Agronomy exam 1 lectures 5-8

What is the link between poverty and obesity?

early poverty associated with obesity in young adults -unhealthy foods are more easily available and are cheaper than healthy foods

Why must refeeding be done slowly?

effects most significant in first few days of refeeding and it may take 1 week to adapt to the increase oxygen demand

Who is affected by chronic disease?

older people who have or used to have some sort of bad nutrition

What is the best way to feed an infant? For how long? Be able to give reasons. What actions have been recommended to support this?

-Breastfed infants usually have better nutritional status than those who are not -breastfeeding leads to stronger intellectual development, reduced risk of cancer, obesity and other chronic disease -recommended to exclusively breast feed for 6 months -complementary feedings added after at 6 months -continue breastfeeding into the second year of life+ -Initiatives developed to support this include: "The Code", the innocenti declaration, and the who/unicef baby friendly hospital initiative

What are the common chronic diseases? What common condition have many been linked to?

-Cardiovascular disease -cancer -chronic respiratory disease -diabetes -account for 80% of all non communicable disease deaths

What is the effect of maternal nutrition on the fetus?

-PEM in early pregnancy resulted in increased rate of fetal loss and malformations -PEM late in pregnancy resulted in low birth weights -anemia: increased blood volume in pregnancy leads to increased iron needs, associated with low birth weights, and low/no iron stores for the infant -iodine deficiency leads to cretinism in infant -intra uterine growth retardation: inadequate maternal nutrtion status and poor nutrition during pregnancy -baby likely to suffer from chronic disease in adulthood

What are the major effects of refeeding?

-RFS (refeeding syndrome) describes the adverse clinical and biochemical problems that may result from feeding malnourished patients -Metabollically: insulin release is stimulated by the presence of carbs and proteins in the gut, switch up from using body stores to using food, stops the release of fat stores and production of glucose from protein, stops sodium excretion -cardiac: increases in heart rate, blood pressure, oxygen consumption, cardiac output and more plasma output -response is dependent on amount of cals, sodium, and protein given -respiratory: excess co2 production and increased oxygen consumption, can get short of breath, fluid buildup in some areas due to increased water load gastrointestinal: enzyme activity/secretion return to normal, requires a period of readaptation to food to minimize GI complaints

What are the major determinants of stunting? What is this linked to in adulthood?

-chronic low intake leads to stunting -estimated about 22% of children under age 5 -less than 2sd from median value of international growth -potential for catch up growth are limited in stunted children after the age of 2 -same catch up is possible between 2-12 if not born with lbw or stunted in infancy -associated with later deficits in cognitive ability -birth contributes to about half of the growth failure and influences mental development -more boys are stunted worldwide than girls

What problems may stunted women have during pregnancy and delivery?

-higher maternal and infant mortality rate and pre-term delivery with adolescent pregnancies -more likely to have obstructed labor due to pelvic disproportion -stunted children leads to stunted adults leading to lbw infantrs

What happens in the adolescent period that challenges nutrition?

-hormonal changes accelerate growth (faster than any other postnatal time except 1st years) -10-19 years

What are the good and bad parts of the nutrition transition?

-less undernutrition and communicable disease -higher risk of obesity and chronic disease

Why is good nutrition important for older adults?

-nutritional status is related to functional ability -undernutrition is associated with higher risks of impairments in: psychomotor speed and coordination, mobility, and ability to live independently -malnutrition leads to decreased functional capacity and need for more help -leads to more depression as well

How does the cost of a healthy diet compare to a nutrient adequate diet or energy sufficient diet?

-the cost of a healthy diet is 60% higher than the cost of a nutrient adequate diet and about 5x the cost of an energy sufficient one -nutritious food is not cheap

What decreases with malnutrition in adults?

-the economic livelihood of populations depends to a large extent on the nutrition/health of adults -work capacity and productivity is linked to body weight -low body weight: fewer days of heavy labor, more likely to miss work due to illness

When should complementary foods be introduced and why?

-they are required in the 2nd 6 months of life to produce adequate nutrition and stimulate development -can result in improved infant growth

What are modifiable risk factors for chronic disease?

-unhealthy diet -physical inactivity -tobacco use -harmful use of alcohol

How many people in 2021 could not afford a healthy diet?

3 billion

What is the nutrition transition? What dietary changes occur?

A model used to describe the physical activity, shift in diets and causes of disease that accompany changes in economic development, lifestyle, urbanization, and demography -refers to the change from traditional diets to "western" diets: high in fats, sugars, meats, preservatives, low in fiber, rise in sedentary lifestyles

What causes diarrhea in refeeding?

Activity of the brush border enzyme and pancreatic enzyme secretion return to normal -requires a period of readapting to food to minimize Gi complaints (diarrhea, nausea, vomiting)

What has been hypothesized regarding in utero malnutrition and health in later life?

Bakers fetal origin of disease hypothesis -Developmental origins of nutrition and disease -nutritional insults during critical periods of gestation and early infancy followed by relative affluence, increase the risk of chronic disease later in adulthood -baby programmed for a life of scarcity and confronted with a world of plenty

Why should prevention focus on the life cycle and not just with fetal and early childhood malnutrition?

Because malnutrition that starts early on in life will most likely continue into adulthood and create more issues like chronic disease

What indicator is used to measure progress in breaking the intergenerational cycle of malnutrition?

Global nutrition targets by WHO -stunting: 40% reduction -anemia: 50% reduction -low birth weight: 30% reduction -child hood overweight: no increase -breastfeeding: increase rate of exclusive breastfeeding in the first 6 months up to 50% -wasting: reduce and maintain to less than 5%

What is the double burden of malnutrition?

Malnutrition + rapid upsurge of risk factors for chronic disease such as overweight and obesity = double burden of malnutrition -undernutrition issues remain unsolved -dietary change in nutrition transition to high sugar, fat, salt, energy dense, and nutrient low: lower in cost and nutrients, with decreased activity results in obesity

What is ORS and what is it used for?

Oral Rehydration Salts Solution -It is an inexpensive solution of sodium and glucose used to treat acute diarrhea

What is RUTF, under what circumstances is it used, and what are the advantages of it?

Ready to use therapeutic food -home based treatment for severe acute malnutrition in children who have no medical complications and have appetite -provides foods that are good to use at home and cause rapid weight gain -ready to use paste in packets that doesn't need to be mixed with any liquid (ex plumpy nut)

What besides nutrients must be part of the therapy for malnourished children?

Sensory stimulation and emotional support antibiotics

What is stunting? Wasting? Underweight?

Stunting - low height for age Wasting - low weight for height Underweight - low weight for age

What is a major issue with early pregnancy in undernourished girls?

Undernourished girls grow for a longer period of time, so they may not be finished growing before the first pregnancy (leads to smaller infants due to competition for nutrients and poorer placental function)

What improves learning in children?

alleviating hunger

What is a common complication? Why?

congestive heart failure: cardiac output can't increase enough to meet the increased needs for plasma volume, oxygen, blood pressure, and heart rate

What is the key indicator of malnutrition?

infant mortality rate: defined as number of children per 1,000 live births who die before their first birthday

Why is exploratory behavior so important in children? What fuels it?

it is important for proper development and stimulus, being well fed and having good nutrition fuels it

What sign indicates that a child is entering the rehabilitation phase? What is encouraged at this point?

return of appetite is usually the sign for entering the rehab stage -during this point very high intake is encouraged to support weight gain -modified porridges or complementary foods can be used if comparable in energy/protein -increase food by 10 ml until some remains uneaten -after gradual transition give frequent feeds -sensory stimulation and emotional support also apart of the therapy

Why are continuing studies on children who have been treated for malnutrition necessary/of interest?

studies of children and health risk has found that the thinnest of children, the more obese they come as adults, and have more chronic disease -care must be taken in children and adults who have a history of malnutrition -education needs to be provided that stresses that overweight and obesity are not good health

Why is it important to frequently weigh and measure a child?

to make sure they are growing at the proper rate, have good weight and height for their age.