Final Exam Review - Prof. Dr. Rittenhouse. Book- Nutrition Through the Life Cycle, 7th Edition, PDF

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Download Final Exam Review - Prof. Dr. Rittenhouse. Book- Nutrition Through the Life Cycle, 7th Edition, PDF

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NFSC 315 Spring 2022 - Final Exam Review The final exam is worth 100 points. Please study the key concepts listed in the following chapters. Remember that this is a guide, but it may not cover every exam question! The exam is comprehensive. The Final Exam is Monday, May 16th at 10:30 AM

New Material (60% of exam) Chapter 8 

Define key terms: o Full-term infant: infants born at or after 37 weeks of gestation. o Preterm infant: infants born before 37 weeks of gestation. o SGA: a baby who is smaller than the usual amount for the number of weeks of pregnancy. o LGA: babies who are born weighing more than the usual amount for the number of weeks of pregnancy. o Root reflex: action that occurs if one cheek is touched, resulting in the infant’s head turning toward that cheek and the infant opening his mouth. o Suckle reflex: a reflexive movement of the tongue moving forward and backward; earliest feeding skill.

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Describe the energy and nutrient needs of infants o The energy needs of infants per kilogram of body weight are higher than at any other time of life. o The range in energy requirements for individual infants is broad, ranging from 80 to 120 kilocalories (kcal) per kg of body weight. o The average energy need of infants in the first six months of life is 108 kcal per kg body weight and is based on growth in breastfed infants. o From 6 to 12 months of age, the average energy need is 98 kcal/kg. o Protein needs  1.52 g per kg body weight (birth to 6 months of age)  1.2 g per kg (7 to 12 months of age) o Fat needs  It provides essential fatty acids, is a concentrated source of energy, and facilitates the absorption of fat-soluble vitamins. Fat is especially important in infancy and early childhood because it is essential for neurological development and brain function.  31 grams for infants 0–6 months of age  30 grams for infants 7–12 months of age o Other nutrient needs include

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Fluoride Vitamin D Sodium Iron Lead

Describe how infant development progresses with an emphasis on feeding skills development o Topics covered include the introduction of solid foods, the importance of infant feeding position, food texture and development, first foods, and commercial baby foods  Responding early & appropriately to infant’s hunger and satiety cues  Recognizing the infant’s developmental abilities and feeding skills  Balancing the infant’s need for assistance with encouragement of age appropriate feeding skills  Allowing the infant to initiate and guide feeding interactions  Effective positioning at mealtimes will facilitate successful infant feeding.  Infant feeding can embrace varied cultural and parenting styles, ethnic foods, and cultural feeding practices. o Identify indicators of normal infant feeding skill development in addition to breastfeeding  Their reflexes  Rooting  Sucking  Gagging  Swallowing  Grasping

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Name 3 measures for assessing newborn health. What health characteristic does each measure and how is that related to nutrition? o Newborn health status is assessed by various indicators of growth and development taken right after birth. o Indicators include:  Gestational age  This allows you to see how well the baby is developing in the womb. After birth, the baby's weight, length, head size, vital signs, reflexes, muscle tone, posture, and skin and hair condition can all be used to determine gestational age.  Birth weight/weight for age  The weight of a newborn at birth is closely linked to mortality risk in the first year, as well as developmental issues in infancy and the chance of developing numerous diseases in adulthood.  Length for age  Head circumference for age  It measures the distance between the tops of the brows and the ears, as well as around the rear of the head. This measurement is used to offer information about a child's health, development, and nutritional status as part of a growth assessment.

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Why are growth curves useful for monitoring infant health? o They help both the parents and their health care provider follow the child as they grow. They may provide an early warning that the child may have a serious medical problem and then action can be taken as soon as possible. Cite examples of nutritional interventions to reduce the number of infants at risk for health problems.

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What are Infant hunger and satiety cues? o From birth to 6 months the infant will signal hunger through  Sucking their thumb  Opening their mouth  Walking and tossing  Crying and fussing  Facial expressions o When an infant is full, they will  Seal their lips  Turn away  Fall asleep  Spit it out

Chapter 9 

Define Key Terms: o Low birth weight: an infant weighing < 2500 g at birth o Very low birth weight: an infant weighing < 1500 g at birth o Extremely low birth weight: an infant weighing < 1000 g at birth

o Enteral feeding: method for delivering nutrients directly to the digestive system, in contrast to methods that bypass the digestive system. o Parenteral feeding: delivery of nutrients directly into the bloodstream. o Necrotizing enterocolitis (NEC): condition with inflammation or damage to a section of the intestine, with grading from mild to severe. o Gastrostomy feeding: form of enteral nutrition support for delivering nutrition by tube placement directly into the stomach, bypassing the mouth through a surgical procedure that creates an opening through the abdominal wall and stomach. 

Describe factors that put infants at nutritional risk and how nutritional assessment and interventions address these risks. o Factors: infants born prematurely, or those who have special health care needs or developmental delay. o Extremely low birth weight, very low birth weight infants, and low birth weight infants. o Abnormal development in utero (down syndrome) o At risk for chronic health problems. o Assessment: ▪ Inadequate nutrient stores, increased nutrient demands, and immature organ function.

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Compare the energy and nutrition needs of preterm infants, infants with special health care needs, and healthy full-term infants. o Preterm infants have higher energy requirements (105-130 or 110-135 cal/kg). o Infants born EP will require higher intakes of protein and micronutrients g/kg. o Infants with PKU may require a restriction with protein because of how PKU affects the metabolism. o The fat % for all infants is 45-55% however preterm infants struggle with digesting and absorbing the fat. o Iron supplements are required for preterm infants. o Some infants with special care needs may be on fluid restriction diets. o Infants with cystic fibrosis may have fat malabsorption so they may require a fat-soluble vitamin.

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What extra vitamin supplementation may be required for preterm infants? o Iron

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Describe nutrition problems that are more frequently identified in preterm infants and infants with special health care needs. o Feeding difficulties, oral motor and swallowing challenges, as well as other nutrition-related issues such as stunted growth, are more common in infants with neurodevelopment impairments or delays (failure to thrive, obesity, and growth retardation) o Nutritional issues were discovered in 70-90 percent of youngsters with exceptional health care needs. o Children with Down syndrome may have difficulty swallowing, self-feeding, getting enough or too much energy, or growing at a slow rate.

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Identify infants with feeding problems and appropriate nutrition services for them. o When compared to healthy newborns, preterm or chronically ill babies may be more irritable and less able to communicate their wants and requirements. o Feeding issues were noted by 40-45 percent of families with VLBW infants. o 70 percent of children with developmental disabilities have regular feeding problems, and up to 70 percent have severe feeding problems. o Failure to flourish, child abuse, and neglect are all risks for difficult-to-feed infants.

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Identify appropriate nutrition intervention strategies for infants who are experiencing problems with linear growth or weight gain. o Increase the frequency with which you measure your weight, length, and head circumference. o Keep an eye on your baby's liquids and food intake. o To accommodate medication or a sleep pattern, adjust the timing of breastfeeding or bottle feedings, meals, and snacks. o Observe the relationship between the infant and the caregiver during feedings, whether at home or in a developmental program, to ensure that hunger, comfort, and satiety result in happy feeding experiences.

Chapter 10 

Define Key Terms: o BMI: an index that correlates with total body fat content or percent body fat and is an acceptable measure of adiposity or body fatness in children and adults. It is calculated by dividing weight in kilograms by the square of height in meters. o Adiposity or BMI rebound: a normal increase in body mass index that occurs after BMI declines and reaches its lowest point at 4-6 years of age. o Recumbent length: measurement of length while the child is lying down. Recumbent length is used to measure toddlers less than 24 months of age and those between 24 and 36 months who are unable to stand unassisted. o Stature: standing height

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What can parents do to encourage healthy eating for preschool-aged children? o Serve new foods along with familiar foods. o Serve new foods when child is hungry and if she sees other family members eating those foods as well.

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What steps are recommended to prevent overweight and obesity in preschoolers? o Limit sugar-sweet beverages o Encourage fruits and veggies o Limit TV and screen time o Eat a daily breakfast o Limit restaurants and fast foods

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What are the key minerals needed by toddlers and preschoolers? o Iron o Calcium o Zinc

Chapter 11 

Define key terms: o Anaphylaxis: sudden onset of a reaction with mild to severe symptoms, including a decrease in ability to breathe, which may be severe enough to cause a coma. o Asthma: condition in which the lungs are unable to exchange air due to lack of expansion of air sacs. It can result in a chronic illness and sometimes unconsciousness and death if not treated. o ADHD: condition characterized by low impulse control and short attention span, with and without a high level of overall activity. o Autism spectrum: a group of developmental disorders characterized by deficits in communication, social interaction, and behaviors that meet diagnostic criteria in standardized testing, with onset generally before age 3. o Down syndrome: a congenital condition characterized by a distinctive pattern of physical characteristics including a flattened skull, pronounced folds of skin in the inner corners of the eyes, large tongue, and short stature, and by some degree of limitation of intellectual ability and social and practical skills. It usually arises from a defect involving chromosome 21, usually an extra copy (trisomy-21). o GERD: occurs when stomach acid frequently flows back into the esophagus.

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How might chronic conditions in children affect their growth? o Chronic conditions cause low appetite/increase caloric needs.  Underweight and overweight are prevalent because of energy need changes. (Overweight/obesity are commonly found with Down syndrome and spina bifida).

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What are some feeding issues that children with special health needs may have? o Those with complex health care needs may have feeding disorders that require them to be dependent on tube. Feedings and other technologically advanced equipment. o Medical diagnoses that may present with signs of feeding problems include gastroesophageal reflux, developmental delay, cerebral palsy, and autism spectrum disorder. o Signs of feeding disorders are:  Low interest in eating  Long mealtimes (over 30 minutes)  Preferring liquids over solids and food refusals

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Which conditions increase energy needs and which will decrease energy needs?

o Increase energy needs:  Cystic fibrosis  Renal disease  Ambulatory children with diplegia  Pediatric AIDS  Bronchopulmonary dysplasia (BPD) o Decrease energy needs:  Down syndrome  Spina bifida  Nonambulatory children with diplegia  Prader-Willi syndrome  Nonambulatory children with short stature 

What is the difference between a true food allergy and food intolerance? o Allergy: immune systems response to a food protein. Requires complete avoidance of allergen. o Intolerance: a digestive or metabolic response to a food but not an immunological one.

Chapter 12 

Define key terms: o Middle childhood: children between the ages of 5 and 10 years (school-age). o Preadolescence: the stage of development immediately preceding adolescence; 9-11 years for girls and 10-12 years for boys.

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DRI for key nutrients for school-age children o Fiber intake should be 31 g/day for boys and 26 g/day for girls o Calcium and vitamin D intake 1,3000 mg a day o Iron intake 8 mg/day o Zinc intake 8 mg/day

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What are the risk factors for childhood obesity? o Diet (regularly eating high-calorie foods, such as fast foods, can cause your child to gain weight) o Lack of exercise o Family factors o Psychological factors o Socioeconomic factors o Certain medications

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What effect does early BMI rebound have on later obesity? o Early rebound detects children whose BMI percentile is high and/or crossing higher, which is a risk factor for subsequent fatness. Later in childhood and maturity, these children are more likely to have a higher BMI.

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What are the BMI assessment categories for overweight and obesity in children?

o Body mass index-for-age percentile is recommended as the screening tool for assessment of pediatric overweight and obesity. o A BMI-for-age percentile of greater than or equal to the 85th but less than or equal to the 94th is defined as overweight. o BMI-for-age percentile greater than or equal to the 95th is defined as obesity. o Other components of assessment include evaluation of the child’s medical risk, including parental obesity, and behavior risk, including dietary and physical activity behaviors. 

What treatment is recommended for childhood overweight and obesity? o 85th-95th percentile:  Weight maintenance or BMI percentile deflection down. o 95th-98th percentile:  Gradual weight loss not more than 1 lb/month. o 99th percentile:  Weight loss. Maximum of and average of 2 lbs per week.

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What is the recommended physical activity time for children? o Children should engage in at least 60 minutes of physical activity every day. o AAP recommendations:  Emphasis on having fun over competition  Organized sports should not take the place of regular physical activity  Proper use of safety equipment should be emphasized  Warning against intensive, specialized training for children  Water for hydration

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What activities are good for bone strength? o Walking o Hiking o Jogging o Climbing stairs o Playing tennis o Dancing o Resistance exercises (lifting weights)

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What are fluid intake recommendations for children? o They need to drink enough fluids to maintain adequate hydration especially during periods of physical activity. o Sports drinks are most appropriate for children who are participating in prolonged vigorous physical activity, especially in hot and humid climates.

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What are the food category requirements of the National school lunch/ breakfast program? o Fruits/veggies (1 cup per day) o Grains and meat (daily minimum and weekly ranges for grains) o Whole grains (all grains must be whole grain rich) o Milk (1 cup, must be fat free (unflavored/flavored or 1% low-fat (unflavored))

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How does the school lunch program benefit children? o Helped provide nutritious meals to all children. o Reinforces nutrition education. o Reduces food insecurity, obesity rates, and poor health.

Chapter 13 

Define key terms: o Type 1 diabetes: the pancreas produces little or no insulin. o Type 2 diabetes: affects the way the body process blood sugar (glucose). o Cystic fibrosis: a genetic disorder that causes problems with breathing and digestion. o Celiac disease: a chronic digestive and immune disorder that damages the small intestine. o Ketogenic: high-fat, low-carb meal plan which in ketones are made from metabolic pathways used in converting fat as a source of energy.

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What are the considerations in assessing the growth of children with special health conditions? o Children with special needs require in-depth growth assessments because interpretation of weight and height in the manner used for healthy children can be misleading. o Making sure you know what condition they have because they will have their own specialized growth charts.

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What modifications are required for celiac disease patients? o When celiac disease has been diagnosed, nutrition intervention by avoiding gluten, a component of wheat, rye, and barley, for life is the most effective treatment.

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What are nutritional concerns with ADHD, AIDS, cystic fibrosis, PKU, diabetes, and kidney disease? o Frequency of meals o Introduce more new foods o Require more calories o CF= 150% of protein DRI (higher protein needs) o Higher fat needs potentially o PKU: can’t break down an amino acid and need to careful with high protein foods o Celiac disease: avoid gluten

Chapter 14 

What are the general differences in energy and nutrient requirements between adolescent males and females? o Energy

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Males have greater increases in height, weight, and lean body mass, so higher caloric needs. 1,800 to 2,400 calories for girls and 3,200 calories for boys. Dramatic growth increases nutrient needs.

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Why is iron a key requirement for adolescents? o Increased needs related to rapid rate of linear growth, increase in blood volume, and menarche in females. o Females needs greatest after menarche and males during the growth spurt. o Prevalence of Fe-deficiency anemia is low; but inadequate Fe stores are higher. o Iron deficiency causes developmental delays and behavioral disturbances.

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Why is calcium and vitamin D intake critical during adolescence? o They're crucial for bone mineral accumulation during adolescence, and calcium homeostasis can affect bone growth.

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What is the period of peak physical growth in male and female adolescents? o Peak linear growth occurs 6-12 months prior to menarche for females o Peak velocity of linear growth occurs following testicular enlargement and faint facial hair around 14.4 years of age for males. o Females peak weight gain follows linear growth spurt by 3-6 months. o Males peak weight gain coincides with peak linear growth and peak muscle mass accumulation.

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What are the changes in fat mass and lean body mass in males and females (generally)? o Females  Average lean body mass decreases  120% increase in body fat  17% body fat is required for menarche  25% body fat needed to maintain normal menstrual cycles o Males  Body fat decreases about 12%  Almost half of bone mass is accrued during adolescence due to many factors  Males have greater increases in height, weight, and lean body mass, so they have higher caloric needs

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How is body fat related to the age of puberty for females? o 17% body fat is required for menarche o 25% body fat needed to maintain normal menstrual cycles

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