1 / 61

Chapter 14 Adolescent Nutrition

Chapter 14 Adolescent Nutrition. Nutrition Through the Life Cycle Judith E. Brown. Vegetarian Diets during Adolescence. About 4% of adolescents report following a vegetarian diet Reasons adolescents adopt a vegetarian diets include: Cultural or religious beliefs Moral or ethical concerns

ofira
Download Presentation

Chapter 14 Adolescent Nutrition

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 14 Adolescent Nutrition Nutrition Through the Life Cycle Judith E. Brown

  2. Vegetarian Diets during Adolescence • About 4% of adolescents report following a vegetarian diet • Reasons adolescents adopt a vegetarian diets include: • Cultural or religious beliefs • Moral or ethical concerns • Health beliefs • To restrict fat and/or calories • A means of independence from family

  3. Types of Vegetarian Diets and Food Excluded

  4. Nutrient Intake of Vegan Adolescents • Well-planned vegetarian diets can offer many healthy advantages • Best when small amounts of animal-derived foods • Vegans may have inadequate intakes • Protein • Calcium, Zinc, and Iron • Vitamins D, B6, and B12

  5. Total Fat and Essential Fatty Acid Intake of Vegan Adolescents • Vegans may have inadequate intakes • Total fat • Essential fatty acids especially alpha-linolenic acid • Encourage intakes of • Soy products: Soybean oil & Soybeans • Flaxseed, Walnuts, Tofu • Walnut oil, Canola oil • Eggs

  6. Nutritional Needs in a Time of Change • Health-compromising eating behaviors • Excessive dieting • Meal skipping • Use of unconventional nutritional and nonnutritional supplements • Fad diets

  7. Nutritional Needs in a Time of Change • Health-enhancing eating behaviors • Healthful eating practices • Physical activity • Interest in a healthy lifestyle

  8. Normal Physical Growth and Development • Puberty occurs during early adolescence • Biological changes of puberty include: • Sexual maturation • Increases in ht & wt • Accumulation of skeletal mass • Changes in body composition • The sequence of maturation events is consistent but great individual variation in age of maturation

  9. Normal Physical Growth and Development • Variations in reaching sexual maturity affect nutrition requirements of adolescents • Sexual maturation (or biological age)—not chronological age—should be used to assess growth and development and nutritional needs

  10. Sexual Maturation Rating or “Tanner Stages” • Sexual Maturation Rating (SMR) (a.k.a. “Tanner Stages”)—scale of secondary sexual characteristics used to assess degree of pubertal maturation • SMR 1=prepuburtal growth & development • SMR 2-4=occurrences of puberty • SMR 5= sexual maturation has concluded

  11. Maturation and Growth of Females • Menarche (onset of first menstrual period) occurs 2-4 years after initial development of breast buds • Age of menarche ranges from 9 to 17 years • Peak linear growth occurs ~6 to 12 months prior to menarche • Severely restrictive diets may delay or slow growth

  12. Maturation and Growth of Males • Males show great deal of variation in chronological age at which sexual maturation takes place • Peak velocity of linear growth occurs during SMR 4 & ends with appearance of facial hair at ~age 14.4 • Linear growth continues throughout adolescence ceasing at ~age 21

  13. Changes in Weight, Body Composition, and Skeletal Muscles in Females • Peak weight gain follows linear growth spurt by 3 to 6 months • Gain of ~18.3 pounds per year • Average lean body mass decreases • 44% increase in lean body mass (LBM) • 120% increase in body fat • 17% body fat is required for menarche to occur • 25% body fat needed to maintain normal menstrual cycles

  14. Changes in Weight, Body Composition, and Skeletal Muscles in Males • Peak wt gain at the same time • Peak linear growth & • Peak muscle mass accumulation • Peak wt gain, ~20 lb per year • Body fat decreases to ~12% • ~Half of bone mass is accrued in adolescence

  15. Normal Psychosocial Development • Adolescents develop: • A sense of personal identity • A moral & ethical value system • Feelings of self-esteem or self-worth • A vision of occupational aspirations

  16. Normal Psychosocial Development • Three periods of psychosocial development: • Early adolescence (11 to 14) • Middle adolescence (15 to 17) • Late adolescence (18 to 21)

  17. Normal Psychosocial Development • The need to fit in can affect nutritional intake • Who they eat with • Where they eat • Peer influences may be greater than family • May improve dietary intake • May lead to poor dietary intake

  18. Health and Eating-related Behaviors during Adolescence • Factors affecting eating behaviors • Peer influence • Parental modeling • Food availability, preferences, & cost • Personal & cultural beliefs • Mass media • Body image

  19. Conceptual Model for Factors Influencing Eating Behavior of Adolescents

  20. Health and Eating-related Behaviors during Adolescence • The model depicts 3 interacting levels of influence on adolescent eating behaviors • Personal or individual • Environmental • Macrosystem

  21. Health and Eating-related Behaviors during Adolescence • Busy lives lead to different eating styles • Little time to sit down for a meal • Snacking and meal skipping common • Eating away from home and at fast-food restaurants • Consuming more soft drinks, less nutrient dense drinks • Eating meals in front of the television

  22. Dietary Intake and Adequacy among Adolescents • Many adolescents have diets that do not match the Dietary Guidelines for Americans or the MyPyramid Recommendations • Most have inadequate consumption of: • Dairy • Grains • Fruits • Vegetables

  23. Dietary Intake and Adequacy among Adolescents • Data from NHANES-adolescents’ diets consist of • Less than 1 serving of vegetables per day • White potatoes make up half of the vegetables • Less than 1 serving fruits per day • Adequate intake of grains but whole grains less than adequate • 32% of calories from fat & 21% from added sugars

  24. Percentage of Adolescents Meeting the Recommended Number of MyPyramid Servings

  25. Energy and Nutrient Requirements of Adolescents • Increases in lean body mass, skeletal mass and body fat • Energy & nutrient needs during adolescence exceed those of any other point in life • Needs correspond to physical maturation stage

  26. Energy and Nutrient Requirements of Adolescents • Dietary references intakes for selected vitamins & minerals are on Table 14.7 • Professional judgment needs to be used • Nutrient recommendations based on chronological rather than biological development

  27. Nutrient Intakes of Adolescents • U.S. adolescents have inadequate intake of vitamins & minerals including: • Folate • Vitamins A, B6, C, & E • Iron & zinc • Magnesium • Phosphorus & calcium

  28. Nutrient Intakes of Adolescents

  29. Energy Requirements of Adolescents • Energy needs are influenced by: • Activity level • Basal metabolic rate (BMR) • Pubertal growth & development • Because males have greater increases in ht, wt, & lean body mass (LBM) & higher BMR, they have a higher caloric need than females • Level of physical activity declines during adolescence resulting in reduced energy requirements

  30. Protein Requirements of Adolescents • Protein requirements influenced by protein needed: • To maintain existing LBM • For growth of new LBM • DRI is 0.85 g/kg body wt • Low protein intakes linked to: • Reductions in linear growth • Delays in sexual maturation • Reduced LBM

  31. Requirements for Selected Nutrients of Adolescents • Carbohydrates: • 130 g/day or 45-65% of calories • Dietary Fiber: • AAP recommends • 26 g/day for adolescent females • 31 g/day for males <14 years of age • 38 g/day for older adolescent males

  32. Requirements for Selected Nutrients of Adolescents • Fat: • Required as dietary fat and essential fatty acids for growth and development • 25-35% of calories from total fat • <10% calories from saturated fat

  33. Calcium Requirements for Adolescents • Adequate intake of calcium is critical to ensure peak bone mass • Calcium absorption rate in females is highest around menarche • Calcium absorption rate in males highest during early adolescence

  34. Calcium Requirements for Adolescents • ~4 times more calcium absorbed during early adolescence compared to early adulthood • Adolescences who do not include dairy should consume calcium-fortified foods • Soft drink consumption displaces nutrient-dense beverages such as milk & fortified juices

  35. Calcium Requirements for Adolescents • DRI for ages 9-18 years is 1300 mg/d • Average intake is: • 865 mg for females • 1130 mg for males • Weight-bearing activities may lead in increased bone mineral density

  36. Iron Requirements for Adolescents • Increased iron needs related to: • Rapid rate of linear growth • Increase in blood volume • Menarche in females • In females, iron needs greatest after menarche • In males, iron needs greatest during the growth spurt

  37. Iron Deficiency in Adolescents • Iron deficiency vs. iron-deficiency anemia • Iron deficiency • Determined by low serum iron, plasma ferritin & transferrin saturation • Iron deficiency more frequent • Often undiagnosed because of expense

  38. Iron Deficiency in Adolescents • Iron deficiency vs. iron-deficiency anemia • Iron-deficiency anemia • Determined by simple and inexpensive hemoglobin or hematocrit levels • Indicates more advanced stage of iron deficiency • Less frequent but almost exclusively females

  39. Iron Deficiency in Adolescents • Estimates of iron deficiency: • 9% of 12-15 y/o females • 5% of 12-16 y/o males • 11% of 15-19 y/o females • 2% of 15-19 y/o males

  40. Vitamin D Requirements for Adolescents • Vitamin D-fat soluble: • Essential role in facilitating intestinal absorption of calcium and phosphorus • Essential for bone formation • Synthesized by the body via skin exposure of ultraviolet B rays of sunlight • Food sources: fatty fish, fish oils, egg yolks of hens fed Vitamin D fortified feed • Majority of Vitamin D from Vitamin D fortified foods (milk, breakfast cereals, margarines, and some juices)

  41. Folate Requirements for Adolescents • Folate required for DNA, RNA & protein synthesis • DRI: 400 mcg • Severe folate deficiency leads to megaloblastic anemia • Severe deficiency rare but inadequate folate status appears to be more common

  42. Folate Requirements for Adolescents • Folate added to fortified foods is better absorbed than folate from natural foods • Adequate folate intake for female adolescents reduces incidence of birth defects like spina bifida

  43. Folate Requirements for Adolescents • It is imperative that women of reproductive age (15 to 44 years) consume adequate folic acid • Increased risk of folate deficiency • Skipping breakfast • Not consuming orange juice or fortified cereals

  44. Vitamin C Requirements for Adolescents • Vitamin C—marginally adequate among adolescents • Involved in the synthesis of collagen and other connective tissues • Acts as an antioxidant • Smoking  need for Vitamin C

  45. Nutrition Screening, Assessment, and Intervention • The AMA recommends all adolescents receive annual health screening & guidance • Screening should include: • Wt, ht, & BMI • Disordered eating tendencies • Blood lipid levels • Blood pressure • Iron status (hemoglobin/hematocrit) • Food security/insecurity • Dietary intake/adequacy

  46. Nutrition Screening, Assessment, and Intervention • Nutrition screening should include a brief dietary assessment • Food frequency questionnaires • 24-hour recalls • Food diaries or Food Records • Table 14.12 lists the advantages and disadvantages of each dietary assessment method • Table 14.13 lists the nutrition risk indicators that may warrant further assessment and counseling

  47. Nutrition Education and Counseling • Considerations when educating & counseling adolescents: 1) Initial component of session should involve: • Getting to know adolescent, including personal health or nutrition-related concerns • Providing overview of events & content of counseling session

  48. Nutrition Education and Counseling • Considerations when educating & counseling adolescents (cont.): 2) Involve adolescent in decision-making process 3) Encourage adolescent to suggest ways to change 4) Work toward only 1 or 2 goals per counseling session

  49. Nutrition Education and Counseling • Use of technology to facilitate education and counseling • Text messaging • Podcasts • YouTube • Facebook • Twitter • Technology can serve as a means to convey nutrition info in an engaging way

  50. Physical Activity and Sports • Physical activity—any bodily movement produced by skeletal muscles that results in energy expenditure • Exercise—a subset of physical activity that is planned, structured, & repetitive & done to maintain physical fitness • Physical fitness—set of attributes that are either health or skill related

More Related