Adolescence Flashcards

1
Q

Age of adolescence

A

Begins at puberty and ends at adulthood; no consensus in age definition
* Early adolescents: 10 to 14 years
* Late adolescents: 15 to 19 years
* Early adulthood: 20 to 24 years

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2
Q

WHO life course model

A
  1. Fetal life
  2. Infancy and childhood
  3. Adolescence
  4. Adulthood
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3
Q

Physiological Development of adolescents

A

Puberty: physical transformation from child to adult and includes
* sexual maturation
* increased rate of gains in height and weight
* completion of skeletal growth
* changes in body composition

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4
Q

Classifications WHO Growth Charts

A
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5
Q

When does sexual maturation for females begin?

A

Starts 8 to 12 years of age and process is ~5 years in length
* big height spurt happens first
* menarche usually develops in the middle
* breast usually develops before pubic hair

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6
Q

primary driver of sexual maturation in females

A

Estrogen
* reproductive organ maturation
* secondary sex characteristics
* menarche (close to middle of puberty)

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7
Q

What are the female tanner stages

A

sexual maturation rating (SMR)
* breast development
* pubic hair growth

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8
Q

When does sexual maturation for males begin?

A

Starts 9.5 to 13.5 years of age and process is ~4 years in length

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9
Q

primary driver of sexual maturation in males

A

Testosterone
* increases testicular volume
* changes to external genitalia
* sperm production
* secondary sex characteristics

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10
Q

Tanner stages for males

A

Sexual Maturation Rating (SMR)
* genital development
* pubic hair growth

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11
Q

How do the stages of development occur?

A

Stages of development are consistent,
but duration and timing varies
* nutritional needs based on stage

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12
Q

What mediates increases in weight and height?

A

Sex hormones and growth hormones mediate increases in weight and height
* gains in bone mass, muscle, organs, blood volume, fat mass (females)

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13
Q

Normal Body Composition Changes in females

A

peak weight gain after peak height velocity and before menarche of both FM and LM but proportionatly more FM
* gain in fat mass (120%) > lean mass (44%)
* Increased proportion FM and decreased proportion LM

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14
Q

Normal Body Composition Changes in Males

A

peak weight gain coincides with peak
height velocity (occur together) with increased LM and decreased FM
* decreased proportion FM and increased proportion LM

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15
Q

Why has the age of menarche decreased?

A

Trend in age of menarche has gone down where it used to be ~13 year but now it is 9-10 year most significantly due to increased BMI associated with earlier puberty in girls
* Leptin is made in adipose tissue and play a role in regulating hormones driving female reproductive cycle which signals that energy stores are adequate for puberty to start
* Permissive signal: removes suppression of GnRH (hypothalamic-pituitary gonadal
axis) iniating menarche`

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16
Q

Role of Leptin in females

A

related to glutofemoral fat
* increase in leptin precede menarche by about 6 months and remains elevated

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17
Q

leptin in males

A

increases in leptin precede initiation of puberty, but leptin concentrations then decline

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18
Q

Consequences of very early age of first menses

A
  • social and behavioral impact
  • increased risk of: metabolic syndrome/PCOS & breast cancer
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19
Q

Cognitive Development

A

Switch from concrete to abstract thinking
* Early adolescence: concrete, egocentrism, impulsive behavior
* Middle adolescence: still concrete but starting abstract thinking
* Late adolescence: abstract thinking

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20
Q

Social Development

A

Starts ~12 years of age and continues until ~24 years of age with development of:
* independence (Getting a vehicle)
* self-identity
* body image
* relationships
* individual beliefs and behaviours related to lifestyle choices

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21
Q

Stages of social development

A

Early adolescence
* body image and awareness of sexuality
* peer influence strong

Middle Adolescence
* emotional and social independence from family; making decisions for self
* peer influence strongest

Later Adolescence
* personal identity and beliefs
* social confidence, less influence of peers

Early Adulthood
* completion of independence
* adult roles and responsibilities

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22
Q

Nutrition Knowledge

A

more advanced concepts
* types of nutrients, food sources, recommendations
* link between food choices and health including long term health

food skills
* shopping for food, planning meals, meal prep and cooking, budgeting

23
Q

What might advanced health knowledge look like?

A

Able to understand more complex concepts about health behaviours and determinants of health
* advertising and marketing
* socioeconomic
* Empowerment for themselves and others

24
Q

Role of adults for adolesence nutrition

A

allow them to have autonomy over their own health and know the consequences

25
Q

Promotion of Health Behaviours

A

Messages about health in general directed at adolescents need to take into consideration:
* development: cognitive and social
* behavioural characteristics
* youth culture and trends (coffee, fast food etc.)

26
Q

Main factors affecting eating behavior

A

Individual
* biological changes, attitudes, beliefs, preferences, self efficacy

Environment
* Family/home, school, extra-curricular activities, peers, norms

Macrosystems
* Availability, production, distribution, media/advertising, policy

27
Q

Common eating behaviours

A
  • Eating more meals away from home (schedule, independance)
  • snacking (ranges 1-7/d; usually higher in fats, sodium and sugar)
  • Meal Skipping (typically breakfast; decreased nutrient dense meal)
28
Q

Diet Quality

A

mostly requires improvement or poor quality
* non good quality

Based on recommendations in Eating Well with Canada’s Food Guide

29
Q

Grain intake

A

large percentage below minimum serving of grains in females, not so much males

30
Q

vegetables and fruits intake

A

Large percentage of both below reccomendations
* females more than males

31
Q

milk intake

A

large percent below for milk intake
* females more than males
* Calcium lacking!!

32
Q

Adolescents – Why Don’t They Eat Healthy Foods?

A
  • Habits of parents modelling
  • Marketing/ advertising
  • Not cool
  • Want to do things havent been able to do
  • Lack of availability and not enough variety at the home or school
  • Defiance
  • Dont realize consequences
33
Q

Young Adults – Barriers to Healthy Eating

A
  • unhealthy diet of friends and family
  • Cheapness and availability of unhealthy foods
  • Preference of unhealthy foods
  • Lack of time
  • Lack of knowledge
  • Lack of self-regulation; emotional response
  • Lack of motivation
  • Risk taking behaviour
34
Q

Energy Intake Recommendations

A

Energy needs are higher than that of adults (per kg and absolute) for maintenance, growth and activity and is determined by tanner stage
* Estimated energy expenditure: height, weight, age, physical activity level
* Low intake: impaired growth and delayed sexual maturation
* Excess intake: overweight/obesity

35
Q

Macronutrient Recommendations

A
36
Q

fibre intake stats

A

Median intake fibre: below AI boys and girls 14-18yrs

Canadian Community Health Survey (CCHS) 2.2 (2004):

37
Q

AMDRs

A
38
Q

What are the micronutrients of concern?

A
  • Vitamin D and vitamin A prominently lacking
  • Ca and Mg lacking
  • Sodium above upper limit
39
Q

Why is Ca so important?

A

Peak Ca accretion rate is highest in adolescence
* females = 12.5 years
* males = 14.0 years

40% of total lifetime bone mass is accumulated during 3-4 years of adolescence
* if calcium intake from foods is inadequate, supplementation (Ca + D) during adolescence can increase bone mineral content
* the more here, the longer it will take to get to fracture zone in later life

40
Q

Importance of Muscle Mass Accretion

A

Prevents reaching the disability threshold in later life

41
Q

Importance of iron

A

Increased demand for rapid rate of growth which includes increased blood volume
Highest requirement:
* Males: Peak growth rate
* Females: After first menses

42
Q

Iron DRIs

A

DRI: accounts for basal loss, maintenance of stores and growth; blood loss in females
* Changers with tanner stage so DRI might depend where you are at in terms of puberty

43
Q

Reasons why more female adolescents do not meet nutrient recommendations?

A
  • Body image play a huge role
  • not eating at home as often
  • Skipping breakfast
  • Advertised diets of restrictions giving misleading information
  • SEM factors
44
Q

What is poor body image associated with?

A

dieting behavior, disordered eating and clinical eating disorders. Body satisfaction in Canadian Youth
* over half didn’t like something about body
* Start to go down with age but only slightly
* True for both males and females

45
Q

Continuum of body image dysmorphia

A

Body Dissatisfaction

Dieting Behaviors (restrictive behaviours)

Disordered Eating

Clinical Eating Disorders

46
Q

Clinical Eating Disorders

A
  • Anorexia nervosa (~0.2% to 1% of adolescents)
  • Bulimia Nervosa (~1% to 2% of adolescents)
  • Binge-Eating Disorder
47
Q

How to deal with clinical eating disorders

A

Causes multi-factorial, but prevention has to include the promotion of positive body image and self-esteem
* Thank about all aspects of food eating behaviour

48
Q

What does Substance Use in Adolescence typically include

A
  • includes tobacco, alcohol, recreational drugs
  • for most, experimentation only
49
Q

Concerns with substance use

A

nutritional concerns are with chronic or excessive use
* appetite suppression and low intake (alcohol replacing nutrition)
* decreased nutrient absorption and increased losses
* higher requirement of some nutrients
* decreased financial resources for foods
* Smoking would need more vitamin C

50
Q

Prevalence of Adolescent Pregnancy

A

Globally, adolescents 15 to 19 years of age give birth to 16 million babies a year (10% of births)
* Canada: 10,600 in 2014 (2.8% of births)
* Rate 3x’s higher in low and middle income
countries: marriage practices, absence of rights, poverty, low education

51
Q

What are some concerns with adolescence pregnancy?

A

Increased risk of poor maternal and fetal/infant outcomes since the female is still growing and still has high demand for nutrients for herself, and then requirement during pregnancy creates compounding situation
* mom: maternal mortality, anemia, postpartum weight retention
* baby: stillbirth, neonatal mortality, low birthweight, prematurity
* low rates of breastfeeding
* poor dietary intake (quality, quantity)

52
Q

Main nutritional issues with adolescent pregnancy

A

Competition between maternal and fetal growth
* demands for maternal growth (increased height and weight associated with normal development
* demands for pregnancy (maternal and fetal tissues) and lactation

In adolescent the calcium coming from her bone does not not go back on

53
Q

Nutritional recommendations for adolescent pregnancy

A
  • Same as for pregnancy and lactation in
    adulthood but higher energy and some minerals (calcium, phosphorus, magnesium, zinc, iron)
    greater need for nutrition support (consult with dietitian, resources)