Chapter 12 Child and Preadolescent Nutrition.docx

Chapter 12
Child and Preadolescent Nutrition
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Definitions of the Life Cycle StageMiddle childhood—between
the ages of 5 and 10 yearsPreadolescence—ages 9 to 11 years
for girls; ages 10 to 12 years for boysmay also be termed
“school-age”
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IntroductionFocuses on growth and development of school-age
and pre-adolescent childrenPhysical, cognitive, emotional,
social growthGrowth spurtsModeling healthy eating and
physical activity behaviors
Importance of Nutrition Establishing healthy eating habits helps

prevent immediate & long-term health problems
Adequate nutrition associated with improved academic
performance
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Tracking Child and Preadolescent HealthData on U.S. children
in 2010Children under 18 were nearly 10% of population7.5
million had no health insuranceDisparities in nutrition status
exist among different races & ethnic groups
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Tracking Child and Preadolescent HealthDisparities in nutrition
status exist among different races & ethnic groups. African
American, American Indian, and Hispanic children more likely
to live in povertyOdds of being obese significantly higher for
non-Hispanic Black children and Mexican American children
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Normal Growth and DevelopmentMeasurement
techniquesGrowth velocity will slow down during the school-
age yearsShould continue to monitor growth periodicallyWeight

and height should be plotted on the appropriate growth chart
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Normal Growth and Development2000 CDC growth chartsTools
to monitor the growth of a child for the following
parametersWeight-for-ageStature-for-ageBody mass index
(BMI)-for-ageCan be downloaded from CDC website:
www.cdc.gov/growthcharts/cdc_charts.htm
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Normal Growth and Development2000 CDC growth chartsBased
on data from cycles 2 & 3 of the National Health & Examination
Survey (NHES) & the National Health & Nutrition Examination
Surveys (NHANES) I, II, & IIIWHO Growth
ReferencesAvailable at www.who.int/childgrowth
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Normal Growth and Development
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Physiological Development in School-Age ChildrenMuscular
strength, motor coordination, & stamina increaseIn early
childhood, body fat reaches a minimum then increases in
preparation for adolescent growth spurtAdiposity rebounds
between ages 6 to 6.3 yearsBoys have more lean tissue than
girls
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Cognitive Development in School-Age ChildrenSelf-
efficacy…the knowledge of what to do and the ability to do
itChange from preoperational period to concrete
operationsDevelops sense of selfMore independent & learn
family rolesPeer relationships become important
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improved feeding skillsMasters use of eating utensilsInvolved
about different foods, simple food prep and basic nutrition facts
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Eating BehaviorsParents & older siblings influence food choices
in early childhood with peer influences increasing in
preadolescenceParents should be positive role modelsFamily
meal-times should be encouragedMedia has strong influence on
food choices
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Body Image and Excessive DietingThe mother’s concern of her
own weight issues may increase her influence over her
daughter’s food intake
Young girls are preoccupied with weight & body size at an early
age
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Body Image and Excessive DietingThe normal increase in
adiposity at this age may be interpreted as the beginning of
obesity
Imposing controls & restriction of ”forbidden foods” may
increase desire & intake of the foods
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Energy and Nutrient Needs of School-Age ChildrenEnergy
needs vary by activity level & body size
The protein DRI is 0.95 g/kg body wt
Intakes of vitamins & minerals appear adequate for most U.S.
children
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DRI for Iron, Zinc and Calcium for School-Age Children
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Common Nutrition ProblemsIron deficiencyLess common in
children than in toddlersDietary recommendations to prevent:
encourage iron-rich foods Meat, fish, poultry and fortified
cerealsVitamin C rich foods to help absorption
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Common Nutrition ProblemsDental cariesSeen in half of

children aged 6 to 9Reduce dental caries by limiting sugary
snacks & providing fluorideChoose fruits, vegetables, and
grainsRegular meal and snack timesRinse (or better yet, brush
the teeth) after eating
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Prevention of Nutrition-Related DisordersPrevalence of
overweight among children is increasingData from NHANES I,
II, & III suggest weight gain linked to inactivity rather than
increases in energy intake Excessive body weight increases risk
of cardiovascular disease & type 2 diabetes mellitus
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Prevalence of Overweight and ObesityDefinitions:Obese = BMI-
for-age ≥95th%Overweight = BMI-for-age from 85th to 95th%
(Discuss meaning of “to”)Obesity more common in Hispanic
and non-Hispanic black children and adolescentsHeaviest
children are getting heavier
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Characteristics of Overweight ChildrenCompared to normal
weight peers, overweight children:Are tallerHave advanced
bone ages Experience earlier sexual maturity Look olderAre at
higher risk for obesity-related chronic diseases
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Predictors of Childhood ObesityAge at onset of BMI rebound
Normal increase in BMI after declineEarly BMI rebound, higher
BMIs in children later
Home environmentMaternal and/or Parental obesity most
significant predictor of childhood obesity
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Effects of Television Viewing TimeObesity related to hours of
television viewing Resting energy expenditure decreases while
viewing TVHealthy People 2020 objective:Increase proportion
of children who view 2 hours or less of TV per day from 78.9%
to 86.8%
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Television Viewing Time

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Addressing the Problem of Pediatric Overweight and Obesity
“An ounce of prevention is worth a pound of cure”
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Prevention and Treatment of Overweight and ObesityExpert’s
recommend a 4-stage approach:The four stages:Stage 1:
Prevention PlusStage 2: Structured Weigh Management
(SWM)Stage 3: Comprehensive Multidisciplinary Intervention
(CMI)Stage 4: Tertiary Care Intervention (reserved for severely
obese adolescents)
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Prevention and Treatment of Overweight and Obesity
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Prevention and Treatment of Overweight and ObesityTreatment
consists of a multi-component, family-based program consisting
of:Parent trainingDietary counseling/nutrition
educationPhysical activity/addressing sedentary
behaviorsBehavioral counseling
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Nutrition and Prevention of CVD in School-Age
ChildrenAcceptable range for fat is 25% to 35% of energy for
ages 4 to 18 yearInclude sources of linoleic (omega-6) and
alpha-linolenic (omega-3) fatty acidsLimit saturated fats,
cholesterol & trans fats
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Nutrition and Prevention of CVD in School-Age
ChildrenIncrease soluble fibers, maintain weight, & include
ample physical activityDiet should emphasize:Fruits and
vegetablesLow-fat dairy productsWhole-grain breads and
cerealsSeeds, nuts, fish, and lean meats

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Dietary SupplementsSupplements not needed for children who
eat a varied diet & get ample physical activity
If supplements are given, do not exceed the Tolerable Upper
Intake levels
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Dietary RecommendationsIronIron-rich foods: meats, fortified
breakfast cereals, dry beans, & peasFiberIncrease fresh fruits
and vegetables, whole grain breads, and cerealsFatDecrease
saturated fat and trans fatty acids
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Dietary RecommendationsCalcium & Vitamin DBone formation
occurs during pubertyInclude dairy products and calcium-
fortified foodsVitamin D from exposure to sunlight and Vitamin
D fortified foodsIf lactose intolerant: Do not completely
eliminate dairy products but decrease only to point of tolerance
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Fluid and Soft DrinksProvide plain water or sports drinks to
prevent dehydrationCold water is the best fluid for
childrenLimit soft drinks because they provide empty calories,
displace milk consumption & promote tooth decayEnergy drinks
should not be consumed by children
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Recommended versus Actual Food Intake Saturated fat—intake
is 11% of calories (recommend <7%)Total fat—intake excessive
in Black & Mexican-American girls and Black boysCaffeine—
increasing because of soft drink consumptionCalcium intake
falls short of RDAFast food—33% of children consume fast
food each day
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Other Considerations Cross-cultural ConsiderationsHealthy
People 2020-a major goal-eliminate health disparities among
different segments of the population
Health care professionals should learn about cultural dietary
practices

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Other Considerations Vegetarian DietsSuggested daily food
guides for vegetarians are availableVegetarian diets should be
planned to provide adequate calories, protein, calcium, zinc,
iron, omega-3 fatty acids, Vitamin B12, riboflavin and Vitamin
D
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Physical Activity RecommendationsRecommendations:Children
should engage in at least 60 minutes of physical activity each
dayParents should set a good example, encourage physical
activity, and limit media & computer useActual: Only 7.9% of
middle & junior high schools require daily physical activity
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Determinants of Physical Activity Determinants may
include:Girls are less active than boysPhysical activity
decreases with ageSeason & climate impact level of physical
activityPhysical education classes are decreasing
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Organized Sports Participation in organized sports linked to
lower incidence of overweightAAP recommends:Participation in
a variety of activitiesOrganized sports should not take the place
of regular physical activityEmphasis should be on having fun
and on family participation rather than being competitive
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Organized Sports Participation in organized sports linked to
lower incidence of overweightAAP recommends:Use of proper
equipment such as mouth guards, pads, helmets, etc.Should not
include intensive, specialized training
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Nutrition EducationSchool-age: a prime time for learning about
healthy lifestylesSchools can provide an appropriate
environment for nutrition education & learning healthy
lifestylesEducation may be knowledge-based nutrition education
or behavior based on reducing disease risk
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Nutrition Education
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Nutrition Integrity in SchoolsAll foods available in schools
should be consistent with the U.S. Dietary Guidelines & Dietary
Reference IntakesSound nutrition policies need community &
school environment supportCommunity leaders should support
the school’s nutrition policy The School Health Index (SHI)
should be completed & implemented
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Nutrition Integrity in SchoolsThe SHI (School Health Index)
helps:Identify strengths and weaknesses in health promotion
policies and strategiesDevelop an action planInvolve
stakeholders (teachers, parents, students, community) in
improving school policies and programs
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School Health Index
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Public Food and Nutrition Programs Child nutrition
programsBegan in 1946Provide nutritious meals to all
childrenReinforce nutrition education Require schools to
develop a wellness policy
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Public Food and Nutrition ProgramsFinancial assistance
provided by the federal gov’t to schools participating in the
National School Lunch ProgramFive requirementsLunches based
on nutrition standardsNo discrimination between those who can
and cannot payOperate on a non-profit basisPrograms must be
accountableMust participate in commodity program
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Public Food and Nutrition ProgramsThe National School Lunch
Program (NSLP) Standards:
1. Both fruits and vegetables every day; increasing whole grains
2. Only fat-free or low fat milk

3. Limiting calories based on child’ age
4. Reduce saturated and trans fats, and sodium
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School Breakfast ProgramAuthorized in 1966States may require
schools who serve needy populations to provide school
breakfastThe NSLP rules apply to the School Breakfast
ProgramBreakfast must provide ¼ the DRI
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Other Nutrition ProgramsSummer Food Service
ProgramProvides summer meals to areas with >50% of students
from low-income families Team NutritionProvides training,
technical assistance, education, or support to promote nutrition
in schools
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ARTICLE REVIEW
PRINCIPLES OF SUSTAINABILITY, ENVR 172
FALL SEMESTER 2016
Assignment
These are the instructions that will help you frame your

thoughts on the article, Costa Rica: Paying Mother Nature to
Multitask,” that I have scanned for you.
You should have two distinct sections in your critique. The
first will simply provide me with a detailed synopsis of what
you have read. This section should be approximately two typed
pages in length (double-spaced). Since there are many issues or
themes exploring a particular topic in the article, you may not
be able to adequately critique the entire article thoroughly. You
are allowed to write as much as you feel is necessary to
adequately cover the content of the article. A portion of your
grade will reflect the thoroughness in which you have reviewed
the issues presented.
Another portion of your critique will be to provide me with an
analysis of the information presented. In this section you will
exercise your own opinion in addressing the following. What
are your perceptions and initial reactions to what was presented
in the article? Do you feel that the problems presented are real
or have they been overstated? Do you feel that there are
realistic solutions to these problems? If so, what are they? You
do not have to rely upon what may have been stated in the
article for solutions but can exercise your own original thoughts
and ideas. Remember that you will not be graded on what you
say but rather how well you express your thoughts and opinions.
So take the liberty to say what you feel about what you have
reviewed. You should have a minimum of 3 typed pages of text
(doubled spaced using 12 point font size) for this section. A
minimal amount of effort on your part will yield an average
grade. Since this exercise will require considerable effort, I
will assign it a total of 20 possible points. Good Luck!
This assignment is due Tuesday, March 15, 2016 @ 3:30 PM.
Papers will NOT be accepted late.
Case Study Assignments
Purpose:

The purpose of these assignments is to enhance learning by
applying nutrition principles to real-life scenarios.Cases:
· Case Study #2 – Pediatric Overweight, p. 330
·
Directions:
In a 3-page paper, use information discussed in class and
textbook reading material to write each of three case studies.
Each case study will present a scenario followed by questions.
Based on the details given, answer the questions demonstrating
mastery of the English language, using information from
lectures and the textbook. You are not expected to do other
research, as the answers will be available in the textbook.
Answers are to be in essay format with topic sentences, proper
grammar, syntax and spelling.Do not include the questions.
Form and Style Guidelines for all Written Assignments
Your paper should:
· be written in narrative, paragraph format
· be typed and double spaced in Times New Roman 12 point
type, left justified with 1 inch margins (APA format)
· include citation and textbook reference in current APA format
· be submitted by the start of class on the due date
Grading Rubric for Written Assignments
Papers will be graded according to the rubric described below.
Assessment will be made not only of the content but also the
quality and clarity of your writing.
score
~grade
Content criteria

50%
A
Outstanding response with superior supporting examples or
evidence; unusual insights, creative and original analysis,
reasoning, and explanation; superior mastery of content; far
beyond the minimum required for the assignment.
43%
B
Good, solid response that uses excellent supporting examples or
evidence; excellent reasoning and explanations; goes beyond the
minimum required for the assignment.
40%
B-
Good, solid response that meets minimum required by
assignment. Reasoning and explanations are adequate.
37%
C
Response is accurate but cursory, and does not meet the
minimum required for completeness; some inaccuracies or
reasoning flaws; response is too general, lacks specific
evidence.
30%
D
Response doesn’t effectively address the question; response
fails to support assertions with data or examples; major flaws in
reasoning; explanations are unclear; displays inadequate
understanding of content.
0<30%
F
Response is missing or not submitted, or does not address the

question.
score
~grade
Writing criteria: in keeping with Department policy, papers will
be returned requiring to be re-written if more than 5
grammatical or spelling errors are identified. An automatic -
10% of grade will be assigned.
50%
A
Meets criteria for 43%, plus demonstrates superior grammatical
correctness and sense of personal style. Effortlessly readable
prose.
43%
B
Very effective organization of paragraphs and paper;
interesting, varied sentences; good grammar (usage,
punctuation, etc.); few spelling mistakes; does not read like a
first draft.
39%
C+
Reasonably effective organization of paragraphs and paper;
serviceable prose; numerous errors of grammar or spelling;
reads like a first draft.
35%
C-
Structurally disorganized; paragraphs lack topic sentences or
are developed ineffectively; awkward sentence structure; poor
grammar; poor spelling.
0<35%
D-

Similar to 35%, but even harder to read.
NuFS 106A Fall 2015 Case Study Assignment
1

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