The science of nutrition 4th edition thompson manore vaughan chapter 18

Chapter 18 Lecture Chapter 18: Nutrition Through the Life Cycle: Childhood and Adolescence © 2017 Pearson Education, Inc Toddlers • Age 12 months to 36 months • • • • © 2017 Pearson Education, Inc Rapid growth rate of infancy begins to slow Gain 5.5 to 7.5 inches, average to 11 pounds Higher energy expended for increased activity levels Increased nutrient needs are based on their larger body size Toddlers (cont.) • 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) â 2017 Pearson Education, Inc 14 grams fiber per 1,000 kcal/day Toddlers (cont.) • Micronutrients: • Ensure adequate intake of the micronutrients obtained from fruits and vegetables, including: vitamins A, C, E, calcium, iron, zinc, potassium • • • Vitamin D supplements recommended for some children Until age 2, drink whole milk for calcium Iron-deficiency anemia is the most common nutrient deficiency in young children © 2017 Pearson Education, Inc Toddlers (cont.) • • As toddlers become more active, they lose more fluids through sweat An active toddler may need more fluids © 2017 Pearson Education, Inc © 2017 Pearson Education, Inc Nutritious Food Choices • • • • • • • 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 © 2017 Pearson Education, Inc © 2017 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 and monitor for allergic reactions © 2017 Pearson Education, Inc 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 â 2017 Pearson Education, Inc 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 © 2017 Pearson Education, Inc 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 © 2017 Pearson Education, Inc 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 © 2017 Pearson Education, Inc 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 is not caused by diet, but a healthy diet can optimize skin health Cigarette smoking, alcohol, and illegal drugs can have an impact on nutrition © 2017 Pearson Education, Inc 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: â 2017 Pearson Education, Inc Exacerbates asthma Causes sleep apnea Impairs the child's mobility Leads to intense teasing Low self-esteem Social isolation Pediatric Obesity • Greater risk for type 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 © 2017 Pearson Education, Inc Pediatric Obesity (cont.) • • • • • 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 © 2017 Pearson Education, Inc 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 © 2017 Pearson Education, Inc 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 © 2017 Pearson Education, Inc Physical Activity • Institute for Medicine recommends aerobic physical activity for at least an hour each day • Physical Activity Guidelines for Americans: bone- and muscle-strengthening activities at least days each week • Encourage noncompetitive, fun, and structured activities in ways that allow selfpacing © 2017 Pearson Education, Inc © 2017 Pearson Education, Inc Physical Activity (cont.) • • • • Parental and adult role models Shared activities: ball games, bicycle rides Television/electronic games: ≤ hours/day Electronic games: virtual tennis, step aerobics, dancing, other active simulations © 2017 Pearson Education, Inc Physical Activity (cont.) • 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 © 2017 Pearson Education, Inc Physical Activity (cont.) • 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 © 2017 Pearson Education, Inc Pediatric Obesity Treatment • Stage 1: lifestyle modifications to improve dietary intake while decreasing energy intake, and to increase physical activity • Stage 2: consultations with a Registered Dietitian Nutritionist, self monitoring, and monthly visits with healthcare provider • Stage 3: care team expands to include behavioral health an exercise specialist, and weekly visits with healthcare provider © 2017 Pearson Education, Inc ... 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... 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: • • • • • • © 2017 Pearson Education,... girl reaches almost full height by the onset of menstruation (menarche); boys can continue to grow during early adulthood • • Skeletal growth ceases closure of the epiphyseal plates Weight and