FSHN 459- Unit 2
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| weight just after birth (1st week) | 6-10% 1st day, 1st week get back to BW
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| 4-6 months growth | 2x BW
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| 6-12 months growth | rate slows
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| 12 months growth | 3x BW
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| 12 months length | increase by 50%
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| when use WHO growth charts? | 0-2 years
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| when use CDC growth charts? | >2 years
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| growth charts are based on (4) | weight for age, weight for length, length for age, head circumference
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| 0-2 percentile weight for length | underweight
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| 2-5 percentile weight for length | at risk of underweight
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| 5-98 percentile weight for length | healthy weight for length
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| 98+ percentile weight for length | overweight
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| feeding as a developmental opportunity | mealtime stimulates language development
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| infant reflexes | controlled by CNS; root/suckle/suck
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| suckle | tongue movements
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| root | touch baby's cheek, it turns head and opens mouth
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| infant motor skill development order | top down, central to peripheral
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| infant motor skills influence what? | ability to feed, amount of calories expended
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| infant sensorimotor development example | putting things in mouth
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| cognitive development infancy- why important? | need social and emotional stimulation to maximize brain maturation
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| holding/physical contact with babies | important for cognitive development
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| digestive system development newborns | swallowed amniotic fluid stimulates intestine, levels of enzymes increase with time
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| fats infancy | short and medium chain more readily utilized than long chain, but limited conversion PUFA (should be provided)
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| why essential fats are important for infants | EPA: substates, DHA: immunologic/phospolipids in retina and brain, energy
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| iron in infants | supplemental for exclusively BF infants
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| lead infants | interferes with calcium and iron absorption, slowed growth
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| thrifty hypothesis | perinatal food deprivation and adult incidence of obesity, TIIDM, HT, CVD
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| predictive adaptive response | LBW show catch-up during 1st year- exacerbates diseases later in life
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| weaning from BM/HMS | 12-24 months, introduce water via cup at 6-8 months
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| food allergies and intolerances infancy | don't avoid foods (except under 1 year)
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| organic failure to thrive | inadequate wt or ht from a health problem
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| inorganic failure to thrive | environmental cause
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| Inappropriate early nutrition leads to | abnormal adipose tissue distribution, insulin resistance, glucose intolerance, high BP
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| Preterm infants are at risk for | suboptimal neurodevelopment etc
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| Correction for gestational age | substract gestational age at birth from 40
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| Born at 28 weeks corrected age | 3 months preterm (12 wks), so subtract 3 months form actual age
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| VLBW/ELBW infants | need respiratory support/GI tract problems
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| Enteral feeding | intestinal
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| Parenteral feeding | IV etc
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| Gavage feeding | tube from mouth or nose into stomach (ideal b/c want to use as much of GI tract as possible)
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| Gastrostomy feeding | directly into stomach
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| Jejunostomy feeding | directly into jejunum
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| Elevated preterm nutrient requirements (what stores are low)? | fat/glycogen, Ca, P, Fe, fat soluble vitamins
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| Forms of protein for preterm infants | may need hydrolyzed or single AAs
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| Fats preterm | 55% of kcal, supplement w/ MCT oil (don’t need bile)
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| Supplemental fats preterm | essential and MCT
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| Vitamins/minerals preterm | need >DRI (not provided in BM)
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| Preterm infant formulas | extra vitamins/minerals and extra calories
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| Preterm/bone mass | most rapid bone growth in 3rd trimester (at risk for low bone mass)
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| Non-nutritive effect of BM on bone development | maybe immunologic benefits
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| Why iron not in human milk fortifier | creates ROS
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| Measuring height of toddlers | <2 recumbent; >2 standing
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| When do growth charts change | 24 months (WHO==>CDC)
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| STRONG kids program | 1st 6 months associated w/ picky eating in early childhood
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| No picky eaters | parents enable picky eating behavior
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| Parent provides (5) | regular schedule, child-size portions, variety of food, limited distractions, family mealtime
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| Child decides | what to eat, how much to eat, whether or not to eat
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| Recommended toddler food intake | 1TBSP per year of age; regular but flexible
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| Food jags | focus/fixation on one food item
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| What types of food to toddlers prefer? | sweet and slightly salty
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| Special events (toddler) | special associated w/ fatty food
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| Context (toddler) | bad if meals are argumentative or hurried
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| What 2 things not to do w/ toddlers? | restricting/bribing with food
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| What considered for toddler nutrition? | gender, height, weight, physical activity
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| What 5 nutrients aren't met in toddlers? | Fe, Ca, D, Zn, N3
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| Fiber infants | too much is bad, but only getting ½ recommended
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| Lead poisoning infants | brain/blood/kidneys (IQ , behavior)
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| Physical activity pre-school | getting basic motor skills, “active play”
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| Active play pre-school | enjoyment (intrinstically), often appears purposeless
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| Active play curve | upside down U/peaks in early childhood
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| Causes of toddler obesity (4) | marketing/convenience of foods, inactivity, parental obesity, screen time
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| Treatment of toddler obesity | maintain weight, set expectations
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| Sleep and obesity preschool | <9.5 hours; maybe low leptin or high ghrelin
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| Celiac disease preschool/highest populations | usually symptoms develop by 2 years (highest middle eastern or Irish)
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| Possible causes of ADHD | genetics, harmful exposures (alcohol, tobacco, lead)
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| Feeding habits ADHD | rigid/self-restricted; drink calories; more likely to have deficiencies
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| Autism food habits | rigid food choices; gluten or casein free may work
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| Pulmonary problems preschool | hunger and fullness cues harder to interpret b/c of fatigue
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| Why nutrition is important preadolescent | sports, academic, health problems
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| 5 pillars of Let’s Move! | healthy start, empowering parents, healthy foods in schools, access to healthy foods, physical activity
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| CDC BMI growth charts | <5 underweight; 85-95 overweight; >95 obese
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| When does BMI increase in childhood? | around age 6
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| Restrictive intake childhood | more influence over hunger and satiety; influenced by parental restrictive intake
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| Excess nutrients childhood | fat, sat fat, sugar, salt
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| Low nutrient childhood | omega 3*
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| Fiber childhood | half recommended amount
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| Dental caries childhood | 50% have decay (soda)
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| Obesity children trend/paradox | increasing w/out increase in energy intake
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| Obesity different countries | more obese in developing than developed
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| Obesity and school | significant amount of time, 35% of food, 50% of energy
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| School lunch | cash and commodity foods provided, direct link b/w food policy and what kids eat at school
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| Consequence of childhood obesity | physically developed sooner (others)
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| Target areas for childhood obesity (4) | breakfast, child involvement, positive environment, communication
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| Treatment of childhood obesity | weight maintenance and height increases; behavior change/not numbers
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| Optimal defaults | make environment safer, people are healthier as a consequence
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| Unit bias | people tend to consume the portion they’re given
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| Proposed legislation Kelly Brownell | 1 penny per ounce of soda
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| Food intolerance | non-immune mediated reaction to food (may take days)
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| Food allergies | response of immune system to certain foods (symptoms appear rapidly)
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| Sensitization (allergies) | GI tract, consequence of prior exposure
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| Allergy prevalence | increasing (small %)
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| What allergies resolve by school age? | milk, eggs, soy
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| What allergies are “permanent”? | peanut, tree nut, seafood
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| Vitamin D and allergies | if vitamin D deficient, more likely to have allergic sensitization to allergens
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| Cow’s milk allergy | accidental exposure very likely, negative quality of life
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| SOTI cows milk | may lessen allergy through incremental administration of cow’s milk
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| Egg allergy | egg white proteins, heavily glycolsylated, cooking may reduce allergenic activity
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| Egg allergy childhood | vaccines, limitations
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| Peanut allergy | prevalence are increasing, anaphylactic reactions
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| Prevalence of peanut allergy | hygiene hypothesis, timing of introduction, additives (cause unknown)
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| Obesity and allergies | may increase prevalence (systemic inflammation)
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| Parental allergy | sex dependent association
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| US food labeling (allergies) | must state if has allergen or derived protein
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| Anxiety and food allergies | anxiety about possible exposure; discomfort associated w/ eating
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| factors influencing needs of childhood chronic conditions (2) | energy output, protein needs
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| other nutrients chronic conditions | begin with DRI; varies widely (medications may increase turnover rate of nutrients)
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| growth assessment chronic conditions | special charts (e.g. Down's Syndrome); age and secondary conditions affect growth
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| meeting nutritional needs of chronic conditions | 1st choice: food and beverage orally
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| eating and feeding problems chronic conditions | most children with developmental delays have feeding difficulties
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| TIDM | 10-14 years onset; peak incidence is becoming earlier
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| why increase in type 1 diabetes? | increased exposure to triggers of autoimmunity
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| hygiene hypothesis | decreased exposure to infections agents (type 1 diabetes)
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| hygiene hypothesis most common populations | low population density, first born, fewer siblings
**higher in more educated/richer people
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| which vitamin is correlated with type 1 diabetes and allergies? | vitamin D (mediates immune effects)
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| risk factors for T2DM in youth | small for gestational age or large for gestational age
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| cystic fibrosis | thick mucus clogs lungs and lack pancreatic enzymes (higher energy needs)
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| cystic fibrosis nutritional interventions | pancreatic enzyme supplements
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| cerebral palsy nutrition related secondary effects (2) | GERD, constipation
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| cerebral palsy feeding problems | spilling, longer mealtimes
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| cerebral palsy problem nutrients | bone density (no weight bearing movement)-> calcium and vitamin D
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| caloric needs cerebral palsy | depends if involuntary/voluntary muscle movement occurs
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| ADHD nutrition interventions (3) | antioxidants, omega 3s, avoid additives
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| cause of autism | genetic, environmental, or both?
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| autism GI disturbances | most have GI symptoms; could be malabsorption or leaky gut syndrome
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| autism has increased incidence of what? (2) | overweight/obesity and allergies/intolerances
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| Opioid excess theory | (Austism); intolerance to casein/gluten because peptides bind to opioid receptors
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| What diet may help with autism? | gluten, casein, and lactose free
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| changes of puberty (4) | sexual maturation, ht/wt, skeletal mass, *body composition
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| patterns of growth puberty | large variation (biological vs chronological age)
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| changes of skeletal mass adolescence | 1/2 of peak is accrued during adolescence
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| nutritional factors contributing to accretion of bone mass during puberty | caffeine, alcohol, Ca/D/minerals/protein
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| eating habits adolescence | snacks up to 1/3 intake, skipping meals more common (BF most commonly skipped); TV during meals
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| role of parents in adolescent eating | provide nutritious foods, model healthy choices, eat breakfast w/ kid (or at all)
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| frequency of family meals | inversely associated w/ disordered eating, BMI, substance use, depression
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| SSBs adolescence | 84%, 30 oz per day
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| zinc adolescence | need/retention increases during growth spurts (sexual maturation)
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| calcium adolescence | need and absorption higher during adolescence (more than any other time except infancy)
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| adolescence vit D | parathyroid hormone becomes elevated if deficient; demineralization of bones ensues
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| bones and soda | high phosphate impairs vit D activation
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| physical activity adolescence | lifelong activity patters develop; 60 minutes per day
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| what puts individuals at risk for disordered eating? (3) | perfectionism, genetics, early age of menarche
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| normal eating | flexible, varies w/ hunger, feelings, schedule, proximity to food
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| dieting behaviors | dieting and weight loss efforts predict more weight gain in adolescents
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| dieting consequences (4) | weight gain, less nutritious foods, binge-eating, development of eating disorders
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| family weight talk and dieting | (teasing/dieting) never produced better outcomes in girls (study)
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| anorexia commonly causes | amenorrhea
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| bulimia | weight is not a predictor (maintenance or fluctuations)
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| binge-eating disorder | not followed by compensatory behavior
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| online media body image | pro-ana, fashion, home decor; exp group= negative affect, thinking about weight afterwards
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| body dissatisfaction increased risk of | decreased activity (clothes, scared of trying, etc)
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| exercise, depression, and adolescence | synthesis and metabolism of serotonin; positive effect is especially strong during adolescence
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| disordered eating and bone mineral density | cortisol will inhibit osteoblast replication (decrease BMD)
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| behavioral objectives for healthy wt mgmt in adolescents (3) | breakfast, mindful eating, "normal eating"
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| preventing obesity and eating disorders (4) | eat healthy, activity, positive self-talk, assume overweight teens have experiences weight mistreatment and address it with them and their families
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| TED talk eating disorders | controversial model
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| emotional/symbolic dimensions of food | research tends to ignore this and focus on rational barriers ("fitting in")
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| best predictor of adult obesity | adolescent obesity
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| general guidelines for weight mgmt therapy (2) | learner-center, accomplishments/positives
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| sports nutrition | protein; vulnerable to special diets
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| hydration/adolescent sports nutrition | vulnerable to heat illness
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| ergogenic supplements side effects | many, renal function
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