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in\tchildren\tand\tadolescents.\tSummary\treport\n,\tNIH\tPublication\tNo\t12-7486A,\tOctober\t2012.\nBox\t17.5\nDietary\tRecommendations\tfor\tAdolescents\twith\tElevated\nTriglyceride\tor\tNon-High-Density\tLipoprotein\tCholesterol\tLevels\n•\t\nLimit\ttotal\tfat\tintake\tto\tno\tmore\tthan\t25%\tto\t30%\n\tof\tcalories.\n•\t\nLimit\tsaturated\tfat\tintake\tto\tno\tmore\tthan\t7%\tof\tcalories.\n•
|
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] |
•\t\nLimit\tsaturated\tfat\tintake\tto\tno\tmore\tthan\t7%\tof\tcalories.\n•\t\nReduce\tintake\tof\tadded\tand\tnatural\tsugars\tin\tthe\tdiet.\n•\t\nReplace\tsimple\tcarbohydrates\twith\tcomplex\tcarbohydrate\tand\twhole\tgrains.\n•\t\nAvoid\tsugar-sweetened\tbeverages.\n•\t\nIncrease\tthe\tintake\tof\tfish\thigh\tin\tomega-3\tfatty\tacids.
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0.05219043046236038,
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] |
•\t\nIncrease\tthe\tintake\tof\tfish\thigh\tin\tomega-3\tfatty\tacids.\nAdapted\tfrom\tU.S.\tDepartment\tof\tHealth\tand\tHuman\tServices,\tNational\tInstitutes\tof\tHealth,\n\tNational\tHeart,\nLung\tand\tBlood\tInstitute:\t\nExpert\tpanel\ton\tintegrated\tguidelines\tfor\tcardiovascular\thealth\tand\trisk\treduction\nin\tchildren\tand\tadolescents.\tSummary\treport
|
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] |
in\tchildren\tand\tadolescents.\tSummary\treport\n,\tNIH\tPublication\tNo\t12-7486A,\tOctober\t2012.\nNational\tscreening\tcriteria\tfor\tblood\tpressure\tlevels\tamong\tadolescents\tare\tavailable\tthrough\tthe\nNational\tHeart\tLung\tand\tBlood\tInstitute\tthrough\tthe\tNIH.\tAdolescents\t13\tyears\n\tof\tage\tand\tolder\twho
|
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] |
reducing\tblood\tpressure\tin\tmany\tindividuals\t(see\t\nChapter\t32\n\tand\t\nAppendix\t17\n).\tIn\taddition\tto\tfollowing\nthe\tDASH\tdiet,\tadolescents\twith\televated\tblood\tpressure\tshould\tbe\tcounseled\tto\treduce\tsodium\tintake\nto\tless\tthan\t2000\tmg/day\tand\tto\tachieve\tand\tmaintain\ta\thealthy\tbody\tweight.
|
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] |
The\tNHLBI\thas\tdeveloped\tthe\tCHILD\t1\t(Cardiovascular\tHealth\tIntegrated\tLifestyle\tDiet)\tdiet\tand\nnutrition\tguidelines,\twhich\tintegrate\tdietary\tapproaches\tto\tprevent\thypertension\n\tand\thyperlipidemia,\nand\tpromote\ta\thealthy\tweight\t(\nTable\t17.11\n).\tThese\tguidelines\tinclude\tthe\tDASH\tdietary\tguidelines\tas
|
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] |
).\tThese\tguidelines\tinclude\tthe\tDASH\tdietary\tguidelines\tas\nwell\tas\trecommendations\tfor\tupper\tlimits\tfor\ttotal\tand\tsaturated\tfatty\tacids\tand\tdietary\tcholesterol\nintake.\tThe\tCHILD\t1\tguidelines\trecommend\tavoiding\tsweetened\tbeverages,\tlimiting\tjuice\tintake,\tand\nincreasing\tfiber\tintake\tto\ta\tlevel\tof\t14\tg/1000\tkcal.\nTABLE\t17.11\nCardiovascular
|
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0.1155853420495987,
0.0013447025557979941,
-0.06849256902933121,
-0.026867376640439034,
0.07061775028705597,
-0.011786225251853466,
-0.05836900323629379,
-0.0992106944322586,
0.04776246100664139,
0.07843557000160217,
0.02452622912824154,
-0.03843094781041145,
0.016015108674764633,
0.08412016183137894,
0.05010261386632919,
0.06469707190990448,
0.008502187207341194
] |
TABLE\t17.11\nCardiovascular\n\tHealth\tIntegrated\tLifestyle\tDiet\t(CHILD\t1)\tRecommendations,\tAges\t11\tto\t21\tYears\nPrimarily\tselect\tfat-free\tunflavored\tmilk,\twater,\tand\tunsweetened\ttea\tas\tbeverage\tchoices.\nLimit\tor\tavoid\tsugar-sweetened\tbeverages.\nTry\tto\tconsume\ta\trange\tof\t25%\tto\t30%\tof\tdaily\tenergy\tneeds\tfrom\ttotal\tfatty\tacids.
|
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0.06512671709060669,
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0.10815034061670303,
0.06415966153144836,
0.06398539245128632,
-0.011663274839520454
] |
Limit\tsaturated\tfatty\tacids\tto\t8%\tto\t10%\tof\tdaily\tenergy\tneeds.\nKeep\tmonounsaturated\tand\n\tpolyunsaturated\tfatty\tacids\tto\tno\tmore\tthan\t20%\tof\tdaily\tenergy\tintake.\nAvoid\ttrans\tfatty\tacids.\nLimit\tdietary\tcholesterol\tto\t300\tmg/day.\nChoose\tfoods\thigh\tin\tdietary\tfiber\toften\tto\tinclude\ta\tgoal\tof\t14\tg\tfiber\tper\t1000\tkcal.
|
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0.01169904787093401
] |
Choose\tnaturally\tsweetened\tjuices\t(no\tadded\tsugar)\tand\tlimit\tintake\tto\t4\tto\t6\toz/day.\nLimit\tsodium\tintake.\nTry\tto\teat\tbreakfast\tdaily.\nTry\tto\teat\tmeals\ttogether\n\twith\tother\tfamily\tmembers\tat\tthe\tsame\ttable.\nLimit\tfast\tfood\tmeals.\nUse\tthe\tDietary\tApproaches\tto\tStop\tHypertension\teating\tplan\tas\ta\tguide\tto\tplan\tmeals.
|
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] |
Aim\tto\tkeep\taverage\tenergy\tintake\tclose\tto\testimated\tenergy\trequirements\twith\tadjustment\tfor\tgrowth\tand\nphysical\tactivity\tas\tneeded.\nAdapted\tfrom\tU.S.\tDepartment\tof\tHealth\tand\tHuman\tServices\t(USDHHS),\tNational\tInstitutes\tof\tHealth\t(NIH),\n\tNational\tHeart,\tLung,\tand\tBlood\tInstitute\n(NHLBI):
|
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National\tHeart,\tLung,\tand\tBlood\tInstitute\n(NHLBI):\t\nExpert\tpanel\ton\tintegrated\tguidelines\tfor\tcardiovascular\thealth\tand\trisk\treduction\tin\tchildren\tand\tadolescents.\tSummary\treport\n,\tNIH\tPublication\nNo\t12-7486A,\tOctober\t2012.\nMetabolic\tsyndrome\tis\tconsidered\tto\tbe\ta\tclustering\tof\trisk\tfactors\tthat,\ttaken\ttogether,\tsignal\ta\tneed
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] |
to\tintensify\tthe\tdepth\tand\tbreadth\tof\tprevention\tmeasures\tthat\tare\n\trecommended.\tIt\tis\testimated\tthat\n3.3%\tof\tall\tU.S.\tadolescents\thave\tmetabolic\tsyndrome;\tthe\trate\tis\tmuch\thigher\tamong\tadolescents\tat\tan\nobese\tBMI,\tamong\twhom\tit\tis\testimated\tto\tbe\t29.2%\t(\nFriend\tet\tal,\t2013\n).\nPreventing\tand\tscreening\tfor\tdiabetes
|
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] |
The\texact\tprevalence\tof\tdiabetes\tamong\tadolescents\tis\tnot\tknown,\tbut\tit\tis\testimated\tthat\napproximately\t193,000\tpeople\tunder\tthe\tage\tof\t20\thave\tdiabetes\n\t(\nCDC,\t2017\n).\tFindings\tfrom\tthe\nSEARCH\tfor\tDiabetes\tin\tYouth\tStudy\tsuggest\tthat\tthe\tincidence\tof\ttype\t1\tand\ttype\t2\tdiabetes\tis\t21.7
|
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] |
cases\tand\t12.5\tcases\trespectively\tper\t100,000\tpeople\tyounger\tthan\t20\tyears\t(\nMayer-Davis\tet\tal,\t2017\n).\nEthnic\tand\tracial\tminority\tyouth\tare\tat\tincreased\trisk\tfor\tboth\ttype\t1\tand\ttype\t2\tdiabetes\tcompared\nwith\ttheir\tnon-Hispanic\twhite\tcounterparts.\nThe\tgrowing\tincidence\n\tof\ttype\t2\tdiabetes\tamong\tadolescents\tis\tof\tparticular\tpublic\thealth\tconcern.
|
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] |
Between\t2002\tand\t2012,\tthe\tincidence\tof\ttype\t2\tdiabetes\tincreased\tby\t7.1%\t(\nMayer-Davis\tet\tal,\t2017\n).\nType\t2\tdiabetes\tis\tmore\tcommon\tin\tthose\twith\ta\tfamily\thistory\tof\tdiabetes\tand\tin\tthose\twho\thave\nsignificant\tand\trapid\tweight\tgain\tor\tobesity.\tRecommendations\tfor\ttype\t2\tdiabetes\tscreening,\tincluding\nassessment\tfor\tphysical
|
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] |
assessment\tfor\tphysical\n\tsigns\tsuch\tas\tacanthosis\tnigricans\t(dark,\tvelvety\tpatches\tof\tskin\tin\tbody\tfolds\nand\tcreases),\tare\tlisted\tin\t\nBox\t17.6\n.\tThe\tprevention\tof\ttype\t2\tdiabetes\tincludes\tfollowing\tthe\tCHILD\t1\ndietary\tguidelines\tand\tadditional\tphysical\tactivity\tat\ta\tlevel\tto\treduce\tbody\tweight\t(\nU.S.\tDepartment\tof
|
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] |
U.S.\tDepartment\tof\nHealth\tand\tHuman\tServices\t[USDHHS],\tNational\tInstitutes\tof\tHealth\t[NIH],\tNHLBI,\t2012\n).\nBox\t17.6\nRecommendations\n\t\nfor\tScreening\tAdolescents\tfor\tType\t2\tDiabetes\nMellitus\nYouth\twho\tare\tat\tan\toverweight\tor\tobese\tbody\tmass\tindex\tand\texhibit\ttwo\tof\tthe\tfollowing\trisk\nfactors\tare\tat\thigh\trisk:\n•
|
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] |
factors\tare\tat\thigh\trisk:\n•\t\nFirst-\tor\tsecond-degree\trelative\twith\ta\thistory\tof\ttype\t2\tdiabetes\n•\t\nMember\tof\ta\tracial/ethnic\tgroup\tconsidered\tat\thigher\trisk\t(American\tIndian,\tAfrican\tAmerican,\nLatino,\tAsian\tAmerican/Pacific\tIslander)\n•\t\nDyslipidemia\n•\t\nHypertension\n•\t\nAcanthosis\tnigricans\n•\t\nPolycystic\tovary\tsyndrome
|
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] |
•\t\nHypertension\n•\t\nAcanthosis\tnigricans\n•\t\nPolycystic\tovary\tsyndrome\nScreening\tshould\tbegin\tat\tage\t10\tor\tthe\tonset\tof\tpuberty,\twhichever\toccurs\tfirst.\nScreening\tshould\toccur\tevery\t2\tyears.\nAdapted\tfrom\tU.S.\tDepartment\tof\tHealth\tand\tHuman\tServices,\tNational\tInstitutes\tof\tHealth,\tNational\tHeart,\nLung\tand\tBlood\tInstitute:
|
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Lung\tand\tBlood\tInstitute:\t\nExpert\tpanel\ton\tintegrated\tguidelines\tfor\tcardiovascular\thealth\tand\trisk\n\treduction\nin\tchildren\tand\tadolescents.\tSummary\treport\n,\tNIH\tPublication\tNo\t12-7486A,\tOctober\t2012.\nPromoting\tphysical\tactivity\nParticipation\tin\tadequate\tphysical\tactivity\tis\tcritical\tto\tthe\tprevention\tof\tdiabetes\tas\twell\tas\tthe
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promotion\tof\tcardiovascular\thealth,\ta\thealthy\tweight,\thigh\tquality\tsleep,\tacademic\tachievement,\tand\noverall\twell-being\t(\nNational\tCenter\tfor\tChronic\tDisease\tPrevention\tand\tHealth\tPromotion,\t2014\n;\nPhysical\tActivity\tGuidelines\tAdvisory\tCommittee,\t2018\n).\tNational\trecommendations\tfor\tphysical\tactivity
|
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).\tNational\trecommendations\tfor\tphysical\tactivity\nare\tfor\tadolescents\tto\tbe\tactive\tat\tleast\t60\tminutes\teach\tday,\tincluding\tparticipation\tin\tvigorous\tactivity\nat\tleast\t3\tdays\teach\tweek\t(\nUSDHHS,\t2018\n).\tIn\taddition,\tit\tis\trecommended\tthat\tmuscle-strengthening
|
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).\tIn\taddition,\tit\tis\trecommended\tthat\tmuscle-strengthening\n(e.g.,\tworking\twith\tresistance\tbands,\tlifting\tweights,\tyoga)\tand\tbone-strengthening\tactivities\n\t(e.g.,\nrunning,\tjumping\trope,\tbasketball)\tbe\tincluded\tin\tthe\t60\tminutes\tof\tphysical\tactivity\tat\tleast\tthree\ttimes
|
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a\tweek.\tThe\tMove\tYour\tWay\tcampaign\tthrough\tthe\tOffice\tof\tDisease\tPrevention\tand\tHealth\tPromotion\nwas\tdeveloped\talong\twith\tthese\tnational\trecommendations\tand\tmay\tbe\ta\tuseful\tsource\tof\teducational\nmaterials.\tIn\torder\tto\tachieve\tthese\trecommendations\tfor\tbeing\tactive\tand\tgetting\n\tadequate\tsleep,\tthe
|
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adequate\tsleep,\tthe\nAmerican\tAcademy\tof\tPediatrics\trecommends\tthat\tadolescents\tand\ttheir\tparents\tdevelop\tlimits\tfor\nmedia\tuse\t(e.g.,\tdesignated\tmedia-free\ttimes,\tconsistent\tlimits\ton\ttime\tspent\tusing\tmedia\tand\ttypes\tof\nmedia)\tas\tpart\tof\ta\tFamily\tMedia\tUse\tPlan\t(\nCouncil\ton\tCommunications\tand\tMedia,\t2016\n).\tMany\tyoung
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] |
television\t3\tor\tmore\thours\tper\tday.\nAdolescent\tathletes\thave\tunique\tnutrient\tneeds.\tAdequate\tfluid\tintake\tto\tprevent\tdehydration\tis\nespecially\tcritical\tfor\tyoung\tathletes.\tYoung\tadolescents\tare\tat\thigher\trisk\tfor\tdehydration\tbecause\tthey\nproduce\tmore\theat\tduring\texercise\tbut\thave\tless\tability\n\tto\ttransfer\theat\tfrom\tthe\tmuscles\tto\tthe\tskin.
|
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] |
to\ttransfer\theat\tfrom\tthe\tmuscles\tto\tthe\tskin.\nThey\talso\tsweat\tless,\twhich\tdecreases\ttheir\tcapacity\tto\tdissipate\theat\tthrough\tthe\tevaporation\tof\tthe\nsweat.\nAthletes\twho\tparticipate\tin\tsports\tthat\tuse\tcompetitive\tweight\tcategories\tor\temphasize\tbody\tweight
|
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] |
are\tat\televated\trisk\tfor\tthe\tdevelopment\tof\tdisordered\teating\tbehaviors.\tA\tconcern\tamong\tfemale\nathletes\tis\tthe\tfemale\tathlete\ttriad\trelationship,\n\ta\tconstellation\tof\tlow\tbody\tweight\tand\tinadequate\tbody\nfat\tlevels,\tamenorrhea,\tand\tosteoporosis\t(see\t\nChapter\t22\n).\tThe\tfemale\tathlete\ttriad\tmay\tlead\tto
|
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0.158277690410614,
0.0575983002781868,
0.11729826033115387,
0.0038968303706496954
] |
Chapter\t22\n).\tThe\tfemale\tathlete\ttriad\tmay\tlead\tto\npremature\tbone\tloss,\tdecreased\tbone\tdensity,\tincreased\trisk\tof\tstress\tfractures,\tand\tinfertility\t(\nDe\nSouza\tet\tal,\t2017\n).\tNutrition\tassessment\tand\teducation\tfor\tteenage\tathletes\tshould\tfocus\ton\tobtaining\nadequate\tenergy,\tmacronutrients,\tand\tmicronutrients
|
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] |
adequate\tenergy,\tmacronutrients,\tand\tmicronutrients\n\tto\tmeet\tthe\tneeds\tfor\tgrowth\tand\tdevelopment\nand\tto\tmaintain\ta\thealthy\tbody\tweight.\tThe\tuse\tof\tanabolic\tagents\t(such\tas\tsteroids\tor\tinsulin)\tand\nother\tergogenic\tsupplements\tshould\talso\tbe\tincluded\tin\tnutrition\tscreening.\tNational\tsurvey\tdata\tshow
|
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that\t2.9%\tof\tU.S.\thigh\tschool\tstudents\thave\ttaken\tsteroids\twithout\ta\tprescription\tat\tleast\tonce\tin\ttheir
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life,\twith\ta\thigher\tproportion\tof\tmales\n\treporting\tsteroid\tuse\tthan\tfemales\t(3.3%\tvs.\t2.4%)\t(\nKann\tet\tal,\n2018\n).\tFurthermore,\tseveral\tstudies\thave\tfound\tthat\tathletes\tare\tmore\tlikely\tthan\tnonathletes\tto\tuse\nperformance-enhancing\tsubstances\t(\nLaBotz\tand\tGriesemer,\t2016\n).\nMeeting\tnutritional\tneeds\tduring\tpregnancy
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).\nMeeting\tnutritional\tneeds\tduring\tpregnancy\nAlthough\tbirth\trates\tamong\tfemales\t15\tto\t19\tyears\thave\tdeclined\tover\tthe\tpast\tfew\tdecades\tand\nreached\ta\tlow\tof\t20.3\tbirths\n\tper\t1000\tadolescents\tin\t2015,\tadolescent\tpregnancy\tremains\ta\tsignificant\npublic\thealth\tissue\t(\nMartin\tet\tal,\t2018\n).\tAdolescent\tfemales\twho\tbecome\tpregnant\tare\tat\tparticularly
|
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] |
).\tAdolescent\tfemales\twho\tbecome\tpregnant\tare\tat\tparticularly\nhigh\trisk\tfor\tnutritional\tdeficiencies\tbecause\tof\televated\tnutrient\tneeds.\tPregnant\tadolescents\twith\ta\ngynecologic\tage\n\t(the\tnumber\tof\tyears\tbetween\tthe\tonset\tof\tmenses\tand\tcurrent\tage)\tof\tless\tthan\t4\nand\tthose\twho\tare\tundernourished
|
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] |
and\tthose\twho\tare\tundernourished\n\tat\tthe\ttime\tof\tconception\thave\tthe\tgreatest\tnutritional\tneeds.\tAs\nwith\tadult\twomen,\tpregnant\tadolescents\trequire\tadditional\tfolic\tacid,\tiron,\tzinc,\tand\tother\nmicronutrients\tto\tsupport\tfetal\tgrowth\t(see\t\nChapter\t14\n).\tCalcium\tand\tvitamin\tD\tare\talso\timportant
|
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] |
Chapter\t14\n).\tCalcium\tand\tvitamin\tD\tare\talso\timportant\nnutrients\tin\tpregnancy,\tbecause\tboth\tare\tnecessary\tfor\tgrowth\tand\tdevelopment\tof\tthe\tadolescent\nmother\tand\tfetus\t(\nYoung\tet\tal,\t2012\n).\tPregnant\n\tadolescents\tneed\ta\tfull\tnutrition\tassessment\tearly\tin
|
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0.0371503122150898,
0.05452499911189079,
0.08003906905651093,
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] |
).\tPregnant\n\tadolescents\tneed\ta\tfull\tnutrition\tassessment\tearly\tin\npregnancy\tto\tdetermine\tany\tnutrient\tdeficiencies\tand\tto\tpromote\tadequate\tweight\tgain.\tWeight\tgain\nrecommendations\tfor\tpregnancy\tare\tlisted\tin\t\nTable\t14.11\n\tin\t\nChapter\t14\n.\tReferral\tto\tappropriate\tfood
|
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0.05454332008957863,
0.07127083092927933,
0.015933161601424217
] |
Table\t14.11\n\tin\t\nChapter\t14\n.\tReferral\tto\tappropriate\tfood\nassistance\tprograms\tsuch\tas\tthe\tSpecial\tSupplemental\tNutrition\tProgram\tfor\tWomen,\tInfants\tand\nChildren\tis\tan\timportant\tpart\tof\tprenatal\tnutrition\n\teducation.\nCLINICAL\tCASE\tSTUDY\nCherise\tis\tan\t18-year-old\twhite\tfemale\tand\thigh\tschool\tsenior\twho\tsaw\ta\tnurse\tat\tthe\tschool-based
|
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] |
clinic.\tWhile\ttaking\ther\tmedical\thistory,\tthe\tschool\tnurse\tnoted\tthat\tCherise\thad\tfrequent\theadaches\nand\tfatigue.\tCherise’s\tblood\tpressure\treading\tfell\tinto\tthe\t92nd\tpercentile.\tThe\tschool\tnurse\treferred\nher\tto\ta\tlocal\tcommunity\tclinic\tfor\ta\tmore\tthorough\tevaluation.
|
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her\tto\ta\tlocal\tcommunity\tclinic\tfor\ta\tmore\tthorough\tevaluation.\nA\tphysician’s\tassistant\t(PA)\tat\tthe\tcommunity\tclinic\ttook\ta\tsocial\thistory\tand\tperformed\ta\tphysical\nexamination\ton\tCherise.\tA\tsexual\tmaturity\trating\t(SMR)\tstage\tof\t5\twas\tnoted.\tThe\tPA\tnoted\tthat
|
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Cherise’s\tBMI\thad\tincreased\tover\tthe\tpast\tyear\tfrom\tthe\t85th\tto\tthe\t95th\tpercentile\tfor\ther\tage\tand\ngender.\tHer\tblood\tpressure\tregistered\tat\tthe\t94th\tpercentile.\tThe\tfamily\thistory\trevealed\ta\tstrong\nfamily\n\thistory\tof\tcardiovascular\tdisease,\tdiabetes,\tand\trenal\tdisease.\tCherise\tthought\ther\tfather\tmay
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be\ttaking\tmedication\tfor\this\tcholesterol\tand\tblood\tpressure,\tbut\tshe\treported\tno\thealth\tissues\tfor\nher\tmother.\tNo\tsigns\tof\tacanthosis\tnigricans\twere\tnoted\ton\tthe\tphysical\texamination.\nLaboratory\tresults\tshow\tthat\tCherise\thad\televated\ttotal,\tnon-HDL,\tand\tLDL\tcholesterol\tlevels\nalong\twith\ta\tmarginally
|
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RDN\talso\tinquired\tabout\tusual\tdietary\tpatterns\tand\tphysical\tactivity\tas\twell\tas\tthe\tpresence\tof\tany\nfood\tallergies/intolerances\tand\tavoidances.\nCherise\treported\tthat\tshe\tusually\tskipped\tbreakfast\tbecause\n\tshe\tdidn’t\thave\ttime\tto\teat\tin\tthe\nmorning,\tbut\tshe\toften\tbuys\ta\tcaramel\tmacchiato\tfrom\tthe\tschool\tstore\tat\t7:15\t\nAM\n.\tThe\tfirst\tfood
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AM\n.\tThe\tfirst\tfood\nCherise\tate\tmost\tdays\twas\tusually\ta\tsnack\tfrom\tthe\tvending\tmachine\tat\t10:30\t\nAM\n,\twhich\tconsisted\tof\na\tgranola\tbar\tor\ta\tbag\tof\tchips\tand\ta\tjuice\tdrink.\tOccasionally\tshe\twould\tpurchase\ta\tla\tcarte\tlunches\nof\ttacos\tor\ta\tburger,\tbut\tgenerally\tshe\tskipped\tlunch.\tCherise\n\twas\tout\tof\tschool\tat\t2\t\nPM\n\teach\tday,\tat
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was\tout\tof\tschool\tat\t2\t\nPM\n\teach\tday,\tat\nwhich\ttime\tshe\twent\tto\twork\tas\ta\tclothing\tsales\tclerk\tat\tthe\tlocal\tmall.\tShe\thad\ta\thalf-hour\tbreak\tin\nthe\tlate\tafternoon\tor\tearly\tevening,\twhen\tshe\twould\tgo\tto\tthe\tfood\tcourt\tfor\tdinner.\tHer\tevening\nmeal\tusually\tconsisted\tof\tone\tto\ttwo\tslices\tof\tpepperoni\tpizza,\ttwo\ttacos,\tor\tone\tto\ttwo\tpieces\tof
|
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] |
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] |
between\tclasses,\tand\tbeing\ton\ther\tfeet\tin\tthe\tevenings\tat\ther\tsales\tjob.\nThe\tRDN\tcounseled\tCherise\tregarding\tdietary\tchanges\tand\tphysical\tactivity.\tA\tfollow-up\tvisit\twas\nscheduled\t4\tweeks\tin\tthe\tfuture.\nCherise\tdid\tnot\treturn\tto\tsee\tthe\tRDN\tfor\ther\tfollow-up\tappointment\n\tand\tdid\tnot\tkeep\ther\tfollow-
|
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] |
and\tdid\tnot\tkeep\ther\tfollow-\nup\tappointments\twith\tthe\tPA.\tFive\tmonths\tlater,\tshe\treturned\tto\tsee\tthe\tPA\tat\twhich\ttime\ther\thealth\nstatus\twas\treassessed.\tCherise’s\tblood\tpressure\twas\tstill\tat\tthe\t94th\tpercentile\tand\ther\tBMI\tnow\tat\nthe\t96th\tpercentile.\tWhen\tcounseled\tabout\ther\tdietary\thabits\tand\tphysical\tactivity,\tCherise\treported
|
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at\thome.\tThe\tPA\tsuggested\tshe\tsee\tthe\tRDN\tagain\tfor\tmore\tdietary\tand\tphysical\tactivity\tcounseling.\nThe\tRDN\treviewed\tthe\tprevious\tdietary\trecommendations\twith\tCherise\tand\tsuggested\n\tshe\tattend\nthe\tclinic’s\t12-week\tweight\tmanagement\tprogram.\tCherise\tattended\tthe\tfirst\tfive\tsessions\tof\tthe
|
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] |
program,\tthen\tstopped.\tShe\thad\tlost\t12\tpounds\tduring\tthe\tfive\tsessions.\tSeveral\tmonths\tlater\nCherise\twas\tonce\tagain\tseen\tby\tthe\tPA.\tHer\tblood\tpressure\tcontinued\tto\tbe\televated\tand\ther\tBMI\nwas\tplotted\tat\tthe\t94th\tpercentile.\tWhen\tquestioned\tabout\tthe\tweight\tloss\tprogram,\tCherise\nreported\tthat
|
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] |
reported\tthat\n\ther\tmother\thad\tchanged\tjobs\tand\tlost\ther\thealth\tinsurance\tbenefits,\tso\tshe\tcould\tno\nlonger\tparticipate\tin\tthe\tprogram.\tThe\tRDN\tconnected\tCherise\twith\tthe\tlocal\tYMCA,\twhich\toffered\ta\nweight\tmanagement\tprogram\tfor\tadults\ton\ta\tsliding\tfee\tscale.\tFive\tmonths\tlater\tCherise’s\tBMI\twas
|
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] |
assessed\tat\t26.8\tand\ta\tweight\tloss\tof\t19\tpounds\tfrom\tprevious\tlevels\twas\tnoted.
|
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] |
Nutrition\tdiagnostic\tstatements\n•\t\nExcessive\tenergy\tintake\t(NI-1.3)\trelated\tto\tinconsistent\tmeal\tpatterns\tand\tdietary\thistory\nincluding\tmostly\tlow\tfiber\tand\tenergy-dense\tconvenience\tfoods\tas\tevidenced\tby\ta\tBMI\tat\tthe\n95th\tpercentile\n•\t\nExcessive\tfat\tintake\t(NI-5.6.2)\trelated\tto\ta\tpreference\tfor\tconvenience\tfoods,\tincluding\tpizza,
|
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fried\tsnacks,\tand\tice\tcream\tas\tevidenced\tby\televated\ttotal\tand\tLDL\tcholesterol\n•\t\nInadequate\tphysical\n\tactivity\t(NB-2.1)\trelated\tto\ta\tbusy\twork\tand\tschool\tschedule\tas\tevidenced\nby\tpatient\treported\tnot\thaving\tenough\ttime\tto\tparticipate\tin\tregular\tphysical\tactivity\n•
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•\t\nLimited\tadherence\tto\tnutrition-related\trecommendations\t(NB-1.6)\trelated\tto\tsocioeconomic\nbarriers\tand\tbusy\twork\tand\tschool\tschedule\tas\tevidenced\tby\tBMI\tup\t1\tpercentile\tat\tfollow-up\nvisit\nNutrition\tcare\tquestions\n1.\t\nHow\twould\n\tyou\tclassify\tCherise’s\tblood\tpressure\tbased\ton\tthe\treading\tat\tthe\tschool\tnurse’s\noffice?\n2.
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] |
office?\n2.\t\nHow\twould\tyou\tclassify\tCherise’s\tweight\tbased\ton\tthe\treadings\tat\tthe\tfirst\tvisit\tat\tthe\ncommunity\tclinic?\tIs\tthere\tany\tadditional\tinformation\tyou\twould\twant\tto\tknow\tabout\ther\nweight\thistory\tto\tmake\tyour\tassessment?\n3.\t\nBased\ton\ther\tfamily\thealth\thistory,\twhat\tlaboratory\ttests\twould\tyou\torder\tto\tbe\tconsistent
|
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] |
with\tthe\tNational\tHeart,\tLung,\tand\tBlood\tInstitute\t(NHLBI)\trecommendations?\n4.\t\nWhat\ttype\tof\tnutrition\trecommendations\twould\tbe\tideal\tfor\tCherise\tbased\ton\ther\tblood\npressure,\tweight\tgain\thistory,\tand\tlaboratory\tresults?\n5.\t\nWhat\tspecific\tstrategies\twould\tbe\tbeneficial\tfor\tthe\tRDN\tto\trecommend\tto\tCherise\tregarding\nimproving\ther\tdietary\tintake?\n6.
|
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] |
improving\ther\tdietary\tintake?\n6.\t\nWhat\tstrategies\twould\tyou\trecommend\tfor\tCherise\n\tto\tchange\ther\tlevel\tof\tphysical\tactivity?\nUseful\twebsites\nAmerican\tAcademy\tof\tPediatrics:\tMedia\tand\tChildren\nAmerican\tSchool\tHealth\tAssociation\nNational\tEating\tDisorder\tAssociation\nSchool\tNutrition\tAssociation\nReferences\nAbreu\tAP,\tKaiser\tUB.
|
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School\tNutrition\tAssociation\nReferences\nAbreu\tAP,\tKaiser\tUB.\t\nPubertal\tdevelopment\tand\tregulation\n\tLancet\tDiabetes\tEndocrinol\t3,\t2016;4:\n254-264.\nAmerican\tAcademy\tof\tPediatrics,\tCouncil\ton\tCommunications\n\tand\tMedia.\t\nMedia\tuse\tin\tschool-aged\nchildren\tand\tadolescents\n\tPediatrics\t5,\t2016;138:\te20162592.\nAnderson\tM,\tJiang\tJ.
|
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Pediatrics\t5,\t2016;138:\te20162592.\nAnderson\tM,\tJiang\tJ.\t\nTeens,\tsocial\tmedia\tand\ttechnology\t2018\n\tPew\tResearch\tCenter\t2018;\nAvailable\tat:\t\nhttps://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-\n2018/\n.\nBerge\tJM,\tArikian\tA,\tDoherty\tWJ.\tet\tal.\t\nHealthful\teating\tand\tphysical\tactivity\tin\tthe\thome\nenvironment:\tresults
|
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environment:\tresults\n\tfrom\tmultifamily\tfocus\tgroups\n\tJ\tNutr\tEduc\tBehav\t2012;44:\t123-131.\nBerge\tJM,\tWall\tM,\tHsueh\tTF.\tet\tal.\t\nThe\tprotective\trole\tof\tfamily\tmeals\tfor\tyouth\tobesity:\t10-year\nlongitudinal\tassociations\n\tJ\tPediatr\t2015;166:\t296-301.\nBowman\tSA,\tFriday\tJE,\tClemens\tJC.\tet\tal.\t\nA\tcomparison\tof\tfood\tpatterns\tequivalents\tintakes\tby\nAmericans
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] |
A\tcomparison\tof\tfood\tpatterns\tequivalents\tintakes\tby\nAmericans\n\tDietary\tData\tBrief\tNo.\tSeptember\t2016;16:.\nBranum\tAM,\tRossen\tLM,\tSchoendorf\n\tKC.\t\nTrends\tin\tcaffeine\tintake\tamong\tU.S.\tchildren\tand\nadolescents\n\tPediatrics\t2014;133:\t386-393.\nBurris\tJ,\tRietkerk\tW,\tWoolf\tK.\t\nAcne:\tthe\trole\tof\tmedical\tnutrition\ttherapy\n\tJ\tAcad\tNutr\tDiet
|
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] |
Acne:\tthe\trole\tof\tmedical\tnutrition\ttherapy\n\tJ\tAcad\tNutr\tDiet\n2013;113:\t416-430.\nBurris\tJ,\tRietkerk\tW,\tWoolf\tK.\t\nRelationships\tof\tself-reported\tdietary\tfactors\tand\tperceived\tacne\nseverity\tin\ta\tcohort\tof\tNew\tYork\tyoung\tadults\n\tJ\tAcad\tNutr\tDiet\t2014;114:\t384-392.\nBurrows\n\tT,\tGoldman\tS,\tPursey\tK,\tLim\tR.
|
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] |
Burrows\n\tT,\tGoldman\tS,\tPursey\tK,\tLim\tR.\t\nIs\tthere\tan\tassociation\tbetween\tdietary\tintake\tand\nacademic\tachievement:\ta\tsystematic\treview\n\tJ\tHum\tNutr\tDiet\t2,\t2017;30:\t117-140.\nCenters\tfor\tDisease\tControl\tand\tPrevention,\tDivision\tof\tAdolescent\tand\tSchool\tHealth.\tResults\nfrom\tthe\tSchool\tHealth\tPolicies\tand\tPractices\tStudy\t2014\t2015;\tAvailable\tat:
|
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] |
https://www.cdc.gov/healthyyouth/data/shpps/results.htm\n.\nCenters\n\tfor\tDisease\tControl\tand\tPrevention.\tNational\tdiabetes\tstatistics\treport,\t2017\t2017;\nCenters\tfor\tDisease\tControl\tand\tPrevention,\tU.S.\tDepartment\tof\tHealth\tand\tHuman\tServices\nAtlanta,\tGA\tAvailable\tat:\t\nhttps://www.cdc.gov/diabetes/data/statistics/statistics-report.html\n.
|
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] |
https://www.cdc.gov/diabetes/data/statistics/statistics-report.html\n.\nCenters\tfor\tDisease\tControl\tand\tPrevention.\t\nPrevalence\tof\tabnormal\tlipid\tlevels\tamong\tyouths—\nUnited\tStates,\t1999\t-2006\n\tMMWR\tMorb\n\tMortal\tWkly\tRep\t2,\t2010;59:\t29-33.\nChild\tTrends.\tFamily\tmeals:\tindicators\ton\tchildren\tand\tyouth\t2013;\tAvailable\tat:
|
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https://www.childtrends.org/wp-\ncontent/uploads/2013/05/indicator0.80414800%201369598448.html\n.\nDe\tSouza\tMJ,\tKoltun\tKJ,\tEtter\tCV.\tet\tal.\t\nCurrent\tstatus\tof\tthe\tfemale\tathlete\ttriad:\tupdate\tand\nfuture\tdirections\n\tCurr\tOsteoporos\tRep\t6,\t2017;15:\t577-587.\nDwyer\tJ,\tNahin\tRL,\tRogers\n\tGT.\tet\tal.
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0.06394954770803452,
0.02906017005443573
] |
Dwyer\tJ,\tNahin\tRL,\tRogers\n\tGT.\tet\tal.\t\nPrevalence\tand\tpredictors\tof\tchildren’s\tdietary\tsupplement\nuse:\tthe\t2007\tNational\tHealth\tInterview\tSurvey\n\tAm\tJ\tClin\tNutr\t2013;97:\t1331-1337.\nEaton\tDK,\tKann\tL,\tKinchen\tS.\tet\tal.\t\nYouth\trisk\tbehavior\tsurveillance—United\tStates,\t2011\n\tMMWR\nSurveill\tSumm\t4,\t2012;61:\t1-162.
|
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] |
18\nNutrition\tin\tthe\tadult\tyears\nJudith\tL.\tDodd,\tMS,\tRDN,\tLDN,\tFAND\nKEY\tTERMS\nconsumer\tprice\tindex\t(CPI)\nfood\tdesert\nfood\tsecurity\nfunctional\tfoods\nhealth\tdisparities\nhealth-related\tquality\tof\tlife\t(HRQOL)\nisoflavones\nmetabolic\tsyndrome\nnutritional\tgenomics\nphytochemicals\nphytoestrogens\nphytonutrients\npremenstrual\tsyndrome\t(PMS)\nwellness
|
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phytoestrogens\nphytonutrients\npremenstrual\tsyndrome\t(PMS)\nwellness\nThis\tchapter\temphasizes\n\tthe\tbackground\tand\ttools\tfor\tencouraging\tadults\tto\tset\tnutrition-related\nlifestyle\tgoals\tthat\tpromote\tpositive\thealth\tand\treduce\trisk\tfactors.\tOther\tchapters\tof\tthis\ttext
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cardiovascular\tdisease\t(CVD),\tdiabetes,\tcancer,\tweight\tgain,\tand\nosteoporosis.\tAdded\tto\tthese\tare\thealth-related\tconditions\tsuch\tas\tarthritis,\tAlzheimer’s\tdisease,\nrenal\tdisease,\tand\tinflammatory-related\tconditions,\twhich\tresearch\tindicates\thave\tpotential\tlinks\tto
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] |
lifestyle\tand\tfood\tand\tnutrition\tchoices.\tThe\trole\tof\tinflammation\tin\tchronic\tdisease\tis\tbecoming\nincreasingly\tevident\t(see\t\nChapter\t7\n).\nThe\tadult\tyears\tare\ta\ttime\tfor\tnutrition\tand\tdietetics\tprofessionals\tto\tbe\tleaders\tand\tteam\nmembers\thelping\tadults\tachieve\tand\tmaintain\tpositive\thealth.\tThe\tgoals\tfor\tHealthy\tPeople\t2020\nprovide\tthe\tframework\t(
|
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] |
provide\tthe\tframework\t(\nCenters\tfor\tDisease\tControl\tand\tPrevention\t[CDC],\t2017a\n).\tThe\tevidence\tis\nconvincing\tthat\tdecisions\tfor\ta\thealthy\tlifestyle\tmust\tbe\tmade\tearly\tin\tlife\tfor\thealth\tpromotion\tand\ndisease\n\tprevention\t(\nAcademy\tof\tNutrition\tand\tDietetics\t[AND],\t2013b\n).\nSetting\tthe\tstage:\tNutrition\tin\tthe\tadult\tyears
|
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).\nSetting\tthe\tstage:\tNutrition\tin\tthe\tadult\tyears\nThe\tfocus\tof\tthis\tchapter\tis\ton\tnutrition\tand\tfood-related\tbehaviors\tfor\tthe\tyears\tafter\tadolescence\nbut\tbefore\tone\tis\tdeemed\tan\t“older\tadult,”\toften\tdefined\tas\tage\t65\tbased\ton\ttraditional\tretirement\nage,\talthough\tthis\tdefinition\tis\tin\ta\tperiod\tof\tchange.\tAdmittedly\tthis\tis\ta\twide
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range\tof\tages,\tand,\nlike\tall\tpopulation\tgroups,\tthe\tadult\tyears\tare\theterogeneous.\tThe\tdescription\tof\twhat\tconstitutes\nbeing\tan\t“older\tadult”\tis\tin\tconstant\tflux\tas\tpeople\tchange\ttheir\tretirement\tage,\tas\tlife\texpectancy\nprojections\tare\tadjusted,\tand\tas\tmedical\tscience\tand\tlifestyle\talterations\textend\tlife\tspans\tand
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opportunities\tfor\tan\toptimum\tquality\tof\tlife.\tA\tlife\texpectancy\tof\t80\tand\tabove\tis\n\ta\treality\tbacked\tup\nby\tCDC\tstatistics\twith\tlife\texpectancy\tin\t2017\tat\t78.8\t(\nCDC,\t2018c\n).\tEvidence\tcontinues\tto\tindicate\nthat\tthe\tadult\tyears\tset\tthe\tframework\tfor\tquality\tof\tlife\tas\twell\tas\tlife\texpectancy.\tNutrition\tand
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food-related\tbehaviors\tare\tkey\tfactors,\tand\tthe\tearlier\tprevention\tbecomes\tthe\tgoal,\tthe\tbetter\tthe\noutcome\t(\nAND,\t2013b\n).\nThe\tdietary\treference\tintakes\t(DRIs)\t(see\tinside\tcover)\n\tprovide\tan\toverview\tof\tthe\tnutrient\nrecommendations\tfor\tage\tgroups\tunder\tthe\tDRI\tumbrella.\tStaying\tcurrent\ton\tchanges\tin\tDRI\tis\ta
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] |
nutrition\tand\thealth\t(\nNational\tInstitutes\tof\tHealth\t[NIH],\t2018d\n)\nWhen\n\tthe\tobjectives\tare\tprevention\tand\tbehavior\tchange,\tsuch\tmarkers\tbecome\tcritical.\tResearch
|
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] |
continues\tto\tindicate\tthat\tpositive\tchanges\tat\tany\tage\tand\tlifestyle\tbehaviors\tcan\tmake\ta\tdifference\nin\ttotal\thealth\tand\tlife\texpectancy.\tMaking\tthese\tchanges\tearly\tin\tlife,\trather\tthan\tlater,\tand\nmaintaining\tthem\tthroughout\tthe\tadult\tyears\tshould\tbe\tgoals.\tGenetics\talways\thas\tbeen\ta\nconsideration\tin\tassessment
|
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] |
consideration\tin\tassessment\n\tof\tnutrition\tstatus\tand\tlife\tpotential,\tbut\tthe\tevolving\tscience\tof\nnutritional\tgenomics\n\thas\tbecome\tan\timportant\tmarker\tin\tnutrition\tand\tdietetics\tpractice\t(see\nChapter\t6\n).\nSetting\tthe\tstage:\tMessages\nA\tfirst\tstep\tfor\tnutrition\tand\tdietetics\tprofessionals\tis\tto\trecognize\tthat\tmany\tadults\tare\tprime
|
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targets\tfor\tnutrition\tand\thealth\tinformation\tthat\toffers\tpositive\tguidance\tthat\tis\tunderstandable\n\tand\nimplementable.\tHowever,\tthis\ttranslates\tinto\tgrowing\tevidence\tthat\tadults\tcan\talso\tbe\ttargets\tfor\nmisinformation\tand\tguidance\tbased\ton\tpromises\tand\tquick-fixes\trather\tthan\tevidence-based\tMNT.
|
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Rebekah\tNagler,\tPhD,\tstudied\tthe\tpotential\trole\tof\tconsumer\treaction\tto\twhat\tappeared\tto\tbe\ncontradictory\tnutrition\tinformation\tor\tguidance.\tAccording\tto\tNagler,\tconfusion\tand\tbacklash\tmay\nmake\tpeople\n\tmore\tlikely\tto\tignore\tnot\tonly\tthe\tcontradictory\tinformation\tbut\talso\tthe\twidely
|
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] |
accepted\tnutritional\tadvice\tsuch\tas\teating\tmore\tfruits\tand\tvegetables.\tNagler\talso\tnoted\tthat\tthose\nwith\tthe\tgreatest\texposure\tto\tcontradictory\tinformation\texpressed\tthe\tmost\tconfusion\twith\tnutrition\n(\nNagler,\t2014\n).\nAs\twith\tany\tgroup,\tadults\tmust\tbe\tapproached\twith\tstrategies\tand\tguidance\tthat\tfit\ttheir\thealth\nand
|
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] |
and\n\teducation\tneeds\tas\twell\tas\ttheir\tcapability\tto\timplement\tthem.\tThere\tneeds\tto\tbe\tan\nunderstanding\tthat\tresearch\tis\tdynamic\tand\tongoing.\tThis\tshould\tbe\tfirmly\tfixed\tin\tthe\tminds\tof\tthe\nmessenger\t(the\tnutrition\tprofessional)\tand\tthe\treceiver\t(the\tpatient\tor\tclient).\tIt\tis\tthe\trole\tof\tthe
|
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than\tevidence\tbased.\nThe\tchallenge\tto\tnutrition\tand\tdietetics\tprofessionals\tis\tstaying\tcurrent\ton\tresearch\tand\tguidelines\nwhile\tacknowledging\tthe\tpotential\tmotivations\tof\ttheir\taudience\tor\tclients\tand\ttheir\tsources\tof\ninformation.\tIn\ta\ttechnologically\tsavvy\tworld\twith\tinstant\taccess\tto\tnutrition\tand\thealth\tadvice\tby
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self-proclaimed\tas\twell\tas\tcredentialed\tprofessionals,\tthis\tbecomes\teven\tmore\tof\ta\tchallenge.\nSurveys\tsupport\tthe\tidea\tthat\tadults\tare\tseeking\tnutrition\tinformation\tand\tusing\tit\tto\tmake\npositive\tlifestyle\tchanges\tbut\tare\tfinding\tthat\tmaking\tthese\tchanges\tis\ta\tchallenge.\tTime,\tlack\tof\nwillpower,
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] |
willpower,\n\tconflicting\tmessages,\tand\tidentifying\tthe\tefficacy\tof\tthe\tmessages\tare\tcited\tas\tbarriers\n(\nInternational\tFood\tInformation\tCouncil\t[IFIC],\t2017\n).\tThe\t2017\tIFIC\tFoundation\tFood\tand\tHealth\nSurvey\tidentified\tbarriers\tand\tnoted\tthat\tconsumer\tconfusion\tis\ta\tkey\tconcern.\tConsumers
|
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] |
expressed\tdoubt\tabout\ttheir\tchoices\tand\tnoted\tthat\tthey\trelied\ton\ttheir\tsocial\tnetwork\tfor\tadvice.\nHowever,\tthey\talso\tnoted\n\tlimited\ttrust\tin\tthe\tadvice\tfrom\tfriends\tand\tfamily.\tTrust\twas\thigh\tfor\nhealth\tprofessionals\tincluding\tRDNs.\tInterest\tin\tadopting\tand\tmaintaining\thealthy\teating\tbehaviors
|
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] |
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