Adolescent Nutrition Flashcards
adolescence is between ages ___ and ____
______ occurs during adolescence
11-21
puberty
biological changes of puberty include
____ maturation
increases in ____ and ____
accumulation of _______
changes in _______
sexual
height and weight
skeletal mass
body composition
The ____ of onset, duration, and speed of the events of puberty vary greatly between individuals
* Variations in reaching sexual maturity affect _______ requirements of adolescents
- Sexual maturation (or ________ age)—not chronological age—should be used to assess growth and development and individual nutritional needs
age
nutrition
biological
girls first signs of puberty from ages ___ to ____
menarche occurs ___ to ___ years after initial development of _____
age of menarche may ranges from _ to ___ yrs with the average being ____
8-13 yrs
2-4 yrs
breast buds
8-17 yrs
12.5 yrs
Menarche may be delayed in highly competitive athletes or in girls who severely restrict calorie intake
* Early onset of menarche (by age ____ yrs) is ___ times
more likely among girls with overweight or obesity
10.6
4x
Linear growth spurt in females:
* Begins between ______ yrs with peak linear growth occurring
~ ____ months prior to menarche
* Lasts ~ _____ months
* Peak velocity of linear growth ~age _____
* During peak of growth spurt females gain ~ ____ inches per year
* Ceases by age ___ for most females
* May be delayed or slowed among those who severely restrict intake
9.5-14.5
6-12 months before menarche
24-26 months
14.4
3.5
16
Peak weight gain follows linear growth spurt by _____ months
* Peak velocity of weight gain occurs ~ _____ yrs of age
* Gain of ~_____ lb per year during peak
* Increase in fat body mass from ~____- ___% at full maturity
* ____% body fat is required for menarche to occur ___% required for development & maintenance of regular ovulatory cycles
3-6 months
12.5 years
18.3 lbs
16% to 26%
17%
25%
Adolescent females often view this normal accumulation of body fat as ______
Weight dissatisfaction can lead to unhealthy behaviors:
* Excessive caloric restriction and dieting
* Use of diet pills, laxatives
* Fasting
* Development of eating disorders or body image distortions
negative
Males First signs of puberty occur ___ yrs
- ____ years being the avg age
- Males show great deal of variation in chronological age at which sexual maturation takes place => ______ yrs
(average age ~ ___) - Peak velocity of linear growth at age ____
- At peak, will increase height by ______ inches/yr
- Linear growth stops at age ____
10.5-14.5 yrs
11.6 years
12.7-17 yrs
14 yrs
14.4 yrs old
2.8-4.8 inches/yr
21yrs old
Peak weight gain for males coincides with peak linear growth and peak muscle mass accumulation
* Peak weight gain=> ~____ lb per year
* Body fat decreases to ~____% by the end of puberty
20 lbs
12%
Almost half of adult peak bone mass is accrued during adolescence
* Adequate intake of _____________ during adolescence is critical to support optimal bone growth & development
calcium, phosphorus, & protein
Adolescents develop:
* A sense of personal _____
* A __________ value system
* Feelings of __________
* A vision of ________ aspirations
identity
moral & ethical
self-esteem or self-worth
occupational
> ____% of adolescents use vitamin-mineral supplements
Most common supplements are
* Multivitamin
* Vitamin ____ – most common individual supplement used
* Calcium
* Iron
* Vitamin E
* B-vitamin complex
> 26%
Vitamin C
Supplement use is positively correlated with household income, high food-security status, having health insurance, & parental education
* Adolescents who take vitamin/mineral supplement tend to consume a more _________ diet
* Also positively correlated with meeting physical activity goals, consuming more fruits & vegetables, and <2 hours of TV/screen time
nutritional adequate
Reasons for taking herbal products include:
* ________ loss
* Build _______
* Treatment of ____
* To increase _______
- More studies needed since many herbal products have potentially dangerous side effects
weight loss
build muscle
ADHD
energy and stamina
Reasons adolescents adopt a vegetarian diets include:
* Cultural or religious beliefs
* Moral or environmental concerns (animal welfare)
* Health beliefs
* To restrict fat and/or calories
* A means of exerting independence from family
Have been found to be _____ than omnivores during childhood
* Begin puberty at a _____ age
* After puberty, are _______
shorter & leaner
later
taller and leaner
Well-planned vegetarian diets can offer many health advantages
* Can provide adequate protein for growth particularly if small amounts of _______ foods are consumed at least ___x/wk
animal-derived
2 times/week
Vegans may have inadequate intakes of:
- Protein
- Calcium, Zinc, & Iron
- Vitamins D, B6, & B12
- Long-chain n-3 fatty acids
on average, diets are low in____ and high in ________, _______, and _____
* Intake of _____ is especially low
fiber
saturated fat, sodium, and added sugars
dairy
Data from NHANES: adolescents’ diets consist of
- Less than ___ serving of vegetables per day
- Less than ___ serving of fruits per day
- Adequate intake of _____ but _____ less than adequate
- ___% of total calories from added sugars
1
1
grains
whole grains
21%
U.S. adolescents have inadequate intake of vitamins & minerals including:
- folate
- vitamins A, B6, C, & E
- iron & zinc
- magnesium
- phosphorus & calcium
Increases in LBM, skeletal mass, & body fat during puberty result in energy & nutrient needs that exceed those at any other point of life
* The ____ provide the best estimate of nutritional needs for adolescents
DRIs
Energy needs are influenced by:
* Resting metabolic rate (RMR)
* Pubertal growth & development
* Activity level
* Because males have greater increases in ht, wt, & LBM they have a higher caloric needs than females
* Level of physical activity ______ during adolescence (particularly in females) resulting in _______ energy requirements
declines
reduced
Boys and Girls 9-18 years should have BMI between ___ and ___ %ile
5th-85th %ile
Requirements are influenced by protein needed:
* To maintain existing LBM
* For growth of new LBM for growth spurt
* DRI: _______
* Low protein intakes linked to:
* Reductions in linear growth
* Delays in sexual maturation
* Reduced LBM
0.85 g/kg of weight
Carbohydrates:
* ______% of daily energy needs
* DRI: ______ minimum
45-65%
130 g/day
Dietary Fiber:
* DRI for females: ____ g/day
- DRI for males 9-13 yrs: ______
- DRI for males 14-18 yrs: _____
Consumption:
Adolescent males consume ~ _____
Females consume ~_____
26 g/day
31 g/d
38 g/d
16.4 g/d
12.6 g/d
Dietary fat and essential fatty acids are required for normal growth & development
* _______% of total calories from fat
* <___% calories from saturated fat
25-35%
<10%
Adequate intake of calcium is critical to ensure peak bone mass
* Calcium absorption rate in females is highest around ______
* Calcium absorption rate in males highest during ______
* Females accrue less bone mass than males during puberty due to lower Ca intake and less weight-bearing activity
menarche
early adolescence
Calcium Requirements for Adolescents
DRI for ages 9-18 yrs is ______
Average intake is
_____ for females
______ for males
1300 mg/day
842 mg for females
1186 mg for males
Adolescences who do not consume dairy products should include __________ foods in diet
* Soft drink consumption displaces nutrient- dense beverages such as milk & fortified juices
calcium-fortified
Increased iron needs related to:
* Rapid rate of linear growth
* Increase in blood volume
* Menarche in females
* In females, iron needs are greatest after _____
* In males, iron needs are greatest during the _______
menarche
growth spurt
IRON DRI:
- Males & females 9-13 yrs: ___ mg/d
- Males 14-18 yrs: ___ mg/d
- Females 14-18 yrs: 15 mg/d
- Males 19-30 yrs: ____mg/d
- Females 19-30 yrs: ____mg/d
Estimated dietary intakes:
* ____ mg/d for males 12-19 yrs
* ____ mg/d among 12-19 yo females
8
11
15
8
18
18.8
12.0
Vitamin D Requirements
* Essential role in facilitating intestinal absorption of ______________
* Synthesized by the body via skin exposure of
ultraviolet B rays of sunlight
- Food sources: _______________
- Majority of Vitamin D from __________(milk, breakfast cereals, margarines, & some juices)
calcium & phosphorus
fatty fish, egg yolks
fortified foods
High risk groups:
- Individuals who live in ______ climates
- Limited sun exposure
- _________________
- Individuals with ____________ skin
- Individuals who frequently use sunblock
Northern
Lactose intolerance or milk allergy
darkly pigmented
Increased requirements of folate during puberty due to folate being required for DNA, RNA & protein synthesis
- DRI: (for males and females)
- Age 9-13 years: ______
- Age 14-18 years: _______
- Severe folate deficiency leads to
____________
300 mcg/d
400 mcg/d
macrocytic anemia
Increased risk of folate deficiency
* Skipping breakfast
* Not consuming orange juice or fortified cereals or breads
*__________ is better absorbed than ______
* Adequate folate intake for female adolescents prior to pregnancy reduces incidence of congenital anomalies such as ________
folic acid
folate
spina bifida
- Annual screening of all adolescents for indicators of nutrition risk is recommended Screening should include:
- ______________ – plotted on CDC growth charts
- Disordered eating tendencies
- Blood lipid levels
- Blood pressure
- _____ status
- Food security/insecurity
- Dietary intake/adequacy
Weight, height, & BMI
Iron
underweight
healthy eight
overweight
obese
percentile ranges?
<5th %ile
5th-85th%ile
85th to 95th %ile
95th or above
Indicators of Nutrition Risk
- Consumes <__ servings of vegetables per day
- Consumes <__ servings of dairy products per day
- Exhibits poor appetite
- Skips breakfast, lunch, or dinner ≥ ___ times per week
- Consumes a vegetarian diet
- Consumes fast food ≥ __ times per week
<3
<3
≥3
≥3
Considerations when educating & counseling adolescents:
1) Initial component of session should involve:
- Getting to know adolescent, including
personal health or nutrition-related
concerns - Establish a ______
- Providing overview of the content of counseling session - with input from the _____
rapport
teen
Considerations when educating & counseling adolescents continued :
2) Involve adolescent in decision-making process
3) Encourage adolescent to suggest ways to change
4) Work toward only ____ goals per counseling session
1 or 2
Use of ________ to facilitate education
and counseling should be implemented to engage adolescents and provide nutrition information between client visits
technology
Teens are “_______-oriented”
Concerned about:
* Physical appearance
* Having lots of ______
* Optimizing sports performance
* Some are concerned with environmental or
_____ aspects of food
* More effective to focus on ________tangible benefits of health behavior changes
present
energy
moral
short-term
Target ___________ in education
They are gatekeepers of foods
- Serve as _________
- Teenagers tend to eat what is ____________
- Parents can capitalize on this by stocking the
kitchen a variety of nutritious ready-to-eat foods and limiting high-sugar, high-fat snacks
parents as well as teens
role models
availability & convenient
- Parental involvement
- Involve adolescents in food shopping and food preparation
- Refrain from offering
____________ for adolescents who do not like what is being served
specially prepared foods
- School-based programs can play an
important role in promoting lifelong healthy eating and physical activity - Nutrition education is provided as part of
health education in _____% of secondary schools - _____% of secondary schools covered all 20 CDC School Health Profiles nutrition & dietary behavior topics
- More teacher training in basic nutrition is
needed
96%
55%
The 2018 Physical Activities Guidelines for
Americans recommend adolescents:
- Engage in __________ or more physical activity daily
- should be either moderate- or vigorous-intensity aerobic physical activity and should include vigorous-intensity physical activity at least _______ a week.
- Include muscle- and bone-strengthening
activities at least __________
60 minutes
3 days
3 days a week
More than half of U.S. adolescents report playing one or more sports
* ____% of males
* _____% of females
* Participation decreases with age
62% of males
53% of female
High levels of activity combined with growth &
development increase needs for energy, protein, and certain vitamins & minerals
* Nutrient needs higher during intense training & competition seasons
* Monitor changes in _________ to assess for
adequate energy and protein intake
body weight
- What sport(s) are engaged in & duration of
competition season(s)? - What is the ______ of competition? (recreational, competitive, or highly competitive)
- What kind of training does adolescent engage in?
- Does the athlete typically _____ profusely or lose ________ during competition?
- Does athlete follow a special diet or take __________ to improve athletic performance?
level
sweat
body weight
supplements
Substances taken to enhance physical performance
Ergogenic Aids
examples of ergogenic aids
Anabolic-androgenic steroids
(e.g. testosterone, nandrolone)
* SE: HTN, infertility, aggression, depression, increased risk of atherosclerosis
- Anabolic steroid precursors
(e.g. androstenedione, DHEA) - Growth hormone
- Creatine
- Individual amino acids or protein powders
Illegal steroid use:
* Use more common in ______
* Most often used outside of the _______
to avoid detection
* Highest use among competitive athletes:
football, gymnastics, weight training, basketball, & baseball
males
sports season
Competitive athletes may need ______
additional calories per day
Those at risk for inadequate intake include:
vegetarian athletes and athletes who restrict
caloric intake to maintain a particular weight
- When main protein sources are plant-based,
additional protein intake may be needed due
to decreased bioavailability
500-1500
additional protein intake
Dietary intake should follow the ______ guidelines
* May need to consume the ______ of food group recommendations to meet kcal needs
* Increased risk of bone fractures make adequate ______ intake important
MyPlate
upper limit
calcium
Adolescents are at risk for dehydration due to:
May be so focused on the physical activity that they do not pay attention to the ________signs of fluid loss
May be unaware of need for fluid
physiological
All athletes should be counseled on fluid needs and to regularly consume fluid even if not thirsty
* Athletes should weigh themselves before & after practice and sporting events
- Replace each pound lost with ______ of
fluid
2-3 cups per lb
Plain water is appropriate source of hydration for routine physical activity
* Sports drinks can be helpful for young athletes engaged in _______ physical activities when the athlete is sweating profusely
* Undiluted juice, fruit drinks, carbonated beverages, & sports drinks may cause _______ due to _________
prolonged, vigorous
GI discomfort
CHO content
