Seizures, Diet, and Cerebral Palsy

Seizures

• Electrical disturbances in the brain cause seizures
• Epilepsy and seizures describe the same condition
• Seizures can manifest as mild blinking or severe jerking
• Postictal state refers to the period following a seizure when consciousness is altered

Phases of Seizures

• Tonic phase involves body stiffening
• Clonic phase involves uncontrolled jerking
• Postictal phase has symptoms like headache, confusion, and sleepiness

Ketogenic Diet

• A ketogenic diet is a carbohydrate-restricted diet high in fat with increased calories
• For every 1 gram of carbohydrate or protein, consume 4 grams of fat on a ketogenic diet
• Ketogenic diets can cause heart disease and reduce brain inflammation

Cerebral Palsy

• A collection of disorders results from brain damage that impairs muscle coordination
• Spastic quadriplegia (SQ), affecting all limbs, causes significant nutritional challenges
• Symptoms may include slow growth and difficulty feeding, increasing energy expenditure
• Athetosis involves uncontrolled movements, which also increases energy expenditure

PKU

• PKU results in incomplete metabolism
• The body lacks the enzyme needed to metabolize phenylalanine
• Managing the breakdown of dietary proteins requires dietary intervention
• A gene mutation encodes PAH, the enzyme responsible for breaking down phenylalanine
• Light hair, skin, and eye color are common in children
• Treatments for PKU include a low or no protein diet, and natural amino acid supplements

Cystic Fibrosis

• Cystic Fibrosis is a disease, no facts provided

Allergies

• Hydrolyzed formulas are needed for infants allergic to typical formulas or breast milk
• Fully hydrolyzed formulas are amino acid and peptide based (alimentum)
• Partially hydrolyzed formulas contains allergens (Nutramigen)

Food Allergies

• 2-8% of children have true food allergies
• Common allergens are Cow's milk, Eggs, Wheat, Peanuts and tree nuts, Soy, and Crustacean shellfish
• Intolerances are local
• No symptoms suggest introducing more foods

Eating Disorders

• Binge/purge eating disorders have less frequency or intensity, which does not allow for a formal diagnosis
• Frequent behaviors include self-induced vomiting, fasting or extreme dieting, compensatory physical activity to burn calories, feelings of guilt after binge eating, and use of laxatives, diuretics, or diet pills

Anorexia Nervosa

• Characterizations include an abnormally low body weight, an intense fear of gaining weight, and a distorted perception of weight
• Behavioral systems include severely restricting food intake through dieting or fasting, exercising excessively, and binging and self-inducing vomiting to get rid of food, including laxatives, enemas, diet aids, or herbal products
• Patients are very underweight

Bulimia Nervosa vs Binge Eating Disorder

• Bulimia nervosa is characterized by repeated episodes of uncontrolled eating followed by self-induced vomiting, laxatives, or diuretic use, fasting or vigorous exercise, and patients may not be underweight
• Binge eating disorder involves periodic binge eating without compensatory behaviors like vomiting or laxative use. It occurs twice a week on average for over 6 months

Eating Disorder Treatments

• Normalize eating patterns, improve social and emotional well-being, and restore body weight
• Core components of programs include medical comorbidity treatment, weight restoration, nutrition education, counseling, individualized psychotherapy, family therapy, and group therapy
• Eating disorder treatment is often successful by targeting high-risk groups, adolescents, and providing information from trained interventionists with multiple sessions and integrated interactive learning

Lactose Intolerance

• No fats provided

Rickets

• Rickets is caused by inadequate calcium and vitamin D
• Wide sutures, bowing of legs, swelling in wrists and ankle joints, and dental hypoplasia are characteristics

Dental Caries

• 1 in 3 kids aged 3-5 have dental caries
• Common causes include bedtime bottles with juice and milk, streptococcus mutans, and sticky carbohydrate foods
• Prevention includes fluoride, with supplemental amounts varying by age and fluoride content in water supply

Rett Syndrome

• Rett Syndrome causes early development of brain stops

Failure to Thrive (FTT)

• A child's growth declines more than two growth percentiles
• The origin is various conditions like digestive, asthma, breathing problems, or neurological conditions

Warning Signs for Growth Problems

• Plateau in weight, pattern of weight gain and then loss, failure to regain weight lost during illness, and unexplained and unintentional weight gain

Higher vs. Lower Energy Needs

• Cystic Fibrosis, Renal disease, Ambulatory children with diplegia, Peditatrics Aids, Bonchopulmonary Dysplasia show the need for higher energy.
• Down Syndrome, Spina Bifida, Non-Ambulatory children with Diplegia, Prader-Willi Syndrome, Non-Ambulatory children exhibit lower energy needs

Obesity

• Obesity has two main causes, BMI rebound and family history
• Additional factors: overweight parents, low socioeconomic status, being non-white or Asian, limited mobility, inadequate physical activity, and diets high in calories, sugar, and fats

BMI Percentiles for Age

• Obesity is classified as >= 95th percentile
• Overweight is classified as >= 85th-95th percentile
  • Risk factors associated with tissue injury
• Underweight is classified as < 5th percentile

Associated Conditions of Obesity

• Conditions include hypertension, dyslipidemia, insulin resistance, type 2 diabetes mellitus, sleep apnea, hypoventilation disorders, orthopedic problems, hepatic disease, body image disturbances, and low self-esteem

Characteristics of Obesity

• Taller stature, advanced bone age, earlier sexual maturation, high blood lipids, elevated liver enzymes, hypertension, abnormal glucose tolerance, and earlier BMI rebound

Obesity Prevention

• Limiting sugar-sweetened beverages, encouraging fruits and veggies, limiting television and screen time, eating daily breakfast, limiting restaurants and fast foods, and limiting portion sizes

Recommendations

• 7 days a week eat breakfast
• A diet of 5 fruits and vegetables a day
• 2 hours of screentime or less
• At least 1 hour of activity a day
• No soda and sugar-sweetened drinks

Obesity Treatments

• Stage one: prevention plus self or parent education
• Stage two: structured weight management focusing on nutrient dense foods
• Stage three: multidisciplinary intervention and steady weight loss
• Stage four: tertiary interventions with surgery, diet, and activity counseling if needed
• Nearly 1/3 of children and adolescents are overweight or obese

Infants Vitamins

• Vitamin D is fat soluble and required for bone mineralization and proper calcium and phosphorus utilization
• Exclusively breastfed infants need supplementation of 400 IU/day
• Deficiency can lead to rickets

Iron

• Infants are born with iron stores reflecting maternal stores and breastfed infants need additional iron by 6 months
• Formula-fed infants should receive iron fortified formula
• Iron deficiency causes irreversible behavioral and brain function abnormalities
• Preterm infant formulas typically have more micro and macronutrients and have higher iron needs

Fluoride

• Fluoride is not an essential nutrient
• It helps create stronger teeth
• Infants under 6 months need 0.1 mg/day and 7-12 month olds need 0.5 mg/day
• Supplementation is sometimes required but not always

Sodium

• An essential mineral
• It is needed for fluid maintenance
• Infants from birth to 5 months should consume 120 mg and infants 6-12 should consume 200 mg
• Based on the amount of sodium found in breastmilk