1. Nutrition

2. Child & Adolescent Nutrition Differs from adult nutrition. Infancy needs Toddlers Adolescents

3. (Story & Stang, 2005)

4. Nutritional Needs Iron is important ▫From toddlers to teenagers Special dietary needs for teenagers: ▫This is a time of growth spurts  20% of adult height  50% of adult weight

5. Iron Deficiency & Anemia What is anemia? Symptoms: ▫Fatigue / weakness ▫Pale skin ▫Rapid heartbeat ▫Irritability ▫Decreased appetite ▫Dizziness / Lightheadedness

6. Preventing Anemia Foods rich in iron ▫Red meat, tuna, salmon, eggs, enriched grains, leafy green vegetables, fortified foods May need a supplement Recommended amounts: ▫7-10 mg/day for children 1-12 years old ▫11 mg/day for adolescent boys; 15 mg/day for girls

7. Teenagers and Calcium Teenagers need calcium to build strong bones ▫Calcium is also important for muscle contractions The osteoporosis connection… ▫Why talk about this in a child & adolescent health class??

8. Osteoporosis 1 of every 2 American women will get osteoporosis after the age of 65. Why worry about teenagers? ▫Less than half of teenagers get enough calcium in their diet.  For girls – about 15% get enough calcium.  The teenage years are the time to build strong bones

10. Soda consumption & Osteoporosis Girls who drank soft drinks: 3x more likely to have a bone fracture ▫Physically active girls: 5x more likely to have a bone fracture ▫Why?  Phosphoric acid  Less calcium consumption  Source: Harvard School of Public Health

11. Who is at risk? Those who do not get enough calcium Females Those with high soft drink consumption Those who do not exercise Caucasians and Asians Family history Smoking Alcohol

12. Prevention Eating calcium-rich foods ▫Dairy products, calcium-fortified orange juice, leafy green vegetables, canned salmon or tuna ▫May need a calcium supplement Weight-bearing exercises Limit soft drink consumption Don’t smoke Notice anything about this list?

13. “Selling” it to teenagers Make it beneficial in the short term ▫May need to relate it to body image  “Calcium will help you grow taller”  “Do you know those older people that are stooped over?”  Low-fat, non-fat alternatives for those worried about gaining weight.

14. Eating Disorders

15. Teenagers & Dieting Over ½ of teenage girls and 1/3 of teen boys use unhealthy weight control behaviors. ▫(Neumark-Sztainer, 2005) ▫These behaviors include:  Skipping meals  Fasting  Smoking cigarettes to control weight  Vomiting  Taking laxatives

16. Teens & Body Image 50-88% of adolescent girls feel negatively about their body size and shape. Over 1/3 of males think their current size is too small. Puberty can amplify body image concerns. (Croll, 2005)

17. The Female Athlete Triad What is it? ▫Disordered eating ▫Bone loss ▫Amenorrhea Who is at risk? Consequences?

18. Teenagers & Eating Disorders Approximately 11 million Americans suffer from an eating disorder. (EDC, 2010) 50-80% of risk is determined by genetics. (ECD, 2010) Three classes: Anorexia Nervosa Bulimia Nervosa Eating Disorders Not Otherwise Specified (EDNOS) Includes Binge Eating Disorder

19. Eating Disorders & Media Tweens & Teens are more likely to be dissatisfied with their bodies after watching media. Movies & Television shows often have characters comment on appearance/weight. Advertisements often use an appeal to beauty to sell the product. ▫National Institute on Media and the Family

20. Anorexia Nervosa Self-starvation ▫Essential nutrients are denied (no or little food) so the body slows down all normal processes to conserve energy. Health consequences ▫Low blood pressure / heart rate ▫Muscle loss / weakness ▫Dehydration ▫Fainting / fatigue ▫Dry hair and skin

21. 90-95% are female so, 5-10% are male. Similar characteristics: ▫Preoccupied with weight  Males may have preoccupation with body building, weight lifting or toning. ▫Compulsive exercise ▫Frequently weighing oneself ▫Distorted body image

23. Bulimia Nervosa Typically a binge – purge method ▫Binge – secret periods of quickly eating high- calorie dense foods. ▫Purge – more than the typical vomiting. 80% are female Health consequences: ▫Irregular heartbeat = heart failure = death. ▫Tooth decay ▫Ulcers

24. Warning Signs Anorexia ▫Becomes very thin ▫Obsesses over eating, food, weight ▫Counts portions, calories carefully ▫Only eats certain foods ▫Feels fat ▫Withdraws from social activities ▫May be depressed, fatigued or cold all the time Bulimia ▫Fears weight gain ▫Intensely unhappy with body size, shape or weight ▫Goes to the bathroom frequently or immediately after meals ▫Regularly buys laxatives ▫Spends most of free time working out ▫Withdraws from social activities

25. Prevention Involves everyone: ▫Parents, communities, schools Examine your own body image Avoid power struggles over food Create a healthy lifestyle for the family

26. More information “Dying to be thin” www.pbs.orgwww.pbs.org ▫Nova program