Chapter 15: Special Adolescent Nutrition Concerns

Which is more common obesity or overweight?

obesity

When should weight loss be a goal for overweight adolescents?

after puberty is completed

if there are any medical complications related to weight

All adolescents should have what assessed annually to determine age- and gender- specific BMI percentiles

weight for height

Since obesity is now a chronic condition it changed its treatment from "staged care process" to

chronic care model of intervention

Interdisciplinary team should include what

1. physician/PA/nurse practitioner

2. behavioral health specialist/ mental health counselor

3. RDN

4. a nurse

5. PT

Pharmocotherapy

obesity treatment

- not recommended as the only treatment

Recommended metabolic & bariatric surgeries

Vertical sleeve gastrectomy

Roux -en-Y gastric bypass

Long term diet recommendations

8-12 servings of sugar free beverages per day

30-60 minutes of PA per day

Adequate protein intake

Daily multi-vitamin mineral supplement

What percent of males and females play sports?

60% of males

55% of females

Adolescent athletes are more likely to..

take steroids

suffer from eating disorders

be injured

- knee and hamstring injuries are 3-4x more likely in young females then males

Side effects of steroids include

severe acne, deeper voice, depression, aggression

Long term effects of steroid use include

risk of heart attacks, HT, stroke, infertility, some forms of cancer

Competitive athletes may need an extra ___ kcal/day to meet energy needs

500-1,300

Pre event meals for athletes should be consumed how many hours prior and should include/avoid what?

2-3 hours prior

avoid high fat, protein, or fiber 4 hr before

Post event meals for athletes should have how many calories and adequate what....

400-500 kcal with adequate carbs and non- caffeinated fluids

Adolescent pregnancy & diet info

extremely high nutrient demands

normal weight gain plus 25-35 to support healthy pregnancy

nutrients should be multiplied for growth of adolescent and fetus

How can we tell if adolescent still has potential for growth?

Gynecological age

- if less than 2 years since menarche, growth is possible

Potential nutrient deficiencies in adolescent pregnancy

Iron

Folate

Calcium

Vegetarian pregnant adolescents are...

even more at risk for preconception nutrient deficiencies

What is the most common nutrient deficiency in adolescents?

Iron deficiency

- more common in females

Risk factors for iron deficiency

rapid growth

low iron rich foods

low vitamin C

dieting

vegan diets

meal skipping

endurance sports

How often should adolesents get screed for anemia?

every 5 years, or every year if risk factors are present

If taking iron supplements avoid..

taking Ca+ supplements, dairy products, coffee, tea, and high fiber foods within 1 hr of taking iron

Classifications of BP are based on how many readings of systolic and diastolic BP, and based on what factors?

3 readings

based on age, sex, and height

Normal BP is what percentile

<30th percentile

Prehypertensive is what percentile

>90th - <95th percentile

Stage 1 hypertension is what percentile

>95th - <99th percentile + 5 mmHg

Stage 2 hypertension is what percentile

>99th percentile _ 5mmHg

Hypertension risk factors among adolescents inclue

family history

high sodium intake

overweight/ obesity

hyperlipidemia

inactive lifestyle

tobacco use

Why are adolescents vulnerable to effects of eating disorders on their nutrition status?

increase in nutrient requirements

potential for growth

body is establishing sexual maturation

Orthorexia

unhealthy obsession with healthy eating

eating becomes increasingly restrictive

Why is orthorexia on the rise?

tendency to categorize foods as good vs bad

such a focus on health we forget to enjoy food and eating

its become socially acceptable

Drunkorexia

binge drinking combined with self-imposed starvation or other extreme dietary restrictions

30% of women between 18-23 diet so they can drink

Bigorexia

muscle dysmorphia

most common in males

~22% of males and ~5% females engage in disordered eating and obsessive exercise to bulk up

How many males and females struggle with eating disorders in the US?

20 million females and 10 million males (~9% of population)

What is the 3rd most chronic illness among adolescents after asthma and obesity?

anorexia

Girls who diet are __ more likelt to binge eat then those that aren't

12x

What % of 10 year olds are afraid of "being fat"

81%

What % of 3rd graders are more afraid of being fat then losing a parent?

60%

Rate of children under 12 admitted to hospitals for eating disorders rose...

119% in less than a decade

1 in every __ are struggling with disordered eating patterns

4

Anorexia has the ___________ of any psychiatric condition

highest death rate

What % of patients who receive and complete eating disorder treatment will recover or improve significantly?

80%

Body dissatisfaction

~60% of girls and 35% of males are not satisfied with their body weight

Dieting behaviors

attempting to lose weight by manipulating food and/or beverage intakes

- ~44- 65% of females and ~15% of males

Disordered eating

~10-20% of all adolescents

Binge Eating Disorder (BDE)

periodic binge eating without the use of compensatory behaviors

Bulimia Nervosa (BN)

repeated episodes of fasting, uncontrolled eating of large quantities of food in very short time, followed by various forms of purging

Anorexia Nervosa (AN)

eating disorder which leads to extreme weight loss through self-starvation, poor body image, and irrational fears about being overweight

3 Main goals of eating disorder treatment programs

1. restore body weight

2. improve social and emotional well-being

3. normalize eating-related thoughts and behaviors