1. l Physiological changes l Nutrient needs »Focus on calcium l Eating behaviors »Feeding responsibility »Vegetarian choices »Eating disorders l Lifestyle behaviors »Substance use/abuse »Fitness and nutrition »Teen pregnancy Nutrition during Adolescence

2. Physiological Changes during Puberty l Puberty = period of ________ from childhood to adulthood »Hormonal changes/body composition triggers? l Physical: »sexual maturation »increased height/weight »body composition nutrition –men: _____ protein, Fe, Zn, Ca –women: _______ menses Fe »acne

3. Psychological Characteristics l Establish l Egocentrism l Imaginary Audience »high self-consciousness »belief in their special, unique existence »“It won’t happen to me” **Health implication =

4. Calcium… l 45-50% of total bone growth occurs during adolescence l can absorb ____________ as adults l Adequate Intake (AI) is set at ______ mg calcium/day to take advantage of opportunity to build (9-18 years old) l High ___________ intake is a concern

5. …and Other Nutrients l Adolescents are generally low in l Protein: they get ~2 times more than needed l Zinc: needed for bioavailability increases l Fiber: 0.5 g/kg body weight; keep < 35 g total l V.C:

6. Eating Behaviors l Teens will take increasing responsibility for their food choices l They still probably need _______ (25-33% of intake) l Skipping breakfast/meals is common but unhealthy l Influences on eating behaviors:

7. Eating Behaviors l Teens will take increasing responsibility for their food choices… »may choose “alternative” eating patterns »greater risk for eating disorders l Vegetarians: start puberty shorter, leaner, and later but no differences eventually »Concern for »higher prevalence of (using vegetarianism as a cover, not as a result of vegetarianism)

8. Types of Vegetarian Diets l Macrobiotic l Fruitarians l Vegan l Lacto-ovo l Lacto-ovo-pollo l Pesco l Macrobiotic l Fruitarians l Vegan l Lacto-ovo l Lacto-ovo-pollo l Pesco l Only a few plant foods l Dried fruit, nuts, honey l No animal foods l Plants + milk, eggs l ditto + poultry l Plants + fish (+ milk, eggs…) TypeFoods eaten

9. Protein Complementation l legumes l vegetables l corn l grains l nuts and seeds l legumes l vegetables l corn l grains l nuts and seeds l met l trp, lys l lys, thr l lys Food source Limiting amino acid met = methioninethr = threonine lys = lysinetrp = tryptophan

10. Nutritional Concerns of Vegetarian Diets l Macrobiotic l Fruitarians l Vegan l Others l Macrobiotic l Fruitarians l Vegan l Others l *vit. C, calcium, protein…* l *energy, protein, minerals…* l vitamin B12!, calcium, zinc, iron, vit. D l probably okay TypeNutrients at risk

11. Eating Disorders l Food itself is not the primary problem; food is a symptom of serious distress. l Early detection is crucial for recovery. l Help is available. Multidisciplinary treatment works best.

12. Prevention l Discourage l Downplay _________; promote healthful behavior l Promote eating when l Do not use food as l Teach proper nutrition and healthy weight approaches

13. Adolescents and Athletics l ________is the nutrient of primary concern for athletes in general l ________ is a performance and a health risk »replace for every pound lost in sweat l Protein: +6-7 g/day (____% of kcal) »More = high fat intake; delayed digestion, absorption; greater dehydration risk

14. Adolescents and Athletics l Energy is primary for still- growing adolescent athletes »Boys: maintain »Girls: maintain l Concern = athletes who manipulate weight l Anabolic steroids increase bulk, but also stunt growth and pose health risk l Long-term effects of ___________ are unknown

15. Female Athlete Triad

16. Prevention l Support adolescents through puberty: recognize l Teach that ______ = better athletic performance l Encourage healthy attitudes from

17. Adolescent Pregnancy l High risk pregnancies due to immaturity: l Gynecological age = time from onset of __________ »< ______ indicates greater risk »less time from completion of puberty means less »e.g. ________ »involve _______ if possible

18. Risks to the Mother l bleeding (1st, 3rd trimesters) l __ l difficult »cephalopelvic __________ l pregnancy-induced hypertension l infections l psychological/social development l mortality: 2.5x greater!

19. l perinatal and neonatal l * »babies weigh less than those of adult mothers with same weight gain »will covering normal gain help? l risk of l life with parent(s) who have ____________ skills l life with one parent only; living below the Risks to the Baby