Adolescence Flashcards
Early adolescence
11-14
Middle adolescence
15-17
Late adolescence
18-21
Nutritional needs required for?
Substantial physical, emotional and cognitive maturation
When does puberty begin?
early adolescence
Biological changes associated with puberty
- increase in height and weight
- sexual maturation
- changes in body composition
- accumulation of skeletal mass
Order and timing for puberty?
Order of changes is consistent, timing is not
Sexual maturation is also referred to as?
Biological age
What should biological age be used for?
to assess nutritional needs
What is used a sexual maturation rating
Tanner stages
What are tanner stages?
scale to assess degree of sexual maturation
SMR 1
pre-pubertal growth and development
SMR 2-5
occurrences of puberty
SMR 5
sexual maturation has concluded
What is involved in sexual maturation in boys
genital development and pubic hair growth
What is involved in sexual maturation in girls
breast development and pubic hair growth
Menarche
onset of first menstrual period
When does menarche appear?
2-4 years after initial development of breast buds (SMR 4)
Age of menarche?
10-17 (average=12.4 years)
When does peak velocity of linear growth occur?
~6 to 12 months prior to menarche (SMR 3)
Peak weight gain follows linear growth spurt by how many months? (in females)
3 to 6 months
Body composition changes in females
- peak weight gain follows linear growth spurt by 3-6 months (50% B.W. gained during adolescence)
- increase in body fat (120% increase in body fat during puberty)
- decrease in lean body mass from 80-74% of B.W.
Body fat levels in females
low 35%
What body fat % is required for menarche?
17%
What body fat % is required to maintain menstrual period?
25%
When does peak velocity of linear growth occur in males?
SMR 4
What signifies ending of peak velocity of growth in males?
appearance of facial hair
When does linear growth continue until in males?
21
Body composition in males
- peak weight gain at time as peak linear growth
- peak weight gain ~20lbs per year
- body fat decreases to ~12%
How much bone mass is accused during adolescence?
~1/2
by what age is 90% of the skeletal mass formed?
18
What factors affect formation of skeletal mass?
genetics, hormones, weight bearing exercise, intake of certain minerals (vitamin D, calcium, phosphorus)
Energy needs influenced by?
activity level, BMR, pubertal growth/development
When does physical activity often decline?
adolescence (mostly in girls)
energy ranges?
males - 2200-3100 kcal/day
females - 2000-2400 kcal/day
Calculating estimated energy requirements (EER)
EER = 88.5-(61.9 x age in years) + PA x [(26.7 x weight in kg) + (903 x height in meters)] + 25
What are protein requirements influenced by?
amount needed to maintain existing lean body mass and develop new muscle
protein DRI
0.85 g/kg BW
Low protein intake during adolescence linked to?
- reductions in linear growth
- delays in sexual maturation
- reduced lean body mass
During peak weight gin, adolescent males gain an average of ? lbs per year?
20lbs
Carb AMDR
130 g/day or 45-65%
Fiber male 9-13
31g
Fiber male 14-18
38g
Fiber female 9-13
26g
Fiber female 14-18
26g
Energy from total fat?
25-35%
Energy from omega 3’s?
0.6-1.2%
Energy from saturated fat?
What is calcium crucial for?
to ensure peak bone mass
When is calcium absorption highest in girls?
around menarche
When is calcium absorption highest in males?
during early adolescence
How much more calcium is absorbed during adolescence vs. adulthood?
4x
Calcium RDA for 9-18 year olds?
1300 mg/day
Functions of vitamin D?
- facilitates absorption of calcium
- essential for bone formation
How is vitamin D synthesized?
By body via skin exposure to (ultraviolet B) rays of sunlight
Vitamin D DRI?
600 IU/day
When are iron requirements the highest in females?
After menarche (15mg/day)
When are iron requirements the highest for males?
After growth spurt (11g/day)
% iron deficiencies in 12-15 year old females/males?
females - 9%
males - 5%
What is zinc required for?
sexual maturation and growth (esp. in males)
Important B vitamins
folate, vitamin B12, niacin, riboflavin, thiamin
B vitamin requirements are how much higher in adolescence vs. school-aged children?
2x
The ‘teen’ brain
- ability to reason, rational thought may be limited
- live in the moment; limited consideration of long term consequences
- reward benefits much more important than possible risk
social and emotional development - early adolescence
- strong need for social acceptance from peers
- body image may change as result of changes in body shape
- increased awareness of sexuality
- strong sense of impulsivity
social and emotional development - middle/late adolescence
- increased opportunities for employment and outside activities
- greater autonomy from parents
- continued need for social acceptance from peers
- increased awareness of social and moral issues
Stater institue parenting recommendations
- try to find the balance between controlling and totally giving up control on what and when food is being served
- consult, support and work out expectations together
- continue to have open communication
- continue to provide leadership with food selection
- give expectations that will feed self responsibility
- teach meal planning and how to prepare meals
What % of adolescents report vegetarian diets?
4%
Reasons adolescents adopt vegetarian diet
- cultural/religious beliefs
- moral/ethical concerns
- health beliefs
- to restrict fat/calories
- means of independence from family
Compared to non-vegetarians, vegetarians had:
- better fruit/vegetable intake
- less overweight/obesity
- more eating disorders
- more weight controlling behaviours
Do vegetarians have a specific guidance from health Canada?
No
Lacto-ovo vegetarians can meet needs following EWCFG by:
- Choosing legumes, nuts, tofu as “alternatives” to meat
- fortified soy beverage as milk “alternative”
Is EWCFG adequate for vegans?
No
Vegetarians need additional supplementation of?
calcium, zinc, iron, vitamins D, B6 and B12
High restriction involved with vegetarian diets pos concerns with?
adequacy, especially for growing children and adolescents
What will help vegans achieve adequate nutrition?
fortification and supplementation
Challenges the teen faces?
- nutrition knowledge may be limited
- may be motivated by weight loss
How parents and providers can assist the teen?
- support with appropriate knowledge
- try to understand motivations
Vegetarian food guide
calcium rich - 8 grains - 6 legumes, nuts, other protein - 5 vegetables - 4 fruits - 2 fats -2
What iron rich food source would be the best choice for an adolescent who is a lacto-vegetarian?
pinto beans and diced tomatoes
Physical activity guide for children 5-17?
- 60+ minutes/day of moderate to intense exercise
- 3+ days/ week intense
- 3+ days/week muscle building
What % of adolescents aren’t doing any sort of PA?
80%
What % of adolescents are using computers for more than 10 hours per day?
14%
Girl’s barriers to physical activity?
- lack of time
- involvement in technology focused activities
- inaccessibile facilities
- cost of facilities
- competition
- body centred issues
In females, lower body satisfaction is associated with:
- increased extreme weight control behaviours
- increased binge eating
- decreased physical activity
- decreased fruit and vegetable intake
In males, lower body satisfaction is associated with:
- increased extreme weight control behaviours
- increased binge eating
- decreased physical activity
The continuum of eating disorders
body dissatisfaction –> dieting behaviours –> disordered eating –> clinically significant eating disorders
Clinically defined/diagnosed eating disorders:
anorexia nervosa, bulimia nervosa, binge eating disorder
What % of girls and boys report being dissatisfied with their bodies?
46 and 26%
What % of 15 year old girls are dieting to lose weight?
48%
What % of Ontario girls 12-18 years report disordered eating behaviours (vomiting, laxative use, fasting)?
27%
key features of anorexia nervosa?
- refusal to maintain body weight at normal weight for age
- intense fear of gaining weight
- amenorrhea
- distorted body image
key features of bulimia nervosa?
- recurrent episodes of rapid consumption of large amounts of food in a discrete period of time
- use of laxatives or diuretics
- 1% of adolescent females (increases to 3% in adults)
Binge eating disorder (BED)
binge eating, not followed by compensatory behaviours
- 2% of general population; 30% of dieting population
Cause of BED
dietary restriction leading to uncontrolled hunger
Role of food in an individuals affected by BED?
comfort, support, deal with stress, to feel numb
Why do eating disorders exist in adolescence?
- life is overwhelming (many changes, struggling with own identity/independence, increased pressure)
- searching for control over stress
Factors associated with the development of eating disorders?
- Public policy = media messages
- community = weight norms
- organizational = food related policies
- interpersonal = weight related teasing/bullying
- individual = self esteem, food preferences, body dissatisfaction
What is the NEDIC?
National eating disorder information centre
What does the NEDIC do?
- developed and disseminates information and resources on eating disorders
- staffs a telephone helpline
- runs prevention and awareness campaigns (Feb - eating disorder awareness week)
- runs workshops and presentations
Some eating disorder prevention strategies?
- persons of influence recognizing their own issues with self esteem and body image
- view self as a “whole person”, discourage negative self talk
- eliminate weight focus, harassing
- stop weigh ins, fat callipers, etc for sports groups
- understand role of media
Eating disorder treatment
- restore body weight
- improve social and emotional well being
- normalize eating behaviours
Binge eating disorder condition, which is indicated by the presence of 3 to 5 criteria. Which of the following are NOT criteria?
Eating until full
