Chapter 13 Diet during Childhood and Adolescence Copyright

Objectives • Identify nutritional needs of adolescents and children age 1 to 12 •

Objectives • Discuss consequences of obesity in childhood • Evaluate nutritive value of fast-food

Nutrition in Children • Children’s nutrition affects physical, emotional, and intellectual development • Once

Children Ages 1 to 12 • Appetites often vary according to rate of growth

Children Ages 1 to 12 • Fats should not be limited before age 2

Children Ages 1 to 12 • Calorie needs depend on rate of growth, activity

Calorie and Nutrient Needs of Young Children • From age 1 to 10, caloric

Calorie and Nutrient Needs of Young Children • Limit sweets and sweetened fruit juices

Childhood Obesity • Child overweight if above 95 th percentile for body mass index

Genetic Factors • Not sole factor for childhood obesity • Increased risk in children

Behavioral Factors • • Large portions of food and beverage Snacking on energy-dense foods

Environmental Factors • School foods often high in fat and calories • Community environment

What Parents Can Do • Model healthy food choices and active lifestyle • Involve

What Parents Can Do • Engage in 60 minutes of physical activity daily as

What Parents Can Do • Never provide food as comfort or reward – But

What Parents Can Do • Eat slowly – Use 20 -minute technique • Determine

Childhood Type 2 Diabetes • In the past, disease of adults only – Now

Osteoporosis and Cardiovascular Disease • Osteoporosis linked to poor calcium intake in childhood and

Adolescence • Period of rapid growth and physical changes – Cause increased calorie needs

Adolescence • Calorie requirement increases • Except for vitamin D, all nutrient needs increase

Adolescent Problems Related to Nutrition • Anorexia nervosa • Bulimia • Overweight Copyright ©

Anorexia Nervosa • Psychological disorder • Causes client to drastically reduce calories consumed –

Anorexia Nervosa • Often exercise excessively • May result in hair loss, low blood

Treatment for Anorexia Nervosa • • • Individual and family counseling Self-acceptance Nutrition therapy

Bulimia • Syndrome when client alternately binges and purges by inducing vomiting and using

Bulimia • Often binge on high-calorie foods • Usually not life-threatening, but can irritate

Treatment for Bulimia • • Eating only at mealtime Portion control Close supervision after

Overweight • Contributing factors: – Heredity, overfeeding as infant or child, and psychological issues

Stop and Share • Consider the following question: – Being overweight is particularly difficult

Stop and Share • Apt to diminish self-esteem • Can exclude from normal social

Fast Foods • • Nutrient charts often available at restaurants Excessively high in fat,

Alcohol • Contains 7 calories per gram but few nutrients • Depressant with serious

Alcohol and the Adolescent • Alcoholism – Abuse or overuse of alcohol • Excessive

Alcohol and the Adolescent • Teenagers often ignore dangers • Drinking teens prone to

Marijuana • Use continues to increase among teens • Increases appetite, especially for sweets

Cocaine • Highly addictive and extremely harmful • Weight loss very common due to

Tobacco • Addictive • Can influence appetite, nutritional status, and weight • Smokers need

Other Addictive Drugs • Amphetamines cause heart, breathing, and blood pressure rates to increase

Other Addictive Drugs • Inhalants – Physically and psychologically addictive – Symptoms: • Depression,

Nutrition for the Athlete • Need additional water, calories, B vitamins, sodium, potassium, iron,

Nutrition for the Athlete • Glycogen loading sometimes used for long activities – Also

Considerations for the Health Care Professional • Young children may have poor appetites, and

Considerations for the Health Care Professional • Working with adolescent clients with disordered eating

Conclusion • Nutrient needs vary as children grow and develop – Gradually increase •

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Objectives • Identify nutritional needs of adolescents and children age 1 to 12 • State effects of inadequate nutrition during growing years • Describe eating disorders that can occur during adolescence Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Nutrition in Children • Children’s nutrition affects physical, emotional, and intellectual development • Once developed, poor eating habits difficult to change • Poor eating habits can exacerbate emotional and physical problems Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Children Ages 1 to 12 • Appetites often vary according to rate of growth • Likes and dislikes change • New foods should be introduced gradually • Children should be involved in food selection and preparation Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Children Ages 1 to 12 • Fats should not be limited before age 2 • Fat intake recommendation: – 30 to 35 percent of calories for 1 - to 3 -year-olds – 25 to 35 percent of calories for 4 - to 18 -year-olds • Whole milk recommended until age 2 – Low-fat or fat-free milk served starting at age 2 Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Children Ages 1 to 12 • Calorie needs depend on rate of growth, activity level, body size, metabolism, and health • Nutrient-dense snacks needed every two to three hours • Forcing a child to eat can cause eating disorders • Choking prevalent in young children Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Calorie and Nutrient Needs of Young Children • From age 1 to 10, caloric needs decrease – But nutrient needs increase • Use My. Pyramid for meal planning for kids • Need 2 to 3 cups of milk or equivalent in terms of calcium per day Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Calorie and Nutrient Needs of Young Children • Limit sweets and sweetened fruit juices • Need 1 m. L of water per calorie • Introduce fiber slowly Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Childhood Obesity • Child overweight if above 95 th percentile for body mass index (BMI) by sex and age • Many factors contribute to this epidemic: – Genetic – Behavioral – Environmental Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Behavioral Factors • • Large portions of food and beverage Snacking on energy-dense foods High sugar intake Lack of physical activity at home, school, or day care • Excessive sedentary activities: – E. g. , television, computer, video games Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Environmental Factors • School foods often high in fat and calories • Community environment not always safe or conducive to physical activity Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

What Parents Can Do • Model healthy food choices and active lifestyle • Involve entire family for lifestyle change • Balance calories with snacking and portion control – But no dieting • Promote healthy food, snacks, and drinks • Remove calorie-rich temptations Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

What Parents Can Do • Engage in 60 minutes of physical activity daily as a family • Limit sedentary time • Ensure child gets enough sleep • Never tell child that he or she is too fat • Understand devastating effects of social discrimination on obese children Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

What Parents Can Do • Never provide food as comfort or reward – But do not forbid food • Eat only at table and at designated times • Give water rather than juice, soda, or sweetened drinks Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Childhood Type 2 Diabetes • In the past, disease of adults only – Now found in obese children • Need education from diabetes educator • Only prevention: – Healthy nutrition and exercise Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Osteoporosis and Cardiovascular Disease • Osteoporosis linked to poor calcium intake in childhood and young adulthood • Cardiovascular disease linked to excess fat in diet • Teenagers typically consume too much saturated fat and soda and not enough milk • Nutrition education crucial Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Adolescence • Period of rapid growth and physical changes – Cause increased calorie needs • Typically enormous appetites • Often substitute popular low-nutrient-dense foods • Food choices affected by peer pressure and busy schedules Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Adolescence • Calorie requirement increases • Except for vitamin D, all nutrient needs increase • Menstruation in girls creates greater need for iron • DRIs for many nutrients higher for boys than girls Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Anorexia Nervosa • Psychological disorder • Causes client to drastically reduce calories consumed – Causes altered metabolism • Distorted body image and fear of being fat Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Anorexia Nervosa • Often exercise excessively • May result in hair loss, low blood pressure, weakness, amenorrhea, brain damage, and even death Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Treatment for Anorexia Nervosa • • • Individual and family counseling Self-acceptance Nutrition therapy Close supervision Time and patience Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Bulimia • Syndrome when client alternately binges and purges by inducing vomiting and using laxatives and diuretics to rid of ingested food • Fear of being overweight Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Bulimia • Often binge on high-calorie foods • Usually not life-threatening, but can irritate esophagus and cause electrolyte imbalances, malnutrition, dehydration, and dental caries Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Overweight • Contributing factors: – Heredity, overfeeding as infant or child, and psychological issues • Treatment: – Evaluation by health care provider – Change in unhealthy eating habits – Exercise Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Stop and Share • Consider the following question: – Being overweight is particularly difficult during the adolescent period. What makes being overweight during adolescence especially difficult? Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Stop and Share • Apt to diminish self-esteem • Can exclude from normal social life of teen years – Further diminishing self-esteem • Makes adolescent prone to being overweight as adult Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Fast Foods • • Nutrient charts often available at restaurants Excessively high in fat, sodium, and calories Limited in minerals, vitamins, and fibers Often used as snacks by teens – Adds extra calories • Should be used with discretion in balanced diet Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Alcohol • Contains 7 calories per gram but few nutrients • Depressant with serious side effects • Affects absorption and normal metabolism of glucose, fats, proteins, and vitamins • Causes excess water and mineral loss Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Alcohol and the Adolescent • Alcoholism – Abuse or overuse of alcohol • Excessive long-term drinking can lead to liver cirrhosis, high blood pressure, and damage to heart muscle Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Marijuana • Use continues to increase among teens • Increases appetite, especially for sweets • Marijuana cigarettes more harmful to lungs than tobacco cigarettes • May lead to use of other drugs Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Cocaine • Highly addictive and extremely harmful • Weight loss very common due to decreased appetite • Crack – Form that can be smoked • Half of crimes against property in U. S. related to use of crack cocaine Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Tobacco • Addictive • Can influence appetite, nutritional status, and weight • Smokers need more vitamin C – Smoking alters its metabolism • Increases risk for lung cancer and heart disease Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Other Addictive Drugs • Amphetamines cause heart, breathing, and blood pressure rates to increase – Methamphetamine • Most potent form of amphetamines – Symptoms: • Dry mouth, difficulty swallowing, dilated pupils, and depressed appetite • As drug wears off, fatigue and depression common Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Other Addictive Drugs • Inhalants – Physically and psychologically addictive – Symptoms: • Depression, apathy, nosebleeds, headaches, eye pain, chronic fatigue, heart failure, loss of muscle control, and death Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nutrition for the Athlete • Need additional water, calories, B vitamins, sodium, potassium, iron, and protein • Increase in calories depends on activity and its length • Plain water recommended liquid for rehydration • Electrolyte drinks useful after athletic event – But not during one Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Nutrition for the Athlete • Glycogen loading sometimes used for long activities – Also known as carbo-loading – Begins six days before event – Regimen of diet and exercise to maximize amount of glycogen in muscles – May result in abnormal heart rate and some weight gain – Should maintain good eating and health habits Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Considerations for the Health Care Professional • Young children may have poor appetites, and parents may have related anxiety • Be most helpful by exhibiting patience and understanding and by listening to client and parents Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. (continues)

Considerations for the Health Care Professional • Working with adolescent clients with disordered eating can be challenging – Should consult with client’s psychological counselor • Parents of clients with disordered eating must be included in counseling Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Conclusion • Nutrient needs vary as children grow and develop – Gradually increase • Anorexia nervosa, bulimia, and obesity are problems of weight control that can occur during adolescence • Alcohol and drug abuse can be serious problems during adolescence Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.