Untitled Quiz

Nutrition Through Life Cycle 1

• Lectures cover conditions and interventions across different life stages
• The human lifecycle includes: fetus in the womb, baby/infant, toddler, preschooler, primary school boy, adolescent/teenager, adult, old person
• Infancy (first 12 months): growth is the key marker of nutritional status
• Weight gain: double birth weight by 4-6 months, triple by 12 months
• Length gain: increase length by 50% by 12 months
• Key vitamins and minerals: Vitamin D, Vitamin K, Vitamin B12, Iron, Fluoride

Infant Nutrition

• Key nutrition concepts: understand the need for accurate nutritional assessment, decide nutritional intake, determine if a child is malnourished
• Definitions: Infant (birth to 1 year), Neonate (birth to 1 month), Full Term (>37 weeks gestation), Premature (< or = 37 weeks)
• Children with special health care needs: Low-Birth-Weight Infant (LBW), Very Low-Birth-Weight Infant (VLBW), Extremely Low-Birth-Weight Infant (ELBW), Neonatal Death, Perinatal Death

Feeding in Early Infancy

• Exclusive breastfeeding preferred for first 12 months
• Other liquids or foods not recommended for infants under 6 months of age

Typical Daily Volumes for Young Infants (Not Breastfed)

• Specific volumes of formula per day based on age (birth to 1 month, 1 to 2 months, 2 to 3 months, 3 to 4 months). Given as fluid ounces

How Infant Formulas are Modified Compared to Breast Milk

• Comparison of protein, carbohydrate and fat percentages in breast milk, cow's milk-based formula, and soybean-based formula

What is Modified (Quality)

• Modifications in calorie levels, protein forms, types of sugar used, and fat compositions in infant formulas compared to breast milk

Thickness, Age of Infant

• Considerations for thickness of formula, target age groups 0-12 months and 9-24 months due to gastrointestinal problems.

Calorie & Protein Goals

• Table provided with calorie and protein goals categorized by age (preterm, infants, children, males, females)

Specific Formula

• Micronutrients: lower supplemental iron, increased calcium and phosphorus concentration for preterm infants, decreased minerals related to renal function in formula

Cow's Milk during Infancy

• Do not use whole cow's milk, skim milk, or reduced-fat milk in infancy
• Iron-deficiency anemia is linked to early introduction of whole cow's milk
• High cost of infant formula may result in families choosing cow's milk instead for older infants not breastfed

Soy Protein-Based Formulas During Infancy

• Use of soy protein formulas is limited by pediatricians
• Soy protein formulas contain hormone-like components and dietary fiber. These components can potentially alter mineral absorption in healthy infants.

Nutrition for Infants

• Guidelines for introducing solids. Categorized by age groups (birth to 6 months, 4 to 6 months, 6 to 8 months, 7 to 10 months, 8 to 12 months, 1 to 2 years). Includes foods introduced.

First Year Solid Foods

• Baby cereal (iron-fortified) is common first food
• Rice cereal is easily digested and hypoallergenic. Fruits and vegetables also commonly offered as first foods.

Infant Feeding Guidelines

• Introduce foods one at a time. Start with foods less allergenic.
• Avoid egg whites and citrus fruits, and honey, until 12 months

Recommendations

• Add only one food at a time and introduce over 2-3 days. Use food preparation methods (blender, food processor, mashing) to avoid contamination. Portion sizes for infants should correspond to appetite

How Infants Learn Food Preferences

• Infants learn food preferences based on their experiences with food.
• Breastfed infants experience a wider variety of tastes compared to formula-fed infants
• Infant acceptance of new foods is often more rapid in the 4-7 months' age range than acceptance after the first year.

Supplements for Infants

• Fluoride supplements recommended for families without fluoridated water
• If solely breastfed after 6 months, fluoride supplements are recommended

Common Nutritional Problems and Concerns

• Failure to Thrive (FTT): inadequate weight or height gain, caused by caloric deficit or a health problem

Colic

• Colic is sudden onset of irritability, fussiness, or crying in infants.

Iron-Deficiency Anemia

• Iron deficiency in infants is less common than in toddlers.
• Iron reserves in full-term infants reflect the prenatal iron stores of the mother and less iron is passed to the fetus when the mother is anemic. Treatment is generally oral elemental iron administered as a liquid.

Diarrhea and Constipation

• Diarrhea and constipation may be attributed to dietary components such as breast milk or iron supplementation. Adequate fluid intake (breast milk or formula) during a bout of diarrhea is sufficient to prevent dehydration.

Hypothyroidism

• Hypothyroidism is a condition where the thyroid hormone is not produced in sufficient quantities, affecting growth and mental development in infants

Key Points

• Infants born full-term and preterm are similar in growth milestones for the first year.
• Crediting access to adequate nutrition with decreasing infant mortality.
• Infant feeding and eating abilities are based on developmental skills.
• Energy and nutrient needs are affected by factors like sleep cycles, exposure and health conditions.

Toddler and Preschooler Nutrition

• Key nutrition concepts: continuing growth and development, learning to enjoy new foods, developing feeding skills, self-regulating food intake, parental/caretaker influences on eating and activity habits

Definitions of the Life-Cycle Stage

• Toddler (1-3 years): rapid increase in gross and fine motor skills, increased exploration and language development.
• Preschool (3-5 years): increasing autonomy, broader social circumstances

Importance of Nutrition

• Proper energy and nutrient intake is critical for toddlers and preschoolers to reach their developmental potential.
• Under-nutrition can impair cognitive development and environmental exploration ability

Nutritional Highlights

• Appetite and food intake in toddlers vs. during infancy
• Toddler development includes high growth velocities, and toddler-sized meal portions are 1 tablespoon per year of age.
• Preschool feeding behaviors, with a slower growth rate and a potentially smaller appetite

Preschool-Age Children

• Children continue to expand their motor capabilities and language development is rapid.
• Feeding behaviors; growth rates are slower, and appetite is smaller. Children can effectively use utensils (fork and spoon).

Ability to Control Energy Intake

• Children's innate ability to adjust caloric intake to match energy needs.
• Children learn eating habits from observing their parents.
• Sharing family meals is important in young children’s developmental process.

Energy and Nutrient Needs

• Table detailing mean percentages of total calories from various macronutrients (carbohydrate, protein, fat, saturated fatty acids, and cholesterol) for children aged 2-5 years. Divided into male and female percentages.

Calorie Intake Reference for Children

• Table detailing estimated energy requirements for boys and girls, depending on age (3, 4, 5 years old) and physical activity level (sedentary, low active, active, very active).

Dietary Reference Intakes

• Tables that detail dietary allowances for key nutrients, along with adequate intakes. Includes age ranges and recommended daily intakes. Iron, Zinc, and Calcium. Protein recommendations.

Child and Preadolescent Nutrition

• Defined stages of middle childhood and preadolescence, based on age

Importance of Nutrition (School Age)

• Adequate nutrition aids children to reach their developmental and health potential. Common nutrition problems can still occur (iron-deficiency anemia, undernutrition, dental caries).

Normal Growth and Development

• Steady growth rate of school-age children.
• Describe average annual growth. (pounds and inches are listed).

The 2000 CDC Growth Charts

• Charts showing growth milestones.

Eating Behaviors and Feeding Skills

• Parent’s influence on a child’s food attitudes and food choices impacts childhood and preadolescence food habits.
• External influences like increased time away from home.

Media Influence

• Media, such as advertisements on television influence snacking habits of school-age children and can substantially contribute to a child’s daily intake. Also impacts decisions on foods to try

Energy and Nutrient Needs (School-Age Children)

• Energy intake based on body weight for active vs. sedentary school-age children.
• Describing the decreasing energy requirement for school-age children (compared to toddlers or preschoolers) as the child's growth rate slows.

Protein

• Daily recommended protein intake for school-age (4-13 years old) boys and girls calculated based on body weight

Nutrient Requirements

• Protein: Minimum of 12% of total calorie needs
• Carbohydrate: 50-55% of total calorie needs
• Fat: 30% of total calorie needs
• Vitamins/Minerals: Daily Reference Intakes

Vitamins and Minerals

• School-age children may not meet their needs for key vitamins and minerals (Iron, Zinc, and Calcium)

Energy Requirements

• Components of calculating energy expenditure, including basal metabolic rate (BMR) or resting energy expenditure (REE), growth rate (growth spurt; catch-up growth), and physical activity (activity level)

How to Calculate Energy Intake

• Schofield equation calculations of BMR/kcal/day for various age ranges for different genders (male/female, 3 years old, 3–10 years old, 10-18 years old)

Why is accurate energy estimation necessary?

• To reduce child mortality
• Prevent overfeeding leading to hyperglycemia, fat deposition, or fatty liver
• Prevent underfeeding leading to malnutrition, impaired immunologic responses or growth impediments

Calorie & Protein Goals (further details of age group specific caloric and protein needs for infants, children, boys & girls).

Carbohydrate and Lipid Requirements

• Carbohydrate requirements are approximately 50-60% of total energy intake.
• Lipid requirements are 30-40% of total energy intake

Fluid Requirements

• Fluid requirements are given based on body weight. Includes ranges for age (0-10 kg, 10-20 kg, > 20 kg).

Common Nutrition Problems (Iron Deficiency)

• Diagnosis criteria for iron-deficiency anemia in children (5-8 years and 8-12 years old) based on hemoglobin concentration.

Dental Caries

• Prevalence of dental caries (decay) in children (6-8 years old) linked to habits (oral health) and to poor diet decisions (sticky carbohydrate-containing food). Better choices include complex carbohydrates versus simple sugars.

Overweight and Obesity (School-Age Children)

• Prevalence of obesity defined by BMI.
• BMI-for-age percentile that is greater than or equal to the 95th.
• Complications, such as hyperlipidemia, liver enzyme concentrations, hypertension, and abnormal glucose tolerance.

Assessment of Overweight and Obesity

• BMI-based definitions of overweight and obesity with percentile cutoffs
• Monitoring for type 2 diabetes starting at age 10

Treatment of Overweight and Obesity

• Four-stage approach to treatment includes Prevention, Structured Weight Management (SWM), and Comprehensive Multidisciplinary Intervention (CMI) stages

Dietary Supplements

• Calcium and Vitamin D recommendations (milligrams and IU) by age group (4-8 years and 9-18 years).

Iron

• Iron deficiency is prevalent during school age.
• Recommended to include iron-rich foods in the diet (meats, fortified cereals, and beans).
• Emphasize the importance of vitamin C-rich foods (orange juice) as aids in absorption of iron.

Fiber

• Importance of fiber in preventing chronic diseases. Provides examples of high fiber foods, including vegetables and whole-grain products

Key Points (School-Age and Preadolescent)

• Slow and steady growth rate.
• Tracking BMI important when assessing overweight or underweight.
• Family mealtimes are critical for promoting a healthy diet.
• Child's food choices are influenced by many external factors like peers, teachers, media, and the internet.
• Overweight/obesity rates in school-age and preadolescent children increasing.
• Sedentary lifestyles and lack of physical activity contribute to overweight, emphasizing the need for physical activity/exercise.
• Consuming sweetened drinks increases overall calorie consumption.

Dietary Guidelines (School-Age and Preadolescent)

• Recommendations for servings of vegetables, fruits, and breads, cereals, rice, pasta

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