1. Chapter 15 Adolescent Nutrition: Conditions and Interventions
Nutrition Through the Life Cycle
Judith E. Brown

2. Overweight and Obesity
Factors contributing to the increase include:
Having one or more overweight parents
From a low income family
African American, Hispanic, American Indian or Native Alaskan descent
Having a condition that limits mobility
Inadequate physical activity
Diets high in calories, sugars, & fat

3. Health Implications of Adolescent Overweight
Range of complications associated with being overweight include:
Hypertension
Dyslipidemia
Insulin resistance or type 2 diabetes mellitus
Sleep apnea
Hypoventilation disorders
self esteem

4. Health Implications of Adolescent Overweight
Range of complications associated with being overweight include (cont.):
Orthopedic problems
Hepatic disease
Body image disturbances
Low

5. Primary Care Assessments Based on Adolescent BMI

6. National Guidelines for Weight Management Therapy
Four stages of treatment
1. Prevention plus
2. Structured weight management
3. Comprehensive multidisciplinary intervention
4. Tertiary care intervention

7. National Guidelines for Weight Management Therapy
1. Prevention plus
BMI >85th but <95th without co-morbidity conditions
Level of treatment builds upon
Basic nutrition
Physical activity
Goal
Promote health
Prevent disease

8. National Guidelines for Weight Management Therapy
2. Structured weight management
Same behaviors as stage 1
More structured
Screen time is limited to <1 hour per day
Emphasize nutrient-dense foods
Minimize energy-dense foods

9. National Guidelines for Weight Management Therapy
3. Comprehensive multidisciplinary intervention
Same behavioral goals as stage 2
More structured eating
More structured physical activity plan
Designed to lead to negative caloric balance

10. National Guidelines for Weight Management Therapy
4. Tertiary care intervention
Appropriate with severely obese youth or those who have significant, chronic co-morbidity conditions
Level of treatment provided through a tertiary wt management center
Diet and activity counseling with behavior modifications

11. National Guidelines for Weight Management Therapy
4. Tertiary care intervention (cont.)
Treatments may include
Meal replacement
A very low energy diet
Medication
Surgery may be implemented

12. Overview of Staged Treatment

13. Bariatric Surgery and Severely Obese Adolescents
Performed only if obesity has life-threatening medical complications
Adolescent must have completed growth spurt and have either:
BMI >40 with medical complications or
BMI >50 without complications

14. Guidelines for Consideration of Bariatric Surgery

15. Potential Effects of Substance Use on Nutrition Status

16. Treatment of Iron- Deficiency Anemia
Treatment includes:
Increase intake of foods rich in irons & vitamin C
Iron supplements
Under age 12—60 mg/day
Over age 12—60 to 120 mg/day

17. Side Effects of Iron Supplements
Common side effects include
Constipation
Nausea
Cramps

18. Side Effects of Iron Supplements
Reduce side effects by
Taking small, frequent doses
Take with meals
Factors  iron absorption include
Calcium supplements
Dairy products
Coffee
Tea
High-fiber foods

19. Hypertension and Hyperlipidemia

20. Blood Pressure Levels

21. Risk Factors for Hypertension
Family history of hypertension
High sodium intake
Overweight
Hyperlipidemia
Inactive lifestyle
Tobacco use

22. Nutrition Counseling for Hypertension
Limit sodium intake
Limit fat to 30% of calories
Consume adequate fruits, vegetables, whole grains, & low-fat dairy
Weight loss if overweight
Dietary recommendations should be encouraged even if meds are prescribed

23. Hyperlipidemia ~1 in 4 adolescents have elevated cholesterol
Risk factors include:
Family history
Cigarette smoking
Overweight
Hypertension
Diabetes
Physically inactive

24. Dietary Recommendations to Reduce Hyperlipidemia
<35% calories from total fat
<10% calories from saturated fat
Cholesterol intake ≤300 mg/day
Adequate fruits, vegetables, grains, & low-fat dairy

25. Continuum of Weight-Related Concerns and Disorders

26. Dieting Behaviors
Dieting most common in Hispanic females followed by white females
Dieting & unhealthy wt control behaviors may increase chance of future overweight or obesity
Effective nutrition messages should focus on lifestyle changes

27. Body Dissatisfaction
Adolescents with low levels of body satisfaction are more likely to use unhealthy weight control behaviors & participate in less physical activity

28. Disordered Eating Behaviors
Anorexic or bulimic behaviors—with less frequency or intensity=unable to do a formal diagnosis
Results of 2005 YRBS:
12% have fasted > 24 hours
6% use diet pills or other diet formulae
7% of Hispanic & white females vomit or use laxatives to control wt

29. Prevalence of Eating Disorders

30. Tips for Fostering a Positive Body Image Among Children & Adolescents

31. Etiology of Eating Disorders
Main groups of contributing factors for eating disorders
1. Environmental
2. Familial factors
3. Interpersonal factors
4. Personal factors

32. Preventing Eating Disorders
Characteristics of successful eating disorder prevention programs:
Target high-risk groups
Target adolescents > 15 years of age
Information provided by trained interventionists
Multiple sessions
Integrated interactive learning