Adolescence is a phase of rapid growth and development marked by dramatic psychological, social, and physiological changes.
Adolescence is a phase of growth and development marked by dramatic changes. Psychologically and socially, the adolescent experiences new independence, new opportunities to make decisions, and an ever-increasing orientation to peer pressure.
Many factors inevitably affect the adolescent’s self-image. As a new self-image evolves, the adolescent is extremely vulnerable to criticism, whether external or self-inflicted. Criticism regarding weight status can be especially devastating.
Obese adolescents are discriminated against in many ways. Not only are they harassed by their parents but they are often rejected by their peer group, laughed at in movies and on television, excluded from the mainstream of teen-age life, and set apart from the “average” by the fashion industry.
Physiological changes occur in every organ of the body during adolescence. At no time other than infancy is the growth rate as rapid as it is during adolescence. Increased metabolic rate and rapid growth both increase the nutrient requirements of the adolescent.
Changes in physical appearance inevitably affect the adolescent’s self-image. Preoccupation with physical appearance can and often does affect nutrition related behavior.
Rapid physical changes inevitably affect adolescents’ self-esteem as they are continually adjusting to an evolving sense of self
The growth spurt occurs approximately 2 to 2.5 years earlier in the female (between 10 and 11 years) than in the male (between ages 12 and 14).
In the female, the adolescent growth spurt is characterized by rapid linear growth, increases in adipose tissue, and small increases in muscle tissue.
The growth-spurt onset is signaled by signs of breast development and pubic hair. Menarche occurs toward the end of the growth spurt. Epiphyses of long bones dose, and the female ends her linear growth at the median age of 17 years.
In the male, secondary sexual characteristics signal the beginning of the growth spurt. Adipose tissue is initially gained and then reduced in the limbs, and muscle mass increases dramatically. By the end of adolescence, males have one-third more muscle cells than females. Males tend to continue linear growth late into their teens and early twenties.
The differences in body composition between adolescent males and females are significant. Nutrient requirements during adolescence also become very different from those of the earlier years.
This can partially be explained because of size, but muscle mass and adipose mass also contribute to the differences in requirements.
Nutrient Requirements for Adolescence
Energy requirements during adolescence increase dramatically during the growth spurt. A particular individual’s needs should be based upon physiological age, maturation, rate of growth, activity level, and size.
The females’ energy needs peak early in adolescence and drop later in the teen years; energy allowance for males peaks in the late teen years and early twenties. These allowances reflect general trends in adolescent growth patterns. The energy needs of an individual can vary considerably from what is recommended.
Nutrient intake during adolescence is very important for maintenance of growth and development. Encouraging an adolescent to become involved in an athletic activity or some other form of physical activity will probably help socialization at the same time it is creating an opportunity to expend more energy.
Protein needs vary with age and sex. Good sources of protein are needed to obtain the required intake of essential amino acids. Essential amino acids are best provided by animal products such as milk, eggs, and meat. Vegetable proteins and rain proteins do not individually contain all the dietary essential amino acids. They do, however, contribute to the amino acid intake, and they can provide all essential amino acids if properly combined.
The average individual in our society eats an adequate supply of essential amino acids by eating animal products. Thus, the quality of protein provided by vegetable proteins is not of concern. It becomes a concern, however, when an individual is a vegetarian, especially a vegan who consumes only fruits, vegetables, and grains but no milk, eggs, or meats.
When an individual’s intake is restricted primarily to vegetables as in the case of the strict vegan, nutritional problems can become complex unless several nutritional requirements are met. Such individuals should be referred to a clinical dietitian for individual counseling.
Adolescents have a high calcium requirement because of fast bone growth. Milk and milk products are the best sources of dietary calcium.
Monitoring calcium nutritive is difficult. The homeostatic mechanisms maintaining serum calcium levels are complex and hormonally controlled. Serum calcium, serum phosphorus, and alkaline phosphatase may all be within normal limits with marginal nourishment.
An increased need for calcium during the adolescent growth spurt and a low intake of calcium as indicated in a diet history should flag the potential for inadequate calcium nutriture. Adolescents should be encouraged to eat at least four servings daily of foods that are good sources of calcium, such as yogurt, cheese, and milk. If the adolescent expresses concern about the high kilocalorie content of these foods, encourage the use of skim milk or yogurt and cheese made from skim milk.
Most teenage girls do not get enough dietary iron. Therefore, dietary supplementation of iron is warranted.
A balanced diet provides the required trace minerals in amounts such that special nutritional supplements are not required to meet the growing needs of the adolescent. Most diets contain all these elements in amounts such that a deficiency would be extremely unlikely.
Increased vitamin needs during adolescence have been extrapolated from the needs of other age groups. Requirements for vitamins, as for other nutrients, increase dramatically with the growth spurt. Mild vitamin deficiencies are not uncommon in adolescence because of idiosyncratic eating practices and increased metabolism.
During adolescence, eating is an important way of socializing with other people. Peers meet and have pizza, “hanging out” at local eating establishments to be together. It is a time of diminished family influence over direct food intake. Patterns that have been formed through family eating habits will always remain with an individual and influence food choices. However, during adolescence, peer pressure often takes precedence over former habits.
Snacking during adolescence
With high energy needs during adolescence, snacking can be an important source of needed nutrients. Teenagers eat about one-third to one-quarter of their total kilocalories as snacks, which contribute significantly to their nutrient intake.
With a little guidance in selecting foods that contain vitamin A, ascorbic acid, iron, and calcium, the teenager’s diet could easily be improved within the snacking pattern. Adolescence can also be a time when the individual develops habits and tastes for high-kilocalorie, low-nutrient dense foods (often called “junk” foods). Soft drinks are examples of high-kilocalorie, low-nutrient dense foods. A soft drink can provide the needed kilocalories to a fast-growing youth; however, if fat tissue is all that is growing, soft drinks should be eliminated from the diet.
Nutritional counseling during adolescence should help present the formation of inappropriate eating behavior. The adolescent’s characteristic drive for autonomy can be an advantage if handled properly in teaching the adolescent.
Appearance is important to adolescents
Adolescents are anxious to test their new independence and are appreciative of being treated in a manner that gives them choices and a part in decision making and goal setting. Suggestions for change should come from a mutual exchange with explanation and a rationale.
When given the information needed to improve one’s own diet, the teenager is apt to convince himself of the relationships between good nutrition and appearance, energy, growth, and development.
Appearance is important to adolescents. Teenage leaders who exemplify good nutritional appearance are more effective counselors with their peers than are adults. Improving the poor self-image that the obese adolescent has may be the first step in treatment.
With the increased development of self-confidence, determination to change physical appearance will motivate the adolescent through the long and difficult struggle with weight control.
The family should be included in counseling sessions so they can offer support; however, meeting separately with the family is often better than meeting with the adolescent and the family together.
The teenager must be the one responsible for food intake. It is possible to help the whole family improve eating habits while you are treating the adolescent.
Of major importance, it is well to remember that it is essential to respect the adolescent’s individual views. A dictatorial approach to counseling is doomed to failure.