Nutrition Problems Who is at risk for nutrition-related Health Problems?

Children and youth with special health care needs are at risk for nutrition related health problems. This population is defined as ³those (children/youth) who have or at increased risk for a chronic physical, developmental, behavioral, or emotional condition who require health and related services of a type or amount beyond that required by children generally.´ Children and youth with special health care needs may have physical impairments, developmental delays or chronic medical conditions that are caused by are associated with the following factors; k Chromosome anomalies, genetic k Neural tube defects conditions k Trauma k Congenital infections k Maternal substance abuse k Inborn errors of metabolism k Environmental toxins k Prematurity k Neurologic insults

What is the significance of nutrition-related problems in children with special health care needs? It is estimated that up to 40-50% of children and adolescents with special health care needs have nutrition related risk factors or health problems that require the attention or a registered dietitian, nutritionist, or health care professional. Nutrition risk factors may be physical, biochemical, psychological or environmental in nature. Physical conditions such as cleft lip or palate or a disease process such as cystic fibrosis may limit an individual¶s ability to feed, digest, or absorb food. Drug-nutrient interactions may alter digestion, absorption or the bioavailability of nutrients in the diet. Psychological factors play a role in an individual¶s ability to accept and cope with a disability or treatment plan. For example, depression may alter an individual¶s appetite and motivation to follow a specified diet plan. Environmental factors such as family and social support, finances and reinforcements for following certain dietary regimens. One or more of these factors may put a child or adolescent with special health care needs at risk for nutrition problems. Common nutrition problems for the child or youth with special care needs may include the following: k k k k k Altered energy and nutrient needs Delayed or stunted linear growth Underweight Overweight or obesity Feeding delays or oral-motor dysfunction k k k k k k Elimination (bowel) problems Drug-nutrient interactions Appetite disturbances Unusual food habits Dental and gum disease

How Can Intervention Help? Nutrition services for a child or youth with special health care needs may require more specialized services to address complex nutrition issues and may involve an interdisciplinary team. Examples of the problems that may impact feeding and the respective team members to address these needs are outlined below: k Medical issues²physicians, nurses

k A specific list of dietary changes.essential nutrients: · carbohydrates: . eggs.k Neuro-motor problems²physical therapists. glycemic index · lipids: . fish. and nutrition education should become parts of routine medical care for children and youth with special health care needs. role of triglycerides . study. speech pathologists k Behavior problems²psychologists k Dental and oral health problems² dentists k Financial issues and²social workers k Community resources²local health education and information center Quality and quantity of diet. The prescription must include the following information: k A statement identifying the clients to adopt a positive attitude towards body image . modifications or substitutions required for the diet. Nutrition screening. and how the disability affects the child¶s diet.provide advice about dietary recommendations to assist the management of body composition. recommended daily intake . poultry. simple sugars . essential fatty acids polyunsaturated fatty acids .food groups: · fats. General principles of nutrition . role of protein . All children and youth with special health care needs should have a consistent plan across all the environments where they live. . Can Nutrition-Related Problems Be Prevented? All health care professionals should be aware that children and youth with special health care needs are at increased risk for nutrition problems. role of carbohydrates . so as to avoid chronic nutrition-related problems. occupational therapists. Beginning early in childhood. To receive this benefit. growth²dietitian or nutritionist. sweets · dairy · meat. nuts.dietary guidelines . recommended daily intake . legumes · fruit and vegetables · breads and cereals . early identification of problems. oils. Explain the relationship between nutrition. k A statement identifying the major life activity affected by the disability. recommended daily intake .recognize the limitations of the roles of a fitness instructor according to industry standards & refer client on 1. cholesterol: high density lipoproteins low density lipoproteins · protein: . children and youth in special education programs must have a diet prescription from a physician. play and work. children with special needs should be screened for nutrition problems and caregivers should be provided with anticipatory guidance regarding the risk of nutrition problems and practical interventions for prevention. complex fibre resistant starch . ROLES & RESPONSIBILITIES OF FITNESS PROFESSIONALS VS DIETITIANS Critical Aspects knowledge of the general nutritional principles ability to provide accurate and current information about nutrition and healthy eating in accordance with recommended guidelines: . health and fitness to clients.

spread of kilojoules over dietician peak bodies.moderate intake of refined .fitness industry regulations nutrient intake sugars . .recommended daily intake · preservatives · vitamins: of nutrients · additives . types .balanced diet Industry standards .government organizations Dietary trends .fuel for minimising post· methods of cooking . essential amino acids hygiene practices .intake of nutrients: 2.nutritional ergogenic aids healthy eating expenditure .hydration levels · modification of recipes .government legislation .changes to body composition: · fat loss · muscle gain Energy substrates .lactic .body mass index .nutritional supplementation · legislative requirements . . non-essential amino .food preparation: . fat soluble .recommended intake of .energy balance · interpretation of label .alactic .nutritional supplementation Fundamental principles of energy intake and energy .balanced diet . Provide basic advice to clients about the fundamental principles of healthy eating. Provide nutritional information to clients regarding body composition folds Management of body composition .aerobic .fuel for exercise .'ideal weight' height/weight charts . Body composition measures .metabolism .girth ratios such as waist/hip ratio.moderate intake of alcohol Dietary recommendations . plant proteins nutrition · ingredient order · minerals: .health intake: · kilojoule value of nutrients . waist/height ratio .lipids .'fad' diets .low in saturated fat and .variety . water soluble .girths . vitamin-mineral exercise fatigue and · effect on nutrient value of interactions maximising recovery food · fluid and electrolytes .meal size . .professional associations nutrients cholesterol .'popular' diets day 3.relative proportion of .balance between energy intake and energy expenditure .body fat changes and body composition .healthy dietary pyramid .food labelling: acids .· safe food handling and .meal frequency .myths and fallacies .energy expenditure: · resting metabolic rate · thermogenesis · thermic effect of food · thermic effect of exercise · adaptive thermogenesis .carbohydrate .protein Energy systems . sources General features of balanced · ingredient list .relationship between .

Medical conditions Medical professional .celiac disease .ulcers .bulimia . calcium . y Recognize and acknowledge the current legal and ethical limitations of a fitness instructor in providing nutritional information. 5.Physiotherapists Gastrointestinal disorders . y Identify gastrointestinal disorders or other medical conditions. and refer clients to a suitably qualified medical professional. fitness testing and nutrition.gout .irritable bowel syndrome .gastrointestinal reflux . disclosed by the clients during a screening process.gallstones . providing referral to an appropriate health professional. Implement strategies to promote body satisfaction when providing advice about exercise.gallstones .nutritional deficiencies including iron.general practitioners .obesity .medical specialists .inflammatory bowel disease .bowel cancer .cancer Allied health professionals .stroke y .Occupational Therapists .diabetes .Sports Physicians . which may affect nutritional intake.hypertension .Podiatrists . y Identify nutritional or dietary concerns and refer clients to contact suitably qualified allied health professionals and medical professionals in accordance with organizational policies and procedures maintaining confidentiality of clients.Massage Therapists . y Recognize indicators of poor body image and discuss body satisfaction with clients.obesity Chronic diseases . y Provide information about diet and nutrition that fosters a positive attitude towards food and eating.diabetes .4.Osteopaths .Medical Practitioners Nutritional or dietary concerns . Support fitness clients with body image issues.lactose intolerance . if required. Refer clients to allied health professionals or medical professionals for further information or consultation.anorexia .Chiropractors .Exercise Physiologist .coronary heart disease .Dietitians .dehydration .