© 2011 pearson education, inc. 17 nutrition through the life cycle: childhood and adolescence
TRANSCRIPT
© 2011 Pearson Education, Inc.
17Nutrition Through the Life Cycle: Childhood and Adolescence
© 2011 Pearson Education, Inc.
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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© 2011 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
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© 2011 Pearson Education, Inc.
© 2011 Pearson Education, Inc.
© 2011 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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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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© 2011 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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© 2011 Pearson Education, Inc.
School
• 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
• Iron-deficiency anemia • Dental caries• Body image• Food insecurity
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© 2011 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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© 2011 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 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
• 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
ABC Video Obesity in Children
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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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© 2011 Pearson Education, Inc.
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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© 2011 Pearson Education, Inc.
© 2011 Pearson Education, Inc.
Physical Activity
• 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