Middle Childhood & Preadolescence Nutrition Lecture 8 PDF

Middle Childhood & Preadolescence Nutrition NUTR 204 Prepared by: Dr. Reham Metwally Updated by: Miss. Seham Alyami & Lena Bogari  Revision of last week lecture Infant Age: 0- 1 year. Toddlers Age: Children b...

Middle Childhood & Preadolescence Nutrition NUTR 204 Prepared by: Dr. Reham Metwally Updated by: Miss. Seham Alyami & Lena Bogari  Revision of last week lecture Infant Age: 0- 1 year. Toddlers Age: Children between the ages of 1 and 3 years. Preschool-Age Children Children between the ages of 3 and 5 years, who are not yet attending kindergarten.  Middle Childhood & Preadolescence “School-Age” Preadolescence: The stage of development Middle childhood: immediately preceding Between the ages of 5 - 10 adolescence: years Girls: 9-11years Boys: 10-12 years 4  Normal Growth and Development  Growth velocity will slow down during the school-age years.  Growth should continue to monitor periodically.  Weight and height should be plotted on the appropriate growth chart.  2000 CDC growth charts: Tools to monitor the growth of a child for the following parameters:  Weight-for-age  Stature-for-age  Body mass index (BMI)-for-age https://www.cdc.gov/growthcharts/ 5 6  Normal Growth and Development 1- Physiological Development 2- Cognitive Development Muscular strength, motor coordination, Self-efficacy…the knowledge of what to & stamina increased. do and the ability to do it Increases in adiposity ( from year 6 ) Develops sense of self more Increases in preparation for adolescent independent & learn family roles growth spurt Peer relationships become important Boys have more lean tissue than girls What’s lean tissue???? Dr.Reham Shawky Metwally 7 10/13/2024  Eating Behaviors  Parents & older siblings influence food choices in early childhood with peer influences increasing in preadolescence  Parents should be positive role models  Family meal-times should be encouraged  Media has strong influence on food choices  Children can not consume large amounts of food at one time, so snacks are needed. 8  Eating Disorders Eating disorders are a group of serious mental health conditions characterized by disordered eating patterns and negative attitudes towards body weight, shape, and food. Eating disorders can threaten one's life and affect physical and mental development, especially in young individuals. To conduct a comprehensive evaluation of a child suspected of having an eating disorder, it is essential to gather a detailed medical, nutritional, and psychiatric history, and proceed with a thorough physical examination. The Academy for Eating Disorders published a web resource for assessment in multiple languages. https://www.aedweb.org/learn/publications/medical-care-standards 9  Eating Disorders Studies suggest that eating disorders can occur in children as young as six years old. Eating disorders among middle children and preadolescents may manifest in various ways, such as restrictive eating, binge eating, purging, and excessive exercising. It is important to recognize the warning signs early on and seek professional help to avoid long-term health complications. 10  Eating Disorder Screening Tool S – Do you make yourself Sick because you feel uncomfortably full? C – Do you worry you have lost Control over how much you eat? O – Have you recently lost more than One stone (6.35 kg or 14 lb.) in a three-month period? F – Do you believe yourself to be Fat when others say you are too thin? F – Would you say Food dominates your life? *Two or more positive responses on the SCOFF indicates a possible ED and should prompt referral for further evaluation. 10/13/2024 Dr.Reham Shawky Metwally 11  Body Image and Excessive Dieting  Young girls are preoccupied with weight & body size at an early age dieting  The normal increase in adiposity at this age may be interpreted as the beginning of obesity  Imposing controls & restriction of ”forbidden foods” may increase desire & intake of the foods 12  Energy and Nutrient Needs for School- Age Children  Energy needs based on gender , age, physical activity and BMI  Intakes of vitamins & minerals should be adequate. 13  Dietary Supplements  Supplements not needed for children who eat a varied diet & get ample physical activity.  If supplements are given, do not exceed the Tolerable Upper Intake levels.  The UL (Tolerable Upper Intake Level) is the maximum amount of daily vitamins and minerals that you can safely take without risk of an overdose or serious side effects.  For certain nutrients, the higher you go above the UL, the greater the chance you'll have problems. 14 Which weight to be used in calculation? 16 MyPlate MyPlate serves as a visual aid to encourage individuals to choose healthier options from the five food groups. It’s created by the U.S. Department of Agriculture (USDA) Calcium and Vitamin D. Fiber Note: Because of Vitamin D children must be Exposed to sunlight. Fiber 17 18  MyPlate The MyPlate Plan is customized to the individual needs and displays the recommended food group amounts and quantities based on factors such as:  Age  Gender  Height & weight,  Physical activity level. You can use this online resource to find plans based on energy requirement MyPlate Plan | MyPlate 19  Common Nutrition Problems 1.Iron Deficiency  Less common in children than in toddlers  Dietary recommendations to prevent:  Encourage iron-rich foods ;meat, fish, poultry, dry beans, & peas.  and fortified cereals  Vitamin C rich foods to help absorption. Example? 20  Common Nutrition Problems 2.Dental caries  Seen in half of children aged 6 to 9  Dental caries in children negatively affects their quality of life due to: discomfort, pain, sleep problems, chewing difficulties, learning disorders, and absenteeism from school.  Dental caries is a multifactorial disease.  The interaction of environmental and genetic factors, such as the effects of oral bacterial flora, dietary habits, oral hygiene, saliva composition, and tooth structure, plays a role in the formation and progression of caries. 21   Reduce dental caries by:  Limiting sugary snacks  Providing fluoride  Choose fruits, vegetables, and grains (Why fruits and vegetables?) The presence of phenolic compounds in fruits and vegetables has been seen to inhibit the proliferation of bacteria associated with dental caries and the development of biofilm.  Rinse (or better yet, brush the teeth) after eating American Academy of Pediatric Dentistry recommend reducing sugar intake to less than 5% to reduce body weight gain, obesity and the risk of dental caries in children. 10/13/2024 Dr.Reham Shawky Metwally 22  What type of diet can be followed to reduce dental carries? Mediterranean diet (MD). What’s the characteristic of MD?? high intake of plant-based foods such as vegetables, fruits, nuts, legumes, and eliminate carbonated beverages, and manufactured pastries due to their high content of added sugars. 10/13/2024 Dr.Reham Shawky Metwally 23  The relationship between caries and obesity has received much attention in recent years. The association is likely derived from common risk factors such as high sugar diet, unhealthy eating habits, lower socio-economic status, and other social-environmental factors 10/13/2024 Dr.Reham Shawky Metwally 24  Common Nutrition Problems 3. Overweight and Obesity  Overweight = BMI-for-age from 85th to 95th%.  Obese = BMI-for-age ≥95th %  Weight gain linked to inactivity rather than increases in energy intake  Excessive body weight increases risk of:-  Cardiovascular disease  Type 2 diabetes mellitus 25  Nutrition and Prevention of CVD in School-Age Children  Acceptable range for fat is 25% to 35% of energy for ages 4 to 18 year.  Diet should emphasize:  Include sources of linoleic (omega-6)  Fruits and vegetables and alpha-linolenic (omega-3) fatty  Low-fat dairy products acids. Example??  Whole-grain breads and cereals  Limit saturated fats, cholesterol &  Seeds, nuts, fish, and lean meats trans fats. Example??  Increase soluble fibers, maintain weight, & include ample physical activity. 26 10/13/2024 27  Prevention and Treatment of Overweight and Obesity  Expert’s recommend a 4-stage approach, each stage require3-6 months before advancing to the next stage of treatment.  Outcome measure is weight or BMI percentile.: The four stages:  Stage 1: Prevention Plus  Stage 2: Structured Weigh Management (SWM)  Stage 3: Comprehensive Multidisciplinary Intervention (CMI)  Stage 4: Tertiary Care Intervention (reserved for severely obese adolescents)  https://www.utmb.edu/pedi_ed/Obesity/page_22.htm 28  Stage 1: Prevention Plus Consume > 5 servings of fruits and vegetables every day. Minimize sugar-sweetened beverages - soda, sports drinks, and punches. These should be completely eliminated if possible although a reduction to 1 serving per day is okay. Decrease television viewing (and all screen time) to < 2 hours per day. (