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Adolescent eating habits

Debby Demory-Luce, PhD, RD, LD
Kathleen J Motil, MD, PhD
Section Editor
Amy B Middleman, MD, MPH, MS Ed
Deputy Editor
Alison G Hoppin, MD


Nutritional needs during adolescence are increased because of the increased growth rate and changes in body composition associated with puberty [1,2]. The dramatic increase in energy and nutrient requirements coincides with other factors that may affect adolescents' food choices and nutrient intake and thus, nutritional status. These factors, including the quest for independence and acceptance by peers, increased mobility, greater time spent at school and/or work activities, and preoccupation with self-image, contribute to the erratic and unhealthy eating behaviors that are common during adolescence [1,3].

Sound nutrition can play a role in the prevention of several chronic diseases, including obesity, coronary heart disease, certain types of cancer, stroke, and type 2 diabetes [4-12]. For this reason, nutrition remains an important objective for Healthy People 2020 [13]. To help prevent diet-related chronic diseases, researchers have proposed that healthy eating behaviors should be established in childhood and maintained during adolescence (table 1) [14-17]. (See "Healthy diet in adults".)

National and population-based surveys have found that adolescents often fail to meet dietary recommendations for overall nutritional status and for specific nutrient intakes [18-21]. Many adolescents receive a higher proportion of energy from fat and/or added sugar and have a lower intake of a vitamin A, folic acid, fiber, iron, calcium, vitamin D, and zinc than is recommended [22-27]. The low intake of iron and calcium among adolescent girls is of particular concern. Vitamin D deficiency is increasingly prevalent, and is associated with decreased bone density and probably fracture risk [28,29]. Vitamin D deficiency is typically defined as 25-hydroxyvitamin D concentrations <15 ng/mL (37.5 nmol/L), and target concentrations for 25-hydroxyvitamin D are at least 20 ng/mL (50 nmol/L). Iron deficiency can impair cognitive function and physical performance, and inadequate calcium intake may increase fracture risk during adolescence and the risk of developing osteoporosis in later life [30-35]. (See "Iron requirements and iron deficiency in adolescents" and "Calcium requirements in adolescents" and "Vitamin D insufficiency and deficiency in children and adolescents".)

Eating habits vary widely between individual adolescents, and also display some general trends over time, reflecting sociocultural trends in food availability and nutritional goals. As an example, data from six national representative surveys showed that total energy intake among us adolescents increased through 2004, then decreased through 2010 [36]. Seven food sources, including sugar-sweetened beverages, pizza, full-fat milk, grain-based desserts, breads, pasta dishes, and savory snacks, consistently contributed to this trend. Intakes of full-fat milk, meats, ready-to-eat cereals, burgers, fried potatoes, fruit juice, and vegetables decreased, whereas nonfat milk, poultry, sweet snacks and candies, and tortilla- and corn-based dishes increased through 2010. The changes contributing to the decline in caloric intake prior to 2010 included significant decreases in sugar-sweetened beverages, pizza, pasta dishes, bread, and savory snacks; and significant increases in fruit.

During adolescence, young people are in a transition period when they gradually take over the responsibility for their own eating habits. Knowledge is one of the factors necessary for a healthy transition of responsibility. Questionnaires used to assess nutrition knowledge demonstrate that more than two-thirds of adolescents, especially boys, adolescents from rural environments, and overweight adolescents, have unsatisfactory knowledge about dietary recommendations, sources of nutrients, diet-disease relationships, and dietary habits [37]. In this group, television was the main source of information about nutrition for adolescents.


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