Pediatric Nutrition in Practice

Adolescent Nutrition 123

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cents need to be tailored to the developmental
level of each individual adolescent to respond to
their needs and should be delivered on a platform
where they can be reached.
This chapter will review the trends for child-
hood and adolescent malnutrition, adolescent
eating behaviors and factors inf luencing them as
well as interventions and platforms to promote
healthy nutrition habits among adolescents and
to prevent obesity.

Adolescent Nutrition Trends

Over the last two decades, increasing prevalence
rates of overweight and obesity among children
and adolescents have been seen in many coun-
tries. Many of the LMICs now bear the double
burden of malnutrition due to the emerging is-
sue of overweight and obesity along with the
existing high rates of stunting and other micro-
nutrient deficiencies. In 2011, an estimated 43
million children under 5 years of age were over-
weight, marking a 54% increase from an esti-
mated 28 million in 1990. In Africa, the estimat-
ed prevalence increased from 4% in 1990 to 7%
in 2011, while it is a little lower in Asia (5% in
2011), with the number of affected children be-
ing higher than in Africa (17 and 12 million, re-
spectively) [4]. Globally, childhood obesity rates
continue to rise in developing countries, while
in the developed part of the world, they are grad-
ually plateauing [5, 6]. These figures are alarm-
ing and require immediate attention, as child-
hood overweight is associated with multiple im-
mediate and long-term risks including raised
cholesterol, triglycerides and glucose, type 2 dia-
betes, high blood pressure as well as adult obe-
sity and its associated consequences [7, 8]. Pri-
mary prevention remains pivotal as there is
strong evidence that obesity is difficult to re-
verse and continues through to adulthood. Ado-
lescent nutrition is also important with regard to
maternal nutrition, as pregnant adolescents are

at risk for adverse outcomes including low birth

weight, preterm delivery, anemia and excessive

postpartum weight retention due to a combina-

tion of physiological, socioeconomic and behav-

ioral factors [9, 10]. Nutrition among pregnant

teens is crucial as they tend to give low priority

to nutrition despite having an enhanced need

for nutrients due to their pregnant state. Recent-

ly, there has been a growing interest in ado-

lescent nutrition in developing countries as a

means of improving the health of women and

children, as interventions targeted at adoles-

cents allow time for the interventions to have the

maximum impact on optimizing health in the

years ahead.

Eating patterns and behaviors are inf luenced

by many factors during adolescence including

peer inf luences, parental modeling, food avail-

ability, food preferences, costs, convenience, per-

sonal and cultural beliefs, mass media and body

image. These could be broadly classified as fol-

lows: (1) personal factors including attitudes, be-

liefs, food preferences, self-efficacy and biologi-

cal changes; (2) environmental factors including

family, friends, peer networks, school, fast food

outlets and social and cultural norms, and (3)

macrosystemic factors including food availabili-

ty, food production, distribution systems, the

mass media and advertising.

I n t e r v e n t i o n s

Various interventions including education,

health promotion as well as behavioral and psy-

chological counseling could be implemented ei-

ther at the individual level or combined with

family/parent support with a focus on diet, phys-

ical activity or lifestyle. These interventions

could be school based, health care center based

or delivered at the community level. Evidence

suggests that educational, health promotional,

psychological and behavioral counseling inter-

ventions focusing on diet, physical activity or

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 122–126
DOI: 10.1159/000367879