nutrition assessment in adolescents

1. CHAPTER FIVE
NUTRITIONALASSESSMENT IN ADOLESCENTS
• The most challenging period in human life is adolescence, due to the
sudden increase in growth; as a result, special nutritional needs are
created.
• Increased nutrient demands, life style and food habit changes, and
special
• nutrients needs make adolescents a vulnerable group [1]. Physical
activity level and maturation stage are main determinants of actual
needs, the best
index to determine caloric needs is calorie per unit of height (kcal/cm) to
compensate the differences in growth by age. Table 1 summarizes the
recommended range of energy and protein for adolescence

2. Table 1. Recommended Energy and Protein Allowances for
Adolescence
Age (yrs) protein
kcal/day kcal/kg kcal/cm g/day g/cm
11-14 2200 47 14 46 0.29
15-18 2200 40 13.5 44 0.26
19-24 2200 38 13.4 46 0.28
male
11-14 2500 55 16 45 0.28
15-18 3000 45 17 59 33
19-24 2900 40 16.4 58 33

3. Table 2. Body Mass Index (BMI in kg/m2) for adolescents at risk for
overweight
Age (years) male female male female
10 20 20 23 23
11 20 21 24 25
12 21 22 25 26
13 22 23 26 27
14
15
16
17
18
19
20-24
23
24
24
25
26
26
27
24
24
25
25
26
26
26
27
28
29
29
30
30
30
28
29
29
30
30
30
30
At risk of
overweight
≥85th and ≤ 95th
percentile
obesity (≥95th percentile)

4. Cont..
 Weight status can be indicated by Body Mass Index (BMI), which
is highly correlated with body fat. Adolescence BMI is calculated
as body weight in kilograms divided by height in square meters.
BMI = weight (kg)/height
(m2). Table 2 is used to determine the adolescent weight status [4].

5. Cont.
• Adolescent BMIs between 85th and 95th percentiles are at risk for
overweight and should be investigated to determine health risk through
nutritional assessment. While adolescents with BMI ≤ 5th percentile are
underweight and should be assessed for diseases or eating disorders.
• Further more, those with BMIs ≥ 95th percentile for age and gender are
obese and should be medically assessed .
• Another evaluation method for overweight and obesity is skin fold
measurement, an individual who is above 75th percentile in weight for
height is being suggested that they are overweight and, ≥90th percentile
suggest obesity.

6. • Skin fold thickness measurement is measured by skin fold caliper
and used to assess an individual body fat],
clinically it is practical method, and its validity depends on the
accuracy of the measuring technique. To measure the triceps and
biceps skin fold you should point
the proper site which is the mid arm point between the acromion
process at the shoulder and the olecranon process at the elbow

7. • Subcutaneous fat assumed to be 50% of body fat, as obesity
increases the accuracy of measurement decreases. There are four skin
fold site that reflects body fatness: biceps, triceps, below the scapula
and above the iliac crest (Supra iliac) (Figure 5 A, B, C, D).

8. Triceps
• Skin fold site is on the posterior aspect of the right
arm, over the triceps
muscle, mid-way between the lateral projection of
the acromion process of the
scapular and the inferior margin of the olecranon
process of the ulna.
The skinfold site should be marked along the
posterior mid line of the upper arm. Measurer should
stand behind the subject

9. Biceps
• Skin fold measures the thickness of the vertical
fold in the front upper left
arm. Sub scapular site is 1 cm below the interior
border of the scapula as shown in Figure (5 C). By
gentle feeling for the inferior angle of the
scapula or by placing the subject right arm behind the
back while subject