Adolescnet Nutrition

Question 1

Nutrition needs in a time of change

Answer 1

Biological, psychosocial and cognitive changes affect nutrition status
Rapid growth increases nutrient needs
Desire for independence may cause adoption of health compromising eating behaviours
Eg. Excessive dieting, meal skipping, unconventional nutrition supplements, dad diets, substance use/ abuse

Question 2

Sexual maturation rating

Answer 2

Consistent but great individual variation in age of maturatartion
Biological age should be used to assess growth and development rather than chronological age (tanner stages)
As much as 50% of ideal adult body weight is gained during adolescence

Question 3

Maturation and growth of females

Answer 3

Menarche occurs 2-4 years after initial development of breast buds
Age of menarche ranges from 9-17 years
Peak linear growth occurs approx 6-12 months prior to menarche
Severely restricted diets may delay or slow growth
Peak weight gain follows linear growth spurt by 3-6 months - gain of 8kg per year, slowing at time of menarche but continuing into late adolescence
44% increase in lean body mass
120% increase in fat
Approx 17% body fat required for menarche to occur
Approx 25% body fat needed to maintain normal menstrual cycle

Question 4

Maturation and growth of males

Answer 4

Show great variation in chronological age when sexual maturation takes place
Peak velocity of linear growth occurs during SMR 4 and ends with appearance of facial hair at approx 14.4
Linear growth continues through adolescence ceasing at age 21
Peak weight gain occurs at same time, approx 9kg per year
Body fat decreases to 12%, half of bone mass is accrued in adolescence

Question 5

Factors affecting eating

Answer 5

Peer influence 
Parent modelling 
Food availability, preferences and cost- pocket money for hot chips rather than healthy smoothie 
Personal and cultural beliefs 
Mass media
Body image 

Eating away from home, eating meals in front of the tv, little time to sit down for a meal

Question 6

Adequacy of nutrition intake in adolescents

Answer 6

Poor intake of dairy, grains, fruits and vegetables

Less than 1 serve if veg
Less than 1 serve of fruit
Adequate intake of grains but whole grains less than adequate
32% of calories from fat and 21% from added sugars

Question 7

Energy requirements

Answer 7

For increase in lean body mass, skeletal mass and body fat
Energy and nutrient needs during adolescence exceed those of any other point in life
Influenced by activity level, BMR, pubertal growth and development, sex, physical activity decline

Question 8

Protein requirements

Answer 8

Required to maintain exisiting LBM, for growth of new LBM

Low protein intakes related to reductions in linear growth, delays in sexual maturation, reduced LBM

Question 9

Poor nutrient intake

Answer 9

Folate
Vit A, B6, C and e
Iron and zinc
Magnesium
Phosphorous and calcium 
Fibre

Question 10

Calcium

Answer 10

Critical to ensure peak bone mass
Absorption highest around menarche
Highest in males around early adolescence
Soft drink consumption displaces nutrient dense beverages

Question 11

Iron requirements

Answer 11

Increased needs: 
Rapid rate of linear growth
Increase in blood volume 
Menarche in females
Iron needs greatest after menarche
Iron needs greatest during growth spurt

Question 12

Vitamin D

Answer 12

Essential role in facilitating intestinal absorption of calcium and phosphorous
Essential for bone formation
Synthesised by the body via skin exposure and ultraviolet B days of sunlight
Food sources: fatty fish, fish oils, egg yolks of Henderson fed vi D fortified feed

Question 13

Folate requirements

Answer 13

Required for DNA, RNA and protein synthesis
Severe folate deficiency leads to megablastic anaimean
Severe deficiency rare but inadequate folate status appears to be more common
Folate added to fortified foods is better absorbed than folate from natural foods
Adequate folate intake for female adolescents reduces incidence of birth defects like Spina bifida

Question 14

Vit c

Answer 14

Marginally adequate among adolescents
Involved in the synthesis of collagen and other connective tissue
Acts as an antioxidant
Smoking increases need for vitamin C

Question 15

Veg diets

Answer 15

4% follow veg diet 
Cultural or religious beliefs
Moral or ethical concerns
Health beliefs
To restrict fat and or calories
A means of independence from family 

Well planned veg diets can offer many health advantages, best when small amounts of animal derived foods are included
Vegans at risk of protein, calcium, zinc, iron, vit d, b6 and b12 inadequate intake

Question 16

Physical activity

Answer 16

Should participate in at least 60 mins of moderate to vigorous pa a day
Should not spend more than 2 hours on electronic media

Improved aerobic endurance and muscle strength 
Reduced risk of obesity
Greater bone density
Positive self esteem and self concept 
Lower levels of anxiety and stress 

Affected by confidence in ability to exercise
Positive perception of activity or sports
Positive attitude toward activity
Peer and family support
Availability of safe and convenient places to play, sports equipment, transportation to sports or fitness programs

Question 17

Factors increasing risk of overweight and obesity

Answer 17

Having one or more overweight parents 
From a low income family
Increased prevalence among indigenous and Pacific Islanders
Mobility limiting conditions
Inadequate physical activity 
Diet high in calories, sugars and fat

Question 18

Nutrition education and counselling

Answer 18

Involve adolescent in decision making process
Encourage adolescent to suggest ways to change
Work toward only 1-2 goals per counselling session

Could utilise technology for optimal outcomes

Question 19

Substance use

Answer 19

Tobacco increases vit C needs
Alcohol can replace nutritious foods and bevs
Illicit drugs may increase risk of disordered eating
Substance use may lead to depleted iron, vit c and thiamin stores
Reduced apprentice decreases intake of range of nutrients

Question 20

Iron deficiency

Answer 20

Determined by low serum iron, plasma ferritin and transferring saturation
Iron deficiency more frequency

Anaemia
Determined by simple and inexpensive haemoglobin or haematocritic levels
Indicated more advanced stage of iron deficiency
Less frequent but almost exclusively females

Question 21

Eating disorders

Answer 21

Most common chronic illness for younger females
Adolescence with diabetes have a 2-4 fold increased risk of developing an eating disorder
70% of adolescent girls have body dissatisfaction

Question 22

Cystic fibrosis

Answer 22

Interferes with lung function
Causes decreased absorption of nutrient
Malabsorption due to lack of pancreatic enzymes
Dietary consideration: calories and protein increases 2 to 4 fold, enzyme taken with meals to aid digestion, frequent meals and snacks, fat soluble vitamin supplements, gastronomy feeding at night may be needed to boost energy intake

Question 23

Phenylketonuria

Answer 23

Inborn error of metabolism
Body lacks enzymes needed to metabolise phenylalanine
Require intervention to manage breakdown of dietary proteins
Diet is adequate on vitamins, minerals, protein fat and calories
Nutrients are often provided in liquids rather than solid form
Dietary treatment includes avoiding meats, eggs, dairy products, nuts and soy beans