Update of nutrition guidelines for the teen: trends and concerns

Practical steps of intervention design for teenage students' musculoskeletal health: An intervention mapping approach

Background

According to the studies conducted, teen pregnancy and its related health issues are among the most significant issues. The purpose of the study was to develop a musculoskeletal health intervention training programme using an intervention mapping approach (IMA) for teenagers aged 12-14 years old.

Methods

The present study is a study protocol where IMA has been used as a planning framework for developing a musculoskeletal health intervention training programme. Six steps of the intervention mapping process have been completed in the study. As the first step, needs assessment has been performed through systematic review and qualitative evaluation. In the second step, a matrix of change objectives was designed. Later on, after designing the programme and planning its implementation, the programme evaluation plan was developed.

Results

IMA guided us in designing and implementing a control-oriented training programme with the participation of the participants, along with the definition of outcomes, performance goals, and determinants, theoretical methods, practical applications, an intervention programme, implementation, and step-by-step assessment.

Conclusion

Intervention mapping is a participation-based approach to designing and implementing promotion programmes.

Study of Adolescents' Puberty, Adolescence Training Program: The Application of Intervention Mapping Approach

BACKGROUND

Adolescence is a significant period of life which is crucial for life long health. The purpose of the study was to develop a puberty intervention-training program using an intervention mapping approach (IMA).

METHODS

The present study was a study protocol where IMA was used as a planning framework for developing a puberty intervention-training program (PITP). Six intervention mapping steps have been described in this protocol. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation, and interviews. In the second step, the matrix of change objectives was designed from the intersection of performance goals and determinants. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed.

RESULTS

IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment.

CONCLUSION

Intervention mapping is a control-oriented, systematic, participation-based approach to design and implement targeted and on-going health promotion programs.

Prevalence and Risk Factors of Disordered Eating Attitudes and Behaviors Among High-school Girls in Al-Madinah City, Saudi Arabia

Objectives::

To determine the prevalence of disordered eating attitudes and behaviors among high-school girls in Al-Madinah City, Saudi Arabia.

Methods::

A cross-sectional descriptive study was conducted in Al-Madinah city in 2014-15. A multi- stage random sampling technique was adopted to include female students of government secondary schools. The Eating Attitudes Test (EAT-26) and socio-economical questionnaires were used in the study for assessing the prevalence of disordered eating. All data were entered and analyzed using SPSS version 20.

Results::

Overweight and obesity were reported among 11.2% and 5.6% of them, respectively, whereas 31.3% of the participants were underweight. The overall prevalence of disordered eating attitudes among female students was 42.5%. This rate was significantly higher among younger (≤16 years old) and those of the first scholastic level than others. The rate of disordered eating attitude was reported at a higher rate among obese students (59.1%) than underweight (41.5%) and normal students (42.4%). The commonest reported disordered eating behavior was self-reported binge eating behaviour (25.2%), followed by self-induced vomiting (8.7%) and the use of laxatives/ diuretics to control weight (6.1%).

Conclusion::

The findings show a high prevalence of disordered eating attitude among high school female students in Al-Madinah city. Younger girls and those of the first scholastic level showed higher disordered eating attitude.

The relevance of restrained eating behavior for circadian eating patterns in adolescents

Background

Restrained Eating, i.e. the tendency to restrict dietary intake to control body-weight, often emerges during adolescence and may result in changes in circadian eating patterns.

Objective

The objective of the present investigation was to determine the cross-sectional relevance of restrained eating for characteristics of circadian eating pattern in adolescents and whether changes in restrained eating are accompanied by concurrent changes in circadian eating pattern over the course of adolescence.

Methods

Two questionnaires assessing restrained eating (Score 0–30) with parallel 3-day weighed dietary records from two different time points were available from 209 (♂:101, ♀:108) 11–18 year old adolescents of the DONALD study. Mixed linear regression models were used to analyze whether restrained eating was associated with eating occasion frequency, snack frequency and morning and evening energy intake [in % of daily energy intake, %E]. Linear regression models were used to examine whether changes in restrained eating were associated with changes in the mentioned variables.

Results

Among girls, greater restrained eating was cross-sectionally associated with higher morning energy intake (p = 0.03). Further, there was a tendency towards lower evening energy intake with higher levels of restrained eating for the whole sample (p = 0.06). No cross-sectional associations were found with eating occasion or snack frequency. Each one-point increase in restrained eating during adolescence was related to a concurrent decrease in eating occasion frequency by 0.04 (95% CI -0.08; -0.01, p = 0.02) and in evening energy intake by 0.36%E (95% CI -0.70; -0.03, p = 0.04). A tendency towards decreasing snack frequency with increasing restrained eating was observed (β = -0.03, 95% CI -0.07; 0.00, p = 0.07). No association was found between changes in restrained eating and concurrent changes in morning energy intake.

Conclusion

We found indications for cross-sectional and prospective associations between restrained eating and chronobiological aspects of food intake in adolescents. Our results suggest that restrained eating should be considered a relevant determinant of circadian eating patterns.

Primary dysmenorrhea: prevalence in adolescent population of Tbilisi, Georgia and risk factors

OBJECTIVE

The study aimed to determine the prevalence of dysmenorrhea in female adolescents living in Tbilisi, Georgia; find possible risk factors and establish an association, if any, with nutrition and sleep hygiene.

MATERIAL AND METHODS

A cross-sectional study was used. A retrospective case control study was used to identify risk factors.

PARTICIPANTS

A total of 2561 women consented to participate in the research. 431 participants were included in the case-control study.

INTERVENTIONS

Detailed questionnaire included: reproductive history, demographic features, menstrual pattern, severity of dysmenorrhea and associated symptoms; information about nutrition and sleep hygiene.

RESULTS

The prevalence of dysmenorrhea was 52.07%. Due to pain, 69.78% reported frequent school absenteeism. The risk of dysmenorrhea in students who had a family history of dysmenorrhea was approximately 6 times higher than in students with no prior history. The prevalence of dysmenorrhea was significantly higher among smokers compared with non-smokers 3.99% vs. 0.68% (p=.0.05 OR:6.102). Those women reporting an increased intake of sugar reported a marked increase of dysmenorrhea compared to women reporting no daily sugar intake (55.61% vs. 44.39%, p=.0023 LR:0.0002). However, alcohol, family atmosphere and nationality showed no correlation with dysmenorrhea. Our study revealed two most important risk factors of dysmenorrhea: meal skipping 59.78% vs. 27.03%, p=.00000 LR: 0.00000 OR:4.014 and sleep hygiene-receiving less sleep 38.77% vs. 19.59%, p=0.000055 LR: 0.000036 OR:2.598.

CONCLUSION

Primary dysmenorrhea is a common problem in the adolescent population of Tbilisi Geogia. It adversely affects their educational performance. Meal skipping and sleep quantity are associated with dysmenorrhea and may cause other reproductive dysfunctions.

Skipping breakfast is associated with dysmenorrhea in young women in Japan

To evaluate the effects of breakfast habits on the quality of life in young women in Japan, the relation between breakfast habits and menstrual and intestinal disorders was estimated by responses to a questionnaire. Subjects were recruited from young Japanese female students of Ashiya College ranging in age from 18 to 20 years. Breakfast habits were classified into three groups (group I, having breakfast every morning, n=289; group II, having breakfast one to six times per week, n=106; group III, having breakfast less than once a week, n=44). The intensity of dysmenorrhea was classified into three grades (score 1, free of pain or painful, but without need for analgesic; score 2, painful, requiring analgesic; score 3, painful, not relieved by analgesic). The grades of bowel movement were classified into three groups (score 1, no more than once a week; score 2, two to six times a week; score 3, every day). Group II and group III had significantly higher scores for dysmenorrhea compared with group I. Students in group III showed a tendency toward constipation. Since dysmenorrhea is a risk factor for psychological disorders as well as gynecological diseases, the present study suggests the importance of eating breakfast to the quality of life of young women.

Diet during adolescence is a trigger for subsequent development of dysmenorrhea in young women

Recently many young women in Japan have been restricting their dietary intake for cosmetic purposes. In this study, the relation between diet and menstrual disorders was investigated by responses to a questionnaire. Subjects ranging from 18 to 20 years old were recruited from 716 female students at Ashiya College. Dietary habits were classified into group I (having no experience with dieting), group II (those currently on a diet) and group III (those with a history of dieting). The intensity of dysmenorrhea was classified into three grades. All participants were divided into two groups as having regular or irregular menstruation. The frequency of irregular menstruation in group II was higher than that in the other groups, while group III had higher intensity of dysmenorrhea than the other groups. These findings suggest that diet during adolescence has long-lasting adverse effects on reproductive function in young women.

Low dietary nutrient intakes and respiratory health in adolescents

BACKGROUND

Epidemiologic studies have indicated that a diet rich in fruit, antioxidants, and n-3 fatty acids may contribute to optimal respiratory health. We investigated whether low dietary nutrient intakes were associated with lower pulmonary function and higher reporting of respiratory symptoms in adolescents.

METHODS

We examined the association of dietary factors (fruit, vegetables, vitamins C and E, beta-carotene, retinol, n-3 fatty acids) with respiratory health in a cohort of 2,112 twelfth-grade students in 13 communities in the United States and Canada during the 1998 to 1999 school year. We assessed the associations between dietary factors and pulmonary function with linear mixed models, and respiratory symptoms with logistic regression using a generalized estimating equation adjusted for individual and group-level covariates.

RESULTS

Low dietary fruit intake was associated with lower FEV(1) (- 1.3% of predicted; 95% confidence interval [CI], - 2.4 to - 0.2% of predicted), and increased odds of chronic bronchitic symptoms (odds ratio [OR], 1.36; 95% CI, 1.03 to 1.73) compared with higher intake. Low dietary n-3 fatty acids intake was associated with increased odds of chronic bronchitic symptoms (OR, 1.37; 95% confidence interval [CI], 1.05 to 1.81), wheeze (OR, 1.34; 95% CI, 1.06 to 1.69), and asthma (OR, 1.68; 95% CI, 1.18 to 2.39) compared with higher intake. Smokers with lower dietary vitamin C intake had higher ORs of respiratory symptoms compared with smokers who had higher intake.

CONCLUSIONS

Adolescents with the lowest dietary intakes of antioxidant and antiinflammatory micronutrients had lower pulmonary function and increased respiratory symptoms, especially among smokers, suggesting that adequate dietary intake may promote respiratory health and lessen the effects of oxidative stress.

Osteoporosis in children and adolescents: etiology and management

Bone mass increases progressively during childhood, but mainly during adolescence when approximately 40% of total bone mass is accumulated. Peak bone mass is reached in late adolescence, and is a well recognised risk factor for osteoporosis later in life. Thus, increasing peak bone mass can prevent osteoporosis. The critical interpretation of bone mass measurements is a crucial factor for the diagnosis of osteopenia/osteoporosis in children and adolescents. To date, there are insufficient data to formally define osteopenia/osteoporosis in this patient group, and the guidelines used for adult patients are not applicable. In males and females aged <20 years the terminology 'low bone density for chronologic age' may be used if the Z-score is less than -2. For children and adolescents, this terminology is more appropriate than osteopenia/osteoporosis. Moreover, the T-score should not be used in children and adolescents. Many disorders, by various mechanisms, may affect the acquisition of bone mass during childhood and adolescence. Indeed, the number of disorders that have been identified as affecting bone mass in this age group is increasing as a consequence of the wide use of bone mass measurements. The increased survival of children and adolescents with chronic diseases or malignancies, as well as the use of some treatment regimens has resulted in an increase in the incidence of reduced bone mass in this age group. Experience in treating the various disorders associated with osteoporosis in childhood is limited at present. The first approach to osteoporosis management in children and adolescents should be aimed at treating the underlying disease. The use of bisphosphonates in children and adolescents with osteoporosis is increasing and their positive effect in improving bone mineral density is encouraging. Osteoporosis prevention is a key factor and it should begin in childhood. Pediatricians should have a fundamental role in the prevention of osteoporosis, suggesting strategies to achieve an optimal peak bone mass.

Nutrition-related habits of Greek adolescents

OBJECTIVE

To investigate nutrition-related habits of Greek school-aged adolescents.

DESIGN

Epidemiological survey.

SETTING AND SUBJECTS

The study was part of the Health Behavior in School Aged Children (HBSC) survey. A representative sample of school-aged adolescents aged 11.5, 13.5, and 15.5 y was obtained. The final sample consisted of 4211 students (51.6% girls and 48.4% boys). They were asked to complete a translated form of the international HBSC questionnaire, including several thematic entities. The Unhealthy Food Choices Score (UFCS) was devised in order to evaluate the overall quality of reported eating habits of respondents; the higher the score, the lower the diet quality.

RESULTS

Among all students surveyed, 14.7% were reported to be on a diet to lose weight (girls: 19.5%; boys: 9.7%; P<0.001), and 22.9% were dissatisfied with their body weight but not on a diet. Girls were found to have lower UFCS values compared to boys (24.7 +/- 4.6 vs 24.1 +/- 4.5, P<0.001). Girls dissatisfied with their weight, but not on a diet, showed the highest UFCS values compared to both those on a diet and those not on a diet. TV viewing was positively associated with the consumption of sodas, crisps, cakes and pastries, and sweets and chocolates.

CONCLUSIONS

Dieting is becoming a major problem, especially among older girls. The findings of this study suggest that eating habits of Greek school-aged adolescents are in the process of changing from more traditional to more Westernized ones.

Food habits of Canadians: food sources of nutrients for the adolescent sample

Adolescents need good nutrition, both to grow to their full potential and to decrease their risk of obesity and chronic diseases in adolescence and later life. The Food Habits of Canadians study provides data on the important food sources of energy and nutrients in a sample of Canadian teenagers. One 24-hour recall was obtained for 178 teenagers living in households participating in a national survey of 1,543 adults. Foods were categorized into 51 groups, and ranked according to contribution of key nutrients, energy, and fibre. Top contributors to energy and other nutrients included foods of low nutrient density (cakes/cookies/pastries, carbonated beverages, sugars/jams/syrups, and salty snacks). A high intake of nutrient-poor foods, particularly high-sugar beverages, is a concern for this sample of Canadian teenagers.

Association between vegetarian diet and menstrual problems in young women: a case presentation and brief review

In the last twenty years, several studies have suggested the existence of an association between vegan diets and adolescent menstrual disorders. We share our experience with this problem and a review of the literature on the subject. We conclude that despite the existence of some evidence to the possible association between vegetarian diet and menstrual disorders, it is still not clear if this association is due solely to the vegetarian diet or due to the overall inadequate nutrition with decreased proportions of fat and protein in the diet. We believe that more prospective, well controlled studies are needed to truly explain this association.

Eating disorders in males

Eating disorders are one of the rare psychiatric disorders with a large preponderance of female patients. The other articles in this issue review eating disorders in children and adolescents and focus primarily on female patients. This article reviews the eating disorders that occur in male children and teenagers, including anorexia nervosa, bulimia nervosa, binge eating disorder, a subtype of body dysmorphic disorder named muscle dysmorphobia, and obesity. This article reviews subgroups of boys who are at higher risk for developing eating disorders. The article commences with the difference in male perceptions of body image and dieting behaviors.

Osteoporosis in children and adolescents: diagnosis, risk factors, and prevention

Bone mass acquired during childhood and adolescence is a key determinant of adult bone health. Peak bone mass, which is achieved in late adolescence, is a main determinant of osteoporosis in adulthood. Therefore, any factor adversely impacting on bone acquisition during childhood or adolescence can potentially have long-standing detrimental effects on bone health predisposing to osteoporosis and fracture risk. Thus, osteoporosis can well have its origin in childhood and adolescence. Pediatricians should be playing an active role in osteoporosis diagnosis and prevention. It is increasingly recognized that osteoporosis may occur in some disorders of children and adolescents. In this paper we review the diagnostic criteria of osteopenia/osteoporosis by densitometric assessment of bone mineral density, the contributing factors, and the mechanisms whereby several disorders may affect the acquisition of bone mass in children and adolescents. Finally, some recommendations to optimize peak bone mass in order to prevent osteopenia/osteoporosis are suggested.