chapter 15 adolescent nutrition: conditions and interventions nutrition through the life cycle...
TRANSCRIPT
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Chapter 15Adolescent Nutrition:
Conditions and Interventions
Nutrition Through the Life Cycle Judith E. Brown
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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
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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
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Health Implications of Adolescent Overweight
• Range of complications associated with being overweight include (cont.):– Orthopedic problems– Hepatic disease– Body image disturbances– Low
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Primary Care Assessments Based on Adolescent BMI
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National Guidelines for Weight Management Therapy
• Four stages of treatment1. Prevention plus
2. Structured weight management
3. Comprehensive multidisciplinary intervention
4. Tertiary care intervention
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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
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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
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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
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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
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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
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Overview of Staged Treatment
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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
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Guidelines for Consideration of Bariatric Surgery
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Potential Effects of Substance Use on Nutrition Status
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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
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Side Effects of Iron Supplements
• Common side effects include– Constipation – Nausea– Cramps
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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
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Hypertension and Hyperlipidemia
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Blood Pressure Levels
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Risk Factors for Hypertension
• Family history of hypertension
• High sodium intake
• Overweight
• Hyperlipidemia
• Inactive lifestyle
• Tobacco use
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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
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Hyperlipidemia
• ~1 in 4 adolescents have elevated cholesterol• Risk factors include:
– Family history– Cigarette smoking– Overweight– Hypertension– Diabetes– Physically inactive
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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
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Continuum of Weight-Related Concerns and Disorders
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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
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Body Dissatisfaction
• Adolescents with low levels of body satisfaction are more likely to use unhealthy weight control behaviors & participate in less physical activity
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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
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Prevalence of Eating Disorders
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Tips for Fostering a Positive Body Image Among Children &
Adolescents
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Etiology of Eating Disorders
• Main groups of contributing factors for eating disorders
1. Environmental
2. Familial factors
3. Interpersonal factors
4. Personal factors
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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