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Life Cycle Nutrition:
From Infancy to Adolescence
Chapter 15
What are Children Eating
in the US?
Too few fruits,
vegetables and
whole grains
 Too many
processed foods
high in added sugar,
salt, and processed
 Gets worse among
From NHANES, 2001-2002
Now vs. 25 years ago, kids eat…
Less milk, fewer vegetables, eggs, and
 More cheese, fruit juices, and
sweetened beverages
 More meals away from home
 Larger portion sizes
 More snacks
Diet-Related Disease Conditions
in Children
The same effects as poor diet in adults
 High calorie, heavily processed,
nutrient-poor diets combined with
sedentary lifestyle
Elevated serum cholesterol
Elevated blood glucose
Type 2 diabetes
Heart disease
Rates of Overweight in
Children and Adolescents
Mental Health Impact of
Overweight and Obesity on Kids
Social and psychological challenges
 Discrimination:
– Ridicule and teasing by peers
– Prejudicial treatment by adults
Poor self-image, low self-esteem
– Rejection
– Social isolation
– Contributes to continued weight issues
BMI-for-age Charts
Nutrient Needs
– Infants: soak 6-8 diapers
– 1-3: 1.3 L/d
– 4-8: 1.7 L/d
– Needs increase with
illness, high
environmental temp, or
– Total amount increases
with age
Fat (%kcal)
Infants: 40-55%
1-3 yrs: 30-40%
4-18 yrs: 25-35%
Adults: 20-35%
– Same percentage as
adults (45-65%)
– Fiber: 14g per 1000 kcals
– Variety of meats,
legumes, eggs, whole
grains, fruits, vegetables,
and dairy (if appropriate)
– Deficiency risks:
Calcium, Iron, Vit. A & D
Introducing Solid Foods
Infants: GI tract still developing over course of
first 2 years
 Early introduction of solids can increase risk
of food allergy/sensitivity
 Recommended to wait until at least 4 months
(6 is best)
 For introduction of common food allergens,
waiting until at least 12 months is
– Cow’s milk, wheat, eggs, corn, soy
– Tree nuts, seafood, peanuts
Food Allergies and Intolerances
More common in infants than adults
– Immature GI tract allows intact proteins to be absorbed
Exposure to allergen (food protein) for first time causes
immune system to produce antibodies to that allergen
Allergy symptoms include coughing/wheezing, rash, eczema,
hives, cramps, aches, vomiting, asthma, diarrhea,
constipation, lethargy, sinus or ear infections, change in
personality/behavior, rhinitis/runny or stuffy nose
– Range from mild to life-threatening
Allergy symptoms may be immediate or take up to 3 days to
 Montior for symptoms after each food is introduced
– Introduce only one at a time!
– Wait 3-5 days before adding a new one
Food intolerances: problems during digestion
– Not related to antibody production or proteins in food
– Example: lactose intolerance
Feeding Children
Development of eating habits begins in
– Caregivers are important guides and role
Division of responsibilities:
– Caregivers decide “what and when”
– Children decide “whether and how much”
» Ellyn Satter, MS RD LCSW (,
author of Child of Mine and Your Child’s Weight:
Helping Without Harming
Meals & Snacks
Good rule of thumb to offer something every
2-3 hours
– Small stomachs, high energy needs
Routines and consistent patterns help
children to feel secure
– Children may not tell you that they are hungry
Sit down with kids and eat what they are
 Breakfast: very important!
– Helping maintain healthy body weight
– Improves performance at school
– Any breakfast is better than none, but
emphasizing balance among macronutrients is
Television & Childhood Obesity
Saturday Morning Food Ads
TV exposes kids to
food industry
Takes the place of
physical activity
Kids who watch 4 or
more hours/day are
40% more likely to
be overweight than
those who watch an
hour or less/day
games also
contribute to
Weight Management in
Children & Adolescents
Increase activity
 Model healthy eating
– Food choices
– Eating habits
– Mindfulness
Provide healthy choices in the home
 Be very cautious if reducing intake is
– Avoid denying or restricting foods
– Avoid any focus on appearance; focus rather on
– Instead, replace empty-calorie foods in home with
nutrient-dense choices
Nutrition in Adolescence
Puberty and continued organ system
– Changes in body composition
– Growth rates and nutritional requirements for boys
and girls diverge
– Total needs greater than at any other time of life!
Adolescent growth spurt: 18-24 month period
of rapid growth
– Girls: 10-13 years of age
– Boys: 12-15 years of age
Nutritional status both during and leading up
to this time affects growth and sexual
Dietary Concerns with
Adolescents & Teens
Influence of caregivers wanes, influence of
peers increases
 Fruits and vegetables likely to be lacking
– French fries: most commonly consumed vegetable
Empty-calorie snack foods
– Snacks are important to meet increased caloric
needs, so having healthy choices around is an
important strategy
Strategies for caregivers
– Prepare nutrient-dense meals in the home
– Engage kids in the growing and preparation of