Nutrition and Diet Therapy – Lecture

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

Session # 13

LESSON TITLE: Nutrition through the Life Span: Materials:

Adolescence Pen and notebook

LEARNING OUTCOMES:

Upon completion of this lesson, you can: Reference:

1. Explain the growth and development during adolescence; DeBruyne, L.K., Pinna, K., & Whitney E., (2016).
2. Describe the nutrient needs of adolescents; and, Nutrition and diet therapy: Principles and practice
3. Enumerate some of the challenges in meeting the (9th ed.). USA: Cengage Learning.
nutritional needs of adolescents.

LESSON PREVIEW/REVIEW
Let us have a review of what you have learned from the previous lesson. Kindly answer the following questions on the
space provided. You may use the back page of this sheet, if necessary. Have fun!

Instruction: List some health habits for children to prevent childhood obesity.

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MAIN LESSON
You will study and read their book, if available, about this lesson.

As children pass through adolescence on their way to becoming adults, they change in many ways. Their physical
changes make their nutrient needs high, and their emotional, intellectual, and social changes make meeting those needs
a challenge. Teenagers make many more choices for themselves than they did as children. They are not fed; they eat.
Food choices made during the teen years profoundly affect present and future health. At the same time, social pressures
thrust choices at them: whether to drink alcoholic beverages and whether to develop their bodies to meet extreme ideals
of slimness or athletic prowess. Their interest in nutrition—both valid information and misinformation—derives from
personal, immediate experiences. They are concerned with how diet can improve their lives now—they try the latest fad
diet to fit into a new bathing suit, avoid greasy foods in an effort to clear acne, or eat a plate of pasta to prepare for a big
sporting event. In presenting information on the nutrition and health of adolescents, this chapter includes topics of interest
to teens.

A. Growth and Development during Adolescence

With the onset of adolescence, the steady growth of childhood speeds up abruptly and dramatically, and the growth
patterns of females and males become distinct. Hormones direct the intensity and duration of the adolescent growth spurt,
profoundly affecting every organ of the body, including the brain. After 2 to 3 years of intense growth and a few more at a
slower pace, physically mature adults emerge.

In general, the adolescent growth spurt begins at age 10 or 11 for females and at age 12 or 13 for males. It lasts about 2½
years. Before puberty, male and female body compositions differ only slightly, but during the adolescent spurt, differences
between the genders become apparent in the skeletal system, lean body mass, and fat stores. In females, fat assumes a
larger percentage of total body weight, and in males, the lean body mass—principally muscle and bone—increases much

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more than in females. On average, males grow 8 inches taller, and females, 6 inches taller. Males gain approximately 45
pounds, and females, about 35 pounds.

B. Energy and Nutrient Needs

The energy needs of adolescents vary greatly, depending on the current rate of growth, gender, body composition, and
physical activity. Boys’ energy needs may be especially high; they typically grow faster than girls and, as mentioned,
develop a greater proportion of lean body mass. An exceptionally active boy of 15 may need 3500 kcalories or more a day
just to maintain his weight. Girls start growing earlier than boys and attain shorter heights and lower weights, so their
energy needs peak sooner and decline earlier than those of their male peers. An inactive girl of 15 whose growth is nearly
at a standstill may need fewer than 1800 kcalories a day if she is to avoid excessive weight gain. Thus, teenage girls need
to pay special attention to being physically active and selecting foods of high nutrient density so that they will meet their
nutrient needs without exceeding their energy needs.
Obesity. The insidious problem of obesity becomes ever more apparent in adolescence and often continues into
adulthood. Without intervention, overweight teens will face numerous physical and socioeconomic consequences for
years to come. The consequences of obesity are so dramatic and our society’s attitude toward obese people is so
negative that even healthy-weight or underweight teens may perceive a need to lose weight. When taken to extremes,
restrictive diets bring dramatic physical consequences of their own.

Vitamin D. Recommendations for most vitamins increase during the teen years (see the tables on the inside front cover).
Several of the vitamin recommendations for adolescents are similar to those for adults, including the recently revised
recommendations for vitamin D. Vitamin D is essential for bone growth and development. Recent studies of vitamin D
status in adolescents show that many are vitamin D deficient; blacks, females, and overweight adolescents are most at
risk. Adolescents who do not receive enough vitamin D from fortified foods such as milk and cereals, or from sun
exposure each day, may need a supplement.

Iron. The need for iron increases during adolescence for both females and males but for different reasons. Iron needs
increase for females as they start to menstruate and for males as their lean body mass develops. Hence, the RDA
increases at age 14 for both males and females. Because menstruation continues throughout a woman’s childbearing
years, the RDA for iron remains high for women into late adulthood. For males, the RDA returns to preadolescent values
in early adulthood.

In addition, iron needs increase when the adolescent growth spurt begins, whether that occurs before or after age 14.
Therefore, boys in a growth spurt need an additional 2.9 milligrams of iron per day above the RDA for their age; girls need
an additional 1.1 milligrams per day. Furthermore, iron recommendations for girls before age 14 do not reflect the iron
losses of menstruation, even though the average age of menarche is 12.

Iron intakes often fail to keep pace with increasing needs, especially for females, who typically consume fewer iron-rich
foods such as meat and fewer total kcalories than males. Not surprisingly, iron deficiency is most prevalent among
adolescent girls. Iron-deficient children and teens score lower on standardized tests than those who are not iron deficient.

Calcium. Adolescence is a crucial time for bone development, and the requirement for calcium reaches its peak during
these years. Unfortunately, many adolescents, especially females, have calcium intakes below recommendations. Low
calcium intakes during times of active growth, especially if paired with physical inactivity, can compromise the
development of peak bone mass, which is considered the best protection against adolescent fractures and adult
osteoporosis. Increasing milk products in the diet to meet calcium recommendations greatly increases bone density. Once

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again, however, teenage girls are most vulnerable, for their milk—and therefore their calcium—intakes begin to decline at
the time when their calcium needs are greatest. Furthermore, women have much greater bone losses than men in later
life. In addition to dietary calcium, physical activity makes bones grow stronger. However, because some high schools do
not require students to attend physical activity classes, many adolescents must make a point to be physically active
during leisure time.

C. Food Choices and Health Habits

Teenagers like the freedom to come and go as they choose. They eat what they want if it is convenient and if they have
the time. With a multitude of afterschool, social, and job activities, they almost inevitably fall into irregular eating habits. At
any given time on any given day, a teenager may be skipping a meal, eating a snack, preparing a meal, or consuming
food prepared by a parent or restaurant. Adolescents who frequently eat meals with their families, however, eat more
fruits, vegetables, grains, and calcium-rich foods and drink fewer soft drinks than those who seldom eat with their
families.1 Many adolescents begin to skip breakfast on a regular basis, missing out on important nutrients that are not
made up at later meals during the day. Compared with those who skip breakfast, teenagers who do eat breakfast have
higher intakes of vitamin A, vitamin C, and riboflavin, as well as calcium, iron, and zinc. Teenagers who eat breakfast are
therefore more likely to meet their nutrient recommendations.

Breakfast skipping may also lead to weight gain in adolescents. Eating breakfast each day, especially a breakfast rich in
fiber and protein, improves satiety and reduces hunger and the desire to eat throughout the day. As adolescents make the
transition to adulthood, not only do they skip breakfast more often, but they also eat fast food more often. Both skipping
breakfast and eating fast foods lead to weight gain.

Ideally, in light of adolescents’ busy schedules and desire for freedom, the adult becomes a gatekeeper, controlling the
type and availability of food in the teenager’s environment. Teenage sons and daughters and their friends should find
plenty of nutritious, easy-to-grab food in the refrigerator (meats for sandwiches; low-fat cheeses; fresh, raw vegetables
and fruits; fruit juices; and milk) and more in the cabinets (whole-grain breads, peanut butter, nuts, popcorn, and cereal).
In many households today, all the adults work outside the home, and teenagers perform some of the gatekeeper’s roles,
such as shopping for groceries or choosing fast or prepared foods.

Snacks On average, about a fourth of an adolescent’s total daily energy intake comes from snacks, which, if chosen
carefully, can contribute some of the needed nutrients. A survey of more than 5000 adolescents found that those who ate
snacks more often were less likely to be overweight or obese and had lower rates of abdominal obesity compared with
those who ate snacks less often.

Beverages Most frequently, adolescents drink soft drinks instead of fruit juice or milk with lunch, supper, and snacks.
About the only time they select fruit juices is at breakfast. When teens drink milk, they are more likely to consume it with a
meal (especially breakfast) than as a snack. Because of their greater food intakes, boys are more likely than girls to drink
enough milk to meet their calcium needs. Soft drinks, when chosen as the primary beverage, may affect bone density,
partly because they displace milk from the diet. Over the past 3 decades, teens (especially girls) have been drinking more
soft drinks and less milk. Adolescents who drink soft drinks regularly have a higher energy intake and a lower calcium
intake than those who do not. Soft drinks and energy drinks containing caffeine present a different problem if caffeine
intake becomes excessive. Many adolescents consume energy drinks on a regular basis and these beverages contain
much more caffeine than soft drinks. * Caffeine seems to be relatively harmless, however, when used in moderate doses
(less than 100 milligrams per day, roughly equivalent to fewer than three 12-ounce cola beverages a day). In greater
amounts, it can cause the symptoms associated with anxiety—sweating, tenseness, and inability to concentrate.

Eating Away from Home. Adolescents eat about one-third of their meals away from home, and their nutritional welfare is
enhanced or hindered by the choices they make. A lunch consisting of a hamburger, a chocolate shake, and french fries
supplies substantial quantities of many nutrients at a kcalorie cost of about 800, an energy intake some adolescents can
afford. When they eat this sort of lunch, teens can adjust their breakfast and dinner choices to include fruits and
vegetables for vitamin A, vitamin C, folate, and fiber, and lean meats and legumes for iron and zinc.) Fortunately, many
fast-food restaurants are offering more nutritious choices than the standard hamburger meal.

Peer Influence. Physical maturity and growing independence present adolescents with new choices whose
consequences influence their health and nutrition status both today and throughout life. Many of the food and health
choices adolescents make reflect the opinions and actions of their peers. When others perceive milk as “babyish,” a teen
may choose soft drinks instead; when others skip lunch and hang out in the parking lot, a teen may join in for the

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camaraderie, regardless of hunger. Some teenagers begin using drugs, alcohol, and tobacco; others wisely refrain. Adults
can set up the environment so that nutritious foods are available and can stand by with reliable information and advice
about health and nutrition, but the rest is up to the adolescents. Ultimately, they make the choices.

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the
correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in your answer/ratio is not
allowed.

1. During the growth spurt of adolescence:

a. females gain more weight than males.
b. males gain more fat, proportionately, than females.
c. differences in body composition between males and females become apparent.
d. similarities in body composition between males and females become apparent.
ANSWER: ________
RATIO:___________________________________________________________________________________________
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2. Two nutrients that are usually lacking in adolescents’ diets are:

a. zinc and fat.
b. iron and calcium.
c. protein and thiamin.
d. vitamin A and riboflavin.
ANSWER: ________
RATIO:___________________________________________________________________________________________
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3. To help teenagers consume a balanced diet, parents can:

a. monitor the teens’ food intake.
b. give up—parents can’t influence teenagers.
c. keep the cabinets and refrigerator well stocked.
d. forbid snacking and insist on regular, well-balanced meals.
ANSWER: ________
RATIO:___________________________________________________________________________________________
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4. A period in which the adolescents develop secondary sex characteristics.

a. thelarche
b. menarche
c. growth spurt
d. puberty
ANSWER: ________
RATIO:___________________________________________________________________________________________
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5. Who has the most influence on the choices of the adolescents?

a. family
b. peers
c. environment
d. genetics
ANSWER: ________
RATIO:___________________________________________________________________________________________
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RATIONALIZATION ACTIVITY
The instructor will now provide you the rationalization to these questions. You can now ask questions and debate among
yourselves. Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:________________________________________________________________________________________
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2. ANSWER: ________
RATIO:________________________________________________________________________________________
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3. ANSWER: ________
RATIO:________________________________________________________________________________________
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4. ANSWER: ________
RATIO:________________________________________________________________________________________
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5. ANSWER: ________
RATIO:________________________________________________________________________________________
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LESSON WRAP-UP

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Activity: DIRECTED PARAPHRASING

Summarize or paraphrase the concepts based on your own understanding of the said topic. After the activity, your teacher
will rate your output as follows: E-Excellent, S-Satisfactory and N- Needs Improvement.

GROWTH OF ADOLESCENCE DEVELOPMENT OF ADOLESCENCE

Define in your own understanding Define in your own understanding

Example Example

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