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)