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Average Annual Growth During the School Years
- 7 pounds in weight
- 2.5 inches in height
During the early childhood years, percent body fat reaches a minimum of what percent in females?
During the early childhood years, percent body fat reaches a minimum of what percent in males?
The increase in percent body fat in puberty averages how much in females?
The increase in percent body fat in puberty averages how much in males?
What is the only way to know whether a child's BMI is outside the normal range for his/her age?
Plotting BMI-for-age on the growth chart
Early "dieting" by preadolescents may be a risk factor for...
What could parents be promoting by imposing controls & restrictions on a child's intake of a certain food?
The intake of the forbidden or restricted food
Approximately how many children aged 6 to 8 years has/have decay in the primary or permanent teeth?
One in two
What may have a protective effect on tooth enamel?
Fats & Proteins
Fats & Proteins
May have a protective effect on tooth enamel
- School-age children need it supplied
- Either through the water system or supplementation
The increase in the prevalence of overweight in children over the years seems to be due to...
Approximately what percent of children ages 6 to 11 are overweight?
Overweight Children & Sexual Maturity
Tend to experience sexual maturity at an earlier age than their non-overweight peers
- The normal increase in body mass index
- Occurs after BMI declines, at about 4 to 6 years of age
What's the most significant predictor of childhood obesity?
For each additional hour of TV viewed in the 12 to 17 age group, the prevalence of obesity increased by what percent?
Which age group has the highest rate of daily television viewing?
Children who have a BMI >/= 95 percent and who have mild hypertension or hyperlipidemia should do what?
In the new DRIs, how much fat should children consume in a day?
No reccomendations have been made
Are sports drinks (4-8% carbs) appropriate for children?
What percent of children aged 7 to 12 years have a good diet?
What percent of middle and junior high schools require daily physical activity for all students?
How many minutes of physical activity is it recommended that children engage in daily?
Contracts btw schools & soft drink companies whereby the school receives a %age of profits in exchange for the school offering only that soft-drink company's products on the school campus
School lunches must provide how much of the DRI's of the age/grade group of children being served for energy, protein, and select vitamins & minerals.
Children with cystic fibrosis may need protein levels at what percent of the RDA?
Caloric and protein needs on a body-weight basis are ___ during childhood than during the preadolescent, toddler, or preschool years.
Gastronomy feeding may be required in children with...
- Kidney stones
- Some cancers
- Severe forms of cerebral palsy
- Severe forms of cystic fibrosis
Which supplements are especially needed in cystic fibrosis?
Vitamins A, D, E, & K
Children with it may need to be supplemented with calcium
Children with it may need to be supplemented with Vitamin C
Type 1 Diabetes
- Related to immune function
- Results in virtually no insulin production
Pancreatic enzymes are lacking
Seizures seem to decrease when...
Brain metabolism is switched from the usual fuel of glucose to ketones
No specific vitamins or minerals are known to correct it
Need to avoid high-protein fruits
The incidence of ADD & ADHD are estimated to be what percent of school-age children?
Have theories about specific foods or nutrients causing ADHD been proven scientifically?
Infants with HIV
Often display failure to thrive
3 Predictors of Childhood Obesity
- 1. The age at "adiposity rebound." A late adiposity rebound- age 7 or later- is linked to a higher chance of childhood obesity.
- 2. Child's home environment. Includes maternal obesity, family income, & the level of cognitive stimulation.
- 3. Parental obesity. Could be due to environmental factors or genetic factors. If both parents are obese, children are even more likely to be obese themselves.
Recommendations for Calcium Intake for Younger & Older Children
- Younger children (ages 4-8): 800mg/day
- Older children (ages 9-18): 1300mg/day
Source of Calcium for Traditional American Diet
Milk or dairy products
Source of Calcium for Vegan Diet
Orange juice fortified with calcium
Source of Calcium for a Diet Limited in Lactose
Low-lactose dairy products
- Used for patients w/ seizures
- Severely limits carbs & increases calories from fat
- Adequate in calories & protein
- Vitamins & minerals added as supplements
- May allow seizure meds to be reduced/eliminated over time
- Causes problems w/ measuring growth, blood glucose, & ketones in urine
- Recommended for 2 years if it proves to be effective
Consequences of ADHD Psychostimulant Medications
- Decrease in appetite
- Maintaining growth while being medicated is difficult
- Mealtime behavior
- Adjustments (like timing medication so it'll peak @ meal/snack times) can help lessen consequences
What should be used to assess biological growth & development of an adolescent?
- Sexual maturation
- Biological age
Average Age of Menarch
For females, what percent of final adult height will be gained during puberty?
As much as what percent of ideal adult body weight is gained during adolescence?
By age 18, more than what percent of adult skeletal mass has been formed?
Body Fat During Puberty (Females)
On average, increases from 16% to 27%
What percent of daily energy intake do snacks account for among adolescents?
How many adolescents skip lunch?
High consumption may increase the risk for bone fractures over an individual's lifetime
Adolescents who consume a (lacto-ovo) vegetarian diet should be carefully assessed for the presence of...
In what circumstance can it be assumed that energy needs are being met?
If, over time, height as well as weight-for-height continuously fall within the same percentiles when plotted on gender-appropriate growth charts
How many tsp. of sugar do males generally consume per day?
How many tsp. of sugar do females generally consume per day?
When is calcium accretion in bone mass almost nonexistant?
- Females: By age 24
- Males: By age 26
Recommended Intake of Carbs for Teens
45-65% of daily energy needs
Recommended Intake of Milk, Milk Products, or Fortified Soy Milk for Teens
4 servings per day
Hemoglobin & Hematrocit Levels
- Commonly used to screen for the presence of iron deficiency anemia
- Actually the last serum indicators of depleted iron stores to drop
Plays an important role in sexual development
Adequate levels prior to pregnancy may reduce the incidence of spina bifida & Down syndrome
Cigarette smoking increases the need for...
It's recommended that adolescents engage in how many minutes of physical activity on most days of the week?
60 minutes or more
What percent of adolescents report no moderate to vigorous physical activity?
Competitive athletes may require how many additional calories per day to meet their energy needs?
The most readily available source of energy during exercise
How should weight status among adolescents be assessed?
By calculating BMI
For severely obese adolescents, as well as those with significant medical complications, doctors may recommend...
- Use of very low-calorie diets
- Protein-sparing modified fasts
- Bariatric surgery
What are recommended for adolescent weight management programs?
No specific physical activities or dietary regimens
Regional data suggest that the prevalence of overweight among which ethnicity adolescent males is higher than other racial/ethnic groups?
- Controlled substances used to increase lean body mass
- Have been linked to infertility & physeal closure
How many ounces of fluid ingestion does each pound of body weight lost during physical activity require to maintain proper hydration?
High Protein Diets
- Should be discouraged among athletes
- May contain high levels of total fat & saturated fat
- May delay digestion & absorption
- May increase the risk of dehydration
Which group reports the lowest prevalence of smoking?
By the twelfth grade, more than what percent of adolescents had tried alcohol?
Most common nutritional deficiency noted among children & adolescents
How often should all adolescent females be screened for anemia?
Every 5 years
Approximately how many adolescents in the US have an elevated cholesterol level.
One in four
Characterized by self-starvation and strong fears of being fat
Characterized by binging & purging, weight maintenance, & weight fluctuations
What percent of adolescent girls in the US consider themselves overweight and have attempted to diet?
What is a reasonable estimate of adolescents who've engaged in anorexic or bulimic behaviors?
The relative risk for dieters to develop an eating disorder was how many times higher than that for non-dieters after a one-year period?
What tips would you give an adolescent to increase the nutrient content of a fast food meal?
- Choose juice, water, or milk instead of soda
- Choose a side of fruit, baked potatoe, or salad instead of french fries
- Keep the meal at small size instead of super size or value size
Relationship Between Adolescents who Consume a Vegetarian Diet & Eating Disorders
- Some adolescents eat vegetarian diets as a way to restrict fat or calories
- Vegetarian adol.'s are almost 2x as likely to report frequent or chronic dieting
- Veg. adol.'s are almost 4x as likely to report purging
- Veg. adol.'s are almost 8x as likely to report laxative use
Criteria for Performing Bariatric Surgery on Adolescents
- Must have a BMI of greater than 40 with medical complications
- OR must have a BMI of greater than 50 w/out medical complications
- Be through most of their growth spurt
- Should try other weight loss methods first
5 General Guidelines for Weight Management Therapy
- 1. All family members & caregivers should be involved in the weight management program
- 2. Weight management programs should emphasize goals of improving eating & physical activity patterns as opposed to specific weight goals
- 3. New behavior changes shouldn't be instituted until previous changes have been accomplished & maintained
- 4. Early intervention is recommended, pref. before the child reaches the 95th percentile for BMI
- 5. Routine follow-up visits should be scheduled to monitor progress & prevent relapse to former eating & activity patterns
Prevalence of Dieting Behavior in Adolescents
Risks of Dieting
- Development of eating disorders
- Not meeting daily energy & nutrient requirements
What has the greatest influence on long life?
Life style factors
Since the first Healthy People 2000 report was generated in 1979, what has not declined?
Overall, approximately what percent of adult body cells are replaced every day?
For men, a gradual decline in testosterone levels begins at about what age?
40 to 50
- 6% of people in their 50s have them
- Approximately 60% of people over 80 y/o have them
After cessation of menstrual blood loss, the need for iron decreases to how many mg daily?
After menopause, the lack of estrogen & progesterone levels...
Leads to a rise in total blood cholesterol
Phytoestrogens (in Soy)
- Have estrogenic activity
- May decrease "hot flashes" during menopause
- Function as antioxidants
- Increases HDL cholesterol
- Decreases LDL cholesterol
- Decreases blood triglycerides
Individuals vary by as much as what percent in their caloric expenditures during light to moderate activity?
How many calories does it take to gain or lose one pound of body fat?
- Yo-yo dieting
- Associated w/ kidney disfunction
The current online pyramid will calculate suggested energy intake based on...
- Activity level
Overall, what percent of adults in the US drink alcohol?
How long can adults survive without food?
Roughly 60 days
How long can adults survive without water?
Is average fluid intake adequate to meet human needs?
Is there evidence connecting drinking coffee or tea or other caffeine-containing fluids w/ dehydration?
What's a simple, yet practical guide to adqueate fluid intake?
Evaluate the colour of urine
Which nutrients are of public health concern because intake levels don't meet recommendations?
- Vitamin E
- Folic Acid
Fat Intake as Percent of Calories
Average Daily Dietary Fiber Recommendations
- Males: 38 grams
- Females: 25 grams
Vitamin E Supplements
Associated with increased all-cause mortality
- A calcium supplement
- Can interfere with iron absorption
By 2010, what percent of food dollars will be spent away from home, with fast-food restaurants as
the fastest-growing type of operation?
What are potential health benefits of vegetarian diets?
- Decreased risk of mortality & symptoms of heart disease
- Vegetable foods are lower on the food chain than meat, fish, & poultry
- Decreased risk of prostate & colorectal cancers
- Improved risk profile for kidney disease
- Lower incidence of hypertension
Protein Intake of Vegetarians
- Generally adequate
- But lower overall protein quality & intake
Inactivity in the IS has ____ in the last 10 years.
What percentage of US adults (18-64 y/o) live in poverty?
Food Stamp Program
The largest of all nutrition assistance programs
What are the 4 most common cancers in adults?
It is estimated that smoking causes about what percent of all US deaths from cancer?
Lifestyle Habits of US Adults
- Smoking rates are decreasing
- Total dietary fat as a percentage of total calories has declined
- Alcohol consumption is stable
- Vegetable consumption isn't meeting national guidelines
What's the main nutrition-risk associated with cancer in the US?
Low intake of Vitamin B12
- A characteristic of Coronary Heart Disease (CHD)
- Hardening of the arteries due to plaque build-up in the walls of the arteries
Strongest Risk Factor for Heart Disease
Abnormal blood lipid levels
Therapeutic Lifestyle Changes Recommended by the National Cholesterol Education Program
- Saturated fat should be less than 7% of calories
- Monounsaturated fatty acids should contribute up to 20% of calories
- Total fat should range between 25-35% of calories
- Dietary cholesterol should be less than 200mg per day
The number of obese individuals has ____ since 1980.
What's a particularly potent risk factor for insulin resistance?
Abdominal obesity ("apple shape")
- Includes a cluster of metabolic abnormalities that increase the risk of type 2 diabetes & heart disease
- High blood insulin levels
- Low levels of HDL cholesterol
- Elevated blood triglyceride levels
- High levels of central body fat
Phytoestrogens in Soy & Alleviation of Menopausal Symptoms in Women
- Supplement endogenous estrogen when estrogen levels are low in women
- Might be related to lower incidences of hot flashes & night sweats
- Can increase HDL cholesterol, decrease LDL cholesterol, & decrease triglycerides
What percent of the North American population is aged 65 and older?
What's the average life expectancy in the US?
What would the greatest dietary improvement in the older adult population be?
To eat more whole grains
What can an energy-restricted diet that meets micronutrient needs do?
Prolong healthy life
Of all physiologic changes that occur during aging, the
biggest effect on nutritional status...
...is due to the shifts in the musculoskeletal system
Many individuals experience a decline in what with aging?
- Body water
- Lean body mass (muscle)
- Body minerals
Elderly People & Thirst
Don't seem to notice thirst as clearly as younger people do
What do older adults tend to consume in insufficient amounts?
- Vitamin E
- Folic Acid
Adequate fiber intake is associated with decreases in what?
- Diverticular disease
- Non-insulin dependent diabetes
- Coronary heart disease
Adequate Carb Intake & Elderly
Not a problem
- High cholesterol
- Safe for most people who don't have a lipid disorder
Age-related metabolic changes affect vitamin D status, primarily due to what?
Decreased ability of the skin to synthesize previtamin D3
Why might not many of the elderly be unable to utilize vitamin B12?
Because of existing atrophic gastritis
Older adults are more likely to overdose with what nutrient than to be deficient in it?
The need for what nutrient decreases with aging for women after menopause?
Which nutrient plays a special role in the health of older adults due to its antioxidant functions, such as hindering development of heart disease and cataracts?
What have low calcium intakes been linked to?
- Colon cancer
Zinc & Older Adults
Plays a role in wound healing, taste acuity, & immune response
Should be used (in general) in physiological rather than high-potency doses to maintain a balance of vitamins & minerals
Leading Practices that Put an Older Person at Risk for Food-Borne Illnesses
- Improper holding temperature of foods
- Poor personal hygiene
- Contaminated food preparation equipment
- Inadequate cooking time
The major determinant of age- & gender-related differences in strenght, independent of where the muscle is located
Senior Nutrition (Title IIIC of the Older American Act)
Community-based nutrition program
Senior Nutrition (Title IIIC of the Older American Act) Provides...
- Congregate meals
- Home-delivered meals
- Nutrition screening & education
- Increased social contact
Participants in home-delivered or congregate meals had up to what percent higher intake of recommended nutrients as compared to non-participants?
What percentage of older people consider their health to be good, very good, or excellent?
What percentage of older Americans has one or more chronic conditions, such as high blood cholesterol, hypertension, osteoporosis, obesity, etc.?
Risk Factors for Stroke
- Cigarette smoking
- Sickle cell anemia
- Diabetes mellitus
- Long-term high blood pressure
What can be protective against stroke?
Moderate amounts of any type of alcohol
Dietary Approaches to Stop Hypertension (DASH Diet)
- Useful in decreasing blood pressure & stroke
- Especially high in fruits & veggies
What's the primary diet strategy for cancer risk reduction?
Fruit & veggie consumption
What's a dietary strategy recommended specifically to reduce prostate cancer risk?
Increase consumption of lycopene (tomatoes)
Consequences of Diabetes
- Tenfold greater risk of: Amputation, Visual loss, Nueropathies
- Also leads to: Declines in organ function
Fasting blood glucose of how many mg/dl or higher is the diagnostic criteria for diabetes?
Has been shown to reduce insulin needs in diabetics
In the United States, nearly how many of older adults are not just overweight, but obese?
BMI & Older Adults
Health care providers should be more flexible when it comes to BMI recommendations for older adults (ie- allow a broader range of BMIs)
Nutritional Remedies that can Improve Calcium Intake & Absorption
- Taking supplements w/ a meal
- Getting adequate Vitamin C, K, & B6
- Drink milk
- Don't take supplements with antacids (since stomach acid will help with absorption)
Individuals choosing not to take hormone replacements may try it for its estrogen-like activity.
Results when a lack of intrinsic factor prevents absorption of Vitamin B12
The first remedy advised for treatment is weight loss
Bacteria in the stomach leads to inflammation, which decreases hormones that make it impossible to take the B12 from its food source
Consequences of Atrophic Gastritis
Eventual B12 deficiency, which causes personality changes, poor physical coordination, & the deterioration of mental functioning
Risk Factors of Diabetes
- 1. Race/Ethnicity: More likely in blacks
- 2. Body Weight/Abdominal Fat: More fat is more likely, esp. when they store it in their abdominal area
- 3. Hyperhomocysteinemia: Condition linked to increased risk of heart disease