A famous quote says, “Investing in early childhood nutrition is a surefire strategy. The returns are incredibly high.”
As we have discussed in part 1 of pediatric nutrition, early childhood is a very sensitive phase, and it gets tougher and tougher as children grow from babies to teenagers.
Physiological and cognitive needs keep changing as children interact with social, environmental, cultural, and economic differences.
This article provides information on nutritional needs for the ages 8- 18.
All About Adolescence
Improving adolescents' nutrition and eating habits will not only help them in their current moment but also provide an opportunity to shape the health and well-being of future generations.
Adolescence is a phase in life that makes or breaks them into adults. In short, teenagers are vulnerable and are urged to explore life in many dimensions.
They display numerous moods and are phrased as ‘teenage tantrums.’ I call it the ‘teenage temperament’ due to the multidimensional changes they undergo in 2 years from 8-10 years.
This transition develops and gradually moves into adolescence from 11-18 with varying physiological and psychological needs.
Researchers have also identified components that play a part in adolescent stages like identity formation, such as identification by gender, ethnicity, and sexual orientation. (Adolescence, 2011)
I receive many questions from teens, especially about their height and weight. Children are more worried about their physical appearance at this phase of life.
Any deviation in their appearance puts them in ‘The ugly duckling’ theory, making them look odd in their peer group. Dietary and lifestyle mistakes are common due to a lack of awareness and peer pressure.
Teenage Psychology & Eating Patterns
Children don’t just need food, but they need ‘nutrient-dense food’. Better nutrition leads to a stronger body, increased endurance, and better emotional stability to perform daily activities without interruption.
Nutritious food helps the child use their cognitive abilities more, improving their memory during exams. Nutrition in children is always balanced, where the brain needs carbohydrates, muscle needs protein, healthy fats for their nervous system (myelination), fiber to develop their gut health, and vitamins and minerals to perform catabolic and anabolic activities that help maintain energy homeostasis. (Norris et al., 2022)
Just like amino acids are known as the building blocks of protein, balanced nutrition during adolescence is the building block for future generations.
School-going children constitute one-fifth of the total population, and they are the nation's future by increasing individual productivity and helping the economy with a better per capita income and GDP. (Das et al., 2018)
In short, nutrition plays one of the crucial roles in individual health associated with the nation’s productivity and economic growth (start-ups, urbanization, jobs, and military participation).
Unmasking Anorexia and Bulimia Nervosa
A decade ago, less light was thrown on anorexia nervosa and bulimia nervosa. These are eating disorders associated with psychological behaviors concerning body weight and body image.
Recent studies have shown that body image is the focus of attention in the early and late teens. Adolescents' Eating behaviors revolve around various factors like economic, cultural, social, and parental beliefs.
Binge eating is also added to the category of eating disorders. (“Eating Disorders in Adolescents: Principles of Diagnosis and Treatment,” 1998)
Anorexia and bulimia can begin to develop in the vulnerable stages of early and late teens. With anorexia, food consumption is severely restricted by the teenager, and with bulimia, binge eating episodes are seen, followed by purging, fasting, or excessively exercising.
Both disorders exhibit extreme symptoms leading to harmful consequences to their health, like medical complications and nutritional disturbances. (Sadhir, 2018)
Some of the health disorders could be:
- Loss of immunity
- GERD
- Esophageal complications
- Loss of dental enamel
- Osteoporosis
- Growth retardation disrupted pubertal development.
- Vitamin and mineral deficiencies.
- Psychological and mental health disturbances.
Suppose a teenager displays symptoms like fasting for days, restricted eating, excessive eating with purging, binge eating, and excessive exercising.
In that case, depending on their needs, it is time to provide them with professional help in hospitals and rehab centers.
Psychoeducation, nutrition education, and medical interventions are necessary at this stage to help the child recoup and get back to normal health. (Bhattacharya et al., 2020)
Could Negligence during Adolescence Increase the Risk of Metabolic Issues in Adulthood?
A cross-sectional prospective study was designed to conduct a detailed physical health assessment of children studying in classes 1-8 (age- 5-13 years) of 31 schools in Ahmedabad City, India, between December 2011 and February 2012.
Under the state government's school health program, medical history, height, weight, and general physical examination findings, including dental and ophthalmic examination, were recorded by qualified medical practitioners.
Children with abnormal results were further investigated and treated by the subject experts.
Out of 28,256 children, 8,319 were found to be underweight. 0.8% and 0.6% are overweight in boys and girls, respectively. 42% of children were diagnosed with worm infestations, followed closely by upper respiratory tract infection (36.39%) and anemia (30.99%).
A total of 1355 children, including those with Squints (54), Dental caries requiring further treatment (1268), orthopedic problems (3), heart diseases (9), handicaps (3), kidney diseases (10), central nervous system disorders (6) and cancer (2) were referred to the concerned higher center.
The most remarkable observation of this study was a far inferior anthropometric measurement of the height and weight of school children across the entire range of ages when matched with the ICMR standards, which is largely representative of the average of Indian children. (Patel et al., 2015)
The study also concludes by saying there should be quality counseling and education around health, sanitation, nutrition, and personal hygiene in children aged 10-18 years.
Is this Negligence? I would rather say, lack of awareness! Education and awareness will help improve their health and anthropometric measurements, ultimately reducing their chances of developing metabolic diseases as they grow into adults.
Macronutrients and Skeletal Development
When children are given high-protein diets like chicken, eggs, milk, legumes, pulses, and beans, you will see that they have sustainable immunity with better muscle mass.
Two glasses of milk and two cups of dairy yogurt will help them improve their bone mass. This combination of diet with protein and calcium helps their skeletal development by reaching their ideal height and growth.
Similarly, carbohydrates serve as energy sources and also help them with better cognitive abilities. Healthy fats are essential for myelination of the nerve sheath and help increase their HDL (high-density lipoprotein) in the serum.
A healthy combination of proteins (crucial for their overall development), carbohydrates, and fats regulate their hormonal functions and reproductive health.
Essential Vitamins and Minerals from the Ages 8-18 Years
Iron, zinc, selenium, calcium, phosphorous, and magnesium combined with high-quality protein-rich foods bring out the best health in growing children, supporting their skeletal growth, iron levels, muscle contractions, and immunity.
All B vitamins are essential for metabolic functions, memory and cognition, vision, skin, joints, RBC homeostasis, mitochondrial health, and immunity. B vitamins also help regulate the action of carbohydrates by storing them as glucose in the blood.
Vitamins A, C, D, & E combined with healthy fats support all the essential physiological functions in their bodies.
Folic acid combined with zinc is an essential support for reproductive health for both genders. Calcium and magnesium combined with Vitamin D support and reduce the risk of depression. Iron combined with B12, B9, and Vitamin C protects from the risk of anemia.
Fortifications and external supplementations should be considered in children diagnosed with underlying health issues and malabsorption. (Soliman et al., 2022)
Binge Eating and Junk food
Bunge eating and excessively consuming junk food can impact their pubertal growth and hormonal responses.
It is always better to restrict them to occasional food outings, packaged foods, and sugary treats.
Physical Activity
Do not forget to exercise and get good quality sleep daily.
Children need 45 -60 minutes of daily activity or play time involving the movement of their entire body.
Avoid usage of lifts and escalators by encouraging them to use the stairs.
Exercise develops their skeletal muscle and bone and increases their lung capacity, reducing the risk of respiratory tract infections.
Conclusion
I strongly recommend supporting adolescents' health both physically and mentally. They are the nation's future, and a healthy adolescent will grow into an economically and mentally stable adult. Good nutrition is crucial for the brain and the body; hence, more educational institutions should also focus on educating their students on mental health and dietary practices.
Parents of teenagers must be open to communicating with their children about mental health. They must be ready to accept professional support to help them establish better dietary habits and nutrition counseling.
References
Adolescence, I. of M. (US) and N. R. C. (US) C. on the S. of. (2011). The Psychology of Adolescence. https://www.ncbi.nlm.nih.gov/books/NBK53420/
Bhattacharya, A., DeFilipp, L., & Timko, C. A. (2020). Feeding and eating disorders. Handbook of Clinical Neurology, 175, 387–403. https://doi.org/10.1016/B978-0-444-64123-6.00026-6
Das, J. K., Lassi, Z. S., Hoodbhoy, Z., & Salam, R. A. (2018). Nutrition for the Next Generation: Older Children and Adolescents. Annals of Nutrition & Metabolism, 72 Suppl 3, 56–64. https://doi.org/10.1159/000487385
Eating disorders in adolescents: Principles of diagnosis and treatment. (1998). Paediatrics & Child Health, 3(3), 189. https://doi.org/10.1093/PCH/3.3.189
Norris, S. A., Frongillo, E. A., Black, M. M., Dong, Y., Fall, C., Lampl, M., Liese, A. D., Naguib, M., Prentice, A., Rochat, T., Stephensen, C. B., Tinago, C. B., Ward, K. A., Wrottesley, S. V., & Patton, G. C. (2022). Nutrition in adolescent growth and development. The Lancet, 399(10320), 172–184. https://doi.org/10.1016/S0140-6736(21)01590-7
Patel, N., Gunjana, G., Patel, S., Thanvi, R., Sathvara, P., & Joshi, R. (2015). Nutrition and health status of school children in urban area of Ahmedabad, India: Comparison with Indian Council of Medical Research and body mass index standards. Journal of Natural Science, Biology, and Medicine, 6(2), 372. https://doi.org/10.4103/0976-9668.160010
Sadhir, M. (2018). Eating disorders in adolescence. Building Youth for the Future: A Path towards Suicide Prevention, 33(6), 165–176. https://doi.org/10.1542/pir.15.2.72
Soliman, A., Alaaraj, N., Hamed, N., Alyafei, F., Ahmed, S., Shaat, M., Itani, M., Elalaily, R., & Soliman, N. (2022). Nutritional interventions during adolescence and their possible effects. Acta Bio Medica : Atenei Parmensis, 93(1), 2022087. https://doi.org/10.23750/ABM.V93I1.12789
