ADOLESCENT/TEEN AGE

NUTRITION
(a-dul-e-sunt)

Dr. Muhammad Aamir

NIFSAT, UAF
 Adolescence:
The Vulnerable Life Stage

“The sate of development between

puberty and maturity”
–Being of the age 13 through 19 years

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 Adolescence:
The Vulnerable Life Stage
• Big changes: Biological
– Boys—get tall, lean, and dense (bones,
that is)
• Attain 15% of final adult height during
puberty
• Lean body mass doubles
• Large calorie needs—increase from
2,000 at 10 yr to 3,000 at 15 yr
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 Adolescence:
The Vulnerable Life Stage
• Girls—get taller and fatter
– % body fat increases from the teens into
the mid-20s
– Gain almost 50% of their adult ideal
weight
– Dieting can have a negative impact on
linear growth during this time
– Calorie needs increase by only 200 from
10 yr to 15 yr
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• Identity development
– Attempt to figure out who they are
– Success is dependent on positive interaction
with the environment—home, school, and the
community
– They will “try on” different lifestyles looking for
the “right fit”
• Risk taking behaviors—alcohol, drugs,
tobacco, self-injury and suicide
– Immediate and severe consequences

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 Behaviors with Less Pronounced
Consequences

• Eating choices
• Physical activity and exercise
• Affect adolescents’ sense of well-being,
energy and health in the short term
• Affect adult-onset chronic disease risk in
the long term

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Nutrition Issues in Adolescent Health

• Cardiovascular and cancer disease risk

• Osteoporosis and bone mineralization
• Overweight and obesity
• Type 2 diabetes
• Eating disorders

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 Cardiovascular Disease and Cancer
Risk
• One-third of CVD and cancer-related diseases attributed to
dietary patterns
– Diets high in sat fat, total fat, sugar and sodium and low in
fiber
– Diets low in fruits and vegetables
• Dietary fat
– Recommended: <10% of calories from saturated fat and
<30% total fat
– Consumed: 1/3 of adolescents are in this range
• Sodium
– Recommended: <2.5 g/d
– Consumed: 3-5 g/d
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• Fiber
– Recommended: Girls = 25g/day
Boys= 31g/day
• Fruits and vegetables-
– high in fiber and low in fat and sodium
– the least consumed food groups for teens
– 1/4 eat 2 or more servings of fruit/day
– <25% eat at least 5 servings of fruits and
vegetables daily

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Eating Away from Home
• Teens directly spend more than
– $5.4 billion in fast food restaurants
– $9.6 billion in food and snack stores
– $736 million in vending machines
• 78% in school
• Fast foods tend to be low in Fe, Ca, riboflavin
(vit B), vitamin C, and folic acid
• More meals missed at home thus the choice of
foods away is more important than the time or
place
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 Heritability
• Survival advantage to conserve energy as fat
through human evolution
• Humans enriched for genes that promote
energy intake, storage and minimize
expenditure
• In modern industrial environment
– easy access to calorically dense foods
– encourages sedentary lifestyle

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 Causes of Marked Increase in
Overweight

• Reflects a shift towards positive energy

balance
energy intake = energy expenditure

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 Other Contributors to Sedentary
Lifestyles
• Video and computer games
• Parental work schedules
• Unsafe neighborhoods
• discourage parents from allowing children to
play outdoors

• Lack of recreational facilities in low-income

neighborhoods

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 Prevalence of Overeating Among 4,746
Adolescents (study by Ackard 2003)
• 17.3 % of girls and 7.8 % of boys reported overeating
and were more likely to:
– be overweight or obese
– have dieted in the past year
– be currently trying to lose wt
• Those who met the criteria for Binge Eating
Syndrome (BED)-3 % of girls and 1 % of boys)
• Had higher suicide risk (28 % for girls and boys)

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 Binge Eating Syndrome (BED)
• Compulsive overeating or consuming
abnormal amounts of food while feeling
unable to stop and a loss of control.
Causes
• Biological
• Psychological
• Social and cultural

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 Health Issues in Overweight
Adolescents
• Growth
– Taller, advanced bone age, mature earlier
– Early maturation is associated with
• increased fatness and fat distribution in adulthood

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 Type 2 Diabetes
• 3-10 fold increase in prevalence in adolescents
• Mean age is 13.5 yrs
• 95 % of teens with Type 2 diabetes have a BMI
>85%ile (overweight)
– increased insulin resistance
• 21 % of adolescents with BMI’s >95th%ile (obese)
had impaired glucose tolerance (Rocchini 2002)
• Tremendous public health implications
– Longer duration of disease, > risks of
complications

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How Do Teens Attempt to Lose
Weight?

– 58 % exercised
– 40 % ate less food or lower fat foods
– 13 % fasted
– 8 % took diet pills
– 5 % vomited or took laxatives

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Osteoporosis and Bone Mineralization
• Osteoporosis affects 25-30 million adults in
the US, women > men
– 15-25 % with hip fractures require long-term
institutional care
– Treatment of osteoporosis costs
$14 billion/yr
• Causes—genetic, hormonal, physical activity,
dietary factors

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• Maximum peak bone mass (PBM) at skeletal
maturity is protective
• PBM is achieved during the late stage of
pubertal development
– 90-95 % of PBM is attained by the 2nd decade of life
– 40 % of which is during adolescence
• Low bone mineral density is associated with
fractures late in life
• Adequate nutrition, including energy, protein,
vitamins and minerals are associated with good
bone health
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 Calcium
• Milk and dairy products are primary source
of calcium
• Only 49 % of boys and 20 % of girls
consume the recommended number of
servings from the dairy group
• Average intake for calcium for 9-18 yr is
1300 mg/day

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 Soda Consumption: Effects on body
weight, dental health and nutritional
status
• 25% of adolescents drink >26 oz of soda/day
• Inverse relationship between intake of nutrients
found in milk and fruit juice with soda
consumption
– Riboflavin, vitamin A, calcium, phosphorus,
and vitamin C

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 Mean Nutrient Intake by Level of Soft Drink
Consumption in Adolescents

Soda/d: 0 oz .1-13 oz 13-26 oz >26 oz

Calories 1984 2149 2312 2604*
Fat % of kcal 34 * 32 32 31
Folate ug 239 238 191* 178*
Vit C mg 98 100 62* 52*
Calcium mg 819 804 652* 635*
Riboflavin 2.1 1.9 1.6* 1.5*
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 To Review Risky Adolescent
Nutritional Issues
• Weight gain leading to obesity and type 2 diabetes
• Calcium intake and soft drink consumption leading to
inadequate bone mineralization
• Eating habits that result in disordered eating
practices
• Low consumption of fruit and vegetables and high
consumption of fat and sodium are related to adult-
onset disease risk

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“The relationship between the adolescent diet and
chronic disease risk is predicated on the
assumption that eating behaviors are learned and
solidified during childhood and adolescence and
are maintained into adulthood”

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 What Influences Adolescents Food
Choices?
• Psychosocial
– Strong Influences
• Food preferences
– Early childhood experiences, exposure,
genetics
• Taste and appearance
– Weak influence
• Health and nutrition
– Only 26% of college students were
motivated by health when making
dietary choices
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 Effective Nutrition Interventions for
Adolescents
• Behaviorally based
• Use developmentally appropriate strategies
• Include an environmental component
• Sufficient amount of contact

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