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listlengths 384
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IOM,\t2011\n).\tSee\nAppendix\t38\n\tfor\tdietary\tsources.\nA\trecent\tIOM\treport\tconcluded\tthat\ta\tserum\t25(OH)D\tlevel\tof\t20\tng/mL\tcovers\tthe\trequirement\tof\n97.5%\tof\tthe\tpopulation\t(\nIOM,\t2011\n).\tHowever,\tit\tis\trecommended\tthat\tindividuals\tat\trisk\tfor\tvitamin\tD\ndeficiency\tmaintain\ta\thigher\tlevel\tof\t30\tng/mL\tand\tthere\tis\ta\tneed\tfor\tadditional\tresearch
|
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] |
to\tresolve\nongoing\tdebate\tand\tcontroversy\tregarding\tcutoff\tvalues\tfor\tadequate\tand\toptimal\tcirculating\tlevels\n(\nSmith\tet\tal,\t2017\n).\nBased\ton\tcurrent\tguidelines,\tthere\tis\ta\thigh\tprevalence\tof\tvitamin\tD\tdeficiency\tamong\tU.S.\nadolescents.\tAmong\tyouth\tages\t14\tto\t18\tyears,\tapproximately\tone\tthird\thave\tserum\t25(OH)D\tlevels
|
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] |
below\t20\tng/mL\tand\t43%\thave\tlevels\tbetween\t20\tto\t29\tng/mL\t(\nMoore\tand\tLiu,\t2017\n).\tThere\talso\thave\nbeen\tnoted\tdeclines\tin\tvitamin\tD\tstatus\tover\tthe\tpast\ttwo\tdecades.\tNHANES\tdata\tcollected\tduring\tthe\npreceding\tfew\tdecades\testablished\tthat\tserum\t25(OH)D\tlevels\tdecreased\tby\t15%\tto\t16%\t(\nGanji\tet\tal,\n2012
|
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] |
Ganji\tet\tal,\n2012\n).\tThe\treductions\twere\tespecially\tobvious\tamong\tnon-Hispanic\tblack\tparticipants\tand\tthose\tin\tthe\nhighest\tBMI\tquintile.\nSeveral\tfactors\tmay\tcontribute\tto\tthe\trecent\tincreases\tand\n\tprevalence\tof\tvitamin\tD\tdeficiency\n(\nFiscaletti\tet\tal,\t2017\n).\tIncreased\tuse\tof\ttopical\tsunblock\tlotions\thas\tbeen\tadvocated\tto\tprevent
|
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premature\taging\tof\tthe\tskin\tand\tsome\tskin\tcancers,\tbut\tits\tuse\talso\tdecreases\tvitamin\tD\tsynthesis.\nSome\tevidence\tsuggests\tthat\tindividuals\twith\ta\thigher\tBMI\tmore\treadily\tsequester\tcutaneous\tvitamin\tD\nin\tadipose\ttissue,\tmaking\tit\tless\tbioavailable.\tFurther,\toverweight\n\tyouth\tmay\tbe\tless\tlikely\tto\tengage\tin
|
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youth\tmay\tbe\tless\tlikely\tto\tengage\tin\nregular\tphysical\tactivity\toutdoors\tand\tthus\thave\tless\texposure\tto\tsunlight.\tOther\trisk\tfactors\tfor\tvitamin\nD\tdeficiency\tinclude\tmalabsorption\tsyndromes\tsuch\tas\tcystic\tfibrosis,\tlong-term\tuse\tof\tmedications\tthat
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increase\tits\tcatabolism\t(e.g.,\tcorticosteroids),\tlactose\tintolerance\tor\tmilk\tallergy,\tdarkly\tpigmented\tskin,\nand\tresidence\tat\tnorthern\tgeographic\n\tlatitudes\twhere\tyouth\tmay\tspend\tlittle\ttime\toutdoors\tduring\ncolder\tmonths.\tLow\tvitamin\tD\tintake\tis\tan\timportant\thealth\trisk\tfor\tadolescents\tand\tdeserves\tattention
|
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] |
during\tnutrition\tassessment,\teducation,\tand\tintervention\t(see\t\nAppendix\t38\n).\nSupplement\tuse\tby\tadolescents\nThe\tconsumption\tof\tmoderate\tportions\tof\ta\twide\tvariety\tof\tfoods\tis\tpreferred\tto\tnutrient\nsupplementation\tas\ta\tmethod\tfor\tobtaining\n\tadequate\tnutrient\tintake.\tDespite\tthis\trecommendation,
|
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] |
adequate\tnutrient\tintake.\tDespite\tthis\trecommendation,\nstudies\tshow\tthat\tadolescents\tdo\tnot\tconsume\tnutrient-dense\tfoods\tand\tusually\thave\tinadequate\nintakes\tof\tmany\tvitamins\tand\tminerals;\tthus\tsupplements\tsuch\tas\ta\tmultivitamin\tmay\tbe\tbeneficial\tfor\nmany\tadolescents\t(\nKeast\tet\tal,\t2013
|
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] |
many\tadolescents\t(\nKeast\tet\tal,\t2013\n).\tFor\tmost\tvitamins\tand\tminerals,\tnational\tsurvey\tdata\tindicate\nthat\tonly\ta\tsmall\tpercentage\tof\tadolescents\t(<15%)\n\tare\tsupplement\tconsumers\t(\nUSDA,\tARS,\t2017\n).\tThe\nadolescents\tmost\tlikely\tto\tuse\tsupplements\tare\tthose\tin\tgood\thealth\twith\ta\thigher\thousehold\tincome\nand\thealth\tinsurance\t(\nDwyer\tet\tal,\t2013\n).
|
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] |
and\thealth\tinsurance\t(\nDwyer\tet\tal,\t2013\n).\nThe\tuse\tof\therbal\tand\tother\tnonvitamin,\tnonmineral\tdietary\tsupplements\tis\tnot\twell\tdocumented.\nNational\tdata\tsuggest\tthat\t5%\tof\tadolescents\tconsume\tnonvitamin,\tnonmineral\tsupplements;\thowever,\nthis\testimate\n\tis\tbased\ton\tparental\treport\tand\tthe\tactual\tprevalence\tof\tuse\tis\tlikely\thigher\tas\tadolescents
|
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] |
may\tnot\tdisclose\tall\tsupplement\tuse\tto\ttheir\tparents\t(\nWu\tet\tal,\t2013\n).\tAdolescents\tmost\tlikely\tto\tuse\nnonvitamin,\tnonmineral\tsupplements\tare\tthose\twho\treport\tnon-Hispanic\twhite\trace,\ta\thigher\thousehold\nincome,\tactivity\tlimitations\tresulting\tfrom\tchronic\thealth\tconditions,\tlong-term\tprescription\tuse,\tor
|
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] |
adolescents\tfor\tsupplement\tuse\tand\tshould\tcounsel\tthem\taccordingly\t(see\t\nChapter\t11\n).\nFood\thabits\tand\teating\tbehaviors\nFood\thabits\tof\tconcern\tthat\tare\tseen\tmore\tfrequently\tamong\tadolescents\tthan\tother\tage\tgroups\tinclude\nirregular\tconsumption\tof\tmeals,\texcessive\tsnacking,\teating\taway\tfrom\thome\t(especially\tat\tfast-food
|
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] |
restaurants),\tdieting,\tand\tmeal\tskipping.\tMany\tfactors\tcontribute\tto\tthese\tbehaviors,\tincluding\ndecreasing\tinfluence\tof\tfamily,\tincreasing\tinfluence\tof\tpeers,\texposure\n\tto\tvarious\tforms\tof\tmedia,\nemployment\toutside\tthe\thome,\tgreater\tdiscretionary\tspending\tcapacity,\tand\tincreasing\tresponsibilities
|
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that\tleave\tless\ttime\tfor\tadolescents\tto\teat\tmeals\twith\ttheir\tfamilies.\tMost\tadolescents\tare\taware\tof\tthe\nimportance\tof\tnutrition\tand\tthe\tcomponents\tof\ta\thealthy\tdiet;\thowever,\tthey\tmay\thave\tmany\tbarriers\tto\novercome.\tAmong\tthe\tmost\tchallenging\tbarriers\tare\thousehold\n\tfood\tinsecurity,\tdiscrimination\tagainst
|
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food\tinsecurity,\tdiscrimination\tagainst\nsome\tethnic/racial\tgroups,\tand\tweight-related\tconcerns\t(\nLarson\tand\tStory,\t2015\n;\t\nWaxman\tet\tal,\t2015\n).\nTeens\tperceive\ttaste\tpreferences,\thectic\tschedules,\tthe\tcost\tand\taccessibility\tof\tdifferent\tfoods,\tand\nsocial\tsupport\tfrom\tfamily\tand\tfriends\tto\tbe\tkey\tfactors\tthat\taffect\ttheir\tfood\tand\tbeverage\tchoices
|
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] |
(\nBerge\tet\tal,\t2012\n).\tFor\texample,\tparents\tmay\tpositively\n\tinfluence\tthe\tfood\tand\tbeverage\tchoices\tof\nteens\tby\tmodeling\thealthy\teating\thabits,\tselecting\thealthy\tfoods\tfor\tfamily\tmeals,\tencouraging\thealthy\neating,\tand\tsetting\tlimits\ton\tthe\tconsumption\tof\tunhealthy\tsnack\tfoods.\tFriends\tinfluence\teach\tother
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] |
through\tmodeling\tand\tshared\tactivities,\tsuch\tas\teating\tout\tat\tfast-food\trestaurants\tand\tpurchasing\nsnacks\tat\tconvenience\tstores\tnear\tschool.\nDevelopmentally,\n\tmany\tteens\tlack\tthe\tability\tto\tassociate\tcurrent\teating\thabits\twith\tfuture\tdisease\nrisk.\tTeens\toften\tare\tmore\tfocused\ton\t“fitting\tin”\twith\ttheir\tpeers.\tThey\tadopt\thealth\tbehaviors\tthat
|
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] |
demonstrate\ttheir\tquest\tfor\tautonomy\tand\tmake\tthem\tfeel\tmore\tlike\tadults\tsuch\tas\tdrinking\talcohol,\nsmoking,\tand\tengaging\tin\tsexual\tactivity.\tNutrition\teducation\tand\tcounseling\tshould\tfocus\ton\tshort-\nterm\tbenefits\n\tthat\tmany\tadolescents\tcare\tabout,\tsuch\tas\timproving\tschool\tand\tsports\tperformance\tand
|
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] |
having\tmore\tenergy.\tAlthough\tappearance\tis\talso\timportant\tto\tmany\tadolescents,\tthis\ttopic\tneeds\tto\tbe\ndiscussed\tcarefully\tso\tas\tto\tnot\treinforce\tnegative\tbiases.\tMessages\tshould\tbe\tpositive,\tdevelopmentally\nappropriate,\tand\tconcrete.\tSpecific\tskills\tsuch\tas\tchoosing\twater,\tunsweetened\ttea,\tor\tmilk\tover\tsugar-\nsweetened
|
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sweetened\n\tdrinks;\tordering\tbroiled\trather\tthan\tfried\tmeats;\tand\tchoosing\tbaked\trather\tthan\tfried\tsnack\nfoods\tare\tkey\tconcepts\tto\tdiscuss.\nIrregular\tmeals\tand\tsnacking\nMeal\tskipping\tis\tcommon\tamong\tadolescents.\tMeal\tskipping\tincreases\tthroughout\tadolescence\tas\tteens
|
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] |
try\tto\tsleep\tlonger\tin\tthe\tmorning,\ttry\tto\tlose\tweight\tthrough\tcalorie\trestriction,\tand\ttry\tto\tmanage\ntheir\tbusy\tlives.\tBreakfast\tis\tthe\n\tmost\tcommonly\tskipped\tmeal.\tNational\tdata\tsuggest\tthat\napproximately\tone\tquarter\tof\tadolescents\t(12\tto\t19\tyears)\tskip\tbreakfast\ton\ta\tgiven\tday\t(\nUSDA,\tARS,\n2016a
|
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USDA,\tARS,\n2016a\n).\tBreakfast\tskipping\thas\tbeen\tassociated\twith\tpoor\thealth\toutcomes,\tincluding\thigher\tBMI;\npoorer\tconcentration\tand\tschool\tperformance;\tand\tincreased\trisk\tof\tinadequate\tnutrient\tintake\n(\nBurrows\tet\tal,\t2017\n).\tAdolescents\twho\tskip\tbreakfast\n\ttend\tto\thave\ta\thigher\tintake\tof\tadded\tsugars\tand
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0.0895906314253807,
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0.03454448655247688,
0.002620384329929948
] |
tend\tto\thave\ta\thigher\tintake\tof\tadded\tsugars\tand\npoorer\tintake\tof\tkey\tnutrients\t(e.g.,\tcalcium,\tvitamin\tA)\tcompared\twith\tthose\twho\teat\tbreakfast,\nespecially\twhen\tthe\tbreakfast\tmeal\tis\tcomposed\tof\thealthy\tfoods\tthat\tmay\tbe\tfortified\tsuch\tas\tready-to-\neat\tcereal.
|
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] |
eat\tcereal.\nTeens\twho\tskip\tmeals\toften\tsnack\tin\tresponse\tto\thunger\tinstead\tof\teating\ta\tmeal.\tMost\tteens\t(92%\tof\nmales,\t91%\tof\tfemales)\tconsume\tat\n\tleast\tone\tsnack\tper\tday,\tand\tthe\tmajority\tof\tteens\twho\treport\nsnacking\tconsume\ttwo\tor\tmore\tsnacks\tper\tday\t(\nUSDA,\tARS,\t2016c\n).\tSnack\tfoods\tconsumed\tby\tteens
|
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USDA,\tARS,\t2016c\n).\tSnack\tfoods\tconsumed\tby\tteens\nare\toften\thigh\tin\tadded\tfats,\tsweeteners,\tand\tsodium.\tSoft\tdrinks\tand\tother\tsugar-sweetened\tbeverages\nare\tconsumed\tcommonly,\taccounting\tfor\ta\tsubstantial\tproportion\tof\tdaily\tcaloric\tintake\tand\nrepresenting\tan\timportant\tsource\tof\tcaffeine\tconsumption\n\t(see\t\nFocus\tOn:\n\tCaffeine\tand\tSubstance\tUse
|
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(see\t\nFocus\tOn:\n\tCaffeine\tand\tSubstance\tUse\nby\tAdolescents\n).\tDaily\taverage\tenergy\tintake\tfrom\tsugar-sweetened\tbeverages\tis\t232\tcalories\tamong\nteen\tboys\tand\t162\tcalories\tamong\tteen\tgirls,\trepresenting\t9.3%\tand\t9.7%\tof\ttotal\tdaily\tcalories\nrespectively\t(\nRosinger\tet\tal,\t2017\n).\tFrequent\tsnacking\tmay\tpromote\thigher\ttotal\tenergy\tintake\tand\ta
|
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).\tFrequent\tsnacking\tmay\tpromote\thigher\ttotal\tenergy\tintake\tand\ta\nhigher\tproportion\tof\tenergy\tprovided\tby\tadded\tand\ttotal\tsugars\n\t(\nLarson\tand\tStory,\t2013\n).\tHowever,\nnational\tdata\tindicate\tthat\tsnacks\talso\tmake\tpositive\tcontributions\tto\tintake\tof\tkey\tnutrients.\tFor
|
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] |
example,\t2013–2014\tNHANES\tdata\tfor\tmale\tand\tfemale\tadolescents\tindicate\tthat\tfoods\tand\tbeverages\nconsumed\tat\tsnack\toccasions\tprovide\t16%\tto\t17%\tof\tfolate\tintake,\t21%\tto\t25%\tof\tvitamin\tC\tintake,\t20%\nof\tvitamin\tD\tintake,\t23%\tto\t25%\tof\tcalcium\tintake,\tand\t16%\tto\t19%\n\tof\tiron\tintake\t(\nUSDA,\tARS,\t2016d\n).
|
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] |
of\tiron\tintake\t(\nUSDA,\tARS,\t2016d\n).\nBecause\tsnacks\tare\tprevalent\tand\toften\tconsumed\tin\tplace\tof\tmeals,\tteens\tshould\tbe\tencouraged\tto
|
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] |
make\thealthy\tchoices\twhen\tchoosing\tthese\tsnack\tfoods\tand\tbeverages.\t\nBox\t17.2\n\tprovides\tideas\tfor\nhealthy\tsnacks\tor\tmeal\talternatives\tfor\tteens.\nBox\t17.2\nAdolescent-Friendly\tHealthy\tSnacks\nUnsweetened,\tlow-fat\tyogurt\tlayered\twith\tberries\tand\tgranola\nOatmeal\n\tmade\twith\tmilk\tand\tsliced\tfruit\nWhole\tgrain\tcrackers\twith\tcheese\tand\tfruit
|
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0.015405955724418163
] |
Whole\tgrain\tcrackers\twith\tcheese\tand\tfruit\nSliced\tapples\tdipped\tin\tpeanut\tbutter\nWhole-wheat\tbagel\tor\tenglish\tmuffin\thalf\ttopped\twith\tcream\tcheese,\tpeanut\tbutter\tor\talmond\nbutter\nAir-popped\tpopcorn\nWhole-wheat\tpita\twedges\ttopped\twith\t1\tto\t2\ttablespoons\tof\thummus\nBaked\ttortilla\tchips\twith\tbean\tdip\tor\tsalsa
|
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] |
Baked\ttortilla\tchips\twith\tbean\tdip\tor\tsalsa\nBaked\tpotato\ttopped\twith\tsalsa\tor\tbroccoli\tand\tmelted\n\tcheese\nGraham\tcrackers\tand\tpeanut\tor\talmond\tbutter\nFrozen\tyogurt\tor\t100%\tjuice\tbars\twith\tno\tadded\tsugar\nTrail\tmix\t(dried\tfruit\twith\tnuts\tand\tseeds)\nBaby\tcarrots\twith\thummus\nWhole\tgrain,\tlow\tsugar\tgranola\tbars
|
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] |
Baby\tcarrots\twith\thummus\nWhole\tgrain,\tlow\tsugar\tgranola\tbars\nMini\trice\tcakes\tor\tpopcorn\tcakes\twith\thummus\nWhole-wheat\ttortilla\twraps\twith\tturkey,\tcheese,\tlettuce,\tand\ttomato\nAdapted\twith\tpermission\tfrom\tStang\tJ,\tStory\tM,\teditors:\t\nGuidelines\n\tfor\tadolescent\tnutrition\tservices\n,
|
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] |
Guidelines\n\tfor\tadolescent\tnutrition\tservices\n,\nMinneapolis,\t2010,\tCenter\tfor\tLeadership\tEducation\tand\tTraining\tin\tMaternal\tand\tChild\tNutrition,\tDivision\nof\tEpidemiology\tand\tCommunity\tHealth,\tSchool\tof\tPublic\tHealth,\tUniversity\tof\tMinnesota.\nFast\tfoods\tand\tconvenience\tfoods
|
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Fast\tfoods\tand\tconvenience\tfoods\nConvenience\tfoods\tinclude\tfoods\tand\tbeverages\tfrom\tvending\tmachines,\tcanteens,\tschool\tstores,\tfast-\nfood\trestaurants,\tand\tconvenience\n\tstores.\tAs\tadolescents\tspend\tconsiderable\tamounts\tof\ttime\tin\tand\naround\tschools,\tconvenience\tfoods\tavailable\tat\tschool\tand\tin\tthe\tsurrounding\tneighborhood\tare\tlikely
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] |
to\tinfluence\ttheir\teating\tpatterns.\tNational\tdata\tindicate\tvending\tmachines\tare\tavailable\tin\t33%\tof\nmiddle\tschools\tand\t66%\tof\thigh\tschools\t(\nCenters\tfor\tDisease\tControl\tand\tPrevention,\t2015\n).\tAbout\tone\nquarter\tof\tall\tmiddle\tschools\n\tand\t29%\tof\thigh\tschools\thave\ta\tschool\tstore\twhere\tstudents\tcan\tpurchase\nfood\tor\tbeverages\t(
|
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] |
food\tor\tbeverages\t(\nCenters\tfor\tDisease\tControl\tand\tPrevention,\t2015\n).\tIn\taddition,\tmiddle\tschools\tand\nhigh\tschools\toften\thave\ta\tfast-food\trestaurant\tor\tconvenience\tstore\twithin\twalking\tdistance.\tFast-food\nrestaurants\tand\tconvenience\tstores\tare\tsocially\tacceptable\tplaces\tfor\tteens\tto\teat,\tspend\ttime\twith\ntheir\tfriends,\tand\n\teven\twork.\n\t\nFocus\tOn
|
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their\tfriends,\tand\n\teven\twork.\n\t\nFocus\tOn\nCaffeine\tand\tSubstance\tUse\tby\tAdolescents\nThree\tout\tof\tfour\tadolescents\tconsume\tcaffeine\ton\ta\tgiven\tday,\tmostly\tfrom\tsoft\tdrinks,\ttea,\tand\ncoffee\t(\nBranum\tet\tal,\t2014\n).\tAlthough\taverage\tcaffeine\tintake\tamong\tadolescents\tdoes\tnot\texceed\nthe\trecommended\tdaily\tlimit\tof\t100\tmg,\tenergy\tdrinks\tare\tbecoming
|
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).\tThe\tFDA\thas\timposed\ta\tlimit\ton\tcaffeine\tof\t71\tmg\tper\t12-\nounce\tserving\tfor\tsoft\tdrinks,\twhereas\tenergy\tdrinks\thave\tbeen\tfound\tto\tcontain\tnonnutritive\nstimulants\t(e.g.,\tcaffeine\tand\tguarana)\tin\tamounts\tthat\trange\tfrom\t2.5\tto\t171\tmg\n\tper\tounce\t(\nTerry-\nMcElrath\tet\tal,\t2014
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per\tounce\t(\nTerry-\nMcElrath\tet\tal,\t2014\n).\tOf\tfurther\tconcern,\tat\tleast\tone\tstudy\thas\tfound\tthat\tenergy\tdrink\tusers\tare\nmore\tlikely\tthan\ttheir\tpeers\tto\treport\talcohol,\tcigarette,\tand\tillicit\tdrug\tuse.\nThe\trelationship\tbetween\tenergy\tdrink\tconsumption\tand\tsubstance\tabuse\twas\texplored\tusing\ta
|
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2010–2011\tsurvey.\tThis\tsurvey\tdata\twere\tcollected\tfrom\ta\tnationally\trepresentative\tsample\tof\t21,995\nsecondary\n\tschool\tstudents\t(grades\t8,\t10,\tand\t12)\twho\twere\tparticipating\tin\tthe\tMonitoring\tthe\nFuture\tstudy\t(\nTerry-McElrath\tet\tal,\t2014\n).\tStudents\tself-reported\thow\tmany\tenergy\tdrinks\tthey
|
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).\tStudents\tself-reported\thow\tmany\tenergy\tdrinks\tthey\nconsumed\ton\tan\taverage\tday.\tSubstance\tuse\tdata\twere\talso\tself-reported,\tincluding\tfrequency\tof\nalcohol,\tcigarette,\tmarijuana,\tand\tamphetamine\tuse\tin\tthe\tpast\t30\tdays.\tEnergy\tdrink\tconsumption\nwas\trelated\tto\tgreater\tuse\n\tof\teach\tsubstance\tfor\tstudents\tin\tall\tgrades.\tThis\tresearch\tsuggests\tthat
|
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certain\tgroups\tof\tadolescents\tmay\tbe\tparticularly\tlikely\tto\tconsume\tenergy\tdrinks\tand\tto\tbe\nsubstance\tusers,\tand\tnutrition\teducators\tshould\tinform\tparents\tand\tadolescents\tabout\tthe\tmasking\neffects\tof\tcaffeine\tin\tenergy\tdrinks\ton\talcohol-\tand\tother\tsubstance-related\timpairments.\nHighly\tprocessed\tconvenience\tfoods\ttend
|
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Highly\tprocessed\tconvenience\tfoods\ttend\n\tto\tbe\tlow\tin\tvitamins,\tminerals,\tand\tfiber,\tbut\thigh\tin\ncalories,\tadded\tfat,\tsweeteners,\tand\tsodium.\tNational\tdata\tsuggest\tthat\tmany\tteens\tconsume\tone\tor\nmore\titem\tfrom\ta\tfast-food\trestaurant\tor\tthe\tconvenient\tsnack\toptions\tat\tschool\ton\ta\tgiven\tday\t(\nPoti\tet\nal,\t2014
|
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Poti\tet\nal,\t2014\n).\tFew\tadolescents\tare\twilling\tto\tstop\tpurchasing\tsuch\tconvenience\tfoods\tbecause\tthe\tlow\tprice,\neasy\taccess,\tand\ttaste\tappeal\tto\tthem.\n\tInstead\tof\tasking\tyoung\tpeople\tto\tnot\teat\tthese\tfoods,\thealth\nprofessionals\tshould\tcounsel\tthem\ton\thow\tto\tmake\thealthy\tchoices\tand\twork\twith\tschools\tto\timplement
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] |
the\tUSDA\tnutrition\tstandards\tfor\tconvenience\tfoods\tsold\tin\tschools\t(\nFig.\t17.4\n;\tHayes\tet\tal,\t2018).\nCounseling\tadolescents\twith\tconcrete\tguidelines\tthat\tare\teasy\tto\tremember,\tsuch\tas\tchoosing\tsnacks\tor\nvending\tand\tfast-food\toptions\twith\n\tfewer\tthan\t5\tg\tof\tfat\tper\tserving\tand\tno\tmore\tthan\ta\tfew\tgrams\tof
|
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] |
fewer\tthan\t5\tg\tof\tfat\tper\tserving\tand\tno\tmore\tthan\ta\tfew\tgrams\tof\nadded\tsugar,\tcan\tbe\tparticularly\teffective.\tAdolescents\talso\tcan\tbe\tencouraged\tto\tcheck\tlabels\tto\ndetermine\twhether\tfoods\tare\tmade\tfrom\twhole\tgrains\tor\tare\thigh\tin\tadded\tsweeteners\tor\tsodium.\nFIG.\t17.4
|
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] |
FIG.\t17.4\nSmart\tSnacks\tin\tSchool:\tU.S.\tDepartment\tof\tAgriculture\tnutrition\tstandards\tfor\tconvenience\tfoods\tsold\nin\tschools.\n\t\nSource:\n\tAvailable\tat:\t\t\nhttps://www.fns.usda.gov/school-meals/tools-schools-focusing-smart-snacks\n.\nFamily\tmeals\nThe\tfrequency\twith\twhich\tadolescents\teat\tmeals\twith\ttheir\tfamilies\tdecreases\twith\tage\t(\nChild\tTrends,\n2013
|
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Child\tTrends,\n2013\n).\tNearly\thalf\tof\t12-\tto\t14-year-olds\teat\tmeals\n\twith\ttheir\tfamilies\tat\tleast\t6\tdays\tper\tweek\ncompared\twith\tjust\tmore\tthan\tone\tthird\tof\t15-\tto\t17-year-olds.\tAdolescents\twho\teat\tmeals\twith\ttheir\nfamilies\thave\tbeen\tfound\tto\thave\tbetter\tacademic\tperformance,\tto\tbe\tless\tlikely\tto\tengage\tin\trisky
|
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] |
behaviors\tsuch\tas\tillicit\tdrug\tuse,\tand\tto\tbe\tless\tlikely\tto\thave\tschool\tproblems\tcompared\twith\tpeers\nwho\tdo\tnot\tfrequently\tengage\tin\tfamily\tmeals\t(\nGoldfarb\tet\tal,\t2015\n).\nDeveloping\thealthful\teating\tpatterns\tat\tfamily\tmeals\tduring\tadolescence\tmay\timprove\tthe\tlikelihood
|
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] |
that\tindividuals\twill\tchoose\tto\tconsume\tnutritious\tfoods\tin\tadulthood\tand\tmay\tprotect\tthem\tfrom\tthe\nfuture\tdevelopment\tof\toverweight\t(\nBerge\tet\tal,\t2015\n).\tFamily\tmeals\tnot\tonly\tallow\tfor\tmore\ncommunication\tbetween\tteens\tand\ttheir\tparents\tbut\talso\tprovide\tan\tideal\tenvironment\tduring\twhich\nparents
|
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] |
parents\n\tcan\tmodel\thealthy\tfood\tand\tbeverage\tchoices\tand\tattitudes\ttoward\teating.\tTeens\twho\teat\tat\nhome\tmore\tfrequently\thave\tbeen\tfound\tto\tconsume\tfewer\tsoft\tdrinks\tand\tmore\tcalcium-rich\tfoods,\tfruit,\nand\tvegetables\t(\nLarson\tet\tal,\t2013\n)\t(see\t\nFocus\tOn:\n\tFamily\tMeals\tand\tNutritional\tBenefits\tfor\tTeens\n).\n\t\nFocus\tOn\nFamily\tMeals\tand
|
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).\n\t\nFocus\tOn\nFamily\tMeals\tand\n\tNutritional\tBenefits\tfor\tTeens\nWhen\tteens\tregularly\tshare\tdinners\twith\ttheir\tfamilies,\tthey\tare\tmore\tlikely\tto\thave\tdiets\tof\thigher\nnutritional\tquality,\tand\tsome\tevidence\tsuggests\tthe\tpractice\tmay\tprotect\tthem\tagainst\tthe\tfuture\ndevelopment\tof\toverweight\tin\tyoung\tadulthood\t(\nBerge\tet\tal,\t2015
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] |
development\tof\toverweight\tin\tyoung\tadulthood\t(\nBerge\tet\tal,\t2015\n).\tHowever,\tdifferent\tschedules\tand\ndifficulty\tfinding\ttime\tto\teat\ttogether\tare\tcommon\tbarriers\tto\tsharing\n\tthe\tevening\tmeal.\tOne\tstudy\nexamined\twhether\tthere\tare\tsimilar\tbenefits\tassociated\twith\teating\tbreakfast\ttogether\t(\nLarson\tet\tal,\n2013
|
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] |
Larson\tet\tal,\n2013\n).\tStudents\tat\t20\tpublic\tmiddle\tschools\tand\thigh\tschools\tin\tthe\tMinneapolis-St.\tPaul\nmetropolitan\tarea\tof\tMinnesota\twere\tsurveyed\tabout\ttheir\tdietary\tpractices\tand\thow\toften\tthey\thave\na\tfamily\tmeal\tat\tbreakfast\tand\tat\tdinner.\tApproximately\t71%\tof\tstudents\tat\tthese\n\tschools\tqualified
|
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schools\tqualified\nfor\tfree\tor\treduced-price\tschool\tmeals\tand\t81%\trepresented\ta\tracial/ethnic\tbackground\tother\tthan\nnon-Hispanic\twhite.\tAmong\tthese\tstudents,\tfamily\tbreakfast\tmeals\toccurred\ton\taverage\tless\toften\nthan\tfamily\tdinners\t(1.5\tbreakfast\tmeals\tversus\t4.1\tdinner\tmeals\tper\tweek)\tand\tless\tthan\t10%\tof
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of\tfamilies\tand\tthus\tsuggest\tthat\talthough\tit\tis\tnot\talways\tpossible\tto\teat\tdinner\n\ttogether,\tcoming\ntogether\tfor\tother\tmeals\tsuch\tas\tbreakfast\tcan\tprovide\tbenefits.\tHealth\tprofessionals\tshould\nencourage\tfamilies\tto\teat\ttogether\tat\tbreakfast\tas\twell\tas\tat\tdinner,\tand\tto\tprovide\tsupports\tfor
|
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] |
addressing\tchallenges\tsuch\tas\tlack\tof\ttime,\tfood\tsecurity,\tand\tlimited\tfood\tpreparation\tskills.\nMedia\tand\tadvertising\nThe\tadvertising\tof\tfood\tand\tbeverages\tis\ta\tmulti-billion\tdollar\n\tbusiness.\tIn\t2016\ta\ttotal\tof\tmore\tthan\n$13.5\tbillion\twas\tspent\tby\tfood,\tbeverage,\tand\trestaurant\tcompanies\ton\tadvertising\ttheir\tproducts\n(\nHarris\tet\tal,\t2017
|
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(\nHarris\tet\tal,\t2017\n).\tThese\tfood-related\tcompanies\tpromote\ttheir\tproducts\tusing\ta\tnumber\tof\tdifferent\ntechniques\t(e.g.,\tcontests,\tproduct\tplacements,\tsponsorships,\tcelebrity\tendorsements,\tviral\tmarketing)\nand\tmultiple\tforms\tof\tmedia;\thowever,\ttelevision\tis\ta\n\tdominant\tadvertising\tmedium.\tOf\tthe\t$13.5\tbillion
|
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dominant\tadvertising\tmedium.\tOf\tthe\t$13.5\tbillion\nspent\ton\tadvertising\tby\tfood-related\tcompanies,\t$10\tbillion\twas\tspent\ton\ttelevision\tadvertising\t(\nHarris\net\tal,\t2017\n).\nThe\thigh\ttelevision\tadvertising\texpenditures\ttranslate\tto\tthe\tdaily\taverage\tof\t10\tto\t11\tfood-related
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2016.\tAn\tanalysis\tof\ttelevision\tadvertising\tfound\tthat\tjust\t56\tof\tthe\tmore\tthan\t20,300\tfood-related\ncompanies\twere\tresponsible\tfor\t85%\tof\tfood-related\tads\tviewed\tby\tyouth;\tthese\tcompanies\tinclude\nseveral\tthat\tparticipate\tin\tthe\tself-regulatory\n\tprograms\tknown\tas\tthe\tChildren’s\tFood\tand\tBeverage
|
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0.11419369280338287,
0.059061240404844284,
0.0656135305762291,
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] |
programs\tknown\tas\tthe\tChildren’s\tFood\tand\tBeverage\nAdvertising\tInitiative\t(CFBAI)\tand\tChildren’s\tConfection\tAdvertising\tInitiative\t(CCAI)\tbut\talso\ta\tlarge\nnumber\tof\tcompanies\tthat\tdo\tnot\tlimit\ttheir\tchild-directed\tadvertising\tto\thealthier\tdietary\tchoices.
|
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] |
Although\tthe\tCFBAI\tand\tCCAI\tcompanies\twere\tfurther\tfound\tto\thave\tkept\ttheir\tpledges\tfrom\t2007\tto\n2016\tby\treducing\tads\tfor\tless\thealthy\n\tproducts\ton\tchildren’s\ttelevision\tchannels\tand\tmedia\tprimarily\ndirected\tto\tchildren\tunder\tage\t12\tyears,\tthese\timprovements\thad\tlimited\tbenefits\tfor\tadolescent
|
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viewers.\tDuring\tthis\tperiod,\tadolescent\texposure\tto\tads\tfor\tcandy,\tsugary\tdrinks,\tsnack\tfood,\tand\tfast-\nfood\tbrands\twas\tconversely\tfound\tto\tincrease.\tMost\tfood\tadvertisements\tviewed\tby\tadolescents\tare\tfor\nproducts\thigh\tin\tfat,\tsugar,\tor\tsodium,\n\tand\tfast-food\trestaurant\tadvertisements\tare\tthe\tmost\tfrequently\nviewed\t(\nPowell\tet\tal,\t2010
|
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] |
viewed\t(\nPowell\tet\tal,\t2010\n).\tResearch\tshows\tthat\tfood\tadvertising\tincreases\tyoung\tpeople’s\timmediate\nand\tfuture\tfood\tchoices\tand\tfood\tbrand\tpreferences\tand\tit\tis\tnot\tuntil\tlate\tadolescence\tthat\ta\tyoung\nperson’s\tability\tto\tcope\twith\tadvertising\twill\tsurface\t(\nLapierre\tet\tal,\t2017\n).\tAlong\twith\tongoing\tefforts\nto\tlimit\tyoung\tpeople’s
|
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advertising\tmessages.\nDieting\tand\tbody\timage\nBody\timage\tconcerns\tare\tcommon\tduring\tadolescence.\tMany\tadolescents\tdescribe\tthemselves\tas\tbeing\noverweight\tdespite\tbeing\tat\ta\thealthy\tBMI,\tsignifying\ta\tdisturbance\tin\ttheir\n\tbody\timage.\tPoor\tbody\nimage\tcan\tlead\tto\tweight\tcontrol\tissues\tand\tdieting.\tThe\tYouth\tRisk\tBehavior\tSurveillance\tSystem\tdata
|
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from\t2017\tshow\tthat\t47.1%\tof\tU.S.\thigh\tschool\tstudents\twere\tattempting\tto\tlose\tweight.\tThe\tprevalence\nof\tdieting\twas\thigher\tamong\tfemale\t(59.9%)\tthan\tmale\t(34.0%)\tstudents.\tHispanic\tfemales\thad\tthe\nhighest\tprevalence\tof\tdieting\tat\t65.6%,\tfollowed\tby\twhite\tfemales\t(58.6%),\n\tblack\tfemales\t(55.3%),
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black\tfemales\t(55.3%),\nHispanic\tmales\t(45.7%),\twhite\tmales\t(30.6%),\tand\tblack\tmales\t(28.9%)\t(\nKann\tet\tal,\t2018\n).\nEating\tnutrient-dense\tfoods\t(e.g.,\tfruits\tand\tvegetables,\tlean\tmeats\tand\tfish,\tlow\tfat\tor\tnonfat\tdairy,\nlegumes,\tnuts)\tto\tlimit\tcalories\tand\tgetting\tregular\texercise\tcan\tbe\tviewed\tas\thealthy\tweight\tloss
|
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] |
behaviors\twhen\tused\tin\tmoderation\tand\tcan\tbe\ta\tstarting\tpoint\tfor\tnutrition\teducation\n\tand\tcounseling\nto\timprove\teating\tbehaviors.\tHowever,\tnot\tall\tdieting\tbehaviors\thave\tthe\tpotential\tto\timprove\thealth.\nHigh-risk\tdieting\tpractices\tare\tused\tby\tmany\tadolescents\tand\tcarry\twith\tthem\tthe\trisk\tof\tpoor\nnutritional\tstatus\tand\tincreased\trisk\tfor
|
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] |
nutritional\tstatus\tand\tincreased\trisk\tfor\t\ndisordered\teating\n\t(see\t\nChapter\t21\n).\tThe\tmost\trecent\tavailable\nnational\tsurvey\tdata\ton\tdisordered\teating\tbehaviors\tindicate\tthat\tfasting,\tor\trefraining\n\tfrom\teating\tfor\nmore\tthan\t24\thours,\twas\tpracticed\tby\t17%\tof\tfemale\tand\t7%\tof\tmale\tU.S.\thigh\tschool\tstudents\tin\tthe\npast\tmonth\tas\ta\tmeans\tof\tdieting\t(
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past\tmonth\tas\ta\tmeans\tof\tdieting\t(\nEaton\tet\tal,\t2012\n).\tFurthermore,\t6%\tof\tfemales\tand\t4%\tof\tmales\thad\nused\tdiet\tpills\tto\tlose\tweight;\tthe\tprevalence\tof\tthis\tbehavior\twas\thighest\tamong\tHispanic\tstudents\tand\nincreased\twith\tage.\tThe\tuse\tof\tpurging\tmethods,\tincluding\tvomiting\tand\tlaxative\n\tor\tdiuretic\tuse,\twas
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appropriate\tcounseling\tregarding\tthe\tharms\tof\tsuch\tpractices\tcan\tbe\n\tprovided.\nNutrition\tscreening,\tassessment,\tand\tcounseling\nThe\tAmerican\tAcademy\tof\tPediatrics\trecommends\tthat\tadolescents\thave\tan\tannual\thealth\tscreening\tto\naddress\tpriority\tissues,\tincluding\tphysical\tgrowth\tand\tdevelopment,\tsocial\tand\tacademic\tcompetence,
|
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emotional\twell-being,\trisk\treduction\t(e.g.,\tfor\tsubstance\tuse,\tsexually\ttransmitted\tinfections),\tand\nviolence\tand\tinjury\tprevention\t(\nHagan\tet\tal,\t2017\n).\tThe\tsupervision\tof\tphysical\tgrowth\tand\tdevelopment\nshould\tinvolve\tan\tassessment\tof\tnutrition\trisk\tand\tthe\tprovision\tof\tanticipatory\tguidance.\tNutrition
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screening\tshould\tinclude\tthe\tassessment\tof\theight,\tweight,\tand\tBMI\tto\tdetermine\tweight\tstatus;\nevaluation\tfor\tthe\tpresence\tof\tiron\tdeficiency\tanemia\t(females\tonly);\treview\tof\toral\thealth\t(e.g.,\tregular\ndental\tvisits,\tintake\tof\thigh-sugar\n\tfoods);\tand\tassessment\tof\tphysical\tfitness\tand\tmedia\tuse,\tincluding\ntime\tspent\tengaged\twith\tsocial\tmedia\t(
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] |
time\tspent\tengaged\twith\tsocial\tmedia\t(\nAnderson\tand\tJiang,\t2018\n).\tAnticipatory\tguidance\tshould\tfurther\naddress\thealthy\teating\tbehaviors\tand\tbuilding\ta\tpositive\tbody\timage.\nWeight,\theight,\tand\tBMI\tshould\tbe\tplotted\tusing\tthe\tCenters\tfor\tDisease\tControl\tand\tPrevention
|
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] |
(CDC)\tNational\tCenter\tfor\tHealth\tStatistics\tBMI\ttables\tto\tdetermine\n\tappropriateness\tof\tweight\tfor\nheight\t(see\t\nAppendix\t3\n).\tA\tBMI\tbelow\tthe\tfifth\tpercentile\tmay\tsignal\tthe\tpresence\tof\tchronic\tor\nmetabolic\tdisease,\tgrowth\tfailure,\tor\tan\teating\tdisorder.\tA\tBMI\tat\tor\tabove\tthe\t85th\tpercentile\tbut
|
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] |
below\tthe\t95th\tpercentile\tmay\tindicate\tthat\tan\tadolescent\tis\toverweight,\twhereas\ta\tBMI\tat\tor\tabove\tthe\n95th\tpercentile\tmay\tindicate\tthe\tpresence\tof\tobesity.\tFor\tsome\tyoung\n\tpeople,\ta\thigh\tBMI\tvalue\treflects\nhigh\tlean\tbody\tmass\trather\tthan\thigh\tlevels\tof\tbody\tfat;\ttherefore,\tit\tcan\tbe\tvaluable\tto\tconduct\tfurther
|
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] |
direct\tassessment\tof\tbody\tfat\twhen\tdone\tin\ta\tsensitive\tmanner\tand\tused\tto\tinform\tcounseling\tthat\tis\nfocused\ton\thealth\tbehaviors\t(\nHagan\tet\tal,\t2017\n)\t(for\tadditional\tinformation,\tsee\t\nChapter\t5\n).\nWhen\tnutrition\tscreening\tindicates\tthe\tpresence\tof\tnutritional\n\trisk,\ta\tfull\tassessment\tshould\tbe
|
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] |
risk,\ta\tfull\tassessment\tshould\tbe\nconducted.\tNutrition\tassessment\tshould\tinclude\ta\tcomplete\tevaluation\tof\tfood\tintake\tthrough\ta\t24-hour\nrecall,\tdietary\trecords,\tor\tbrief\tfood\tfrequency\tquestionnaire\t(see\t\nChapter\t4\n).\tThe\tadequacy\tof\tenergy,\nfiber,\tmacronutrients,\tand\tmicronutrients\tshould\tbe\tdetermined,\tas\twell\tas\texcessive\tintake\tof\tany
|
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dietary\tcomponents\tsuch\tas\tsodium\tor\tsweeteners.\tNutritional\n\tassessments\talso\tshould\tinclude\tan\nevaluation\tof\tthe\tnutritional\tenvironment,\tincluding\tparental,\tpeer,\tschool,\tcultural,\tand\tpersonal\nlifestyle\tfactors.\tThe\tattitude\tof\tthe\tadolescent\ttoward\tfood\tand\tnutrition\tis\timportant;\thelping\tthe
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food\tsupply.\n\tHomeless\tteens,\tas\twell\tas\tthose\tliving\tin\ttemporary\tshelters,\tbenefit\tfrom\tnutrition\ncounseling\tfocusing\ton\tlightweight,\tlow-cost,\tprepackaged\tfoods\tthat\tdo\tnot\trequire\trefrigeration\tor\ncooking\tfacilities.\tDried\tfruit,\tnuts,\tgranola\tbars,\tcereal\tbars,\ttuna\tin\tpouches,\tand\tmeat\tjerky\tare\tfoods
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] |
that\tshould\tbe\tavailable\tfor\trunaway\tor\thomeless\tteens.\nEducation\tand\tcounseling\tshould\tbe\ttailored\n\tto\tmeet\tany\tspecific\tnutrition\tdiagnoses\tidentified\tduring\nthe\tassessment.\tAn\tadolescent\twith\ta\tdiagnosis\tof\ttype\t2\tdiabetes\twho\texperiences\trapid\tweight\tgain
|
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] |
requires\ta\tdifferent\ttype\tand\tintensity\tof\tcounseling\tthan\ta\tteen\twho\thas\tbeen\tdiagnosed\twith\tiron\ndeficiency\tanemia.\tKnowledge,\tattitude,\tmotivation,\tand\tbehavior\tmust\tbe\taddressed\twhen\tguiding\nadolescents\ttoward\tacquiring\thealthful\tfood\thabits.\n\tFor\ta\tplan\tto\tsucceed\tthe\tadolescent\tneeds\tto\tbe
|
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] |
For\ta\tplan\tto\tsucceed\tthe\tadolescent\tneeds\tto\tbe\ninterested\tin\tmaking\tchange;\ttherefore\tan\tassessment\tof\ta\tteenager’s\tdesire\tto\tchange\tis\tessential.\nEncouraging\tthe\tdesire\tto\tchange\tusually\trequires\tattention,\tcreativity,\tpatience,\tand\tsignificant\nrapport\tbuilding\t(see\t\nChapter\t13\n).
|
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] |
rapport\tbuilding\t(see\t\nChapter\t13\n).\nInformation\tcan\tbe\tprovided\tin\tvarious\tsettings\tranging\tfrom\tthe\tclassroom\tto\tthe\thospital\t(\nFig.\t17.5\n).\nIt\tis\tvaluable\n\tfor\tclinicians\tto\tunderstand\tthe\tchange\tprocess\tand\thow\tto\tcommunicate\tit\tmeaningfully\nso\tthey\tcan\tprovide\tpersonalized\tand\tmore\teffective\tcounseling.\tParents\tmay\tbe\tincluded\tin\tthe\tprocess
|
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] |
and\tare\tencouraged\tto\tbe\tsupportive.\tRecommended\teating\tplans\tbased\ton\trecommended\tenergy\nintakes\tfor\tadolescents\tare\tshown\tin\t\nTable\t17.7\n.\nFIG.\t17.5\nAdolescents\twho\thelp\tprepare\tnutritious\tmeals\tbecome\tengaged\tin\tthe\thealthy\teating\tprocess.
|
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] |
TABLE\t17.7\nRecommended\tNumber\tof\tServings\tfor\tAdolescents\tAges\t13\tand\t16\tYears\tBased\ton\tActivity\tLevel\n*\nGrains\n(oz-\neq/day)\nWhole\nGrains\n(oz-\neq/day)\n†\nVegetables\n(cups/day)\nFruit\n(cups/day)\nDairy\n(cups/day)\nSeafood\n(oz/week)\nMeat,\npoultry,\neggs\n(oz/week)\nNuts,\nseeds,\nsoy\nproducts\n(oz/week)\nOils\n(g/day)\nMales\n13\tYears\nSedentary\n6\n3\n2.5\n2\n3\n8\n26\n5
|
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] |
(oz/week)\nOils\n(g/day)\nMales\n13\tYears\nSedentary\n6\n3\n2.5\n2\n3\n8\n26\n5\n27\nModerately\nActive\n7\n3.5\n3\n2\n3\n9\n28\n5\n29\nActive\n9\n4.5\n3.5\n2\n3\n10\n31\n5\n34\n16\tYears\nSedentary\n8\n4\n3\n2\n3\n10\n31\n5\n31\nModerately\nActive\n10\n5\n3.5\n2.5\n3\n10\n33\n6\n36\nActive\n10\n5\n4\n2.5\n3\n10\n33\n6\n51\nFemales\n13\tYears\nSedentary\n5\n3\n2\n1.5\n3\n8\n23\n4\n22\nModerately\nActive\n6\n3\n2.5\n2\n3\n8\n26\n5\n27
|
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] |
5\n3\n2\n1.5\n3\n8\n23\n4\n22\nModerately\nActive\n6\n3\n2.5\n2\n3\n8\n26\n5\n27\nActive\n7\n3.5\n3\n2\n3\n9\n28\n5\n29\n16\tYears\nSedentary\n6\n3\n2.5\n1.5\n3\n8\n23\n4\n24\nModerately\nActive\n6\n3\n2.5\n2\n3\n8\n26\n5\n27\nActive\n8\n4\n3\n2\n3\n10\n31\n5\n31\noz-eq
|
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Active\n6\n3\n2.5\n2\n3\n8\n26\n5\n27\nActive\n8\n4\n3\n2\n3\n10\n31\n5\n31\noz-eq\n,\tone\tounce-equivalent\tis:\t1\tslice\t(1\tounce)\tof\tbread;\t1\tounce\tuncooked\tpasta\tor\trice;\t½\tcup\tcooked\trice,\tpasta,\tor\tcereal;\t1\ttortilla\t(6”\tdiameter);\t1\npancake\t(5”\tdiameter);\t1\tounce\tready-to-eat\tcereal\t(about\t1\tcup\tcereal\tflakes)
|
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] |
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