13.2: Early Adolescence and Nutrition

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Learning Objectives

Summarize nutritional requirements and dietary recommendations for adolescents.
Discuss the most important nutrition-related concerns during early adolescence.
Discuss the growing rates of childhood obesity and the long-term consequences of it.

Puberty is the beginning of adolescence. The onset of puberty brings a number of changes, including the development of primary and secondary sex characteristics, growth spurts, an increase in body fat, and an increase in bone and muscle development. All of these changes must be supported with adequate intake and healthy food choices.

Energy

The energy requirements for adolescents differ according to sex, growth, and activity level. Physically active adolescents who regularly participate in sports or exercise need to eat a greater number of calories to account for increased energy expenditure.

Macronutrients

The Acceptable Macronutrient Distribution Ranges (AMDRs) for 9-13 year olds are listed in Table \(\PageIndex{1}\).For carbohydrates, the AMDR is 45 to 65% of daily calories which is the same AMDR as adults. Fiber recommendations increase from childhood. The recommendation for 9-13 year old females is 26 grams of fiber per day; the recommendation for males is 31 grams per day. The AMDR for protein is 10-30% of daily calories (0.85 grams of protein/kg body weight/day) and the AMDR for fat is 25-35% of daily calories.

Table \(\PageIndex{1}\): Acceptable Macronutrient Distribution Ranges (AMDRs) for Early Adolescence¹
Macronutrient	AMDR
Carbohydrate	45-65% of total calories
Protein	10-30% of total calories
Fat	25-35% of total calories

Micronutrients

Key vitamins needed during early adolescence include vitamins A and D. Adequate calcium intake is essential for building bone and preventing osteoporosis later in life. Young females need more iron at the onset of menstruation, while young males need additional iron for the development of lean body mass. Almost all of these needs should be met with dietary choices, not supplements (iron is an exception since it is hard to get enough iron from food during this stage of life). Table \(\PageIndex{2}\) shows the micronutrient recommendations for young adolescents.

Table \(\PageIndex{2}\): Micronutrient Levels during Early Adolescence
Nutrient	Adolescents, Ages 9–13
Vitamin A (mcg)	600
Vitamin B₆ (mg)	1
Vitamin B₁₂ (mcg)	1.8
Vitamin C (mg)	45
Vitamin D (mcg)	15
Vitamin E (mg)	11
Vitamin K (mcg)	60
Calcium (mg)	1,300
Folate (mcg)	300
Iron (mg)	8
Magnesium (mg)	240
Niacin (B₃) (mg)	12
Phosphorus (mg)	1,250
Riboflavin (B₂) (mg)	0.9
Selenium (mcg)	40
Thiamin (B₁) (mg)	0.9
Zinc (mg)	8

Childhood Obesity

Children need adequate caloric intake for growth, and it is important not to impose very restrictive diets. However, exceeding caloric requirements on a regular basis can lead to childhood obesity, which has become a major problem in North America. According to a recent national survey, 18.5% of children ages 2 to 19 were obese.²

There are a number of reasons behind the problem of childhood obesity, including:

larger portion sizes
increased consumption of sugary beverages
limited access to nutrient-rich foods
increased access to fast foods and vending machines
lack of breastfeeding support
declining physical education programs in schools
insufficient physical activity and a sedentary lifestyle
lack of sleep
community factors (safe environment for physical activity, affordability of healthy food options)
media messages encouraging the consumption of unhealthy foods

Children who suffer from obesity are more likely to become overweight or obese adults. Obesity has a profound effect on self-esteem, energy, and activity level. Even more importantly, it is a major risk factor for a number of diseases later in life, including high blood pressure, heart disease, Type 2 diabetes, sleep apnea, joint problems, and certain cancers.³

A percentile for body mass index (BMI) specific to age and sex is used to determine if a child is overweight or obese. For example, if BMI is higher than that of 85% of U.S. children of the same age and sex, the child would be classified as overweight. If BMI is higher than that of 95% of U.S. children of the same age and sex, the child would be classified as obese. This is more appropriate than the BMI categories used for adults because the body composition of children varies as they develop, and differs between boys and girls. If a child gains weight inappropriate to growth, parents and caregivers could use strategies such as:

limiting energy-dense, nutrient-poor snack foods
encouraging 60 minutes or more of physical activity through fun activities each day
limiting sedentary activities such as watching television, playing video games, or surfing the internet
limiting sugar-sweetened beverages

Programs to address childhood obesity can include behavior modification, exercise counseling, psychological support or therapy, family counseling, and family meal-planning advice. For most, the goal is not weight loss, but rather allowing height to catch up with weight as the child continues to grow. Rapid weight loss is not recommended for preteens or younger children due to the risk of deficiencies and stunted growth.

Key Takeaways

The energy requirements for adolescents differ according to sex, growth, and activity level.
Micronutrients of concern during early adolescence include vitamin A, vitamin D, calcium, and iron.
One of the primary nutritional concerns for early adolescents is obesity. Adolescents should be encouraged to develop good habits, including consuming a healthy diet and regularly participating in physical activity.

References

Summary Report of the Dietary Reference Intakes. nationalacademies.org. www.nationalacademies.org/our-work/summary-report-of-the-dietary-reference-intakes. Accessed July 13, 2020.
NCHS Data Brief, Number 288, October 2017. cdc.gov. https://www.cdc.gov/nchs/data/databriefs/db288.pdf. Accessed July 13, 2020.
Childhood Obesity Causes & Consequences. cdc.gov. https ://www.cdc.gov/obesity/childhood/causes.html. Accessed July 13, 2020.