Characterizing nutrient intakes of adolescents by sociodemographic factors

Gender differences in dietary behaviors among Japanese adolescents

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Few studies assessed a variety of adolescent dietary behaviours in Japan.

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The findings suggest that gender differences existed in dietary behaviors.

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Girls tended to adopt regular dietary behaviors as compared to boys.

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Schools support modeling and reinforcing healthy dietary behaviors.

Unhealthy dietary behaviors in adolescence are an important public health problem. Gender differences in dietary behaviors have already appeared during adolescence. However, few studies have assessed a variety of adolescent dietary behaviors in Japan. We aimed to clarify gender differences in unhealthy dietary behaviors among Japanese adolescents. The participants consisted of 84,988 participants from seventh to 12th grades. Unhealthy dietary behaviors were defined according to the National Health and Nutrition Survey. Multivariable logistic regression was used to analyze a nationally representative sample of Japanese adolescents from the 2014 to 2015 Lifestyle Survey. The effective response rate was 51.4%. The prevalence of unhealthy dietary behaviors (skipping breakfast, snacking, eating out, skipping meals, eating alone at dinner, and subjectively poor diet quality) among boys and girls was 14.2% versus 12.4%, 19.6% versus 14.1%, 10.6% versus 7.0%, 7.9% versus 5.6%, 13.3% versus 12.1%, and 12.3% versus 15.8%, respectively. Compared with boys, girls were more negatively associated with skipping breakfast [OR = 0.76 (95% CI 0.73–0.79)], snacking [OR = 0.67 (95% CI 0.65–0.70)], eating out [OR = 0.62 (95% CI 0.59–0.66)], skipping meals [OR = 0.61 (95% CI 0.58–0.65)], and eating alone at dinner [OR = 0.79 (95% CI 0.76–0.83)]. However, girls were more positively associated with subjectively poor diet quality [OR = 1.19 (95% CI 1.14.1.24)]. The findings suggest that gender differences existed in dietary behaviors. Gender differences in dietary behaviors suggest opportunities for tailoring interventions related to dietary education in schools.

Direct and indirect effects of childhood conditions on survival and health among male and female elderly in China

This paper investigates whether childhood conditions affect survival and health, both directly and indirectly through the mediating variable of adulthood socioeconomic status, among Chinese elderly. Using data from the 2008-2009 and 2011-2012 waves of the Chinese Longitudinal Healthy Longevity Survey, we apply structural equation models to estimate these effects. We find that favorable childhood conditions exert a negative direct impact on survival probability at senior ages, possibly resulting from mortality selection. Our results also support the pathways model, which indicates that advantageous childhood conditions improve socioeconomic status in adulthood and thus indirectly promote longevity and health at advanced ages. Combining the direct and indirect effects, the total effects of childhood advantages on survival and health are positive. We further demonstrate that direct and indirect effects of childhood conditions are stronger for women than they are for men. Our findings suggest that public policies that target childhood wellbeing may have far-reaching protective impacts on health among seniors.

Food group intake and micronutrient adequacy in adolescent girls

This study explores the contribution of food group intakes to micronutrient adequacy among 2379 girls in the National Growth and Health Study during three age periods (9–13, 14–18, and 19–20 years). Data on food and nutrient intakes from 3-day diet records over 10 years were used to estimate mean intakes and percent meeting Dietary Guidelines (DGA) recommendations for food intakes and Institute of Medicine’s recommendations for vitamins and minerals. More than 90% of girls failed to consume the recommended amounts of fruit, vegetables and dairy; 75% consumed less than the recommended amounts in the “meat” group. The vast majority of girls of all ages had inadequate intakes of calcium, magnesium, potassium, and vitamins D and E. In contrast, they consumed >750 kcal/day (~40% of total energy) from the DGA category of solid fat and added sugars, about five times the recommended maximum intakes. This study shows the importance of consuming a variety of foods in all five food groups, including those that are more energy dense such as dairy and meats, in order to meet a broad range of nutrient guidelines. Diet patterns that combined intakes across food groups led to greater improvements in overall nutritional adequacy.

Zinc status and its association with the health of adolescents: a review of studies in India

BACKGROUND

Zinc is important in adolescence because of its role in growth and sexual maturation. Adolescents from developing countries such as India may be at high risk of zinc deficiency because of unwholesome food habits and poor bioavailability of zinc from plant-based diets.

OBJECTIVE

(1) to study zinc status and its association with profile of other micronutrients, (2) to construct a simple tool in the form of Adolescent Micronutrient Quality Index (AMQI) to assess quality of diets of the girls and (3) to examine the effect of zinc supplement on health of adolescent girls.

METHODS

Girls (10-16 years) from two secondary schools of Pune, Maharashtra state, in Western India were enrolled in a cross-sectional study (n = 630). Data were collected on dietary intake, cognitive performance, taste acuity, haemoglobin, erythrocyte zinc and plasma levels of zinc, vitamin C, β-carotene and retinol. AMQI was developed using age-sex-specific Indian dietary guidelines and healthy foods and habits described in the recent US dietary guidelines. Zinc-rich recipes were developed considering habitual diets of the girls and vegetarian sources of zinc. An intervention trial (n = 180) was conducted to assess the effect of zinc-rich dietary supplements and ayurvedic zinc (Jasad) supplementation.

RESULTS

Prevalence of micronutrient deficiencies was high in these girls. Poor cognitive performance was seen in half of the girls, and salt taste perception was affected in 45%. AMQI was correlated with nutrient intakes and blood micronutrient levels (p < 0.01), indicating the potential of AMQI to measure micronutrient quality of diets of adolescent girls. Results of the intervention trial indicated that supplementation of zinc-rich recipes vis-a-vis ayurvedic Jasad zinc has the potential to improve plasma zinc status, cognitive performance and taste acuity in adolescent girls.

CONCLUSIONS

Review of the studies on Indian adolescent girls demonstrates the necessity of adopting zinc and micronutrient-rich diets for positive health building in adolescents.

Dietary patterns in relation to socio-economic and lifestyle characteristics among Greek adolescents: a multivariate analysis

Background

We sought to evaluate the relationship between selected lifestyle and socio-economic characteristics and dietary habits of Greek adolescents.

Methods

During 2004, 2118 school adolescents were selected from twelve schools in Vyronas region, Athens. Dietary intake was assessed through a semi-quantitative FFQ. Principal components analysis was applied to extract dietary patterns.

Results

Seven components, explaining the 50 % of the total variation in intake, were extracted. Component 1 (‘junk food’ pattern) was heavily loaded by the consumption of ‘sweet’ and ‘salty’ snacks, soft drinks and other ‘fast foods’. Component 2 was characterized as ‘red meat’ consumption pattern. Component 3 was characterized by the consumption of vegetables, fruits and juices. Component 4 was characterized by the intake of dairy products, pasta and wholegrain bread. Component 5 can be described as rice, fish, potatoes and poultry intake. Component 6 was characterized by the consumption of ‘traditional Greek cooked foods’ and legumes, and component 7 was characterized by the consumption of eggs and white bread. Time spent watching television was positively associated with the ‘junk food’ pattern and inversely associated with the ‘vegetarian/healthy’ pattern. Moreover, the ‘junk food’ pattern was positively related to smoking status and the ‘vegetarian/healthy’ pattern was positively correlated with sports activities outside school.

Conclusion

An unhealthy dietary behaviour is associated with an overall unhealthy lifestyle. Taking into account the fact that unhealthy eating habits and sedentary lifestyle have been associated with increased obesity prevalence, school- or community-based programmes should be conducted promoting healthy dietary and lifestyle behaviours.

Diet patterns of lactovegetarian adolescent girls: need for devising recipes with high zinc bioavailability

OBJECTIVE

Populations subsisting on plant foods are believed to be at a high risk of mineral deficiencies. The aim of the present study was to examine the diet patterns of vegetarian adolescent girls for zinc adequacy and devise recipes to improve bioavailable zinc intakes.

METHODS

A cross-sectional survey was carried out in 630 schoolgirls (10-16 y old) from Pune, India, from 2006 to 2007. Diet was assessed by a 24-h recall method on 3 random days. Diet patterns were identified by principal component analysis. Nutrient intakes were estimated using the cooked-foods database of our laboratory. Twenty recipes representing the diet patterns were formulated using foods that have a high zinc content and using methods such as sprouting/fermentation. In vitro zinc dialyzability of the recipes was determined by simulating gastrointestinal conditions and atomic absorption spectrometry.

RESULTS

Five diet patterns were identified reflecting intakes of different cereals. Girls in the five diet patterns had inadequate intakes of energy, protein, and micronutrients including zinc compared with the recommended dietary intakes of India. In the new cereal-based recipes, the average contents of energy, protein, iron, calcium, zinc, beta-carotene, and vitamin C per 100g of cooked weight were 205 kcal, 6.2g, 2.5mg, 105 mg, 1.5mg, 716 microg, and 4.4 mg, respectively. Therefore, a supplement of 200 g of the recipe would fulfil 75% of the daily zinc requirement of adolescents and increase other micronutrient intake manifolds.

CONCLUSION

Diets of Indian schoolgirls were deficient in zinc. Zinc-rich recipes with high bioavailability have the potential to alleviate zinc deficiency in adolescents.

Longitudinal assessment of micronutrient intake among African-American and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study

OBJECTIVE

Low intakes of micronutrients among adolescents may be linked to long-term health risks, especially in African-American girls. This report describes intake of key micronutrients relative to the Dietary Reference Intakes in a sample of African-American and white girls.

DESIGN

Longitudinal analyses used data from 3-day food records collected in the National Heart, Lung, and Blood Institute Growth and Health Study.

SUBJECTS/SETTING

Subjects included 1,166 white and 1,213 African-American girls (aged 9 to 18 years).

MAIN OUTCOME MEASURES

Estimated usual daily intakes of vitamins A, E, C, D, B-6, B-12, magnesium, folate, calcium, and zinc were compared to the Adequate Intake (for vitamin D and calcium) or the Estimated Average Requirement (EAR) (all other micronutrients).

STATISTICAL ANALYSES PERFORMED

Usual daily intake of each micronutrient was estimated. For nutrients with an EAR, the EAR cut-point method was used to assess the prevalence of low nutrient intakes. Mixed models were used to identify age and racial differences in usual daily intake of each nutrient.

RESULTS

African-American girls consumed less vitamin A and D, calcium, and magnesium compared to white girls. Regardless of race, a substantial percentage of girls had intakes below the EAR: vitamin E (81.2% to 99.0%), magnesium (24.0% to 94.5%), folate (46.0% to 87.3%). Intakes of vitamins A, D, and C; calcium; and magnesium decreased across years. As girls aged, there was an increasing proportion with intakes below the EAR for vitamins A, C, B-6, and B-12.

CONCLUSIONS

Food and nutrition professionals should continue to educate adolescent girls, especially those who are African American, about the importance of a nutrient-dense diet for optimum health.

Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however, are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.

Nutrient Inadequacy in Obese and Non-Obese Youth

Purpose: In this study, the Dietary Reference Intake standards were used to evaluate the prevalence of inadequate intakes of micronutrients in obese and non-obese youth.

Methods: Dietary intake was analyzed with a dietary history taken by a registered dietitian. The obese group (n=156) had a body mass index (BMI) above the 95th percentile for age and sex. The non-obese group (n=90) was between the tenth and 85th BMI percentiles.

Results: In the obese subjects, the prevalence of inadequate intakes was 81% for vitamin E and 27% for magnesium; the proportions with intakes below the Adequate Intakes (AIs) for calcium and vitamin D were 55% and 46%, respectively. The obese children consumed 124% of estimated need for energy, 32% of which came from fat. The non-obese had a similar prevalence of inadequate intakes (vitamin E, 93%; magnesium, 29%; calcium, 51%; vitamin D, 44%). They consumed 107% of estimated need for energy, and 31% of energy came from fat. For both groups, all other nutrient intakes were adequate.

Conclusions: Even though children may consume an excess of energy, they may not be meeting all of their micronutrient needs.

A national study of obesity prevalence and trends by type of rural county

CONTEXT

Obesity is epidemic in the United States, but information on this trend by type of rural locale is limited.

PURPOSE

To estimate the prevalence of and recent trends in obesity among US adults residing in rural locations.

METHODS

Analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) for the years 1994-1996 (n = 342,055) and 2000-2001 (n = 385,384). The main outcome measure was obesity (body mass index [BMI] > or = 30), as determined by calculating BMI from respondents' self-reported height and weight.

RESULTS

In 2000-2001, the prevalence of obesity was 23.0% (95% confidence interval [CI] 22.6%-23.4%) for rural adults and 20.5% (95% CI 20.2%-20.7%) for their urban counterparts, representing increases of 4.8% (95% CI 4.2%-5.3%) and 5.5% (95% CI 5.1%-5.9%), respectively, since 1994-1996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and Texas; obesity prevalence increased for rural residents in all states but Florida over the study period. African Americans had the highest obesity prevalence of any group, up to 31.4% (95% CI 29.1%-33.6) in rural counties adjacent to urban counties. The largest difference in obesity prevalence between those with a college education compared with those without a high school diploma occurred in urban areas (18.4% [95% CI 17.9%-18.9%] vs 23.5% [95% CI 22.5%-24.5%], respectively); the smallest difference occurred in small, remote rural counties (20.3% [95% CI 18.7%-21.9%] versus 22.3% [95% CI 20.7%-24.0%], respectively).

CONCLUSIONS

The prevalence of obesity is higher in rural counties than in urban counties; obesity affects some residents of rural counties disproportionately.

Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years

It is the position of the American Dietetic Association that children ages 2 to 11 years should achieve optimal physical and cognitive development, attain a healthy weight, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity. The health status of American children has generally improved over the past three decades. However, the number of children who are overweight has more than doubled among 2- to 5-year-old children and more than tripled among 6- to 11-year-old children, which has major health consequences. This increase in childhood overweight has broadened the focus of dietary guidance to address children's over consumption of energy-dense, nutrient-poor foods and beverages and physical activity patterns. Health promotion will help reduce diet-related risks of chronic degenerative diseases, such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis. This position paper reviews what US children are eating and explores trends in food and nutrient intakes as well as the impact of school meals on children's diets. Dietary recommendations and guidelines and the benefits of physical activity are also discussed. The roles of parents and caregivers in influencing the development of healthy eating behaviors are highlighted. The American Dietetic Association works with other allied health and food industry professionals to translate dietary recommendations and guidelines into achievable, healthful messages. Specific recommendations to improve the nutritional well-being of children are provided for dietetics professionals, parents, and caregivers.

Factors in the school cafeteria influencing food choices by high school students

This study set three objectives: 1) to examine the perceived influence of health concerns, labeling and nutrition information, taste, cost, availability, and peers on adolescents' food choices, particularly in the school cafeteria; 2) to determine whether these factors vary by gender, grade level, or adolescents' health and weight concerns; and 3) to provide recommendations regarding promotion of low-fat foods in the school cafeteria based on factors associated with food choices. Data were collected from a school survey that assessed key influences on adolescents' food choices, including low-fat foods. Some 289 students in grades 10-12 from a senior high school in a metropolitan area served as subjects. Descriptive statistics, chi-square, and general linear models were used for analysis. Results indicated that, when choosing foods from the school cafeteria, taste and getting a lot for their money were important to most students (93.7% and 71.7%, respectively). Females, and students who thought about their health and weight more frequently when deciding what to eat, were more likely to report greater interest in labeling and nutrition information and availability of low-fat foods in the school cafeteria. Findings suggest that efforts to promote low-fat foods to adolescents need to address the taste of low-fat foods, availability of low-fat options, and point-of-purchase labeling of low-fat foods. Focusing on the value and cost of low-fat foods may offer a key strategy for promoting low-fat foods to males.

Using Dietary Reference Intake-based methods to estimate the prevalence of inadequate nutrient intake among school-aged children

OBJECTIVE

To estimate the prevalence of inadequate usual intakes of nutrients by school-aged children.

DESIGN

A descriptive study using data from the US Department of Agriculture 1994 to 1996 Continuing Survey of Food Intake by Individuals. Each subject provided two 24-hour recalls. We adjusted for day-to-day variation in nutrient intake and estimated the percentage of children with intakes below the Estimated Average Requirement (EAR) using the Software for Intake Distribution Estimation Program.

SUBJECTS

A national sample of noninstitutionalized children aged 6 to 18 years (N=2,692).

STATISTICAL ANALYSES

Chi2 tests showed that background characteristics or percentages with intakes below the EAR were the same across the 6 gender-age and racial/ethnic groups. The SUDAAN statistical package was used to account for the complex sample design.

RESULTS

Usual intakes were more favorable for 5 B vitamins and iron than for the other nutrients examined. High percentages of children had intakes below the EAR for vitamin E. Many children aged 9 years and older had intakes below the EAR for folate and magnesium. Females aged 9 years and older had low calcium intakes relative to the Adequate Intake value. Females aged 14 to 18 years were at highest risk of usual intakes that did not meet the EARs. Few males in this age group met the EAR for vitamin E or magnesium.

APPLICATIONS

Females aged 14 to 18, in particular, should be targeted for efforts to improve nutrient intakes. Studies should monitor children's usual nutrient intakes after adjusting for day-to-day variation.

Nutritional issues for adolescents

This article describes important issues for the nutritional health of adolescents. The issues discussed include dietary factors involved in cardiovascular and cancer disease risk; osteoporosis and bone mineralization; overweight and obesity; related risk factors such as type 2 diabetes; and eating disorders. The discussion focuses on nutritional issues for the general adolescent population, rather than high-risk adolescents. Data are primarily drawn from large, population-based studies using representative samples of adolescents.

Individual and environmental influences on adolescent eating behaviors

Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).

Urine-based screening for Chlamydia trachomatis in men attending sexually transmitted disease clinics

BACKGROUND

Nucleic acid-amplified tests for Chlamydia trachomatis are accurate but costly. Screening strategies for asymptomatic men are needed.

GOAL

To assess C trachomatis screening strategies for asymptomatic males.

STUDY DESIGN

Men attending a sexually transmitted disease clinic were tested for C trachomatis with ligase chain reaction and culture, and for urethral inflammation with urine leukocyte esterase and urethral Gram stain.

RESULTS

C trachomatis prevalence was 5.5% among 1,625 asymptomatic men. Ligase chain reaction increased detection by 49% among men without urethral inflammation. An age of younger than 25 years and urethral inflammation were associated with positive ligase chain reaction results. The negative predictive value of urine leukocyte esterase was highest among older men, but urethral Gram stain was equally sensitive in predicting infection regardless of age. An age of younger than 30 years or urethral inflammation identified the highest proportion of infections (92%) and reduced the percentage of men screened by 43%.

CONCLUSIONS

Urine ligase chain reaction increased C trachomatis detection, particularly among men without urethral inflammation. Testing all asymptomatic men younger than 30 years is optimal, whereas negative urine leukocyte esterase or urethral Gram stain results in men 30 years or older support no testing.

Consumo de energia e macronutrientes por adolescentes de escolas públicas e privadas

O objetivo deste trabalho foi avaliar a adequação do consumo de energia e macronutrientes em adolescentes de escolas públicas (EPU) e privadas (EPR) do município de Florianópolis, SC. A amostra constou de 797 estudantes: 466 (228 meninas e 238 meninos) de EPU e 331 (175 meninas e 156 meninos) de EPR. Os dados foram obtidos através do método recordatório de 24 horas. Observou-se que aproximadamente 50% dos adolescentes apresentaram consumo energético insuficiente e mais da metade tiveram um consumo adequado de carboidratos. Entre os adolescentes do sexo masculino que apresentaram alto consumo de carboidratos, houve maior prevalência na rede pública (12,6% EPU e 3,8% EPR). Mais da metade dos estudantes apresentaram alto consumo de proteínas (54,3% EPU e 58,9% EPR), havendo maior prevalência entre os de sexo masculino (61,7% masculino e 50,6% feminino). Apenas 30,5% dos estudantes das EPU e 36,5% das EPR apresentaram consumo adequado de lipídios; ressalta-se o elevado percentual de adolescentes com alto consumo deste nutriente (33,9% EPU e 39,0% EPR). Entre os estudantes que apresentaram baixo consumo de lipídios, houve maior prevalência dos adolescentes do sexo masculino (35,3% masculino e 26,8% feminino), estudantes da EPU (41,6% EPU e 25,6% EPR). Pode-se concluir que o padrão alimentar apresentado por estes adolescentes pode estar associado a riscos para a saúde na vida adulta.

Zinc intake of the U.S. population: findings from the third National Health and Nutrition Examination Survey, 1988-1994

National survey data for 29,103 examinees in the third National Health and Nutrition Examination Survey were used to estimate mean and percentile distributions of dietary and total zinc intakes based on 24-h dietary recalls and vitamin/supplement use. Mean daily total intakes ranged from 5.5 mg in non-breast-feeding infants to 13 mg in adults and were higher in adolescent and adult males than in females (P <0.01). Mean total zinc intakes (22 mg) were approximately 10 mg higher in pregnant and lactating females than in nonpregnant, nonlactating females of the same age. Mean total zinc intakes were 0. 7 mg higher in adolescents (11.1 mg) and 2.5-3.5 mg higher in adults (13 mg) compared with mean dietary intakes, indicating the average contribution of supplements to total zinc intake. Mean total zinc intakes were significantly higher in non-Hispanic whites than in non-Hispanic blacks (P<0.01) and Mexican Americans (P<0.01) for men and women aged 51-70 y and > or =71 y due to higher zinc supplement use. The prevalence of zinc-containing supplements use ranged from 0. 1% in infants to 20.5% in adults. "Adequate" zinc intake in this survey population was 55.6% based on total intakes of >77% of the 1989 recommended dietary allowance. Young children aged 1-3 y, adolescent females aged 12-19 y and persons aged > or =71 y were at the greatest risk of inadequate zinc intakes.

Moderate zinc-iron deprivation influences behavior but not growth in adolescent rhesus monkeys

Primate species demonstrate a prolonged period of development before reproductive maturity that includes distinctive periods of rapid growth in the late fetal, late infancy and early adolescent stages. Rhesus monkeys resemble humans in this discontinuous pattern of growth and also in its relationship to brain development. Studies of zinc deprivation in rhesus monkeys have suggested an important relationship among growth rate, nutrient status and behavioral performance in infancy as well as adolescence. Recently, moderate combined zinc and iron deprivation (intake 0.2 mg Zn and 0.8 mg Fe/d, compared with control intake of 2.9 mg Zn and 1.7 mg Fe/d) during the adolescent growth spurt (29-32 mo. of age) of female rhesus monkeys (n = 8/group) was shown to influence behavior without affecting growth. Behavioral assessments included the Continuous Performance Test, the Delayed Nonmatch to Sample Test and activity (measured with an actimeter). The behavioral syndrome was characterized by reduced activity, reduced participation in behavioral testing and slower response. These changes could be reversed or prevented to some extent by altering the diet to include tablets of powdered beef (adding approximately 1.7 mg Zn and 0.7 mg Fe to daily intake). The study suggests that behavior may be sensitive to the quality of the diet available during the period of rapid adolescent growth and development.

Behavioral and hematologic consequences of marginal iron-zinc nutrition in adolescent monkeys and the effect of a powdered beef supplement

BACKGROUND

The adolescent growth spurt and menarche increase iron and zinc needs and could precipitate functional deficiencies if dietary sources are inadequate.

OBJECTIVE

The effects of mild, combined zinc and iron deprivation during the growth spurt and the ability of meat as a common dietary source of zinc and iron to reverse these effects was studied.

DESIGN

Pubertal female rhesus monkeys were fed control diets (n = 8) or diets marginally deficient in zinc (2 microg/g diet; n = 8) and iron (10 microg/g diet; n = 8) for 3 mo. A powdered beef supplement (104 microg Zn/g and 43 microg Fe/g, 11 +/- 2 g/d) was then fed daily to half of the deprived group for 3 additional months.

RESULTS

Growth and hematology were not affected significantly by iron-zinc deprivation, but plasma zinc and iron were somewhat lower in the deprived group than in the control group after 3 mo. The deprived monkeys reduced their participation in behavioral testing, responded more slowly and less frequently to test stimuli, and were less active. The beef supplement increased participation in testing and stabilized activity levels, but response times remained depressed. Plasma ferritin was lower in the nonsupplemented deprived monkeys than in the controls by the end of the experiment. Four of 8 of the deprived monkeys had iron deficiency anemia compared with none of the controls and 1 of 8 who received the beef supplement.

CONCLUSIONS

Marginal zinc and iron deprivation in early adolescence can lead to behavioral and hematologic dysfunction in nonhuman primates and dietary beef supplements can prevent and reverse some of these effects.

Factors influencing food choices of adolescents: findings from focus-group discussions with adolescents

OBJECTIVE

To assess adolescents' perceptions about factors influencing their food choices and eating behaviors.

DESIGN

Data were collected in focus-group discussions.

SUBJECTS/SETTING

The study population included 141 adolescents in 7th and 10th grade from 2 urban schools in St Paul, Minn, who participated in 21 focus groups.

ANALYSIS

Data were analyzed using qualitative research methodology, specifically, the constant comparative method.

RESULTS

Factors perceived as influencing food choices included hunger and food cravings, appeal of food, time considerations of adolescents and parents, convenience of food, food availability, parental influence on eating behaviors (including the culture or religion of the family), benefits of foods (including health), situation-specific factors, mood, body image, habit, cost, media, and vegetarian beliefs. Major barriers to eating more fruits, vegetables, and dairy products and eating fewer high-fat foods included a lack of sense of urgency about personal health in relation to other concerns, and taste preferences for other foods. Suggestions for helping adolescents eat a more healthful diet include making healthful food taste and look better, limiting the availability of unhealthful options, making healthful food more available and convenient, teaching children good eating habits at an early age, and changing social norms to make it "cool" to eat healthfully.

APPLICATIONS/CONCLUSIONS

The findings suggest that if programs to improve adolescent nutrition are to be effective, they need to address a broad range of factors, in particular environmental factors (e.g., the increased availability and promotion of appealing, convenient foods within homes schools, and restaurants).

Prática alimentar de adolescentes

Visando conhecer a prática alimentar de adolescentes, foi realizado inquérito alimentar com um grupo de 153 estudantes, de ambos os sexos, com idade média de 14,0 ± 1,5 anos, utilizando questionário auto-aplicado. Foi efetuada análise qualitativa das três principais refeições diárias, comparando-se com padrão estabelecido. Verificou-se que o desjejum foi consumido por 45% (44% meninos e 56% meninas), o almoço por 76% (36% meninos e 64% meninas) e o jantar por 53% (40% meninos e 60% meninas). Observou-se que a constituição do jantar é basicamente, a mesma que a do almoço, notando-se porém a diminuição da ingestão de alimentos fonte de proteína e ferro, tais como a carne e o feijão, substituídos por alimentos fonte de proteína e cálcio (leite e derivados), o que remete a hipótese de que o lanche está tomando o lugar do jantar. O desjejum é a refeição mais negligenciada pelos adolescentes estudados. Faz-se necessário controlar a ingestão de alimentos entre as três refeições, pois esta poderá estar contribuindo de duas formas: favorecendo o consumo de nutrientes que poderiam estar deficientes ou, por outro lado, agravando quadros tais como obesidade entre outros.

Eating patterns, physical activity, and attempts to change weight among adolescents

OBJECTIVE

To determine eating patterns and demographic and dietary factors associated with adolescents' attempts to change weight.

METHODS

Data from students participating in the Massachusetts Youth Risk Behavior Survey (YRBS) were analyzed. Race, age, school grade, academic achievement, gender, body image, eating patterns, level of exercise, participation in team sports, cigarette use, diet pill use, and vomiting were examined. The weighted sample included 3055 students: 49% female and 78% white. Mean age was 16 years (+/- 1.2 years). Associations were measured using Spearman's r, Chi-square, Mantel-Haenszel test for trend, and logistic regression analyses.

RESULTS

A total of 61.5% of females and 21.5% of males reported trying to lose weight; 6.8% of females and 36.3% of males were trying to gain weight. There was a strong correlation (r = 0.62, p < 0.0001) between attempting to gain weight and self-perception of underweight for both genders. Females reported having changed their intake of several foods if attempting to change weight; males changed their intake of dessert foods. Hard exercise, stretching, and toning were associated with trying to lose weight among females and with trying to gain weight among males.

CONCLUSIONS

High-calorie food consumption and exercise were associated with attempts at weight change. Unhealthy eating to change weight highlights the need for effective nutrition and weight counseling among adolescents.

Food habits of young and middle-aged women living outside the capital cities of Australia

Young (18-22 years) and middle-aged (45-49 years) women living in urban and rural areas of New South Wales completed a brief food frequency questionnaire as part of a wider health survey. Urban women in both age groups consumed meat less frequently than women in rural areas, and women in the less populated rural areas were more likely to eat green and yellow vegetables and least likely to eat dried beans. There were few other geographic differences in food habits. Middle-aged women consumed reduced-fat milk, fruit, vegetables, fish, biscuits and cakes significantly more frequently, and rice, pasta, full-cream milk, fried food and take-away food less frequently than younger women. Smokers in both age groups consumed fresh fruit, vegetables and breakfast cereals significantly less frequently than non-smokers, and women with low levels of habitual physical activity consumed fresh fruit and cereals less frequently than more active women. The findings suggest that strategies aimed at changing eating behaviours should be age-group-specific and targeted specifically to smokers and less active women.

Promoting healthy eating and ensuring adequate weight gain in pregnant adolescents: issues and strategies

The seven specific strategies discussed for promoting the nutritional health of pregnant adolescents can be categorized into three broad areas: (1) improve nutrition knowledge and skills of adolescents, as well as health care providers; (2) improve programs, including access to prenatal care, and developing effective nutrition interventions; and (3) direct research efforts to better understand barriers to behavior change and conduct scientifically rigorous program evaluations of efficacy of nutrition interventions. Nutritional health should be viewed within the context of improving overall health and lifestyles. Simple solutions focused solely at the individual level are not effective. We need to advocate for and support policy efforts to address the economic, familial, and social issues that impact health and adolescent pregnancy.

Food habits and energy and nutrient intake in Swedish adolescents approaching the year 2000

In 1993-94 a nutritional survey of 15-year-old adolescents was carried out in Uppsala, a university city in eastern Sweden, and in Trollhättan, an industrial town in the western part of the country. The study was the beginning of a longitudinal nutritional survey of 193 boys and 218 girls randomly selected from the official population register. The dietary methods used were a food frequency questionnaire (FFQ) and a combined estimated and weighed 7-day dietary record. According to the FFQ both boys and girls consumed cereals, butter or margarine and something from the group meat/fish/eggs every day. Milk, milk products, sweets and snacks were consumed more than once per day. Vegetables and fruit/roots were consumed less often. There was relatively good correlation between the FFQ and the 7-day record results. The mean daily energy intakes of the 15-year-old boys and girls were 10.2 and 8.3 MJ, respectively, in Uppsala, and 9.8 and 7.4 MJ in Trollhättan. The mean daily intakes of sucrose were 74 and 58 g in boys and 64 and 52 g in girls. The average daily dietary fibre intake was 1.8 g/MJ. The daily intake of energy obtained from breakfast was 18% on weekdays and 22% on weekends; 18 and 11% from prepared lunch; 24 and 30% from dinner, 21 and 14% from light meals; and 16 and 28% from snacks, in Uppsala and Trollhättan respectively. The lowest energy intake from a prepared lunch meal was noted during weekends. On both weekdays and weekends, considerable energy was obtained from light meals and snacks. However, nearly 40% of the girls and 28% of the boys had an energy intake from fat of < 30 energy%. The mean intakes of vitamin D and selenium and, in the case of girls, iron and zinc, were below the official Swedish Nutrition Recommendations. The daily median intake of iron was 18.7 mg in boys and 14.1 mg in girls. The iron intakes varied between 6 and 35 mg per day. Low serum ferritin concentrations, defined as s-ferritin < 12 micrograms/L, were found in 7 boys (3.7% and in 29 girls (13.9%). Significant negative correlations were found between smoking and frequency of consumption of vegetables, roots, fruits and meat. A negative correlation was also found between smoking and the intake of energy and a number of nutrients. Socioeconomic factors seem to be less important for the food habits of teenagers than for those noted during childhood. Only frequent consumption of vegetables was positively correlated to the mothers' educational level.

Determinants of health of North-American adolescents: evolving definitions, recent findings, and proposed research agenda

The recent literature on the determinants of adolescent health is reviewed. Four definitions of adolescent health are presented: successful transition to adulthood, successful coping, lack of mortality and morbidity, and healthy behaviors and risk avoidance. The review of determinants of health is presented within a framework focused upon adolescent characteristics, aspects of adolescents' immediate environments, and adolescents' ongoing activities and aspirations. An expanded framework which considers societal and structural factors and adolescent health is considered and a proposed research agenda presented.

The effects of race, household income, and parental education on nutrient intakes of 9- and 10-year-old girls. NHLBI Growth and Health Study

Nutrient intakes of 2149 black and white, 9- and 10-year-old girls varied by race, household income, and parental education. Of the three variables, higher education was most consistently associated with more desirable levels of nutrient intakes, that is, lower percentage of dietary fat and higher levels of vitamin C, calcium, and potassium. Higher income was related to higher intakes of vitamin C, but lower intakes of calcium and iron. Higher income was associated with lower percentage of dietary fat. After adjustment for income and education, race was associated with intakes of calcium, vitamin C, and to a lesser extent, percentages of kilocalories from total fat and polyunsaturated fat, and potassium. Black girls had a significantly lower intake of calcium (720 versus 889 mg) and a higher intake of vitamin C (91 versus 83 mg). Proportions of the cohort with inadequate or excessive intakes of micronutrients and macronutrients were also estimated. A high proportion of girls exceeded the recommended intake level of 30% of kilocalories from total fat (90% of black girls; 84% of white girls) and 10% of kilocalories from saturated fat (92 and 93%, respectively). Low intakes of calcium (40% of black girls and and 20% og white girls) and zinc (36 and 38%, respectively) commonly were found for girls of both names.