Chapter 12 - Nutrition

Community based strategies for improving child and family nutrition

1. Promote breastfeeding 2. Provide food supplements or conditional cash transfers to vulnerable households 3. Using WHO recommended case management strategies 4. Education about complementary feeding

International Code of Marketing of Breast-milk Substitutes

1. Stresses that breastmilk is the best option for feeding babies 2. Marketing personnel should not directly contact pregnant women or new mothers 3. Health facilities should not promote formula use 4. Samples of formulate should not be distributed at hospitals or by retailers

Stunting affects one in every three children in what three regions

1. West and Central Africa (32%) 2. Eastern and Southern Africa (33%) 3. South Asia (34.5%)

How many deaths can be attributed to undernutrition or children under-5

1/5

Approximately how many women cannot breastfeed? A. 18% B. 2% C. 22% D. 8%

2%

_____ in Middle East and North Africa have moderate or severe stunting A. 30% B. 18% C. 20% D. None of the above

20%

Global prevalence of stunting

21.9%

____ of children age 4-6 are are vitamin A deficient

30%

As of 2015, prevalence of obese and overweight adults A. 30% B. 29% C. 39% D. 12%

39%

Food security

Access to enough food to sustain a healthy and active life

SDG 2.2

Addressing the nutritional needs of adolescent girls, pregnant and lactating women and older persons

Early breastfeeding

Breastfeeding within first hours after birth

Exclusive breastfeeding

Breastmilk is the only substance the baby consumes

Food sources of Iodine

Cheese, cows milk, saltwater fish, soy sauce, iodized salt

Stunting

Child with low height for age Chronic malnutrition

Wasting

Child with low weight for height Acute malnutrition Rapidly decreasing nutritional health status

Iodine

Element needed for the production of thyroid hormone

SDG 2.1

End all forms of malnutrition

SDG 2

End hunger, achieve food security and improved nutrition and promote sustainable agriculture

Region with the highest prevalence of iodine deficiency

Eurasia, parts of Africa

Overnutrition

Excessive intake of calories and nutrients

WHO breastfeeding recommendations

Exclusively breastfeed for 6 months, add complementary foods up to 2 years

T or F: Lower income countries spend less on food than higher-income countries

False

T or F: Prevalence of chronic undernourishment is increasing

False

T or F: Vitamins can be synthesized by the body

False

T or False: There has been an increase in number of children affected by stunting from 2000 to 2017

False, decrease significantly

Iodine salt is an example of... A. Supplementation B. Enrichment C. Fortification D. All of the abve

Fortification

Minor iodine deficiencies lead to A. Stunting B. Impaired mental function C. Anemia D. Xeropthalmia

Impaired mental function

Goiter

Iodine deficiency that leads to the enlargement of the thyroid

Most common micronutrient deficiencies globally

Iron Zinc Vitamin A Iodine

A child that is undernourished and has a distended stomach most likely has what health condition A. Marasmus B. Anemia C. Xerophthalmia D. Kwashiorkor

Kwashiorkor

Early weaning is associated with what health condition A. Marasmus B. Anemia C. Xerophthalmia D. Kwashiorkor

Kwashiorkor

Food sources of folate

Liver and spinach

Marasmus

Long-term calorie deprivation that can lead to an emaciated, weak and lethargic state

Undernutrition

Malnutrition resulting from deficiences in the amount of food or types of nutrients eaten or from poor absorption of the nutrients that have been consumed

Cycle of Poverty

Malnutrition that leaves the body vulnerable to infectious disease Infectious disease leaves body nonfunctional

Global Hunger Index

Metric that estimates burden from undernutrition in a population with focus on young children

Colostrum

Milk produced in first days after giving birth that contains large quantities of proteins and antibodies

Deficiency of folate during first weeks of pregnancy results in

Neural tube defects in developing fetus - Anencephaly and spina bifida

Undernutrition includes all of the following except what? A. Noncommunicable diseases B. Wasting C. Underweight D. Stunting

Noncommunicable diseases

BMI > 30 A. Underweight B. Normal C. Overweight D. Obese

Obese

BMI 25-29.9 A. Underweight B. Normal C. Overweight D. Obese

Overweight

_____, ____ and _____ of food predicts food security

Physical availability Economic affordability Nutritionally valuable

Supplementation

Pill, tables or capsule that delivers one or several micronutrients

What is an underlying cause in nearly all cases of severe undernutrition in children

Poverty

Fortification

Process of adding micronutrients not naturally present in a food's ingredients to a food product

Enrichment

Process of adding nutrients lost during handling, processing or storage back to food products

Bioavailability

Proportion of the nutrient consumed that is able to be absorbed and used by the body

Edema is associated with A. Severe acute malnutrition B. Inadequate vitamins and minerals C. Obesity D. Protein energy malnutrition

Protein energy malnutrition

Marasmus and kwashiorkor are two life-threatening conditions that can result from: A. Severe acute malnutrition B. Inadequate vitamins and minerals C. Obesity D. Protein energy malnutrition

Protein energy malnutrition

Xerophthalmia

Severe dryness of the eye, progress to night blindness and eventually ulceration and scarring of the cornea

Protein energy malnutrition (PEM)

Severe form of chronic undernutrition that presents in two different forms

Nutrient transition

Shift from having undernutrition and nutrient deficiencies as the most prevalent nutritional concerns to have overweight and obesity as dominant nutritional disorders Common in developing countries as economy transitions

Complementary foods

Solid foods that accompany breast milk and do not immediately replace it

Fat-soluble vitamins

Stored in body tissues

What region has the highest percentage of children receiving breast milk? A. U.S.A B. South and Central America C. Europe D. Sub-Saharan Africa

Sub-Saharan Africa

Highest burden of VAD A. Europe and South Asia B. Sub-Saharan Africa and South America C. Sub-Saharan Africa and South Asia D. Central America and Eastern Europe

Sub-Saharan Africa and South Asia

Folic acid

Synthetic form of folate added to foods or supplements

T or F: Globally, obesity has tripled since 1975

True

T or F: There has been an increase in the number of children affected by obesity from 2000 to 2017

True

T or False: Distribution and affordability of food are two important factors in food security

True

Obesity increases risk of

Type 2 Diabetes, hypertension/high blood pressure, heart disease, strokes, colon cancer, arthritis

3 forms of malnutrition

Undernutrition Inadequate vitamins or minerals Overweight, obesity, diet related noncommunicable diseases

Dual burden

Undernutrition continues to be prevalent among children while adult obesity becomes common

BMI < 18.5 A. Underweight B. Normal C. Overweight D. Obese

Underweight

What vitamins are necesssary for regulation of energy use and critical cellular functions? A. Vitamin A B. Vitamin C C. Vitamin K D. A and B E. All of the above

Vitamin B and C

Folate

Vitamin B that is critical for growth, red blood cell production and fetal development

Fat soluble vitamins include

Vitamins A, D, E and K

Vitamin A deficiency (VAD) lead to A. Stunting B. Impaired mental function C. Anemia D. Xeropthalmia

Xeropthalmia

Food sources of Vitamin A

Yellow, orange and dark green veggies Fortification of foods with vitamin A, oil filled vitamin A capsules

Ready-to-use therapeutic food (RUTF)

high energy and protein food made from a peanut base

Underweight

low weight for wage

Micronutrients

minerals and vitamins -- required in small amounts and consumed mostly through food

Kwashiorkor

protein deficiency necessary for healthy growth and development characterized by edema

Severe acute malnutrition (SAM)

Child with weight for height z score below -3 Requires urgent medical care

Nutrition

Consumption of food that allows body to survive, grow, health and be healthy and processing of those nutrients within the body

Vitamin A

Critical for growth and vision

Malnutrition

Deficiencies, excesses or imbalances in person's intake or energy and/or nutrients

Water-soluble vitamins

Easily dissolved in the body but are not able to be stored in body tissues

T or F: Mild and moderate undernutrition do not pose any health risks to children

False, increases risk of illness and death

Edema

Fluid retention in extracellular spaces that causes swelling of the tissues in the arms, legs and face

BMI

weight (kg) / height (m^2)