students had access to vending machines, school stores,
canteens, or snack bars. Nutrition experts have worked
with educators to present adolescents with healthier
choices at school, to decrease or change the messages
of food advertising, and to better educate students in
the classroom about good nutritional choices.Calories and weight management
The new guidelines and pyramid focus on the
basics of calorie management. It’s all about balancing
energy, or the amount of calories eaten vs. the amount
of calories used by the body. By managing portions,
eating a balanced diet from the food groups, and not
taking in too many calories on high-sugar or high-fat
foods, adolescents can maintain a reasonable intake of
calories. Regular physical activity can help to balance
energy. Research has shown that subtracting just 100
calories a day from the diet can help manage weight.
The typical soda contains 150 calories. Adults need to
help teens understand that balanced eating and calorie
management help manage weight, not unhealthy
stretches of fasting or reliance onfad diets. Physical
activity also helps manage weight. Encouraging more
participation in sports or just spending time outside
with family and friends vs. ‘‘screen time’’ in front of the
television, computer, and video games, also can help
manage weight safely.
Dieting is an important predictor of eating dis-
orders among adolescents. Girls who practiced rigid
dieting are about 18 times more likely to have eating
disorders such asanorexia nervosa,bulimia nervosa,
or eating disorder not otherwise specified. Teen
girls who have dieted moderately are five times
more likely to be diagnosed with an eating disorder.
If an eating disorder is diagnosed, the adolescent
will receive therapy with behavioral and nutritional
approaches.
Nutritional therapy for teens with eating disor-
ders will first correct possible malnutrition caused by
the eating disorder. Refeeding must be carefully
planned to avoid complications brought on by sud-
den increased calories and weight gain. The meal plan
will be based on the Dietary Guidelines with gradual
increases in calories as the teen’s lean body mass
increases.
Some adolescents with diabetes have been known
to use doses of insulin below those recommended by
their physicians to promote weight loss. Teens with
Type 1 diabetes will have nutritional counseling upon
diagnosis and regular checks with a registered dieti-
cian. They will have to count carbohydrates and care-fully plan diet around exercise to avoid weight gain.
Teens with Type 2 diabetes also will be taught how to
control blood glucose levels.Precautions
Like adults, adolescents need to understand that it
is best to achieve recommended levels of nutrients
through consumption of foods instead of through
vitamins and supplements. Use of supplements should
be done only under the supervision of a professional
medical provider who understands adolescent nutri-
tion needs. Adolescents should understand that the
best way to manage weight is through a balanced
approach to eating fresh foods and through remaining
physically active, not through fasting, use of drugs or
supplements, or through participation in fad diets.Complications
Failing to eat a nutritious diet can cause growth
and developmental problems in adolescents and cause
long-term complications such as obesity or osteoporo-
sis. Eating disorders can lead to serious complications
in teens, including malnutrition, changes to heart func-
tion caused by starvation, stomach bleeding, and may
cause depression leading to suicide. Improper manage-
ment of diabetes can lead to loss of consciousness and
seizures, and in the longer term, eye disease, kidney and
heart disease, or nerve damage.Parental concerns
Parents are up against the peer pressures and
constant conflicting images that adolescents get from
the media. On the one hand, teens see unrealistic
images of body types on television and in magazines.
On the other hand, they are bombarded with adver-
tisements for processed, convenient, and unhealthy
foods. Girls also frequently read magazine articles
about dieting and weight loss, a practice that leads to
unhealthy weight control behaviors. Internet Web
sites even provide advice to teens on how to accom-
plish and hide their eating disorders and what sorts of
products help people with bulimia nervosa in their
purging of foods.
Parents can help by promoting healthy habits at
home. Teens can be encouraged to snack on healthy
foods. Parents can educate their teens about nutrition
and the nutrients that are essential to them as they
grow. Houses with teens should have fresh fruits and
vegetables on hand to hold hunger off after school.
Teens also should be encouraged to participate inAdolescent nutrition