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Chapter 14Chapter 14
Adolescent NutritionAdolescent Nutrition
Key Nutrition ConceptsKey Nutrition Concepts
Nutrition needs should be Nutrition needs should be determined by the degree of determined by the degree of sexual maturation and biological sexual maturation and biological maturity (biological age) instead of maturity (biological age) instead of by chronological age.by chronological age.
Unhealthy eating behaviors Unhealthy eating behaviors common among adolescentscommon among adolescents
Key Nutrition ConceptsKey Nutrition Concepts
Concrete thinking and abstract Concrete thinking and abstract reasoning abilities do not develop reasoning abilities do not develop fully until late adolescence or early fully until late adolescence or early adulthood; therefore, education adulthood; therefore, education efforts need to be highly specific and efforts need to be highly specific and based on concrete principles.based on concrete principles.
Nutritional Needs in a Time of Nutritional Needs in a Time of ChangeChange
Biological, psychosocial and Biological, psychosocial and cognitive changes affect nutritional cognitive changes affect nutritional statusstatus
Rapid growth increases nutrient Rapid growth increases nutrient needsneeds
Desire for independence may Desire for independence may cause adoption of health-cause adoption of health-compromising eating behaviorscompromising eating behaviors
Normal Physical Growth and Normal Physical Growth and DevelopmentDevelopment
PubertyPuberty
Sexual Maturation Rating (SMR) or Sexual Maturation Rating (SMR) or “Tanner Stages”“Tanner Stages”
Changes in weight, body composition Changes in weight, body composition and skeletal massand skeletal mass
Normal Psychosocial Normal Psychosocial DevelopmentDevelopment
Early adolescence (11 to 14)Early adolescence (11 to 14)
Middle adolescence (15 to 17)Middle adolescence (15 to 17)
Late adolescence (18 to 21)Late adolescence (18 to 21)
Health and eating-related Health and eating-related behaviors during adolescencebehaviors during adolescence
Vegetarian dietsVegetarian diets
Dietary intake and adequacy Dietary intake and adequacy among adolescentsamong adolescents
Energy and Nutrient Energy and Nutrient Requirements of AdolescentsRequirements of Adolescents
EnergyEnergy
ProteinProtein
CarbohydratesCarbohydrates
Dietary fiberDietary fiber
CalciumCalcium
IronIron
ZincZinc
FolateFolate
Vitamin AVitamin A
Vitamin EVitamin E
Vitamin CVitamin C
Nutrition AssessmentNutrition Assessment
Nutrition screeningNutrition screening
Nutrition assessmentNutrition assessment
Nutrition interventionsNutrition interventions– nutrition education and counselingnutrition education and counseling
Physical Activity and SportsPhysical Activity and Sports
¼ of people ages 12-21 in the U.S. ¼ of people ages 12-21 in the U.S. are sedentaryare sedentary
Factors affecting physical activityFactors affecting physical activity– individualindividual– socialsocial– environmentalenvironmental
AthleticsAthletics– may affect nutritional needsmay affect nutritional needs
Promoting Healthy Eating and Promoting Healthy Eating and Physical ActivityPhysical Activity
Effective nutrition messages for Effective nutrition messages for youthyouth
Parent involvementParent involvement
School programsSchool programs– classroom nutrition educationclassroom nutrition education– school food servicesschool food services– nutrition environment of the schoolnutrition environment of the school
Eating DisordersEating DisordersObesity: Approx. 10 to 20 % of Obesity: Approx. 10 to 20 % of adolescents are obese and will remain adolescents are obese and will remain obese as adults. This is escalating as we obese as adults. This is escalating as we speak!speak!– Psychologic factors: Developmental obesityPsychologic factors: Developmental obesity
Food abuse as a result of abnormal family Food abuse as a result of abnormal family interactionsinteractions
– Physiologic factors: Examples:Physiologic factors: Examples:Set-point theorySet-point theory
Lower basal energy needLower basal energy need
Body temperature differences, etc Body temperature differences, etc
Treatment for ObesityTreatment for Obesity
Make sure the adolescent has reached Make sure the adolescent has reached full heightfull height
Make sure the adolescent is committedMake sure the adolescent is committed
Consider failure and self-esteem of Consider failure and self-esteem of adolescentadolescent
If the Adolescent is a good candidate, If the Adolescent is a good candidate, slow weight loss with increased activity slow weight loss with increased activity and diet modification are used.and diet modification are used.
Eating Disorders: Anorexia Eating Disorders: Anorexia NervosaNervosa
1 in 250 females 12-18 yrs1 in 250 females 12-18 yrs– 9 % die of starvation9 % die of starvation– 2-5 % commit suicide2-5 % commit suicide– 20% have decreased bone density20% have decreased bone density
Other problems:Other problems:– decreased heart sizedecreased heart size– damage to sex organsdamage to sex organs– abnormal metabolic rateabnormal metabolic rate
Physical signsPhysical signsFat store depletion Fat store depletion Muscle wasting Muscle wasting Skeletal appearance (cachexia) Skeletal appearance (cachexia) Amenorrhea/delayed menarche Amenorrhea/delayed menarche Fainting (postural hypotension) Fainting (postural hypotension) Irregular pulse/heart beat (cardiac Irregular pulse/heart beat (cardiac arrhythmia) arrhythmia) Fissures at corners of mouth (cheilosis) Fissures at corners of mouth (cheilosis) Yellowed skin (carotonemia) Yellowed skin (carotonemia) Dry, scaly skin Dry, scaly skin
Physical signsPhysical signsFine downy hair (lanugo) growing over body Fine downy hair (lanugo) growing over body (hirsutism) (hirsutism) Thin, dry, brittle hair Thin, dry, brittle hair Loss of hair from head (alopecia) Loss of hair from head (alopecia) Degradation of fingernails Degradation of fingernails Bluish tips of fingers and ear lobes (acrocyanosis) Bluish tips of fingers and ear lobes (acrocyanosis) Feeling extremely cold or hot (inability to regulate Feeling extremely cold or hot (inability to regulate body temperature) body temperature) Frequent night urination (inability to concentrate Frequent night urination (inability to concentrate urine) urine) Constipation Constipation
Anorexia Diagnosis Dx defined Anorexia Diagnosis Dx defined by Am. Psychiatric Assoc.by Am. Psychiatric Assoc.
Refusal to maintain body wt.: 15% Refusal to maintain body wt.: 15% below expectedbelow expected
Fear of gaining wt even though under Fear of gaining wt even though under wtwt
Disturbance in body imageDisturbance in body image
Absence of three consecutive Absence of three consecutive menstrual cyclesmenstrual cycles
Bulimia NervosaBulimia Nervosa
Incidence: 2-4 % of college females Incidence: 2-4 % of college females may meet criteria with as many as may meet criteria with as many as 20% showing some characteristics20% showing some characteristics
Symptoms: gorging with vomiting or Symptoms: gorging with vomiting or purging (vomiting, laxative, purging (vomiting, laxative, excessive exercise)excessive exercise)
APA Criteria for BulimiaAPA Criteria for Bulimia
Recurrent episodes of food bingingRecurrent episodes of food binging
lack of control over bingeslack of control over binges
regular self-induced vomiting, use of regular self-induced vomiting, use of laxative, diuretics, strict dieting or laxative, diuretics, strict dieting or fasting or vigorous exercisefasting or vigorous exercise
average of 2 or more binges/week for average of 2 or more binges/week for 3 months3 months
Over concern with body shape and Over concern with body shape and weightweight
Problems with BulimiaProblems with BulimiaDental decayDental decay
Throat irritationThroat irritation
Esophageal Esophageal inflammationinflammation
Rectal BleedingRectal Bleeding
Swollen Salivary Swollen Salivary glandsglands
broken blood broken blood vessels in face and vessels in face and throat throat
DehydrationDehydration
FistulasFistulas
Kidney damageKidney damage
Syrup of ipecac Syrup of ipecac toxicitytoxicity
Eating Disorder TreatmentEating Disorder Treatment
Psychotherapy: Address the Psychotherapy: Address the underlying problemunderlying problem
Medical: Keep the person alive while Medical: Keep the person alive while therapy happenstherapy happens
Nutritional: Meet client’s nutritional Nutritional: Meet client’s nutritional needs; re-learn proper eating habits needs; re-learn proper eating habits and intakesand intakes– Client has lost touch with what is normalClient has lost touch with what is normal
Adolescent PregnancyAdolescent Pregnancy
Factors affecting pregnant nutritional Factors affecting pregnant nutritional needsneeds
GrowthGrowth
Nutrient storesNutrient stores
Gynecologic ageGynecologic age
Preconception nutritional statusPreconception nutritional status
Gynecologic AgeGynecologic Age
The number of years between the The number of years between the onset of menses and conceptiononset of menses and conception– More sexually mature adolescents have More sexually mature adolescents have
no more physically-based complications no more physically-based complications than do adult womenthan do adult women
– Few adolescents within 2 years of Few adolescents within 2 years of menarche ovulate regularlymenarche ovulate regularly
– Those who become pregnant will need Those who become pregnant will need special attention to reduce risk of lbw and special attention to reduce risk of lbw and other complicationsother complications
Complications of Adolescent Complications of Adolescent PregnancyPregnancy
1st and 3rd trimester bleeding1st and 3rd trimester bleeding
anemiaanemia
difficult labor and deliverydifficult labor and delivery
cephalopelvic disproportioncephalopelvic disproportion
PIHPIH
InfectionsInfections
Maternal mortality is 2.5 X greater Maternal mortality is 2.5 X greater than older womenthan older women
Hazards to InfantHazards to Infant
PrematurityPrematurity
stillbirthstillbirth
LBWLBW
perinatal and infant deathsperinatal and infant deaths
physical deformitiesphysical deformities
Community involvement in Community involvement in nutritionally supportive environmentsnutritionally supportive environmentsModel nutrition programModel nutrition program– CANfit ProgramCANfit Program– The California Adolescent Nutrition and The California Adolescent Nutrition and
Fitness Program | Home | CANFIT works Fitness Program | Home | CANFIT works to improve the nutrition and fitness of to improve the nutrition and fitness of California´sCalifornia´s low-income African American, American low-income African American, American Indian, Latino, and Asian/ Pacific Islande Indian, Latino, and Asian/ Pacific Islander youthr youth