BSN 2A2-3

VALDEZ, THOMAS GIL

NUTRITION
ON
ADOLESCENTS
ADOLESCENTS

In general, a person between the ages of 13 and 20 is considered an adolescent.

Adolescence is a period of rapid growth that causes major changes. It tends to begin between the
ages of 10 and 13 in girls and between 13 and 16 in boys. The growth rate may be 3 inches a year
for girls and 4 inches for boys. Bones grow and gain density, muscle and fat tissue develop, and
blood volume increases. Sexual maturity occurs. Boys voices change, girls experience the onset
of menses, and both may experience acne. Acne is not caused by specific foods but by
overactivity of the sebaceous glands of the skin. These changes are obvious and have a
tremendous effect on an adolescents psychosocial development. No two individuals will develop
in the same way. One girl may become heavier than she might like, another may be thin, a boy
may not develop the muscle or the height he desires, and some may develop serious complexion
problems. It can be a time of great joy, but it also can be a time when counseling is needed.

FOOD HABITS
Adolescents, especially boys, typically have enormous appetites. When good eating
habits have been established during childhood and there is nutritious food available, the
teenagers food habits should present no serious problem. Adolescents are imitators, like
children, but instead of imitating adults, adolescents prefer to imitate their peers and do what is
popular. Unfortunately, the foods that are popular often have low nutrient density such as potato
chips, sodas, and candy. These foods provide mainly carbohydrates and fats and very little
protein, vitamins, and minerals, except for salt, which is usually provided in excess. Adolescents
eating habits can be seriously affected by busy schedules, part-time jobs, athletics, social
activities, and the lack of an available adult to prepare nutritious food when adolescents are
hungry or have time to eat. When the adolescents food habits need improvement, it is wise for
the adult to tactfully inform her or him of nutritional needs and of the poor nutrition quality of
the foods she or he is eating. The adolescent has a natural desire for independence and may
resent being told what to do. Before attempting to change an adolescents food habits, carefully
check her or his food choices for nutrient content. It is too easily assumed that because the
adolescent chooses the food, the food is automatically a poor choice in regard to nutrient content.
It might be a good choice. An adolescent who has a problem maintaining an appropriate weight
may need some advice regarding diet.

CALORIE AND NUTRIENT NEEDS

Because of adolescents rapid growth, calorie requirements naturally increase. Boys calorie
requirements tend to be greater than girls because boys are generally bigger, tend to be more
physically active, and have more lean muscle mass than do girls. Except for vitamin D, nutrient
needs increase dramatically at the onset of adolescence. Because of menstruation, girls have a
greater need for iron than do boys. The DRIs for vitamin D, vitamin C, vitamin B12, calcium,
phosphorus, and iodine are the same for both sexes. The DRIs for the remaining nutrients are
higher for boys than they are for girls.
SPECIAL CONSIDERATIONS FOR THE ADOLESCENT
RELATED TO NUTRITION CONCERNS

Adolescence is a stressful time for most young people. They are unexpectedly faced with
numerous physical changes, an innate need for independence, increased work and extracurricular
demands at school, in many cases jobs, and social and sexual pressures from their peers. For
many teens, such stress can cause one or more of the following problems.

ANOREXIA NERVOSA
In general, adolescent boys in the United States are considered well nourished. Studies show,
however, that girls sometimes have diets deficient in calories and protein, iron, calcium, vitamin
A, or some of the B vitamins. These deficiencies can be due to poor eating habits caused by
concern about weight. A moderate concern about weight is understandable and possibly even
beneficial, provided it does not cause diets to be deficient in essential nutrients or lead to a
potentially fatal condition called anorexia nervosa. Anorexia nervosa, commonly called
anorexia, is a psychological disorder more common to women than men. It can begin as early as
late childhood, but usually begins during the teen years or the early twenties. It causes the client
to drastically reduce calories, causing altered metabolism, which results in hair loss, low blood
pressure, weakness, amenorrhea, brain damage, and even death. The causes of anorexia are
unclear. Someone with this disorder (an anorexic) has an inordinate fear of being fat. Some
anorexics have been overweight and have irrational fears of regaining lost weight. Some young
women with demanding parents perceive this as their only means of control. Some may want to
resemble slim fashion models and have a distorted body image, where they see themselves as fat
even though they are extremely thin. Some fear growing up. Many are perfectionistic
overachievers who want to control their body. It pleases them to deny themselves food when they
are hungry. These young women usually set a maximum weight for themselves and become an
expert at counting calories to maintain their chosen weight. They also often exercise
excessively to control or reduce their weight. If the weight declines too far, the anorexic will
ultimately die.

Treatment requires the following:

1. Development of a strong and trusting relationship between the client and the health care
professionals involved in the case.
2. That the client learn and accept that weight gain and a change in body contours are normal
during adolescence.
3. Nutritional therapy so the client will understand the need for both nutrients and
calories and how best to obtain them.
4. Individual and family counseling so the problem is understood by everyone.
5. Close supervision by the health care professional.
6. Time and patience from all involved.
BULIMIA
Bulimia is a syndrome in which the client alternately binges and purges by inducing vomiting
and using laxatives and diuretics to get rid of ingested food. Bulimics are said to fear that they
cannot stop eating. They tend to be high achievers who are perfectionistic, obsessive, and
depressed. They generally lack a strong sense of self and have a need to seem special. They
know their bingepurge syndrome is abnormal but also fear being overweight. This condition is
more common among women than men and can begin any time from the late teens into the
thirties. A bulimic usually binges on high-calorie foods such as cookies, ice cream, pastries, and
other forbidden foods. The binge can take only a few moments or can run several hoursuntil
there is no space for more food. It occurs when the person is alone. Bulimia can follow a period
of excessive dieting, and stress usually increases the frequency of binges. Bulimia is not usually
life-threatening, but it can irritate the esophagus and cause electrolyte imbalances, malnutrition,
dehydration, and dental caries. Treatment usually includes limiting eating to mealtimes, portion
control, and close supervision after meals to prevent self-induced vomiting. Diet therapy helps
teach the client basic nutritional facts so that he or she will be more inclined to treat the body
with respect. Psychological counseling will help the client to understand his or her fears about
food. Group therapy also can be helpful. Both bulimia and anorexia can be problems that will
have to be confronted throughout the clients life.

OVERWEIGHT
Being overweight during adolescence is particularly unfortunate because it is apt to
diminish the individuals self-esteem and, consequently, can exclude her or him from the normal
social life of the teen years, further diminishing self-esteem. Also, it tends to make the individual
prone to overweight as an adult. Although numerous studies have been done, the cause of being
overweight is difficult to determine. Heredity is believed to play a role. Just as one inherits
height, color of hair, or artistic talents, it appears that one may inherit the tendency (or lack of it)
to be overweight. Overfeeding during infancy and childhood also can be a contributing factor.
Then, once a person is overweight, the overweight itself contributes further to the problem. For
example, if a teenager becomes the center of his classmates jokes, he or she may prefer to spend
time alone, perhaps watching television and finding comfort in food. This behavior adds more
calories, reduces activity, and, thus, worsens the condition. The problem of being overweight
during adolescence is especially difficult to solve until the individual involved makes the
independent decision to change lifestyle habits. After making such a decision, the teenager
should see a physician to ensure that his or her health is good. The health care provider can play
an important role by offering guidance on changing eating habits, increasing exercise, and
adopting a healthier lifestyle.

FAST FOODS
Many Americans have become extremely fond of fast foods. Many others are highly critical of
their nutrient content. Examples of these foodsmost of which are favorites of teenagers
include hamburgers, cheeseburgers, French fries, milkshakes, pizza, sodas, tacos, chili, fried
chicken, and onion rings. Many fast-food companies have the nutrient content of their products
available to help the public make better choices. Generally speaking, fast foods are excessively
high in fat and sodium, as well as calories, and contain only limited amounts of vitamins and
minerals (other than sodium) and little fiber. The nutrient content of some varieties of fast foods
are shown compared with the DRIs for a 16-year-old girl. This shows the potential for problems
with a diet that regularly consists of these foods to the exclusion of others. Nevertheless, these
foods are more nutritious than sodas, cakes, and candy. When used with discretion in a balanced
diet, they are not harmful. However, teens often use fast foods as a snack to hold them over until
dinner, and this results in consumption of many extra calories.
ALCOHOL
In a process called fermentation, sugars and starches can be changed to alcohol. Enzyme
action causes this change. Alcohol is typically made from fruit, corn, rye, barley, rice, or
potatoes. It provides 7 calories per gram but almost no nutrients. Alcohol is a substance that can
have serious side effects. Initially, it causes the drinker to feel happy because it lowers
inhibitions. This feeling affects the drinkers judgment and can lead to accidents and crime.
Ultimately, alcohol is a depressant; continued drinking leads to sleepiness, loss of consciousness,
and, when too much is consumed in a short period, death. Abuse (overuse) of alcohol is called
alcoholism. Alcoholism can destroy the lives of families and devastate the drinkers nutritional
status and thus health. It affects absorption and normal metabolism of glucose, fats, proteins, and
vitamins. When thiamine and niacin cannot be absorbed, the cells cannot use glucose for energy.
Blood cells, which depend on glucose for energy, are particularly affected. Over time, if alcohol
abuse continues, fat will accumulate in the liver, leading to cirrhosis. Alcohol causes kidneys to
excrete larger-than-normal amounts of water, resulting in an increased loss of minerals. In a poor
nutritional state, the body is less able to fight off disease. In addition, excessive, long-term
drinking can cause high blood pressure and can damage the heart muscle. It is associated with
cancer of the throat and the esophagus and can damage the reproductive system. The risks to the
drinker are obvious. When a pregnant or lactating woman drinks, however, she puts the fetus or
the nursing infant at risk as well. Alcohol can lower birth weight and cause fetal alcohol
syndrome or fetal alcohol effect, with related developmental disorders.
Unfortunately, many teenagers ignore the dangers of alcohol and use it in an effort to
appear adult. In addition to the damage to their own health and the accidents and the random acts
of violence caused by their drinking, their behavior inspires younger children to emulate them.
The health professional is in a good position to spread the message that alcohol is a substance
and can cause severe economic and family problems, as well as addiction, disease, and death.

Marijuana
Marijuana use continues to increase among teenagers. Marijuana increases appetite, especially
for sweets. One marijuana cigarette is as harmful as four or five tobacco cigarettes because the
marijuana smoke is held in the lungs for a longer period of time. As marijuana is smoked, the
lungs absorb the fat-soluble active ingredient, delta-9-tetrahydrocannabinol (THC), and store it
in the fat. Experts believe that the use of marijuana can lead to the use of other drugs such as
cocaine. Common street names for marijuana include grass, weed, pot, and dope.

Cocaine
Cocaine is highly addictive and extremely harmful. It causes restlessness, heightened self-
confidence, euphoria, irritability, insomnia, depression, confusion, hallucinations, loss of
appetite, and a tendency to withdraw from normal activities. Cocaine can cause cardiac
irregularities, heart attacks, and cardiac arrests resulting in death. Weight loss is very common,
mostly because it decreases appetite; addicts would give up food for the drug. The smokable
form of cocaine is crack, which is more addictive than any other drug. It is estimated that half of
all crimes against property committed in major cities are related to the use of crack cocaine and
the addicts need for money to buy the drug.