking to severe jerking

postictal state

time after a seizure of altered consciousness

treatment for epilepsy

medications

ketogenic diets

during the postictal state after a seizure … is not recommended

eating/drinking

cerebral palsy

group of disorders resulting from brain damage with impaired muscle activity and coordination

Cerebral palsy causes

slow growth

difficulty feeding and eating

PKU is an inborn error of

metabolism

pku occurs in

1 in every 12000 births

PKU diet is adequate in

vitamins, minerals. protein, fat, and calories

dietary treatment of PKU includes

meats, eggs, dairy products, nuts, and soybeans

PKU is the inability to convert … to …

phenylalanine to tyrosine

PKU is common among the

amish

ADHD is the … … problem among children

most ocmmon

ADHD causes meals to be

chaotic

ADHD medications

may decrease appetite and growth

peak activity is aimed during school hours

appetite for ADHD returns

when meds are not given (vacations, holidays, weekends)

Chronic celiac disease may interfere with

learning and growth

once children are diagnosed with celiac disease they need a

gluten free diet for life

what condition is underdiagnosed in children

celiac disease

Celiac disease is an … disorder

autoimmune

common nutrition deficiencies in celiac disease

anemia (iron, folate, vitamin B12)

Vitamins A, D, E, and K

Calcium, phosphorus, vitamin D

GF diet is low in

fiber

middle childhood ages

5-10

preadolescence ages

9-11 for girls, 10-12 for boys

establishing healthy eating habits early prevents

immediate and long term health problems

adequate nutrition is associated with

improved academic performance

disparities in nutrition status exists among different

races and ethnic groups

Growth velocity will slow down during

school age years

CDC growth charts are used to monitor

weight for age

stature for age

BMI for age

physiological development in school age children leads to

increase in muscular strength, muscular coordination, and stamina increases

adiposity rebounds in ages between

6-6.3 years

Parents should be

positive role models

family meal times should be

encouraged

media has a strong influence on

food choices

a mother’s concern for weight increases her influence over her

daughters’ 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

obesity

imposing controls and restriction of forbidden foods may increase

desire and intake of the forbidden foods

energy needs vary ny

activity level and body size

the protein DRI is

.95 g/kg of body weight

intakes of vitamins and minerals appear … for most US children

adequate

nutrient concerns for school age children

iron, zinc, and calcium

iron deficiency is less common in … than …

children than toddlers

iron rich foods

meat, fish, poultry, fortified cereals

vitamin c rich foods helps with

iron absorption

dental carries are seen in … of children aged 6-9

half

reduce dental carries by limiting

sugary snacks and providing fluoride

fruits, vegs, and grains

regular meal and snack times

rinse or brush teeth after eating

Dental carries can come from

sticky carbohydrates as well as sugary foods

Obese BMI for age is in what percentile

95th

overweight BMI for age is from

85th to 95th percentile

compared to normal weight peers, overweight children are

\-taller

\-have advanced bone ages

\-sexually mature earlier

\-look older

\-are at higher risk for obesity related chronic disease

predictors for obesity are

age at onset of BMI rebound

home environment

4 stages to prevent pediatric obesity

prevention plus

structured weight management

comprehensive multidisciplinary intervention

tertiary care intervention

treatment of overweight and obesity in children includes

parent training

dietary counseling

nutrition education

physical activity

behavioral counseling

nutrition range for fat is

25-35%

\

saturated fats, cholesterol, and trans fats should be

limited

Prevention of CVD in school age children include

increase soluble fibers

maintain weight

ample physical activity

diets should emphasize

fruits and vegs

low fat diary products

whole grain breads and cereals

seeds, nut, fish, and lean meats

calcium and vitamin D is good for

bone formation

… is the best fluid for children

cold water

… drinks should not be consumed by children

energy drinks

soft drinks

soft drinks are bad for children because

they provide empty calories, and displace milk consumption, promote tooth decay

children should be encouraged to take … mins of physical activity each day

60

to encourage physical activity parents should

set a good example

encourage physical activity

limit media

girls are … active than boys

less

physical activity … with age

decreases

season and climate change impacts

level of physical activity

physical education classes are

decreasing

the nutritional school lunch program includes

fruits and vegs every day

increasing whole grains

fat free or low fat milk

limiting calories based on child’s age

reduce saturated/ trans fats, and sodium

school breakfast program was authorized in

1966

school breakfast must supply… of the DRI

1/4

states may require schools who serve needy populations to provide

school breakfast programs