Children's and Adolescents' Health

Children's Health

• Timely immunizations are key to preventing disease in children.
• Accidents are the leading cause of death during childhood.
• Caregivers play an important role in promoting children's health.
• Poor health is of special concern for children in low-income families.
• Lack of usual source of health care and malnourishment influences resistance to disease for children in low-income families.
• Number of young children who have died because of HIV/AIDS transmission from their parents has dramatically increased.
• Many deaths around the world could be prevented by reducing poverty and improving nutrition, sanitation, education, and health services.

Adolescents' Health

• Adolescence is a critical juncture for adopting behaviors that affect health.
• Many factors linked to poor health habits and early death begin during adolescence.
• Social contexts influence adolescent health, including families, peers, schools, neighborhoods, and culture.
• Many adolescents have a limited capacity to resist peer pressure and risk taking.
• Improving adolescent health involves reducing health-compromising behaviors and increasing health-enhancing behaviors.

Emerging and Young Adults' Health

• Emerging adults have more than twice the mortality rate of adolescents.
• Few consider how their personal lifestyles will affect their health later in their adult lives.
• Common pattern: not eating breakfast and regular meals, relying on snacks, eating excessively, smoking, drinking, failing to exercise, and getting inadequate sleep.

Health and Aging

• Chronic disorders become more common, defined as those characterized by a slow onset and long duration.
• Cancer is the leading cause of death for adults aged 65-74 in the United States.
• For those aged 75 and over, cardiovascular disease remains the leading cause.
• Arthritis is the most common chronic disorder.
• Women are especially vulnerable to osteoporosis, which involves an extensive loss of bone tissue.
• Dementia is a neurological disorder where primary symptoms involve deterioration of mental functioning.
• Alzheimer's disease is a progressive, irreversible brain disorder with gradual deterioration of memory, reasoning, language, and physical function.
• As many as 10 million baby boomers are expected to develop Alzheimer's disease.
• Specific causes of Alzheimer's have not been identified, but age is an important risk factor and genes likely play an important role; healthy lifestyle factors may lower the risk or delay onset.
• Mild cognitive impairment (MCI) is a risk factor for Alzheimer's, as 10%-20% of individuals 65 years or older have MCI.
• Those with MCI and a copy of the ApoE4 allele may be more susceptible to developing Alzheimer disease.
• Family members who provide care for individuals with Alzheimer disease face emotional and physical strain.
• Respite care is a temporary relief for caregivers and can ease the stress.
• Parkinson's disease is another type of dementia that's a chronic, progressive disease that involves muscle tremors, slowed movements, and partial facial paralysis.
• Parkinson's is triggered by degeneration of dopamine-producing neurons in the brain.
• Drug treatments and deep brain stimulation (DBS) are available as treatment for Parkinson's disease, and stem cell therapy and gene therapy may offer hope for treatment in the future.
• As older adults age, the likelihood of being in a nursing home or extended-care facility increases.
• More than one-third of such facilities are seriously deficient.
• Home health care, elder-care centers, and preventive medicine clinics can be good alternatives to nursing homes or extended-care facilities.
• Feelings of control and self-determination are important factors related to health and survival in care settings.

Nutrition and Eating Behavior in Infancy

• Adequate energy and nutrient intake in a loving and supportive environment is of critical importance during infance.
• Caregivers are important in eating pattern development.
• Too many young children already do not eat enough fruits and vegetables, which can have negative consequences later in life.
• Growing consensus is that breastfeeding is better than bottle feeding for the baby's health.
• American Academy of Pediatrics Section on Breastfeeding recommends exclusive breast feeding in the first 6 months.
• There are some women, such as those with infections that can be transmitted through her milk, who should not breastfeed.

Outcomes of Breastfeeding

• Breastfeeding results in fewer gastrointestinal and lower respiratory tract infections for the child.
• Breastfeeding offers protection against wheezing, but not necessarily asthma.
• Breastfeeding lowers risk of middle ear infections (otitis media), of becoming overweight or obese, of diabetes, and of SIDS.
• Breastfeeding results in lower rates of hospitalization for a number of conditions.
• There is no evidence that breastfeeding protects infants from developing allergies.
• For the mother, breastfeeding lowers the incidence of breast and ovarian cancer, provides a small reduction in type 2 diabetes, and results in lower rates of hospitalization for cardiovascular problems and diabetes.

Nutrition and Eating Behavior in Childhood

• Malnutrition is a major threat to millions.
• Malnutrition and starvation are a daily fact of life for children in many developing countries.
• Poor nutrition is a special concern for infants from low-income families in the United States.
• Women, Infant, and Children (WIC) program provides federal grants to states for healthy supplemental foods, health-care referrals, and nutrition education.
• Participants' children from WIC programs have shown higher cognitive scores on the Bayley Scales of Infant Development.
• Overweight children have become a serious health problem.
• Overweight is defined as a body mass index (BMI) at or above the 95th percentile.
• Obese is defined as a body mass index (BMI) at or above the 97th percentile.
• More children are overweight in middle and late childhood than in early childhood.
• Being overweight as a child is linked to being an overweight adult.
• Consequences of being overweight include increased risk of many medical and psychological problems.
• A diet, exercise, and behavior modification is often recommended for overweight children.

Nutrition and Eating Behavior in Adolescence

• Nutrition and being overweight are also key problems among adolescents.
• Fast-food consumption is high in childhood and continues to increase in adolescence.
• Team sports participation and family meals both appear to lower risk for being overweight or obese.
• Calorie restriction, exercise, reduction of sedentary activity, and behavioral therapy are moderately effective in helping overweight adolescents lose weight.
• Anorexia nervosa is an eating disorder that involves a relentless pursuit of thinness through starvation.
• Characteristics of anorexia include restricted energy intake leading to significantly low body weight, intense fear of gaining weight or becoming fat or persistent behavior that interferes with gaining weight, and disturbance in how body weight or shape is experienced.
• Anorexia typically begins in the early to middle adolescent years, often after a period of dieting and some type of life stress, and is about 10 times more likely to occur in females.
• Anorexia involves both biology and culture, or biology, genes, dieting, and the thin fashion image.
• Bulimia nervosa is an eating disorder that involves a consistent binge-and-purge eating pattern.
• Bulimia may involve self-induced vomiting or using a laxative.
• Bulimia may involve preoccupation with food, strong fear of becoming overweight, and depression or anxiety.
• Those with bulimia are highly perfectionistic and have difficulty controlling emotions.
• Bulimia typically begins in late adolescence or early adulthood, and about 90% of cases are women.
• Drug therapy and psychotherapy are effective with anorexia nervosa and bulimia nervosa.
• Cognitive behavior therapy is especially helpful for bulimia.
• Binge eating disorder (BED) involves frequent binge eating but without purging.
• Binge eating disorder involves recurrent episodes of eating large quantities and feeling a lack of control over eating.
• Individuals with binge eating disorder are frequently overweight.
• Far more females than males develop BED, and Cognitive behavior therapy and pharmacological treatments have been successful.

Nutrition and Eating Behavior: Adult Development and Aging

• Obesity is a serious and pervasive problem.
• In 2017-2018, 42.4% of U.S. adults 20 years and older were classified as obese.
• Overweight and obesity are linked to increased risk of early death, hypertension, diabetes, and cardiovascular disease.
• Overweight and obesity are also associated with mental health problems.
• Genetic factors are countered with higher activity levels, environmental and sociocultural factors are significant.
• Effective weight loss programs include exercise.
• Adults who follow diet-plus-exercise programs lose more weight than those on diet-only programs.
• Successful dieters exercise 30 min a day, plan meals, and weigh themselves daily.
• Some studies have shown calorie restriction (CR) increases longevity in laboratory animals.
• Further research is needed to determine if CR actually increases longevity, especially in humans.
• Antioxidants are promoted as helping slow the aging process and improve health.
• Recent research does not support the conclusion that antioxidants slow the aging process and improve health.

Exercise in Childhood

• Children need daily exercise to support the development and coordination of large muscles.
• Daily activity has been linked to benefits for insulin resistance and body fat levels, decreased cardiovascular risk, and improved bone strength.
• Children's brain and cognitive development benefit from regular exercise.
• Attention, memory, effortful and goal-directed thinking and behavior, creativity, academic success, and literacy all improve with exercise.
• Parents and schools strongly influence children's exercise habits.

Exercise in Adolescence

• Individuals become less active as they reach and progress through adolescence.
• Boys more likely to engage in physical activity for 60 min or more per day in adolescence.
• Positive weight status, reduced triglyceride levels, lower blood pressure, lower risk of diabetes, better connectivity between brain regions, and improved sleep patterns are all benefits of regular exercise for adolescents.
• Fewer depressive symptoms, higher academic achievement, and improved memory are benefits of regular exercises for adolescents.
• Parents and peers play important roles in determining adolescent exercise.

Exercise in Adulthood

• Benefits of exercise continue in adulthood.
• Reduced risk for obesity, cardiovascular disease, and diabetes are a benefit of regular exercise in adulthood.
• Lower levels depression and stress are a benefit of regular exercise in adulthood.
• Aerobic exercise is a sustained activity that stimulates heart and lung function; it's important to get aerobic exercise.
• Health experts recommend 45 min or more of moderate physical activity on most days of the week.
• Performing exercise that raises heart rate to at least 60% of maximum is recommended for adults.
• Only about one-fifth of adults achieve these recommendations.

Exercise: Aging and Longevity

• In a study of middle-aged and older adults, sedentary participants were more than twice as likely to die than those who were moderately fit.
• Sedentary people were three times more likely to die than highly-fit participants.
• Strength training, aerobic activity, and stretching is recommended for older adults.
• Resistance exercise can help preserve and possibly increase muscle mass.
• For adults aged 60 and older, 30 min of moderately intense activity, 5 days a week and strength training 2 or more days a week is recommended.
• Exercise in older adults is associated with increased longevity, prevention of common chronic diseases, and improved outcomes for many diseases.
• Improved cellular functioning and improved immune system functioning are also associated with exercise in older adults.
• Optimizing body composition and reducing declines in motor skills are also associated with exercise in older adults.
• Reduced likelihood of mental health problems is also associated with exercise in older adults.
• Exercise can also be part of the treatment of certain conditions in older adults.
• Improved brain and cognitive functioning is also associated with exercise in older adults.

Substance Use in Adolescence

• Adolescence is a critical time for the onset of substance abuse.
• United States has one of the highest rates of adolescent drug use of any industrialized nation.
• Notable declines have been seen in drug use in the 21st century for LSD, cocaine, cigarettes, sedatives, tranquilizers, and ecstasy.
• Marijuana is the most widely used in the U.S. and Europe.
• Although alcohol use has declined, driving while under the influence of alcohol is still a serious problem.
• Cigarette smoking has declined but remains one of the most serious yet preventable health problems.
• E-cigarette use has surpassed tobacco cigarette use.
• Development, parents, peers, and educational success all play a role in predicting the substance use of an individual.
• Drugs and drinking in adolescence or even childhood increase risk of heavy consumption and abuse in later life.
• Positive relationships with parents and others can reduce drug use.
• Low parental knowledge of adolescents' peer relations and behavior predicts adolescent substance use.
• Peer relations and neighborhood disadvantage are other risk factors.
• Educational success acts as a buffer for the emergence of drug problems.

Substance Use in Emerging Adulthood

• Transition from high school to college is often a critical risk period for alcohol abuse.
• Drinking is common, largely acceptable, and even expected in emerging adulthood.
• Binge drinking is having five or more drinks in a row, and is linked to missed classes, physical injuries, troubles with police, drinking and driving, and unprotected sex.
• Pregaming, or drinking before going out, has become common among college students.
• Cigarette smoking is on the decline; but many young smokers transition to heavier use after high school.
• E-cigarette use has dramatically increased.

Substance Use in Older Adults

• Alcohol and substance use peaks in emerging adulthood and declines somewhat by the mid-20s.
• Substance use often goes undetected in older adults and has been identified as the “invisible epidemic.”
• Risk rises for those taking multiple medications.
• Moderate drinking, especially of red wine, may have a protective effect.