ES 3105 Exam 3 | Complete Solutions (Verified Answers)

ES 3105 Exam 3 | Complete Solutions (Verified Answers) Twins Silvia and Lynette have now entered junior high school. Their parents, Brett and Brenna, love that the girls are still well-behaved compared to their peers and hope it stays that way as long as possible. They encourage the girls to be active in extracurricular activities, but also frequently plan family time to balance everything out. 1. The twins are now 12 years of age, right before their teenage years, and Brett and Brenna are starting to notice some early "tween" attitudes. They know, based on their stage in adolescence, the twins will start developing new sensations about themselves. Brett and Brenna believe it is helpful to know what category the girls fall into in order to base nutrition education messages and efforts on their age period. Which of the following adolescent age periods do the girls fall into? a. high adolescence b. early adolescence c. middle adolescence d. pre-adolescence 2. Silvia and Lynette are growing and developing into mature girls. Yesterday, Silvia asked her mom Brenna about what she should be experiencing during puberty, because she feels that her body is changing a lot lately. Brenna explains that she is experiencing the conclusion of sexual maturation, which is why there are so many changes in her body. What are some physiological signs that Silvia is currently experiencing? a. mature, adult contour of the breasts and adult-type pubic hair spread to medial thighs b. enlargement of the areola and an increase in pubic hair c. small, raised breast buds and pubic hair along the labia d. nipple elevation, but no pubic hair 3. Silvia is becoming increasingly focused on her body image and how she thinks she appears to her friends. This is both concerning and frustrating to her parents. They want to understand where she is coming from without promoting disordered eating. True or False: As Silvia is becoming an adult, it is best to use the same approach in nutritional counseling as it would be when counseling an adult. Adolescents are able to understand the long-term effects of their behavior. a. True b. False 4. Both Silvia and Lynette, now 14-year-olds, have increased nutritional needs for growth and development. Which of the following is considered a factor that plays a role in the energy needs of adolescents? a. activity level b. basal metabolic rate c. pubertal growth and development d. All of these are correct. 5. As teenagers, Brett and Brenna struggled with making healthy food choices, which led to them both being overweight. Now, as adults, they believe it is their mission to provide a healthy food environment for their daughters. They have stocked the kitchen with nutritious ready-to-eat foods available for whenever the girls are hungry. True or False: Since the girls are exposed to a more healthy food environment, they are less likely to consume healthy foods to retaliate against their parents as they grow up. a. True b. False 6. Silvia recently announced that her most recent research project in journalism class made her realize that eating animals is cruel and contributes to global warming. She has decided to become vegan. What nutrient concerns does this bring about? a. protein intake b. deficiency in minerals like calcium, iron, and zinc c. insufficient long-chain fatty acids d. intake of vitamins B6, B12, and D e. All of these are correct. Menarche may be delayed in highly competitive athletes or in girls who severely restrict their caloric intake to reduce body weight. a. True b. False The consumption of excess dietary fat contributes to the risk of iron-deficiency anemia and impaired growth. a. True b. False The simultaneous search for personal autonomy and peer acceptance that characterizes adolescent psychosocial development often leads to the development of health-compromising eating behaviors. a. True b. False Adolescence is usually defined as the period of life between _____ years of age. a. 18 and 22 b. 10 and 16 c. 11 and 17 d. 11 and 21 e. 15 and 18 Menarche occurs most commonly during sexual maturation rating (SMR) stage _____. a. 4 b. 3 c. 1 d. 2 e. 5 Research by Frisch suggests that _____ percent body fat is required for the development and maintenance of regular ovulatory cycles. a. 20 b. 25 c. 15 d. 18 e. 22 Cognitively, early adolescence is a time dominated, in part, by _____. a. a reduction in impulsive behavior b. the development of social independence from family c. the development of a personal identity d. abstract thinking e. egocentrism At SMR stage _____, sexual maturation has concluded. a. 3 b. 5 c. 1 d. 2 e. 4 According to the nutrition standards for schools, any food sold in schools must have a calorie limit of _____ for snacks. a. ≤200 kcal b. ≤250 kcal c. ≤350 kcal d. ≤480 kcal e. ≤230 kcal Mass media and advertising are some of the _____ factors that play a more distal and indirect role in determining food patterns yet can exert a powerful influence on specific food choices. a. microenvironmental b. behavioral c. immediate social environmental d. macrosystem e. cognitive-affective The DRIs set the recommended intake of dietary fiber for adolescent females at _____ g/day. a. 40 b. 31 c. 26 d. 38 e. 43 According to the Dietary Reference Intakes, females between the age of 14 and 18 years should have _____ mg of iron every day. a.5 b. 27 c. 8 d. 15 e. 11 An underweight 17-year-old male was 15 minutes late to his nutrition counseling appointment, and he had to leave for a school-related practice in 20 minutes. Which dietary assessment method would be the most appropriate in which the dietician can complete the assessment through a telephonic conversation with the client? a. diet history b. 24-hour recall c. food frequency d. food record e. ASA24 Mortality for bulimia nervosa appears to be higher than for anorexia nervosa. a. True b. False BED is defined by recurrent episodes of binge eating at least one day a week for at least three months. a. True b. False Metformin is an FDA-approved drug for the treatment of obesity in youth. a. True b. False Nutritional monitoring is important only in the long-term and not short-term follow-up care of adolescents who have undergone bariatric surgery. a. True b. False Risk factors for the development of overweight and obesity among children and adolescents include _____. a. participation in organized sports b. high socioeconomic status c. the use of vitamin/mineral supplements d. being diagnosed with a chronic condition that limits mobility e. consuming a diet high in fruits and vegetables Specific topics that should be included as components of Stage 1 obesity treatment include _____. a. limiting screen time to no more than 2 hours of nonacademic time per day b. a very-low-energy diet c. the consumption of at least 5 servings of red meat per day d. the elimination of fast food meals e. extensive physical activity for 5 hours per day One side effect of iron supplementation often reported by adolescents is _____. a. headache b. constipation c. fat-soluble vitamin deficiency d. hypertension e. muscle soreness During eating-disorder treatment, a major role of the dietitian is to _____. a. treat comorbidities b. moderate group therapy sessions c. provide psychotherapy to the parents d. help the adolescent normalize eating patterns e. monitor physical activity level every minute Creatine is sold as a nutritional supplement to _____. a. decrease body fat b. decrease risk of osteoporosis c. increase lean body mass d. increase immune system function e. increase endurance Requirements of _____ may be higher among adolescents who frequently consume large quantities of alcohol. a. thiamin and other B vitamins b. fiber and carbohydrates c. fat and vitamin C d. iron and zinc e. vitamin D and protein Identify a major factor that contributes to poor growth and short stature in adolescents. a. dieting b. consumption of fast food c. swallowing disorder d. malnutrition e. unusual food habit The nutritional needs of adolescents are MOST influenced by _____ a. changes in weight, body composition, and skeletal mass. b. the onset of linear growth. c. the sexual maturation rating. d. the chronological age at which puberty began. e. the ethnicity and socioeconomic status of the adolescent. About 25 percent of teens' energy intake is supplied by snacks; therefore, adolescents should ensure that their snacks are ____ a. more salty than sugary. b. high in protein. c. kept to a maximum of two 100-kcal items daily. d. nutrient dense. e. sweetened artificially instead of with sugars. The low energy content of vegan diets may make them inadequate to support an adolescent's rapid growth. a. True b. False For greatest nutritional value, an adolescent should choose ____ a. 12 ounces of lemonade. b. a whole orange. c. a juice drink. d. a lime squeezed on chips. e. mandarin oranges in light syrup. Which nutrient is LEAST likely to affect bone health? a. vitamin K b. vitamin D c. chromium d. vitamin A e. magnesium Select the statement about sexual maturity that is INCORRECT. a. Early onset of menarche is four times more likely among overweight and obese females. b. The age of onset, duration, and tempo of puberty is consistent among all adolescents. c. Puberty usually occurs earlier among females than males. d. As much as 50 percent of ideal adult body weight is gained during adolescence. The ____________, also known as Tanner Stages, is a scale of secondary sexual characteristics that allows health professionals to assess the degree of pubertal maturation among adolescents, regardless of chronological age. SMR Select a nutrient that is critical for supporting optimal bone growth and development during adolescence. a. vitamin K b. vitamin D c. magnesium d. All of these are correct. Which strategy would best support nutrition education for young adolescents based on their psychosocial and cognitive development? a. Emphasize the value of developing healthy habits in adolescence that are more likely to be carried into adulthood. b. Teach adolescents the importance of getting enough calcium in order to prevent osteoporosis later in life. c. Focus on eating behaviors that can impact daily concerns like physical attractiveness and academic ability. d. Each of the listed strategies would be beneficial to an adolescent nutrition education program. Which cognitive ability is associated with development during late adolescence? a. impulsive behavior b. abstract thinking c. concrete thinking d. egocentrism Which factor plays a more distal and indirect role in determining food patterns, yet can exert a powerful influence on specific food choices? a. environmental factors b. macrosystem factors c. interpersonal factors d. personal factors Which snack item is among the most commonly chosen snack items for adolescents and is considered the number one source of energy and added sugars in the diets of teens? a. chips b. soft drinks c. fruits d. protein bars Identify a benefit to teens who participate in family meals at least 6 days per week. a. improved academic outcomes b. less likely to use alcohol c. improved dietary intake d. All of these are correct. Which food would a lacto-ovo-vegetarian consume, but a vegan would avoid? a. poultry b. eggs c. fish d. meat What percentage of U.S. adolescents are active every day of the week? a. 32 percent b. 10 percent c. 27 percent d. 45 percent Health care professionals should avoid relying solely on ____________ when determining the nutrient needs of an adolescent. chronological age About 45-65 percent of an adolescent's daily energy needs should come from which nutrient group? a. protein b. fat c. carbohydrate d. vitamins and minerals On average, adolescents exceed current recommendations for total consumption of which nutrient? a. sodium b. iron c. calcium d. zinc ____________ is an integral part of DNA, RNA, and protein synthesis, but evidence indicates a significant proportion of adolescents have inadequate amounts in their diet. Folate All women of reproductive age should consume adequate ____________ to reduce the incidence of spina bifida and other congenital anomalies. folic acid An adolescent whose BMI-for-age is less than the 5th percentile fits into which weight status category? a. overweight b. underweight c. obese d. healthy weight Select the BEST example of a limitation associated with the 24-hour recall dietary assessment method. a. relies on self-reported information b. low respondent burden c. does not require skilled staff d. does not require literacy What is an important consideration that health professionals should keep in mind when providing nutrition counseling to adolescents? a. Involve the adolescent in the decision-making processes. b. Establish a good rapport. c. Develop one or two goals during a counseling session. d. All of these are correct. Which of the following is NOT included in the CDC school health guidelines to promote healthy eating and physical activity? Provide competitive fitness experiences to build physical health, teamwork, and sportsmanship. Which teaching method is found to be most effective in school health education curricula? a. rote memorization b. discovery learning c. lecture d. frequent testing Define adolescents The period of life between 11 and 21 years of age. Early: 11-14 Middle: 15-17 Late: 18-21 Review the "sexual maturity rating" (SMR) stages Sexual Maturation Rating (SMR), also known as Tanner Stages, is a scale of secondary sexual characteristics that allows health professionals to assess the degree of pubertal maturation among adolescents, regardless of chronological age. SMR is based on breast development and the appearance of pubic hair among females and on testicular and penile development and the appearance of pubic hair among males. SMR stage 1 corresponds with prepubertal growth and development, while stages 2 through 5 denote the occurrence of puberty. At SMR stage 5, sexual maturation has concluded. Sexual maturation correlates highly with linear growth, changes in weight and body composition, and hormonal changes. Understand the importance of family meals As adolescents spend more time with peers, participation in family meals tends to steadily decline. Only about one-third of 15- to 17-year-olds report eating meals with their family at least six days per week, compared to half of 12- to 14-year-olds. This is an unfortunate occurrence, as more frequent family meals are associated with improved dietary intake among adolescents, including higher intakes of fruits, vegetables, and foods that are good sources of calcium, and decreased intake of soft drinks. Family meals can promote long-term healthy eating habits as parents have the opportunity to model healthy eating attitudes and introduce teens to a wide variety of foods, behaviors that may track into adulthood. Teens who participate in family meals at least six days per week are less likely to utilize substances such as alcohol and street drugs, are less likely to smoke, and experience better academic outcomes. Similar improvements in dietary intake are found among older adolescents living away from their parents who eat meals with others compared to those who eat alone. Review snacking Snacking: Snacking, skipping meals, and eating foods that are cheap and quick, such as vending machine snacks and fast foods, are commonplace behaviors among adolescents who report a lack of time as a major barrier to healthy eating. Adolescent males report consuming 2.1 servings of snacks per day while adolescent females consume 2.2 servings each day, with a range of 0 to more than 18 daily snacks. Factors associated with higher frequency of snacking include self-identifying as a picky eater, frequent involvement in cooking at home, attempting to gain weight, snacking while watching television, and amount of time spent playing video games. Factors associated with lower snack consumption were attempting to lose weight, concern over weight, dieting, and greater nightly sleeping time. Frequent snacking is associated with higher energy, sugar sweetened beverage, and fast food intakes as well as lower fruit and vegetable intake. Foods and beverages consumed during snacks contribute significantly to daily nutrient intake, providing 17 percent of folate, 31–39 percent of vitamin C, 18–22 percent of vitamin D, 22–27 percent of calcium, and up to 20 percent of iron. Unfortunately, the food choices made by adolescents while snacking tend to favor foods high in sugar, sodium, and fat, and are relatively low in vitamins and minerals. Soft drinks are among the most commonly chosen snacks for adolescents. Other snack foods that are significant sources of energy, fat, and sugars in the diets of teenagers include fruit drinks, dairy desserts, salty snacks, and pizza. Review meal skipping Meal Skipping: The occurrence of meal skipping increases as adolescents mature. Breakfast is the most commonly skipped meal with only 36 percent of adolescents reporting eating breakfast daily, and 14 percent of students skipping breakfast every day. Skipping breakfast can dramatically decrease intakes of energy, protein, fiber, calcium, and folate due to the absence of fortified breakfast cereal with milk or other nutrient-dense foods commonly consumed at breakfast. Lunch is skipped by 17 percent, and dinner is skipped by up to 8 percent of teens. Missing lunch has been found to be most frequent on the weekend when school lunches are not available, with almost one third of teens skipping lunch. Females are more likely to skip lunch compared to males (19 percent and 15 percent respectively) and Black and Hispanic youth are more likely to skip lunch compared to White teens. As with breakfast, skipping lunch and/or dinner reduces intakes of energy, protein, and other nutrients. Adolescents who skip meals should be counseled on convenient, portable, and healthy food choices that can be taken with them and eaten as meals or snacks. Review nutritional recommendations for energy Energy: The DRI for energy is based on the assumption of a light to moderate activity level. Therefore, adolescents who participate in sports, those who are in training to increase muscle mass, and those who are more active than average may require additional energy to meet their individual needs. Estimated Energy Males 9-13 2279 Males Females 9-13 2071 Females Review nutritional recommendations for iron. Iron: The rapid rate of linear growth, the increase in blood volume, and the onset of menarche during adolescence increase a teen’s need for iron. The DRIs for iron for male and female adolescents are below. These recommendations are based on the amount of dietary iron intake needed to maintain a suitable level of iron storage, with additional amounts of iron added to cover the rapid linear growth and onset of menstruation that occur in male and female adolescents, respectively. Note that even though DRIs are based on chronological age, the actual iron requirements of adolescents are based on sexual maturation level. Iron needs of an adolescent will be highest during the adolescent growth spurt in males, and after menarche in females. Dietary intakes of iron are estimated at 17.4 mg day among 12- to 19-year-old males and 12.1 mg per day among 12- to 19-year-old females. Iron (mg/d) Category 8 Male 9-13 years 11 Male 14-18 years 8 Females 9-13 years 15 Females 14-18 years 27 Pregnancy =18 years 10 Lactation = 18 years Review nutritional recommendations for folate. Folate: Folate is an integral part of DNA, RNA, and protein synthesis. Thus, adolescents have increased requirements for folate during puberty. Severe folate deficiency results in the development of megaloblastic anemia, which is rare among adolescents. Evidence, however, indicates that a significant proportion of adolescents have inadequate folate status. Red blood cell and serum folate levels drop during adolescence as sexual maturation proceeds, suggesting that increased folate needs during growth and development are not being met. Poor folate status among adolescent females presents an issue related to reproduction. Studies show that adequate intakes of folate prior to pregnancy can reduce the incidence of spina bifida and selected other congenital anomalies, and may reduce the risk of Down syndrome among offspring. The protective effects of folate occur early in pregnancy, often before a woman knows she is pregnant. Thus, it is imperative that all women of reproductive age (15–44 years old) consume adequate folic acid, preferably through dietary sources, or if needed, through supplements. Despite the low serum and red blood cell levels of folate, national data suggest that many adolescents consume adequate amounts of folate. Mean intakes of folate among adolescent males average 620 μg per day, while females consume 467 μg per day. The DRI for folate among adolescents is 400 μg per day. Category Folate (mg/d) Males 9-13 years 300 Males 14-18 years 400 Females 9-13 years 300 Females 14-18 years 400 Pregnancy =18 years 600 Lactation =18 years 500 Understand the onset of puberty-timing of onset, changes in composition, compare males and females The age of onset, duration, and tempo of these events may vary a great deal between and within individuals. Thus, the physical appearance of adolescents of the same chronological age covers a wide range. These variations in development directly affect the nutrition requirements of adolescents. Puberty usually occurs earlier in females at 10.5-14 years and males at 12-16.5 years. Changes in height and weight, accumulation in skeletal mass, and changes in body composition take place. Should assess with Tanner SMR rather than chronological age. Be able to provide tips for counseling teenagers successfully Young adolescents also lack the ability to see how their current behavior can affect their future health status or health-related behaviors. The messages provided focus on how nutritional status and eating behaviors can impact daily concerns, such as physical attractiveness, academic ability, or physical performance. Adolescents will revert to concrete thinking skills if they feel overwhelmed or experience psychosocial stress; thus, health information should be presented in very concrete, understandable examples. Health practitioners working with adolescents need to understand that snacking is a commonplace behavior among adolescents and should work with adolescents to improve food choices rather than discouraging snacking. Adolescents may look like young adults, but they are not. They may not respond favorably to traditional adult counseling methods. Don't provide nutrition education messages or materials that are too childish in nature. Treat them as individuals. The initial component of the counseling session should involve getting to know the adolescent, including personal health or nutrition-related concerns. The adolescent should be encouraged to add his or her own nutrition concerns to the list of topics to be discussed. The counselor and teen should work together to establish goals for improving dietary in-take and reducing nutrition risk. Involve the adolescent in decision-making processes during nutrition counseling. Set one or two goals during a counseling session. Behavior-change strategies should be mutually agreed upon for meeting goals. Strategies should be instigated by the teen. The adolescent and the counselor should work together to decide how to determine when a goal is met. Use of technology to facilitate nutrition. What is the impact of a vegetarian diet on growth and development in adolescents? Adolescents adopt vegetarian eating plans for a variety of reasons, including cultural or religious beliefs, moral (animal welfare) or environmental/sustainable food systems concerns, health beliefs, as a means to restrict calories and/or fat intake, and as a means of exerting independence by adopting eating behaviors that differ from those of their family. Adolescents who follow vegetarian diets have been found to be shorter and leaner and to enter puberty at a later age than omnivores. On average, menarche occurs six months later in vegetarians than among omnivores. After puberty, teens who consume vegetarian diets are as tall as or taller than omnivores and are generally leaner, although final adult height may be reached at a later age. Well-planned vegetarian diets can offer many health advantages to adolescents, such as a high intake of fiber, a lower intake of saturated fat, and relatively high intake of the vitamins and minerals found in plant-based foods. Data suggest that vegetarian adolescents consume more fruits and vegetables, fewer sweets, fewer salty snack foods, and less fat compared to omnivorous teens. Vegetarian diets can provide adequate protein to promote growth and development among pubescent adolescents, particularly if small amounts of animal-derived foods, such as milk or eggs, are consumed at least two times per week. If vegetarian diets restrict intake of all animal-derived food products such as in vegan diets, however, careful attention must be paid to ensure adequate intakes of protein, calcium, zinc, iron, long-chain n-3 fatty acids, and vitamins D, B6, and B12. Supplements of vitamins B12 and D, iron, zinc, and calcium are often required among vegans unless fortified foods are routinely consumed. What are the risk factors for obesity in adolescents? Environmental factors, or interactions between genetic and environmental factors, are the most likely causes of the dramatic rise in overweight and obesity. Risk factors for the development of overweight and obesity among children and adolescents include having at least one overweight or obese parent; low socioeconomic status; being of African American, Hispanic, or American Indian/Alaska Native race/ethnicity; and being diagnosed with a chronic or disabling condition that limits mobility. Inadequate levels of physical activity and consuming diets high in total calories and added sugars and fats are behavioral risk factors common among a significant proportion of adolescents. These environmental factors increase the risk of developing obesity if an adolescent is genetically predisposed to obesity. A range of medical and psychosocial complications accompanies overweight among adolescents, including hypertension, dyslipidemia, insulin resistance, type 2 diabetes mellitus, sleep apnea and other hypoventilation disorders, orthopedic problems, hepatic diseases, body image disturbances, and lowered self-esteem. Longitudinal studies of obesity and chronic disease risk among youth suggest an increased risk of morbidity and premature mortality from coronary heart disease, stroke, diabetes, asthma, and hypertension among adults who were overweight or obese during adolescence. What is anorexia nervosa and what are concerns? Anexoria Nervosa: Anorexia nervosa and its impact on morbidity and mortality make it the most severe condition on the continuum of eating disorders. Among adolescent girls and young women, prevalence estimates of anorexia nervosa range from 0.2 to 1.0 percent. Anorexia nervosa presents more frequently among females than among males; about 9 out of 10 individuals with anorexia nervosa are female. Only in recent years has attention been directed toward males with this condition; they may not be suspected of having anorexia nervosa and therefore may be diagnosed at later stages of the disease, when treatment is more difficult. Characteristics of anorexia nervosa include preoccupation with food, self-starvation, and strong fears of being fat. An adolescent may begin with dieting behaviors due to social pressures to be thin, comments by others about weight, or as a result of their discomfort with the normal pubescent weight gain. Weight loss may result in adolescents feeling more in control of their body or other aspects of their life, which further reinforces the restricting behavior. If the weight loss and accompanying body-image and self-esteem issues are not addressed early on, anorexia nervosa develops. What is bulimia nervosa and what are concerns? Bulimia Nervosa: Bulimia nervosa is an eating disorder characterized by the consumption of large amounts of food with subsequent purging by self-induced vomiting, laxative or diuretic abuse, enemas, and/or obsessive exercising. While anorexia nervosa is characterized by severe weight loss, bulimia nervosa may show weight maintenance or extreme weight fluctuations due to alternating binges and fasts. In some individuals, anorexia and bulimia nervosa overlap. Reliable estimates of bulimia nervosa range from 1.0 to 3.0 percent. As with anorexia nervosa, the vast majority of individuals with bulimia nervosa are female. Key features of bulimia nervosa include recurrent episodes of binge eating (rapid consumption of a large amount of food in a discrete period of time), a feeling of lack of control over eating during the binge, some form of purging food and calories from the body, and a persistent over- concern with body shape and weight. There are two categories of bulimia nervosa: purging and non-purging. Individuals with the purging subtype of bulimia nervosa regularly engage in self-induced vomiting and/or the use of laxatives, diuretics, or enemas to purge calories from the body. Individuals with the non-purging subtype may fast in between binge episodes and utilize compensatory exercise as a means of compensating for caloric intake. People with bulimia nervosa can be overweight, underweight, or of average weight for their height and body frame. Bulimia nervosa may be preceded by a history of dieting or restrictive eating, which are thought to contribute to the binge–purge cycle. What is binge eating and what are the concerns? Binge-eating: Binge-eating disorder is a condition in which an individual engages in eating large amounts of food and feels that these eating episodes are not within one’s control. BED is defined by recurrent episodes of binge eating at least one day a week for at least three months. In addition, the person feels a subjective sense of a loss of control over binge eating, which is indicated by the presence of three of the following five criteria: eating rapidly, eating when not physically hungry, eating when alone, eating until uncomfortably full, and feeling self-disgust about bingeing. BED differs from bulimia nervosa in that binge eating is not followed by compensatory behaviors such as self-induced vomiting, as occurs in bulimia nervosa. Dieting may be a risk factor for BED; however, 35–55 percent of women may experience binging before dieting. Females who report dieting before bingeing are more likely to have experienced sexual or physical abuse, which may lead to feelings of loss of control and the desire to participate in restricting behaviors to regain a sense of control. Females who experienced stressful situations, such as the death of someone close to them, were more likely to report bingeing prior to dieting, consistent with an emotional eating response. Age of onset of BED is somewhat lower for women who report bingeing first (20 years) versus those who report dieting first (25 years). What are sources of ergonomic aids in adolescents? The most common sources of ergogenic aids are parents and coaches. Supplements used by adolescent athletes include creatine; individual amino acids or protein powders; dextrose; caffeine; carnitine; anabolic-androgenic steroids; anabolic steroid precursors, including dehydroepiandrosterone (DHEA) and androstenedione; beta-hydroxy-beta-methylbutyrate; growth hormone; Xenadrine; and ephedra. What is the nutrition risk for adolescent athletes regarding fractures? Fracture Risk: Calcium intakes have been shown to be below the DRIs in a significant proportion of adolescents, especially females. Athletes’ increased risk for bone fractures makes adequate calcium intake extremely important. Although the mechanism responsible for this tendency has not been identified, female adolescent athletes with low calcium consumption appear to be the highest-risk group of all adolescents for bone fractures, and they therefore should make every effort to consume adequate calcium in their diets. Teen athletes who cannot or will not consume calcium from dietary sources should be counseled to take a daily calcium supplement that meets their daily requirements. What is meal nutrition for adolescent athletes? Meals: Adolescent athletes may follow special diets or consume nutritional and non-nutritional supplements in an effort to improve physical performance and increase lean body mass. Special diets that are noted among adolescent athletes include carbohydrate-loading regimens and high-protein diets. Distance runners and other endurance athletes traditionally used carbohydrate loading to improve the glycogen content of muscle. High-protein diets may take many forms for teen athletes. In general, athletes who follow high-protein diets may consume three to four times the recommended protein intake, accompanied by a relatively low intake of carbohydrate. High-protein diets should be discouraged as pre-performance dietary regimens among athletes for several reasons. First, many dietary protein sources are also sources of total and saturated fats, which may increase lifetime risk of coronary artery disease. Second, high protein and fat intakes result in reduced carbohydrate intake and may delay digestion and absorption, limiting the amount of energy available for use during physical activity. What are fluid recommendations for adolescent athletes? Fluid Recommendations: Young adolescents and those who are prepubertal present a particular vulnerability to heat illnesses because their bodies do not regulate body temperature as well as those of older adolescents. Adolescents can become so mentally and physically involved in physical activities that they do not pay attention to physiological signals of fluid loss, such as excessive sweating and thirst. Some athletes commonly assume they do not need additional fluids if they are not actively moving all of the time during exercise. Other factors such as ambient temperature and humidity levels and weight of equipment (helmets, padding, etc.) worn or utilized during exercise also play a role. Recommended fluid intake is: Time Amount of Fluids 1–2 hours prior to event 12–22 oz cool water 10–15 minutes before event 10–20 oz cool water During event 4–6 oz cool water every 15–20 minutes After event 2–3 cups of cool fluid for every pound of body weight loss The type of fluid an athlete drinks is affected more by peer pressure and mass media than by actual physiological need. Sports drinks and energy drinks are very popular among teens, even those who do not participate in sports. Data on children suggest that even though water is an economical, easily available fluid, it may not provide optimal benefits for athletes who participate in physically intense events or those of great duration. In such events, juice diluted at a ratio of 1:2 with water, or sports drinks that contain no more than 6–8 percent carbohydrate, may allow for better hydration and physical performance. What is the prevalence, needs, and status of alcohol on nutrition? Alcohol: Data from the YRBS suggest that 33 percent of teens report current alcohol use; 17 percent reported binge drinking (drinking five or more alcoholic drinks during one occasion) on at least one day during the past month. Alcohol use is higher among White (35 percent) and Hispanic (34 percent) youth compared to Black youth (24 percent). Binge drinking is also more common among White and Hispanic teens than among Black students (20 percent, 18 percent, and 11 percent, respectively) and increases with age. The consumption of alcohol may replace nutritious foods and beverages in the diet, compromising nutritional status. Thiamin and other B-vitamin requirements may be higher among adolescents who frequently consume large quantities of alcohol. What is the prevalence, needs, and status of drugs on nutrition? Drugs: According to YRBS data, illicit drug use is reported by a significant number of adolescents. Twenty-two percent report current marijuana use, 9 percent report synthetic marijuana use, 5 percent report cocaine use, 7 percent have used inhalants, 5 percent have used Ecstasy (MDMA), 3 percent have used methamphetamine, 6 percent had used hallucinogens, 2 percent have used heroin, and 2 percent have used other injectable drugs. Illicit drug use may alter dietary intake patterns through influences on appetite and metabolism as well as dietary choices made while under the influence of these substances. In addition, for older adolescents who are financially independent, money used to purchase alcohol and illicit substances may reduce the amount of money available to purchase food and pay for other daily living expenses, thus increasing the risk of food insecurity and/or homelessness. Be able to describe the DASH diet and conditions it is used to treat. The dietary recommendations suggested for adolescents to promote health and reduce cardiovascular risk factors (DASH diet) are below. The DASH diet is used to treat hypertension and hyperlipidemia. Grains (with whole grains the majority of choices) Vegetables Fruits Milk and milk products (fat free or low-fat choices) or substitutes Lean meats, poultry or fish Nuts, seed and Legumes Fats and Oils Sweets and added sugars An adolescent with a BMI-for-age of 96 percent is at risk for unrealistic body image, hypertension, diabetes, hyperlipidemia, and sleep apnea. a. True b. False A disadvantage of using energy drinks for hydration during athletic events is _____ a. energy drinks provide extra calories from probiotics. b. energy drinks do not provide enough fluid to counter dehydration during exercise. c. the high level of sugar substitutes in energy drinks. d. energy drinks can cause hyponatremia. e. the amount of added sugar in most energy drinks. Adolescent risk factors such as rapid growth, inadequate mineral intake, vegan diets, skipping meals, and heavy menstrual bleeding can lead to a deficiency of _____. a. zinc b. iron c. copper d. selenium e. molybdenum Which lipid source has the greatest influence on blood cholesterol levels? a. corn and safflower oils b. egg yolks and liver c. salmon and tuna d. vegetable oil and nuts e. beef and butter Susie tends to eat when she is not really hungry and eats more food when she is angry or depressed. These are examples of environmental cues to overeating. a. True b. False Which stage of care for the treatment of adolescent overweight and obesity would likely be recommended for an adolescent with a BMI of greater than or equal to the 85th percentile but less than the 95th percentile who also does not exhibit significant comorbid conditions and/or has not completed her or his adolescent growth spurt? a. Stage 3: Comprehensive Multidisciplinary Intervention b. Stage 4: Tertiary Care Intervention c. Stage 2: Structured Weight Management d. Stage 1: Prevention Plus To be considered a candidate for bariatric surgery, adolescents must have a BMI of greater than _____ with medical major complications, or a BMI of greater than _____ with minor comorbidities. a. 30; 32 b. 32; 35 c. 35; 40 d. 28; 30 Dextrose, caffeine, carnitine, anabolic-androgenic steroids, growth hormone, and ephedra are a few examples of _____________ supplements used by teens. Ergogenic What is the recommended fluid intake during strenuous physical activity? a. 12-22 oz b. 4-6 oz c. 10-20 oz d. 2-3 cups Why should high-protein diets be discouraged as pre-performance dietary regimens among adolescent athletes? a. Many dietary protein sources are also sources of total and saturated fats. b. Reduced carbohydrate intake may delay digestion and absorption, limiting energy available for an activity. c. A high-protein diet increases risk of dehydration. d. All of these are correct. What is considered to be the most common nutritional deficiency among children and adolescents? a. hyperlipidemia b. hypertension c. iron-deficiency anemia d. metabolic syndrome The best time to screen for hyperlipidemia is around age ____________ (before the onset of puberty) or after age _____________ when growth is largely completed. 10;17 Hypertension is diagnosed if the average of three systolic and/or diastolic blood pressure readings exceeds the ____________ percentile based on age, sex, and height. 95th Select the example of one diagnostic criterion for anorexia nervosa. a. recurrent episodes of binge eating b. recurrent inappropriate compensatory behavior, such as self-induced vomiting, to prevent weight gain c. eating much more rapidly than normal d. intense fear of gaining weight or becoming fat, even though underweight ___________________ is an eating disorder characterized by periodic binge eating, which normally is not followed by vomiting or the use of laxatives. Binge-eating disorder Which component of the Eating Competence Model means being comfortable eating a preferred food but also means being able to settle for less-preferred food when necessary? a. food acceptance b. eating context c. regulation of food intake d. documentation of food intake e. eating attitudes The average daily dietary fiber recommendations are _____ for males and females, respectively. a. 35 and 21 grams b. 38 and 25 grams c. 56 and 46 grams d. 45 and 38 grams e. 30 and 25 grams Which of the following is a risk factor for heart disease? a. high sodium intake b. high intake of antioxidants c. high potassium intake d. burnt and charred food e. unstructured eating The additional energy required for the digestion, absorption, and metabolism of what people eat results from _____. a. an individual's basal metabolic rate (BMR) b. estimated energy requirements (EER) c. activity thermogenesis d. the thermic effect of food (TEF) e. resting energy expenditure Between the ages of 25 and 65, physical working capacity declines by _____% per decade. a. 1-2 b. 3-5 c. 10-20