Adolescent Nutrition Problems and Interventions

Adolescent Nutrition Problems and Interventions

• Dietary concerns include overweight/obesity (discussed in childhood obesity lecture), substance abuse, supplements, participation in competitive sports, and eating disorders.
• High-risk behaviors, according to the YRBSS (Youth Risk Behavior Surveillance System/CDC survey data), include behaviors contributing to unintentional injuries and violence, sexual behaviors related to unintended pregnancy and STDs, alcohol and other drug use, tobacco use, unhealthy dietary behaviors, and inadequate physical activity.
• Substance abuse, particularly in males, is a significant concern, with varying rates across racial/ethnic groups (data from the YRBSS, 2017).
• Substance use (tobacco, alcohol, and recreational drugs) can negatively impact nutritional status by suppressing appetite, reducing nutrient intake, decreasing nutrient bioavailability, increasing nutrient losses, altering nutritional synthesis, impairing nutrient metabolism/absorption, increasing nutrient destruction, requiring higher metabolic nutrient requirements, leading to inadequate weight gain/loss, causing iron deficiency anemia, and decreasing financial resources for food.
• Ergogenic supplements, such as anabolic-androgenic steroids, dehydroepiandrosterone (DHEA), androstenedione, and creatine, are discussed.
  • Anabolic-androgenic steroids increase lean body mass and strength but are linked to infertility, hypertension, depression, aggression, and atherosclerosis risk.
  • DHEA and androstenedione are precursors to testosterone and estrogen, and users may seek them to decrease body fat, improve insulin resistance, increase immune function, and decrease osteoporosis risk. However, they present risks like breast enlargement in males and facial hair growth in females.
  • Creatine increases strength, lean body mass, and recovery but potential chronic use can cause renal damage.
• Competitive sports are common among adolescents(>50% in the US), and athletes' nutrient needs differ from general recommendations. Initial estimations use general standards (SMR), then adjustments of 500-1500 additional calories per day are added for energy. Protein intake should not exceed 30% of calories.
• Calcium supplementation may be necessary for female athletes, as those in adolescence have a high risk for calcium deficiencies.
• Hydration is key for athletes. Young adolescents may not regulate body temperature well or recognize signs of fluid loss, and consistent fluid intake is vital, including 10-20 oz before exercise, 4-6 oz every 15-20 minutes during exercise, and at least 8 oz after exercise, plus 2-3 cups per pound of weight lost.
• Hyponatremia should be considered when discussing excessive water consumption.
• Carbohydrate loading, while effective for replenishing glycogen before intense events, is discouraged as a constant pre-performance regimen due to the high saturated fat content of high-protein foods, which displace carbohydrate foods, and require more water for protein breakdown
• Eating disorders are characterized by severe eating behavior disturbances like eating too little or too much, often linked to body dissatisfaction.
• Common, clinically relevant behaviors for eating disorders include self-induced vomiting, extreme dieting, binge eating, compensatory physical activity, laxative/diuretic/diet pill use, and require nutritional care.
• The goals of nutritional care for eating disorders include assessing dietary intake and adequacy, recommending nutrition-related interventions, counseling for regular meal patterns, monitoring dietary intake and activity levels, ensuring fiber and fat intake for satiety, mental health counseling, and gradually introducing avoided foods, and monitoring nutritional status.