Transcript Chapter 10

Chapter 17 Lecture
The Science of Nutrition
Third Edition
Nutrition
Through the
Life Cycle:
Childhood and
Adolescence
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Toddlers
• Age 12 to 36 months
– Rapid growth rate of infancy begins to slow
– Gain 5.5 to 7.5 inches, average 9 to 11
pounds
– Higher energy expended for increased activity
levels
– Increased nutrient needs are based on their
larger body size
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Toddlers
• Macronutrients:
– Estimated Energy Requirement (EER) varies
according to the toddler's age, body weight,
and level of activity
– 30−40% of total kcal from fat
– 1.1 grams of protein per kg body weight
– 130 grams carbohydrates per day (most of
the carbohydrates should be complex)
– 14 grams fiber per 1,000 kcal/day
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Toddlers
• Micronutrients:
– Ensure adequate intake of the micronutrients
obtained from fruits and vegetables, including:
vitamins A, C, E, calcium, iron, zinc,
potassium
– Until age 2, drink whole milk for calcium
– Iron-deficiency anemia is the most common
nutrient deficiency in young children
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Toddlers
• Fluid needs: active toddler may need more
• Physicians may recommend supplements:
– Toddlers with erratic eating habits
– Fluoride supplement, if the community water
supply is not fluoridated
– Vegan families
– Medical conditions or dietary restrictions
– Supplement should not exceed 100% Daily
Value for any nutrient per dose
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© 2014 Pearson Education, Inc.
Nutritious Food Choices
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Most are able to match intake with needs
Healthful variety of food available
Food should not be forced on a child
Frequent small meals for small stomach
Developmentally appropriate foods
Small portions, limited healthful alternatives
Role modeling is important
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© 2014 Pearson Education, Inc.
© 2014 Pearson Education, Inc.
© 2014 Pearson Education, Inc.
Allergy Watch
• Continue to watch for common food allergies:
wheat, peanuts, cow's milk, soy, citrus, egg
whites, seafood
• Introduce one new food at a time
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Vegetarian Families
• Eggs and dairy: part of a healthful diet
• Vegan diet may be low in protein, minerals
(calcium, iron, zinc), vitamins (D and B12)
• High fiber may impair iron and zinc absorption
and promote a premature sense of "fullness" at
mealtimes
• Fortified foods and supplement use to ensure
adequate nutrition
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Preschool and School-Age Children
• Growth slows: average gain 2–4 in./year
• Values for most nutrients increase
• For children ages 6−11 years: USDA developed
a MyPyramid for Kids
• Sexual maturation begins ages of 8 and 9: DRI
values are separately defined for boys and girls
beginning at age 9
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© 2014 Pearson Education, Inc.
Macronutrients
• Total fat intake should gradually drop to a level
closer to adult fat intake
• 25−35% of total energy from fat
• 130 grams carbohydrate per day
• 14 grams fiber per 1,000 kcal
• 0.95 grams protein per kg body weight
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Micronutrients
• Consuming adequate fruits and vegetables in
the diet continues to be a concern (vitamins A,
C, and E, fiber and potassium)
• "Milk displacement"—low-calcium diets also tend
to be low in other nutrients
• RDAs for iron and zinc also increase
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Nutritious Food Choices
• Peer pressure encourages unhealthful food
choices
• Families who plan, prepare, and eat meals
together are more successful at promoting good
food choices
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© 2014 Pearson Education, Inc.
Role of School Attendance
• School breakfasts: optimize nutrient intake and
avoid behavioral and learning problems from
hunger in the classroom
• No monitoring for adequacy of food eaten
• Soft drinks and snack foods in school
• School lunches: what's actually eaten (not
planned/served) tends to be higher in fat
• Options to entice healthful selections
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Nutrition-Related Concerns
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Iron-deficiency anemia
Dental caries
Body image
Food insecurity
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© 2014 Pearson Education, Inc.
Adolescents
• Adolescence continues to 18 years
• Puberty: secondary sexual characteristics
develop; capacity for reproduction
• Emotions and behaviors unpredictable and
confusing
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Adolescents
• Growth spurts begin at age 10−11 for girls,
12−13 for boys
• Average 20−25% increase in height
• Skeletal growth ceases closure of the epiphyseal
plates
• Weight and body composition also change
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© 2014 Pearson Education, Inc.
Macronutrients
• EER for adolescents is based on gender, age,
activity level, height, and weight
• 25−35% of total energy from fat
• <10% of total energy from saturated fat
• 45−65% of kcal from carbohydrates
• 0.85 grams protein per kg body weight
• 26−38 grams of fiber per day
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Micronutrients
• Calcium intakes must be sufficient for achieving
peak bone density: 1,300 mg/day
• Iron needs are relatively high: 11 mg/day for
boys, 15 mg/day for girls
• Vitamin A is critical for supporting rapid growth
and development
• Supplement should not be considered a
substitute for a balanced, healthful diet
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Fluid Recommendations
• The need to maintain fluid intake is increased
with higher activity levels
• Boys: 11 cups/day
• Girls: 10 cups/day
• Importance of including water
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Nutritious Food Choices
• Parents can act as role models
• Strong influence of peers, mass media, personal
preferences
• Encourage whole grains, fruits, vegetables, and
milk or calcium-rich beverages
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Nutrition-Related Concerns
• Adequate calcium intake maximizes bone
calcium uptake and bone mineral density
• Disordered eating and eating disorders can
begin in these years
• Acne and diet
• Cigarette smoking, alcohol, and illegal drugs can
have an impact on nutrition
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Pediatric Obesity
• Overweight: BMI above the 85th percentile of
the same age and gender
• Obese: BMI above the 95th percentile
• Higher risk of health problems:
– Exacerbates asthma
– Causes sleep apnea
– Impairs the child's mobility
– Leads to intense teasing
– Low self-esteem
– Social isolation
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Pediatric Obesity
• Greater risk for type 2 diabetes, high blood
lipids, high blood pressure, gallstones,
depression, and other medical problems
• Higher risk of becoming overweight adults
• Reversal of pediatric obesity can be
accomplished through an aggressive,
comprehensive nationwide health campaign
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Pediatric Obesity
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Early tendency during toddler years
Monitor if >80th percentile for weight
Encourage physical activity
Limit foods with low nutrient density
Early intervention is often the most effective
measure against lifelong obesity
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Role of the Family
• Provide nutritious food choices
• Encourage a healthful breakfast
• Sit down to a shared family meal each evening
or as often as possible
• No television at mealtimes: encourage attentive
eating, enjoyment of the food
• Parents should retain control over the
purchasing and preparation of food
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Role of the School
• Federal school lunch program: limit the amount
of fat, sugar, and sodium served
• Many schools sell foods and beverages that
exceed federal guidelines
• Nutrition education programs: health
departments, Dairy Councils
• Consistent and repeated school-based
messages on good nutrition
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Physical Activity
• Recommendation: daily physical activity and
exercise for at least an hour each day
• Bone- and muscle-strengthening activities at
least 3 days each week
• Encourage noncompetitive, fun, and structured
activities in ways that allow self-pacing
• Fitness Pyramid for Kids: guide children toward
a physically active lifestyle
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© 2014 Pearson Education, Inc.
Physical Activity
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Parental and adult role models
Shared activities: ball games, bicycle rides
Television/electronic games: < 2 hours/day
Electronic games: virtual tennis, step aerobics,
dancing, other active simulations
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Physical Activity
• Overweight children can "catch up" to their
weight as they grow taller without restricting food
(nutrient) intake
• Acquire motor skills and muscle strength
• Establish good sleep patterns
• Develop self-esteem; lower stress
• Optimize bone mass
• Enhance cardiovascular and respiratory function
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Physical Activity
• Physically fit children:
– Have improved behavior
– Are more attentive
– Are more focused
– Have higher levels of academic achievement
• Parents, healthcare providers, and community
members can work with school boards to
optimize opportunities for physical activity
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