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Chapter 16-1
Chapter 16 – Life Cycle Nutrition: Infancy, Childhood, and Adolescence
Learning Objectives
After completing Chapter 16, the student will be able to:
16.1
16.2
16.3
H16
List some of the components of breast milk and describe the appropriate foods for infants during the first
year of life.
a. Describe growth patterns of infants and demonstrate the ability to use growth charts.
b. Identify nutritional and other health benefits of breast feeding.
c. Discuss the factors used in the selection of an infant formula.
d. Discuss the appropriate age and procedure used for the introduction of cow’s milk and solids into an
infant’s diet.
e. Discuss guidelines to follow at mealtimes with toddlers
Explain how children’s appetites and nutrient needs reflect their stage of growth and why iron deficiency
and obesity are often concerns during childhood.
a. Explain the nutritional needs of young children, including energy, protein, lipids, vitamins, minerals,
and water.
b. Discuss the effect of nutritional deficiency on behavior.
c. Discuss food allergies and intolerances in children and identify common allergens.
d. Describe the incidence of childhood obesity and the role of heredity and environmental factors in
obesity development.
e. Discuss the nutritional programs in schools, including the school lunch program.
Describe some of the challenges in meeting the nutrient needs of adolescents.
Describe the lifestyle factors that can help prevent childhood obesity and the development of type 2
diabetes and heart disease.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-2
Glossary
Chapter Key Terms
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adolescence: the period from the beginning of puberty until maturity.
adverse reactions: unusual responses to food (including intolerances and allergies).
alpha-lactalbumin (lact-AL-byoo-min): a major protein in human breast milk, as opposed to casein
(CAY-seen), a major protein in cow’s milk.
anaphylactic (ana-fill-LAC-tic) shock: a life-threatening, whole-body allergic reaction to an offending
substance.
botulism (BOT-chew-lism): an often fatal foodborne illness caused by the ingestion of foods containing a
toxin produced by bacteria that grow without oxygen.
breast milk bank: a service that collects, screens, processes, and distributes donated human milk.
colostrum (ko-LAHS-trum): a milk-like secretion from the breast, present during the first few days after
delivery before milk appears; rich in protective factors.
food allergy: an adverse reaction to food that involves an immune response; also called foodhypersensitivity reaction.
food intolerances: adverse reactions to foods that do not involve the immune system.
gatekeepers: with respect to nutrition, key people who control other people’s access to foods and thereby
exert profound impacts on their nutrition. Examples are the spouse who buys and cooks the food, the parent
who feeds the children, and the caregiver in a day-care center.
hyperactivity: inattentive and impulsive behavior that is more frequent and severe than is typical of others
a similar age; professionally called attention-deficit/hyperactivity disorder (ADHD).
milk anemia: iron-deficiency anemia that develops when an excessive milk intake displaces iron-rich
foods from the diet.
nursing bottle tooth decay: extensive tooth decay due to prolonged tooth contact with formula, milk, fruit
juice, or other carbohydrate-rich liquid offered to an infant in a bottle.
puberty: the period in life in which a person becomes physically capable of reproduction.
tolerance level: the maximum amount of residue permitted in a food when a pesticide is used according to
the label directions.
wean: to gradually replace breast milk with infant formula or other foods appropriate to an infant’s diet.
Chronic Diseases Terms
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atherosclerosis (ATH-er-oh-scler-OHsis): a type of artery disease characterized by plaques (accumulations
of lipid-containing material) on the inner walls of the arteries.
o athero = porridge or soft
o scleros = hard
o osis = condition
cardiovascular disease (CVD): a general term for all diseases of the heart and blood vessels throughout
the body. Atherosclerosis is the main cause of CVD. When the arteries that carry blood to the heart muscle
become blocked, the heart suffers damage known as coronary heart disease (CHD).
o cardio = heart
o vascular = blood vessels
fatty streaks: accumulations of cholesterol and other lipids along the walls of the arteries.
plaque (PLACK): an accumulation of fatty deposits, smooth muscle cells, and fibrous connective tissue
that develops in the artery walls in atherosclerosis. Plaque associated with atherosclerosis is known as
atheromatous (ATH-er-OHma-tus) plaque.
type 2 diabetes: the more common type of diabetes in which the cells fail to respond to insulin. Type 2
diabetes usually accompanies obesity and results from insulin resistance coupled with insufficient insulin
secretion.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-3
Lecture Presentation Outline
Key to instructor resource annotations (shown to the right of or below outline topics):
Website = Available for download from book companion website: HN = student handout
IM = Included in this instructor’s manual: CS = case study, WS = worksheet, CA = classroom activity
Introductory/whole chapter resources: PL figure JPEGs; Test Bank; IM WS 16-3
I.
Nutrition during Infancy
IM WS 16-1
A. Energy and Nutrient Needs
1. Energy Intake and Activity
a. Weight doubles the first five months, triples by one year (Figure 16-1)
b. High basal metabolic rate
c. Growth slows by the end of the 1st year of life
d. 100 kcalories per kilogram of body weight
2. Energy Nutrients (Figure 16-2)
a. Carbohydrates to provide glucose for the brain
b. Fat provides most of the energy
c. Protein especially important for growth and development
3. Vitamins and Minerals
a. More than double the needs of an adult in proportion to weight
b. Vitamin A, vitamin C, vitamin D, and iodine are especially high
4. Water
a. Higher percentage of water compared to adults
b. Found outside the cells and easily lost
c. Dehydration from diarrhea and vomiting is a concern
B. Breast Milk
1. Frequency and Duration of Breastfeeding
a. First few weeks: 8-12 feedings per day on demand
b. Every two to three hours
2. Energy Nutrients (Figure 16-3)
a. Lactose
b. Alpha-lactalbumin
c. Fat is generous in essential fatty acids
3. Vitamins
a. Vitamin D content is low
b. Vitamin D supplementation is recommended
4. Minerals
a. Calcium is well absorbed
b. High bioavailability of iron and zinc
c. Low in sodium and fluoride
5. Supplements
a. Vitamin D, iron, and fluoride during first year
b. A single dose of vitamin K
6. Immunological Protection
a. Colostrum
b. Bifidus factors
c. Lactoferrin
d. Lactadherin
e. Breast milk also contains growth factors and enzymes (e.g., lipase)
7. Allergy and Disease Protection
a. Fewer allergies
b. Lower blood pressure
c. Lower blood cholesterol
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-4
8.
Other Potential Benefits
a. May protect against obesity
b. Indications of positive effect on later intelligence
9. Breast Milk Banks
a. Donated milk
b. Cigarette smokers, and those who use illegal drugs, take medications, drink alcoholic beverages
(greater than 2 per day), or have communicable diseases are not allowed to donate
c. Available by prescription
d. May be used for very-low-birthweight infants
C. Infant Formula (Figure 16-4)
1. No cow’s milk in first year of life
2. Infant Formula Composition
a. Copy breast milk if possible
b. Iron fortified
3. Risks of Formula Feeding
a. Be careful about contaminated water
b. Contains no antibodies
c. Use proper food handling techniques
4. Infant Formula Standards
a. In the United States, standards are developed by the AAP
b. FDA mandates safety and nutritional qualities
5. Special Formulas
a. For premature infants or those with inherited diseases
b. Hydrolyzed protein formulas
c. Soy formulas
6. Inappropriate Formulas
a. Soy beverages
b. Goat’s milk
7. Nursing Bottle Tooth Decay (Figure 16-5)
a. Can be caused by formula, milk, or juice
b. Prolonged exposure to formula when sleeping
c. Upper and lower teeth may be affected by decay
D. Special Needs of Preterm Infants
1. Limited nutrient stores
2. Physical and metabolic immaturity
3. Long-chain fatty acids are important for the healthy growth of blood vessels and bones
4. Preterm breast milk fortified with preterm supplement
E. Introducing Cow’s Milk
1. Contains the protein casein and may cause intestinal bleeding and anemia in the first year of life
2. Whole cow’s milk from 1-2 years of age
3. Reduced-fat cow’s milk gradually introduced between 2 & 5 years of age
F. Introducing Solid Foods
1. When to Begin
a. 4-6 months
b. Timing varies from infant to infant depending on growth rates, activities, and environmental
conditions
2. Food Allergies
a. Introduce single-ingredient foods, one at a time
b. Period of 3 to 5 days between new foods
c. Rice cereal, then oat and barley, and lastly wheat
d. Allergic reactions include skin rash, digestive upset, or respiratory discomfort
3. Choice of Infant Foods
a. Should be provided with variety, balance, and moderation
b. Palatable and nutritious
c. No added salt, sugar, or seasonings
d. Safe and convenient
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-5
e. Fat information is not provided on food labels
Foods to Provide Iron
a. Iron-fortified cereals with vitamin C-rich foods and juices
b. Meat or meat alternatives such as legumes
5. Foods to Provide Vitamin C
a. Vegetables first, then fruits (suggestion; not evidence based)
b. Set limits on fruit juice consumption (4-6 oz./day)
6. Foods to Omit
a. Concentrated sweets
b. Sugar alcohols
c. Canned vegetables
d. Honey and corn syrup
e. Choking hazards
7. Vegetarian Diets during Infancy
a. Rice milk
b. Iron-fortified cereals
c. Milk products
d. Deficiencies of vitamin D, vitamin B12, iron, and calcium may develop
e. Energy-dense foods are required
8. Foods at 1 Year (Figure 16-6)
a. 2-3 cups cow’s milk
b. Milk anemia
c. Balance and variety from all food groups
d. Drink liquids from a cup, not a bottle
G. Mealtimes with Toddlers
1. Discourage unacceptable behavior
2. Let toddlers explore and enjoy food
3. Don’t force foods
4. Let children choose among nutritious foods
5. Limit sweets
6. Make mealtimes pleasant
4.
II. Nutrition during Childhood
IM CS 16-1
IM CA 16-1, 16-2
A. Energy and Nutrient Needs
1. Energy Intake and Activity (Figure 16-7)
a. Needs vary widely
b. Energy requirements:
1. 1 year: 800 kcalories
2. 6 years: 1,600 kcalories
3. 10 years: 2,000 kcalories
c. Inactivity can lead to obesity
d. Vegans may have difficulty in meeting energy needs
2. Carbohydrate and Fiber
a. Carbohydrate recommendations are the same as those for adults
b. Fiber recommendations change with age (energy intake)
3. Fat and Fatty Acids
a. Children 1-3 years should have 30-40% of energy from fat
b. Children 4-18 years should have 25-35% of energy from fat
c. Low-fat diets may have low vitamin and mineral content
4. Protein
a. Needs increase slightly with age
b. Requirement considers nitrogen balance, the quality of protein consumed, and the added needs of
growth
5. Vitamins and Minerals
a. Needs increase with age
b. Balanced diet meets all needs except iron
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-6
B.
C.
D.
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F.
c. Iron-fortified foods are important
d. Vitamin D supplements may be needed
6. Supplements
a. Should rely on foods
b. Supplements not needed other than fluoride, iron, & vitamin D as specifically recommended
7. Planning Children’s Meals (Figure 16-8)
a. Variety of foods from each food group
b. Proper portion sizes
Hunger and Malnutrition in Children
1. Hunger and Behavior
a. Missing meals affects behavior and academic performance
b. Low blood glucose due to smaller glycogen stores
2. Iron Deficiency and Behavior
a. Affects behavior and intellectual performance
b. Affects attention span and learning ability
c. Brain is affected by low iron before the blood is affected
3. Other Nutrient Deficiencies and Behavior
a. Marginal malnutrition may affect behavior
b. Also affects personal appearance
The Malnutrition-Lead Connection
Website HN 13-1, 13-2
1. Malnourished children are more vulnerable to lead poisoning
2. Anemia caused by lead may be mistaken for an iron problem
3. Exposure disrupts normal brain development
4. Can develop learning disabilities and behavioral problems
5. Reduction in lead present in food and the environment has helped
Hyperactivity and “Hyper” Behavior
1. Hyperactivity
a. Interferes with social development and academic behavior
b. Dietary changes and alternative therapies do not solve true hyperactivity
c. No evidence that sugar causes hyperactivity
d. Certain food additives may contribute to hyperactivity
2. Misbehaving
a. Need consistent care
b. Should receive regular hours of sleep, regular mealtimes, and regular outdoor activity
Food Allergy and Intolerance
1. Detecting Food Allergy
a. Immunologic response
b. Diagnosis requires medical testing & food challenges
2. Anaphylactic Shock
a. Life-threatening food allergy reaction
b. Eggs, milk, soy, peanuts, tree nuts, wheat, fish, and shellfish
c. Often outgrow allergies to eggs, milk, and soy
d. Recognize symptoms
e. Epinephrine injections
3. Food Labeling
a. Common allergens must appear on a food label
b. If cross-contamination is possible, this must be stated on the label
4. Food Intolerances
a. Adverse reactions
b. Symptoms without antibody production
c. Tolerance level
Childhood Obesity (Figures 16-9 & 16-10)
IM CS 16-2
1. Genetic and Environmental Factors
IM CA 16-3
a. Parental obesity is a risk factor
b. Poor diet and physical inactivity are risk factors
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-7
c. Convenience foods and meals eaten away from home
d. Non-nutritious choices at school
e. Sedentary activities
f. Energy-dense soft drinks
2. Growth
a. Grow taller at first, then stop growing at a shorter height
b. Greater bone and muscle mass to support weight
3. Physical Health
a. Abnormal blood lipid profile
b. Increases the risk for high blood pressure, type 2 diabetes, and respiratory disease
4. Psychological Development
a. Emotional and social problems
b. Stereotypes and discrimination
5. Prevention and Treatment of Obesity
a. Integrated approach with diet, physical activity, psychological support, and behavioral changes
b. Begin early treatment – before adolescence
6. Diet
a. Reduce rate of weight gain, rather than attempt weight loss
b. Strategies (Table 16-9)
7. Physical Activity
a. Limit sedentary activities
b. Encourage regular vigorous activity (Table 16-10)
c. Parents need to set good examples
8. Psychological Support
a. Weight-loss programs with parental involvement
b. Positive influence on eating behaviors
9. Behavioral Changes
a. Focus on how to eat
b. Teaching healthy habits/consumer skills
10. Drugs
a. Long-term impact on growth and development are unknown
b. Only approved drug for children is orlistat
11. Surgery – May result in significant weight loss and decrease disease risk
G. Mealtimes at Home – with parents as gatekeepers
1. Honoring Children’s Preferences
a. Offer variety of foods
b. Fun mealtimes
2. Learning through Participation
Website HN 16-1
a. Help plan meals
b. Assist with food preparation
3. Avoiding Power Struggles
a. Children need to regulate their own food intakes
b. Can determine their own likes and dislikes
c. Offer new foods at the beginning of meals and in small quantities
4. Choking Prevention
a. Be alert to foods that are common causes of choking
b. Make sure children are sitting, not running or in danger of falling, when eating
5. Playing First
a. Schedule outdoor play before meals
b. Relax and take time while eating
6. Snacking
a. Teach how to snack
b. Limit access to concentrated sweets
7. Preventing Dental Caries
a. Brush and floss after meals
b. Brush or rinse after snacks
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-8
c. Avoid sticky foods
d. Select crisp and fibrous foods
8. Serving as Role Models
a. Children learn through imitation of parents, older siblings, and care givers
b. Help children to develop positive attitudes toward food and eating
H. Nutrition at School
1. Meals at School
a. Breakfast and lunch at a reasonable cost
b. Some free and reduced cost to low-income children
c. Offer variety of choices
2. Competing Influences at School
a. Short lunch periods and long lines
b. Snack bars, school stores, and vending machines
c. State laws and school policies
III. Nutrition during Adolescence
IM CA 16-4
IM CA 16-5
A. Growth and Development
1. Growth speeds up and continues for about 2 to 3 years
2. Gender differences
a. Females begin growth spurt at 10-11 years of age
b. Males begin growth spurt at 12-13 years of age
c. Body compositions change
B. Energy and Nutrient Needs
1. Energy Intake and Activity
a. Needs vary depending on rate of growth, gender, body composition, and physical activity
b. Energy needs can range from 1800 kcalories per day for an inactive female to 3500 kcalories per
day for a highly active male
c. Problems with overweight and obesity
2. Vitamins
a. Needs for all vitamins increase
b. Vitamin D needs special attention
3. Iron
a. Females’ needs increase because of menstruation
b. Males’ needs increase because of developing lean body mass
c. Iron deficiency is a concern
4. Calcium
a. Crucial time for peak bone mass
b. Increase milk and milk products
c. Low calcium intakes and physical inactivity may cause problems with osteoporosis in later life
C. Food Choices and Health Habits
IM WS 16-2
1. Snacks
a. Provide ¼ of daily energy intake
b. Favorite snacks are often high in sugars, saturated fat, and sodium and low in fiber
2. Beverages
a. Soft drinks replace fruit juices and milk
b. Caffeine may be an issue
3. Eating Away from Home
a. 1/3 of meals are consumed away from home
b. Influence of fast-food restaurants
4. Peer Influence – Peer influence is strong when making nutritional choices
IV. Highlight: Childhood Obesity and the Early Development of Chronic Diseases
A. Early Development of Type 2 Diabetes
1. On the increase in recent years
2. Risk factors include obesity, sedentary lifestyle, and family history
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-9
B.
C.
D.
E.
3. Insulin resistance
4. Increased blood cholesterol and blood pressure leading to atherosclerosis and CVD
5. Many complications leading to a shorter life span
Early Development of Heart Disease
1. Atherosclerosis
a. Is often a part of cardiovascular disease
b. Artery walls thicken with plaque (Figure H16-1)
c. Fatty streaks begin to accumulate in fibrous connective tissue
d. Lesions in the arteries
2. Blood Cholesterol
a. Tends to rise as dietary saturated fat increases
b. Correlation with childhood obesity
c. Family relationship
d. Screening and education are key
2. Blood Pressure
a. May be a sign of underlying disease
b. More common in obese children
Physical Activity
1. Active children have better lipid profiles
2. Habits developed at this age are carried into later life
Dietary Recommendations for Children
1. Moderation, Not Deprivation
a. Less saturated fat
b. More fruits and vegetables
c. Nuts, vegetable oils, and some fish provide essential fatty acids
2. Diet First, Drugs Later – Treat problems with diet first, then drugs
Smoking
1. Increases risk for heart disease
2. Half of teens who continue to smoke will die of smoking-related causes
Case Studies
Case Study 16-1: Vegan Diets for Children1
Frank and Jan W. are the proud parents of Jesse, an 18-month-old child who has been breastfed from birth. Jesse
was 7 pounds 1 ounce at birth and at her last check up she weighed 20 pounds. Jesse’s mom breastfeeds her in the
morning and before putting her to bed at night. During the day, Jesse drinks juice and water from a cup. Jesse’s
parents have been feeding her a vegan diet since her birth, citing a strong family history of heart disease as their
reason for this choice. Jesse’s current diet includes a variety of chopped fruit, vegetables, cereal, mashed beans, and
soy-based cheeses. Both parents want the best for their child and are carefully considering whether to continue her
current diet restrictions.
1.
2.
3.
4.
5.
6.
1
Using the “How to” feature on page 507, plot Jesse’s birth weight and her current weight for age. What might
this information indicate to Jesse’s parents?
What impact might a vegan diet have on Jesse’s nutritional status and development that her parents should
consider?
What components of a Jesse’s diet may contribute to her low rate of weight gain? Explain.
In view of her current diet, what nutrition strategies might Jesse’s parents consider to improve her weight gain?
Give specific examples.
As Jesse is weaned from breast milk, what vegan foods might be added to her diet to prevent nutrient
deficiencies?
Using the meal plan in Figure 16-6 as a guide, show how Jesse’s parents might provide a child-friendly and
balanced diet that contains no animal foods.
Contributed by Barbara Quinn.
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-10
Answer Key
1. Jesse’s birthweight was at the 25th percentile. Her current weight is at the 3rd percentile for her age. Jesse’s
dramatic change from the 25th to the 3rd percentile weight-for-age indicates a slowed rate of weight gain and
may be cause for concern.
2.
Deficiencies of protein, vitamin D, vitamin B12, iron, and calcium have been reported in infants fed vegan diets.
A strict vegan diet can significantly slow Jesse’s growth as she transitions from breast milk to solid foods.
3.
Fruits, vegetables, and other plant foods are high in fiber and water and may fill a child’s stomach before
meeting energy needs, resulting in a lower weight gain.
4.
Answers should include the consumption of more energy-dense foods such as nut butters (with careful
supervision since these can pose a choking risk), legumes, dried fruit spreads, and mashed avocado.
5.
Answers may include: Soy milk fortified with calcium, vitamin B 12, and vitamin D. Add vitamin C–containing
foods at meals to enhance iron absorption.
6.
Answers will vary and should include plant foods or plant-based substitutes for each food group that are safe for
children to consume without risk for choking.
Case Study 16-2: Childhood Obesity
Ryan is a 6-year-old elementary school student. At his last well child exam, his measured height was 46 inches and
his weight was 60 pounds. His pediatrician is concerned that Ryan has gained an excessive amount of weight over
the past year. His usual diet consists of sweetened cereal with whole milk and fruit juice for breakfast and a juice
drink and crackers for his mid-morning snack. During the week, Ryan buys his lunch at school; his favorite menu
items are pizza and tacos. His mother states that she started a new job this past year, which requires that Ryan attend
an after-school program until 5:30 or 6 in the evening. He receives a snack there, usually an 8-ounce box of fruit
juice and crackers. Ryan’s parents report that Ryan is “always hungry” and they will often stop for his favorite
chicken nuggets, fries, and a soda on late evenings when the family is too tired to cook. Ryan likes to play video
games and has a computer and television in his room. His father complains that he spends more time in his room
than playing outside. Ryan’s mother is overweight and his father is of normal weight, although he states he was
overweight as a child. The family has discussed getting more exercise on the weekends but are not sure how to add
this to their busy schedules.
1.
What is Ryan’s body mass index?
a. 17.9
b. 18.9
c. 19.9
d. 20.9
e. 21.9
2.
Using the criteria set forth in your text, how would Ryan’s BMI be classified?
a. underweight
b. normal weight
c. overweight
d. obese
e. morbidly obese
3.
What would a reasonable goal be for Ryan?
a. lose at least 15% of his weight in 6 months
b. reduce his BMI to a lower weight category within 6 months
c. maintain his current weight as he grows taller
d. achieve normal weight for age and sex within 6 months
e. use an over-the-counter weight loss drug in accordance with instructions.
4.
What percentage of U.S. children and adolescents, ages 2 through 19, are overweight?
a. 12
b. 22
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-11
c.
d.
e.
32
42
52
5.
If a teen has at least one obese parent, what are the teen’s chances of becoming an obese adult?
a. 40 to 50%
b. 50 to 60%
c. 60 to 70%
d. 70 to 80%
e. greater than 80%
6.
In the U.S. how much time do 8 to 18 year-olds spend watching television each day, on average?
a. 1.5 hours
b. 2.5 hours
c. 3.5 hours
d. 4.5 hours
e. 5.5 hours
7.
As a sedentary 6 year-old boy, what is Ryan’s estimated daily energy need?
a. 1000 kcalories
b. 1200 kcalories
c. 1400 kcalories
d. 1600 kcalories
e. 1800 kcalories
Answer Key
1. c
2.
d
3.
c
4.
c
5.
e
6.
d
7.
b
Critical Thinking Questions2
1.
Explain why infants require more energy per unit of body weight than adults.
2.
Explain how breast milk provides immunological protection for the newborn.
3.
What strategies can be implemented to prevent the occurrence of nursing bottle tooth decay in infants?
4.
Describe how solid foods should be introduced to prevent reactions to potential allergens in the diet.
5.
Describe the difference between food allergy and food intolerance. What methods can be used to increase food
safety related to these two health concerns?
6.
What competing factors influence a student’s food selections?
Answer Key
1. Even though adults weigh more than infants, infants require more energy per pound of body weight. Infants
have a greater body surface area in proportion to weight than do adults, so fluid losses in the infant are more
2
Contributed by Daryle Wane.
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license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-12
critical as compared to adults. The infant’s brain occupies a greater percentage of body weight compared to the
adult, so there is an increased need for glucose to fuel the nervous system. Increased energy needs of infants are
due to their rapid periods of growth and development that extend over a two-year period. During this time, the
infant’s weight will double by six months, triple by one year, and quadruple by two years, as compared to birth
weight. Independent of weight, the infant will also grow in terms of height and circumference. Thus, more
energy is required during these growth periods to sustain and build body tissues.
2.
The constituent parts of breast milk contribute to immunological protection for the newborn, as breast milk
contains antibodies, essential fatty acids, and other metabolic compounds that attack bacteria prototypes.
Immunoglobulins are secreted in colostrum, the precursor to breast milk, and afford significant protection.
Essential fatty acids are also present in breast milk along with DHA and arachidonic acid. These fatty acids are
associated with visual and mental development. Breast milk composition also allows for easier digestion and
increased bioavailability of nutrients. Substances in breast milk prevent viral replication and bacterial growth in
the intestines to minimize the risk of diarrhea and/or respiratory/ear diseases. (These include antibodies,
oligosaccharides, bifidus factors, lactoferrin, lactadherin, growth factor, and lipase enzymes.)
3.
Infants should not be put to bed with either a formula or juice bottle as this will lead to accumulation on dental
tissue. Formula and fruit juice represent concentrated sugar sources and as such are excellent growth mediums
for bacteria when placed against dental tissue overnight. Alternate methods for helping infants go to sleep that
do not rely on formula/juice bottle administration should be encouraged.
4.
Single food items should be introduced over a period of a few days to determine if there is any potential allergic
reaction. If foods are not introduced this way, and a reaction is observed, it may prove difficult to isolate the
offending item. Progression of food choices is based on beginning with the least allergic food. Solid food
introduction typically begins with rice cereal. Wheat cereal is used last as there is an increased potential of
wheat to have antigenic properties.
5.
Food allergy involves the development of antibodies based on an antigen-triggered response. The food allergy
response may intensify over time with subsequent exposures to the trigger item. Food intolerance does not
involve antibody production but symptoms occur in response to food ingestion. Some of the symptoms may be
similar in nature to those observed with a food allergy but again, no antibody production is initiated. Avoidance
of the identified food is always the first option for individuals. Reading of food labels to identify specific food
triggers is also a recommended choice. The method of food preparation as well as location of food preparation
may be of concern due to cross-contamination. Individuals who have food allergies and/or a food intolerance
should make prudent choices based on their medical history and experience.
6.
Students who attend school are subject to a variety of competing factors that influence their individual food
choices. Economics plays a role in what students are able to select from school cafeterias. Additionally, students
are limited in their available food choice based on provided foods in the cafeteria. Competition from fast food
providers and/or vending machine locations also influence food selection. Snacking as a food option is
promoted by vending machine usage. Time also plays a role in food selection, as the time period assigned for
the meal may be short, thus favoring a quick fast-food item.
IM Worksheet Answer Key
Worksheet 16-1: Infant Feeding Review (Internet Exercise)
1. c
2. b
3. a
4. b
5.
a
6.
b
Worksheet 16-2: How to Rate Your Food Behaviors
Instructor memo: The likelihood that your students will answer “True” or “False” to all of the questions is small. If
you look at questions 1 through 9, all of them are concerned with food behaviors that are influenced by multiple
factors, both internal and external. However, question number 10 is solely based on one’s evaluation of caloric
intake. The probability is exceedingly high that individuals are NOT aware of their daily caloric intake.
Worksheet 16-3: Chapter 16 Crossword Puzzle
1. solid foods
4. colostrum
2. vitamin D
5. cow’s milk
3. lactose
6. sixty
7.
8.
9.
protein
calcium
fat
10. saturated fat
11. iron
12. Snacks
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-13
Worksheet 16-1: Infant Feeding Review (Internet Exercise)
Instructions: Go the following website: http://fnic.nal.usda.gov/lifecycle-nutrition/infant-nutrition. Click
on Food for Baby’s First Year and read the fact sheet to answer questions 1-6.
1. Your baby is likely ready to eat solid foods when s/he _____.
a. drinks less than 32 ounces of milk per day.
b. has tripled in birth weight and is above the 50th percentile for height
c. is more interested in what you’re eating than in what that s/he is eating
d. can recognize and ask for solid foods by name
2. You should use a bottle to provide juice to infants after 6 months of age.
a. True
b. False
3. Salt should not be added to an infant's food.
a. True
b. False
4. The amount of fat in a baby's diet should be limited.
a. True
b. False
5. Honey should not be given to infants.
a. True
b. False
6. Shellfish should be avoided in an infant’s first year because it causes diarrhea.
a. True
b. False
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-14
Worksheet 16-2: How to Rate Your Food Behaviors
Fill out the following table with respect to your own observations about food behaviors.
Question
True
False
1. I only eat when I am hungry.


2. When I go into a restaurant, I have a definite idea of what I
want to eat.


3. When I am watching television and a food commercial comes
on, I think about eating the food item advertised.


4. I can remember everything that I ate yesterday in terms of
amounts and food products.


5. When I am reading a magazine and view a food advertisement,
I think about eating that food item.


6. When I go to the supermarket I become hungry as I walk up
and down the aisles.


7. I snack on food in between and after meal times.


8. I prepare all of the food that I eat during the week.


9. I purchase foods from a vending machine during the week.


10. I am aware of the amount of kcalories in the foods I eat on a
daily basis.


© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
Chapter 16-15
Worksheet 16-3: Chapter 16 Crossword Puzzle
1
3
4
2
5
6
7
8
9
10
11
12
Across:
Primary source of protein in most infant formulas
Key nutrient of concern for adolescent and adult
bone health
10. Limiting _____ is important for the prevention of
chronic diseases such as diabetes and heart disease.
11. Foods high in _____ should be emphasized in the
diets of children and adolescents.
12. _____ provide about one-fourth of adolescents’
daily energy intake.
5.
8.
1.
2.
3.
4.
6.
7.
9.
Down:
At 4-6 months an infant may start eating _____.
Breastfed infants need daily supplementation of
_____.
Primary carbohydrate in breast milk or infant
formula
Available before breast milk for 2-3 days; provides
antibodies
At least _____ minutes of daily physical activity is
recommended for children.
Food allergies are typically a reaction to a _____
molecule in the food.
Energy-yielding nutrient that provides the majority
of kcalories in breast milk or infant formula
© 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.