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“NOW OR NEVER”- DIET FOR ADOLESCENTS. Dr.M.Vijayarani Sneham – Guidance Centre for Children & Adolescents. Ranipet Adolescon2013. A Healthy diet meets the needs of the individual without producing too much or too little energy.
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“NOW OR NEVER”- DIET FOR ADOLESCENTS Dr.M.Vijayarani Sneham – Guidance Centre for Children & Adolescents. Ranipet Adolescon2013
A Healthy diet meets the needs of the individual without producing too much or too little energy. The phenomenal growth in body proportion during adolescence > the first year of life. India faces double burden: UNDERNUTRITION & OVERNUTRITION. Under nutrition – macro & micronutrients deficiency. Over nutrition- macronutrient excess, micronutrient deficiency.
Adolescence – period of physical growth, reproductive maturation & cognitive transformation. • UN delays growth spurt, sexual maturation, arrest linear growth. • Iron& folic acid, iodine, zinc, calcium, Magnesium, selenium, Vitamin ABCDE –deficiency have an important role. • Effect on muscles – economic ability. • Long term intellectual ability.
Adolescents diet must be coupled with Physical Activity. • Over Nutrition with micronutrient deficiency causes Obesity, Hypertension, Type2Diabetes Melletis, CVD, Stroke, Osteoporosis & Cancer. • Excess nutrition – lack of exercise. • Rise in incidence of PCOS. • UN – impact on scholastic performance. • Nutrition & Mental health.
Why is adolescent nutrition an emergent subject? • HUNGaMA Study on UN : India- largest no of UN people in the world. • “Obesity” – new world syndrome • Significantly in children & adolescents • Rise in the global burden of illness - epidemic • Serious public health consequences. • Implication of this on future generation will be serious.- prevention in war footing. Icmr.nic.in/ifmr/2010/november/1117.pdf
Adolescent nutrition Vs Clinical consequences • Two fold increase in Early menarche with BMI > 85% • Barker hypothesis or Fetal origin hypothesis: IU Growth pattern has a role in development of obesity • By modifying fat & lean body mass, neuro-endocrine appetite control mechanism & pancreatic function.LBW – Higher BMI attained in later life--- central adiposity, IR, CVD
Research on “Adolescent nutrition Vs Clinical consequences” • High consumption of fruits & vegetables during childhood & adolescents is more effective in reducing cancer risk than in adult life due to long latency of cancer manifestation. • Regular consumption of red meat – increased colorectal cancer. (more so with processed meat) • calcium supplements reduced risk of colorectal adenomas(study). • High Vit-D plasma levels associated decreased risk of many cancers including cancer of breast, prostrate and pancreas.
Research on “Adolescent nutrition Vs Clinical consequences” • Alcohol associated with increase in Ca breast incidence – countered by high Folate intake • Energy dense, hot and spicy macronutrients with deficient folate, vit E and selenium intake – risk for esophageal squamous cell Ca. • If major risks are avoided, 75% reduction in CVD/stroke/DM.Heance it is essential to establish preventive health strategies • Ref: UN general assembly on NCD prevention & control.2011.
Diet Requirement • Calories – F-2,200/day . M – 2,300-2,500/day Adolescents involved in athletics and other sport activities need more calories. Carbohydrates – 50-60% of total calories. • Proteins – F- 0.8gm & M- 1gm/kg body wt • Fats – 30% of total calories, in he form of poly unsaturated fats • Vitamins – A-, D- 400IU/day • Minerals –Fe 8-12mgs/kg/day, Ca- 1400mg/day Zn-12-15mg/day, Iodine-150mg/day • Fibre – 20-25gms/day • Water -
What is the Role of Adolescent physicians in nutrition? BFHI = AFHI Aggressively promote Healthy diet coupled with physical activity like Breast feeding promotion. Talk about a HEALTHY Diet and the need for physical activity at every adolescent visit. HEADDSS – Nutrition – ask about sources of CHO/Protein/fats Show a Healthy Eating Plate. Give guidelines on available food, affordable to the adolescent, Talk about “junk food” : for eg. Locally available energy dense food to be avoided, awareness of sweetened carbonated drinks, salt & chips, benefits of low fat milk etc Never forget to discuss physical activity. Discuss unhealthy dieting , food fad & unsafe dieting practices.
What is the parental role in adolescent nutrition? • Parent should be a role model in healthy eating and daily exercise • Promote breakfast consumption. • Prepare healthy family meals at least on weekends. • Encourage family meals once a day – even if one parent can attend. • Providing adolescents with good nutritional guidance and regular family meals counteract influence of peers. • Restrict other unhealthy practices viz.TV viewing while eating, eating out in restaurants.