Food and Nutrition Guidelines for Healthy Adolescents

A Background Paper - (full text version)Published in June 1998


ISBN 0-478-22847-3 (Booklet)
ISBN 0-478-22848-1 (Internet)
HP 2204

This is the full text online version of this document.

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ContentsAcknowledgements

Foreword

Background

Introduction

Definition of Adolescence

Energy

Energy requirements
Energy intake

Obesity
Definition
Inactivity and obesity
Diet composition
Treatment
Recommendations for achieving a healthy body weight
Recommended energy intakes for adolescents

Protein
Recommended protein intake

Fat
Fat in the diet
Fat intake
Cardiovascular disease and fat intake
Recommended fat intakes for adolescents

Carbohydrate
Carbohydrate and dietary fibre
Non-starch polysaccharides (NSPs)
Resistant starch
Carbohydrate, dietary fibre, NSP and resistant starch intake
Ensuring an adequate carbohydrate and dietary fibre intake
Recommended intakes for adolescents

Iron
Dietary iron and absorption
Iron deficiency
Dietary iron intakes
Ensuring an adequate iron intake
Vegetarian, vegan or other diets not containing animal tissues
Pregnancy
Iron supplements
Adolescent athletes
Recommended iron intakes for adolescents

Calcium
Skeletal calcium and peak bone mass
Calcium absorption and excretion
Calcium intake
Ensuring an adequate calcium intake
Recommended calcium intakes for adolescents

Other Nutrients
Sodium
Folate
Zinc
Vitamin A
Vitamin C
Vitamin B6
Vitamin B12
Niacin, riboflavin, thiamin

Fluid Intakes
Water balance
Fluid intakes of adolescents
Fluid needs of very physically active adolescents
Alcohol
Suitable fluids for adolescents

Supplementation

Fortification

Vegetarian Diets
Nutritional adequacy of lacto-ovo-vegetarian diets
Nutritional adequacy of vegan diets
Nutrients to monitor and practical suggestions

Body Image, Dieting and Eating Disorders
Body image
Exercise and weight control
Eating disorders
Risk factors for the development of eating disorders
Nutritional effects of eating disorders
Treatment

Pregnancy

Physical Activity Guidelines for Adolescents
Background
Recommendations
Participation levels
Motivation for participation in physical activity

References

Appendix 1: Recommended dietary intakes (RDIs)

Appendix 2: Recommended dietary allowances 10th Edition (US RDA)

Appendix 3: Dietary reference values for food energy and nutrients for the United Kingdom

Appendix 4: Levels of total blood cholesterol in New Zealand adolescents

Appendix 5: Adolescents – sample diet

Appendix 6: Food Fantastic – eating for healthy adolescents
Acknowledgements

The Ministry of Health would like to thank the main authors of this paper, Dr Clare Wall who wrote the Food and Nutrition sections and Tim Colbert who wrote the Physical Activity section. The Ministry would also like to thank the many individuals and groups who commented on the draft.
Foreword

This background paper reviews key nutrition areas affecting adolescent health. It has provided the material for the development of the guidelines presented in the health education booklet, Food Fantastic – Eating for Healthy Adolescents (Code 4389) and presents a comprehensive set of references relevant to the guidelines.

These guidelines are an important part of the National Nutrition Policy and will be a valuable resource for health professionals, educators and caregivers.

New Zealand offers a wide variety of healthy food to choose from and the guidelines will give adolescents sound information on which to base their food choices.

Karen O Poutasi (Dr)

Director-General of Health

Background

Adolescence is a time of newly discovered independence and freedom of choice. This puts adolescents in a group susceptible to external influences, particularly from the media, school and their peers.

Adolescents experience periods of rapid growth associated with hormonal, cognitive and emotional changes. These are often confounded by lifestyle changes, such as leaving home, changing schools or starting work.

Healthy eating during adolescence is an extension of healthy eating during childhood but often in an environment that relies on snacking and irregular meal patterns.

This background paper has been prepared to support Food Fantastic – Eating for Healthy Adolescents by the Ministry of Health in March 1998 (A ppendix 6).

These guidelines recommend that healthy adolescents should:

• eat many different kinds of food each day
  
• eat enough for growth and physical activity
  
• choose foods low in fat, sugar and salt
  
• choose snacks well
  
• drink plenty every day
  
• not drink alcohol
  
• take part in regular physical activity.

The suggested minimum serving sizes for the four food groups outlined in Food Fantastic – Eating for Healthy Adolescents (Code 4389) do not necessarily need to meet 100 percent of the Recommended Dietary Intake (RDIs) for all nutrients. This is because:

• RDIs apply to a population group’s needs rather than individual needs
  
• RDIs incorporate a safety margin
  
• people usually eat more than the recommended number of servings
  
• foods that do not fit into a specific food group, that is, mixed foods are likely to make up the additional energy and nutrient requirement
  
• cooking and preparation methods will influence energy intake.

Introduction

Dietary habits and food preferences which affect energy consumption and nutrient intake, are generally developed over a period of time and particularly during adolescence. Two major factors affect food choices during adolescence. The first is a greater quest for independence; as in earlier periods of life, one of the ways independence is exhibited is through eating, or not eating. It is often a time for making rebellious or non-conformist statements and adopting social causes. This, coupled with a lack of knowledge and experience necessary to make adequate evaluations of dietary practice, may lead to the adoption of ill-conceived diets . The second factor is greater purchasing power to obtain meals, snacks and beverages. Rather than relying solely on family foods, sources of food may include food outlets, vending machines and school canteens.

There are many other factors noted to influence the food choices and nutritional intake in this age group, including general nutrition knowledge, socioeconomic status, urban or rural residence, family composition, cultural and religious events, participation in sport and food advertising (Worsley et al 1993; Fuamatu et al 1996; Maskill et al 1996). However, the living situation during adolescence is noted as an important influence on food choice during this period, with families serving as role models that reinforce and support the acquisition and maintenance of eating behaviour (Epstein 1996; Rolls 1988; Fuamatu et al 1996; Maskill et al 1996). Some individuals in the adolescent age group live independently with little or no family contact. However, there is a lack of research about the dietary practices of independent adolescents in New Zealand.

Peer influence through increased social activity also affects food choices of adolescents (Truswell and Darnton-Hill 1991; Huenemann et al 1968; Farthing 1991). Loss of appetite or refusing to consume food, overeating, eating whatever is available and eating convenience or junk foods are some of the food-related responses to the stress of teenage lifestyle (King and Parham 1981; Hetzler and Owen 1984). Alcohol, tobacco and drug use can also affect nutrition status and food choice in the adolescent, and they also need to be considered (Crawley and While 1996).

Research into the eating behaviours and patterns of adolescents indicate the unique lifestyle of this age group that creates a particular context for nutrition education and intervention. Also, it must be noted that the onset of the pubertal growth spurt varies for individuals and thus, any advice given to adolescents as a group must consider the wide variation in individual needs. It is also important to consider cultural-specific dietary practices when evaluating and promoting nutrition education for this age group (Fuamatu et al 1996).


Definition of Adolescence

The period of adolescence has wide cultural and individual variation. The World Health Organization (WHO) defines ‘young people’ as those aged between 10 and 24 years (World Health Organization 1989).

Adolescents of a given chronological age usually vary in their physiological development. Because of this variability among individuals, age is often a poor indicator of physiological maturity and nutritional needs (Lifshitz et al 1993 ).

Physiologically, adolescence can be defined as the period between pubescence (the time of initial physiological development during which the reproductive organs mature) and the time when the changes are complete.

While the dietary recommendations are expressed by chronological age, the information in this paper will encompass adolescence as defined physiologically.

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