Module 14 - Children Adolescents and Adults

Childhood

time between 2nd birthday and puberty

What happens to nutrient needs during childhood

nutrient needs increase to support growth and maintenance

Significance of childhood eating habits

lifelong consequences for HEALTH and BEHAVIOUR

rate of growth

• girls tend to gain weight and get taller before boys

  • height = girls (11 - 13), boys (14 - 15)

  • weight = girls (11 - 12), boys (14 - 15)

child need for calories depends on which 4 factors

• age

• body size (weight)

• growth rate/ activity level

How does an adequate amount or deficiency in calories effect children

• adequate calories and protein support growth

• lack of calories slow growth

• the amount of needed calories fluctuate during periods of growth

Calories and protein needs per kg body weight per day ____ in intial years of childhood and ____ as child ages

increases; decreases

• total calories and protein needs overall increase

Energy and Protein Recommendations for Active Children Compared to Adults

kcal per kilogram decreases with age, however total amount of kcals per day increase as size increases

MyPlate Recommendations for children

• 1 cup of fruits

  • focus on whole fruits

• 1 ½ cups of vegetables

  • vary vegetables

• 4 ounces of grains

  • half of grains should be whole grains

• 3 ounces of protein

  • vary protein

• 2 ½ cups of dairy

  • move to low fat or fat free milk or yoghurt

What does “variety of foods = fill the gap” mean?

A balanced diet that includes all food groups “fills the gaps” and helps ensure adequate intake of vitamins, minerals, fiber, and protein.

True or False: younger children have ability to monitor calorie intake

True

• children good at understanding and responding to hunger and fullness cues

Six factors that influence acceptance of new foods in children

• colour, flavour, texture, temperature, serving size

• attitude of server/ preparer

Division of Responsibility for Caregiver/ Parent (what, when, where)

• provide regular meals and snacks

  • when; provide regular meals/ snacks at defined times to aid in body fullness cues - toddlers (2-3hrs), preschoolers (3-4hrs)

• choose and prepare foods

  • what; prepare foods with a variety of options

• lead by example

  • what; show how to behave at meals - include how you eat, what and how you relate to foos

• provide the right location

  • where; make meals pleasant, with a positive environment and limit distractions

Division of Responsibility for Child (how much and whether)

• determine how much

  • child will eat based on fullness cues

  • provide appropriate amount to reduce food waste

• grow through observation

  • observe caregivers food behaviours

• make mealtime fun

  • eat in a positive environment where child’s feelings are accepted

Risk and Implication of Iron Deficiency Anemia in Children

• greatest risk

  • children in low income homes

• implications of iron deficiency

  • influence on mood and attention span

  • may impair learning

Sources of Iron

• lean meat, peanut butter, fortified breakfast cereals and grains, apricots

Why does lead toxicity cause anemia

• inhibits iron absorption

• inhibits enzyme needed to synthesize hemoglobin

Causes of anemia

• iron deficiency

• lead toxicity

sources of lead

• paint in older homes

• lead pipes in plumbing

• possible some imported eating utensils and toys

Lead exposure and risk in children

• developing brains are sensitive to even low levels of lead

• early lead exposure may increase the risk of lifelong learning diabilities

Obesity in Children (incidence)

• incidence in U.S has more than tripled since the 1960s

Obesity in Children Causes

• physical inactivity

• more time with video games, TV and computer

• larger portion sizes

• food advertising directed to children

• widespread availability of food

• use of food as a reward

How id obesity measured in children?

• BMI for age growth chart

  • Calculate BMI for children

  • plot on growth chart for BMI for age

    • done for ages 2 to 20 years

• compare to national standards

BMI for Age (What are the percentiles)

• Overweight

• Obese

• Underweight

• Overweight = 85th to 95th percentile

• Obese = 95th percentile or greater

• Underweight = less than 5th percentile

Food Allergies Definition

• condition in which the body produces antibodies against particular protein in food

Physical Symptoms of Allergies

• skin rashes

• intestinal upset

• diarrhea and vomiting

• difficulty in breathing

  • severe reactions may result in anaphylactic shock

Anaphylactic Shock

• condition in which blood pressure is very low and breathing is shallow

The Big 9

• common foods for allergic reactions

• required by law to be declared on labels

What is a new factor that contributes to overall body growth and development in Adolescent years

• hormonal changes

Ages of Growth Spurts in Girls and Boys

• Girls (10 - 11 years)

• Boys (12 - 13 years)

What does the TIMING of growth spurts rely on for adolescents

• reaching a certain critical weight

• In United States, this is ~66lb, and a body fat of ~10%

Puberty

• period of sexual maturation that occurs until sexual

• reproduction is possible

• sex hormones are produced

Puberty in Boys

• gain proportionately more lean muscle mass

• related to increase in testosterone

Energy and Protein Recommendation for Adolescents Compared to Adults

• starting to see the kcal/ kg decrease with age

• furthermore the k/cal per day increase from 14-18 increase in boys and then decreases for adulthood

Why is it very important for adult to have accumulated an adequate amount of calcium during adolescence?

• 45% of calcium used for adult peak bone mass is gradually acquired during adolescence

Mineral needed to support bone health in adolescence

• calcium

Good sources of Calcium

• dairy products and fortified foods

What can be used to help adolescence that do not require an adequate amount of calcium?

• Supplementation

  • can help achieve greater bone mass

Eating habits in Adolescents that increase risk of deficiency

• skipping meals

• inadequate consumption of calcium rich foods

• nutrient poor food selection away from home

• dieting due to body image issues

• alcohol use

Why are girls more vulnerable to iron anemia during adolescence

• blood loss during regular menstrual cycles

• adolescent girls may consume less meat

• often diet for weight loss

Are the number of elderly Americans (>65) increasing or decreasing?

INCREASING

Social and Psychological Aspects of Aging (LEAD)

• living alone

  • lack of motivation to cook meals

• depression

  • overeating or undereating

• anxiety

  • reduction in digestive secretions

• economic constraints

Eight Physical and Physiological Function Decline with Aging (How it affects food)

• Decreased secretion of digestive enzymes

  • decreased micronutrient absorption

• Slowing of gastric motility

  • constipation

• loss of neuromuscular coordination

  • cooking and feeding oneself is difficult

• Diminished senses of taste and smell

• loss of teeth and xerostomia (dry mouth)

  • difficulty chewing and swallowing

• impaired hearing and vision

  • age related macular degeneration

• loss of muscle mass

  • reduced basal metabolism and calorie needs

• Arthritis

Alzheimers

• abnormal deterioration of the brain

Nutrients associated with reducing risk of Alzheimers (start early -20/30s)

• antioxidants foods (berries)

• omega -3 fatty acids

Nutrients of concern for aging

• water

• energy

• fiber

• protein

• Vitamin B12

• Vitamin D

• calcium

• iron

• zinc

Effect of aging on water

• lack of thirst and decreased total body water intake makes dehydration likely

  • dehydration can cause confusion

Effect of aging on energy

• need decreases as muscle mass decreases

  • physical activity moderates the decline

Effect of aging on fiber

• likelihood of constipation increases with low intakes and changes in the GI tract

  • can be affected by inadequate water intake, lack of physical activity along with some medication

Effect of aging on protein

• needs may stay the same or increase slightly

  • low fat and high fiber legumes and grains meet both protein and other nutrient needs

Effect of aging on Vitamin B12

• atrophic gastritis is common

  • deficiency causes neurological damage, supplements may be needed

Effect of aging on Vitamin D

• increased likelihood of inadequate intake - skin synthesis declines

  • Daily sunlight exposure and supplements may be helpful

Effects of aging on calcium

• intakes may be low - osteoporosis is common

  • stomach discomfort commonly limits milk intake

  • calcium supplements may be helpful

Effects of Aging on Iron

• in women status improves after menopause

• deficiencies are linked to chronic blood loss and low stomach acid output

  • vitamin C and meat increase absorption

Effects of Aging on Zinc

• intakes are often inadequate and absorption may be poor, but needs may also increase

  • medications interfere with absorption

  • deficiency may depress appetite and sense of taste

Why do iron requirements decrease for postmenopausal women

• iron requirements decrease

Causes of anemia in older women that are postmenopausal

• tends not to be iron deficiency if women are postmenopausal

• They tend to be from

  • gastric ulcers and related ailments leading to blood loss over time

  • reduce absorption of Vitamin B12

Undernutrition in Elderly populations

• older adults who are hospitalized are often malnourished

Conditions that most commonly cause undernutrition in Elderly populations

• little or no appetite

• problems with chewing or swallowing

• consuming inadequate amounts of nutrients

• eating fewer than two meals a day

Drug-Nutrient Interaction (risk factors for elderly)

• polypharmacy

  • multiple drugs by an individual

Negative nutritional impacts of drugs in older adults include

• reduced appetite

• decreased absorption and utilization of some nutrients

• Increase nutrient excretion