Adolescent Nutrition Problems and Intervention Lecture 21 PDF

ADOLESCENT NUTRITION- PROBLEMS AND INTERVENTION LECTURE 21 Dietary Concerns  Overweight and Obesity (discussed in ‘childhood obesity lecture’)  Substance abuse  Supplements  Participation in competitive sports  Eating disorder High Risk Behaviors The Youth Risk Behavior Surveilla...

ADOLESCENT NUTRITION- PROBLEMS AND INTERVENTION LECTURE 21 Dietary Concerns  Overweight and Obesity (discussed in ‘childhood obesity lecture’)  Substance abuse  Supplements  Participation in competitive sports  Eating disorder High Risk Behaviors The Youth Risk Behavior Surveillance System (YRBSS) - CDC survey data Behaviors contributing to unintentional injuries and violence Sexual behaviors related to unintended pregnancy and sexually transmitted diseases Alcohol and other drug use Tobacco use Unhealthy dietary behaviors Inadequate physical activity Substance Abuse Common in males YRBSS – CDC Substance Abuse Use of tobacco, alcohol, and recreational drugs can affect nutritional status  Ergogenic Supplements Anabolic-androgenic steroids - ↑ lean body mass - Improve strength - Stacked, so peak dose of one dose may overlap with another substance dose - Linked to infertility, hypertension, depression, aggression, and increased risk of atherosclerosis ps://www.drugabuse.gov/publications/drugfacts/anabolic-ste Ergogenic Supplements Dehydroepiandrosterone and androstenedione Precursor to testosterone and estrogen Why are they taken? - ↓ body fat - ↓ insulin resistance - ↑ immune system function and lean body mass - ↓ risk of osteoporosis Risks Males - Breast enlargement, Prostate enlargement Females - Facial hair Ergogenic Supplements Creatine Why is this consumed? ↑ strength, ↑ lean body mass, faster recovery - Naturally formed in liver and kidneys - Main dietary sources are meats - Studies show mixed results on benefits - Side effects are numerous - Chronic use = renal damage Competitive Sports >50% U.S. adolescents report playing one or more organized sports For energy and nutrient determination Begin with general SMR, adding additional allowance - Energy = 500-1500 additional calories per day - Protein = no more than 30 % of calories Competitive Sports May need upper limit of food group servings; increased energy needs How should the pre-event and post-event meal look like? Pre-event meal - 2-3 hours prior to exercise; avoid foods high in fat, fiber, protein at least 4 hr prior Post-event meal - 400-600 calories, high-carbohydrate foods, and non-caffeinated fluids Competitive Sports Calcium - Female adolescence athletes at highest risk - Daily calcium supplement if not taken in food Fluid level and dehydration Young adolescents are at risk for dehydration - Do not regulate body temperatures well - Ignore physiological signs of fluid loss - May be unaware of need for fluids Competitive Sports How much water is recommended? Table 15.5 Book 10-15 min before exercise = 10-20 oz During exercise = 4-6 oz every 15-20 min After exercise = at least 8 oz following exercise and 2-3 cups every pound weight loss Too much of a good thing? BE AWARE OF HYPONATREMIA!! Competitive Sports - Training Diets  Carbohydrate-loading Deplete muscle glycogen and then replete before the event  High-protein diet Effective in recovering from intense physical activity Discouraged as a pre-performance regimen - High protein foods also high in saturated fats - Displace carbohydrate foods - Slow digestion, slow availability - More water required for protein breakdown Eating Disorders What comes to mind when you think of eating disorder? Severe disturbances in eating behaviors, such as eating too little or eating too much What is the most common reason for ED? Dissatisfaction with one’s body shape  Why is dieting behavior a nutrition problem? - Inadequate intake of nutrients - Restricting behavior lead to hunger and craving for specific foods and binge eating - Risk of eating disorders at later stage - Risk for future overweight and obesity What is the main contributor to restrictive dietary behaviors? Clinically Body Significant dissatisfaction Dieting Disordered eating behaviors eating disorders  Example Case of Eating Disorder Daniel is a 14-year-old boy who presented to an ED evaluation with a 2-year history of significant weight loss (39.5 kg) that developed in the context of a history of obesity. Daniel reached his highest BMI of 33.6 when he was 12 years old. At that time, Daniel weighed 40 kg above the 50th percentile for BMI-for-age for boys. Throughout development, Daniel’s BMI had always trended well above his same age and gender peers and appeared to be moving steadily upward from the 90th percentile at age 3 to well beyond the 97th percentile. Daniel’s weight-loss efforts began with attempts to eat healthily and exercise but quickly developed into severe restriction: he reported eating no more than 600 kcal per day while running high school cross country. He eliminated sweets, fats, and carbohydrates from meals and would only eat “diet food.” Daniel also exhibited many physical and emotional sequelae of low weight including difficulties concentrating, worsening mood and irritability, extreme social withdrawal, as well as cold intolerance, significant fatigue, bloating, and constipation Daniel’s weight loss came to the attention of his medical providers in the context of a pediatric gastroenterology evaluation for concerns regarding constipation, bloating, and intermittent postprandial chest pain. Laboratory results were consistent with significant dehydration. Leslie A. Sim et al. Pediatrics 2013;132:e1026-e1030  Example Case of Eating Disorder Medical documentation associated with the evaluation stated, “there is no element to suggest that he has an eating disorder at this particular time.” Leslie A. Sim et al. Pediatrics 2013;132:e1026-e1030 Eating Disorders Frequent behaviors to be considered that are clinically relevant for diagnosis -Self-induced vomiting -Fasting or extreme dieting -Binge eating -Compensatory physical activity -Use of laxatives, diuretics, or diet pills Eating Disorders – Anorexia Nervosa Extreme weight loss, poor body image, and irrational fears of weight gain BMI