Nutrition and Adolescence

1
Nutrition and Adolescence
2
Adolescence Growth

• Increased Rate of Growth need for more Kcal and
  Nutrients
• Thru 8 yo No DRI/RDA difference between sexes
• At 9, sex specific DRI/RDAs are made
• Based on difference in growth spurt

3
Peak Growth Velocities

• Sex Ht Wt
• Male 10.3 cm/y 9.8 kg/yr
• 14.1 yrs 14.3 yrs
• Female 9.0 cm/yr 8.8 kg/yr
• 12.1 yrs 12.9 yrs

4
Peak growth velocities generally happen ______ in
males than females.

• 2 years earlier
• 2 years later
• About the same time
• 4 years earlier
• None of the above

5
Adolescence Requirements

• Age or Weight alone are not good predictors of
  energy/nutrient needs
• Rate of growth is most important factor
• Difficult to measure at any given time

6
Energy and Protein

• Energy
• female 11-14yo 1500-3000 kcal/day
• male 15-18 2100-3900 kcal/day
• Protein
• 12-16 of total energy needed

7
Energy in Adolescents

• Age Allowance Ref. Ht Energy
• (cm)
  kcal/cm
• Males
• 11-14 2500 157 15.9
• 15-18 3000 176 17.0
• Females
• 11-14 2200 157 14.0
• 15-18 2200 163 13.5

8
Mineral Needs

• Calcium Needs depend on rate of growth
• 1300 mg/day is Adequate Intake (AI) for males
  females 9-18 years
• Good sources of calcium are very important for
  proper bone development
• Concern about switch from milk to soda pop
• Iron Needs related to growth
• Also to menstruation in females
• RDA 11 mg/day for males and 15/mg/day in females
  14-18 years

9
Adolescence and Body Image

• Females Think they are overweight
• Males Think they are too skinny
• What influences these thoughts?
• Family
• Peers
• Media
• Independence food selection

10
Eating Disorders

• Obesity Approx. 10 to 20 of adolescents are
  obese and will remain obese as adults. This is
  escalating as we speak!
• Psychologic factors Developmental obesity
• Food abuse as a result of abnormal family
  interactions
• Physiologic factors Examples
• Set-point theory
• Lower basal energy need
• Body temperature differences, etc

11
Treatment for Obesity

• Make sure the adolescent has reached full height
• Make sure the adolescent is committed
• Consider failure and self-esteem of adolescent
• If the Adolescent is a good candidate, slow
  weight loss with increased activity and diet
  modification are used.

12
Eating Disorders Anorexia Nervosa

• Up to 5 of females 12-18 yrs display disordered
  eating
• 9 die of starvation
• 2-5 commit suicide
• 20 have decreased bone density
• Other problems
• decreased heart size
• damage to sex organs
• abnormal metabolic rate

13
Anorexia Diagnosis Dx defined by Am. Psychiatric
Assoc.

• Refusal to maintain body wt. 15 below expected
• Fear of gaining wt even though under wt
• Disturbance in body image
• Absence of three consecutive menstrual cycles

14
All but one of the following are APA criteria for
diagnosis of Anorexia.

• Refusal to maintain body weight
• Fear of gaining weight
• Absence of 1 menstrual cycle
• Disturbed body image
• All of the above are criteria for Anorexia

15
Bulimia Nervosa

• Incidence 2-4 of college females may meet
  criteria with as many as 20 showing some
  characteristics
• Symptoms gorging with vomiting or purging
  (vomiting, laxative, excessive exercise)

16
APA Criteria for Bulimia

• Recurrent episodes of food binging
• lack of control over binges
• regular self-induced vomiting, use of laxatives,
  diuretics, strict dieting or fasting or vigorous
  exercise
• average of 2 or more binges/week for 3 months
• Over concern with body shape and weight

17
Problems with Bulimia

• Dental decay
• Throat irritation
• Esophageal inflammation
• Rectal Bleeding
• Swollen Salivary glands
• broken blood vessels in face and throat

• Dehydration
• Fistulas
• Kidney damage
• Syrup of ipecac toxicity

18
Eating Disorder Treatment

• Psychotherapy Address the underlying problem
• Medical Keep the person alive while therapy
  happens
• Nutritional Meet clients nutritional needs
  re-learn proper eating habits and intakes
• Client has lost touch with what is normal

19
Effective eating disorder treatment requires
which of the following

• Psychotherapy
• Medical care
• Nutrition education/intervention
• 1 and 2
• All of the above

20
Adolescent Pregnancy

• Factors affecting pregnant nutritional needs
• Growth
• Nutrient stores
• Gynecologic age
• Preconception nutritional status
• Overweight and physical maturity earlier
  ovulation

21
Gynecologic Age

• The number of years between the onset of menses
  and conception
• More sexually mature adolescents have no more
  physically-based complications than do adult
  women
• Few adolescents within 2 years of menarche
  ovulate regularly
• Those who become pregnant will need special
  attention to reduce risk of lbw and other
  complications

22
Complications of Adolescent Pregnancy

• 1st and 3rd trimester bleeding
• anemia
• difficult labor and delivery
• cephalopelvic disproportion
• PIH
• Infections
• Maternal mortality is 2.5 X greater than older
  women

23
Hazards to Infant

• Prematurity
• stillbirth
• LBW
• perinatal and infant deaths
• physical deformities

24
Pregnant Adolescent Weight Gain

• How much weight would a non-pregnant adolescent
  gain?
• Postmenarcheal Yr lb kg
• 1 8 3.45
• 2 5 2.0
• 3 2 0.90
• 4 and 5 1.32 0.60

25
Rate of Weight Gain

• Normal wt .361-.529(.440 avg)kg/wk
• Underweight .386-.588(.490 avg)kg/wk
• Overwt .218-.386(.300 avg)kg/wk

26
In the first year post-menarche, about how much
weight would you expect the non-pregnant person
to gain?

• Nothing
• 1 pound
• 8 pounds
• 30 pounds
• 40 pounds