adolescence is a phase rather than a fixed duration of time where occurs the importance of nutrition during this transition.

1. ADOLESCENT NUTRITION
PRESENTOR- DR. SUGANYA R
MODERATOR- DR. PAWAN GHANGHORIYA SIR
[PROFESSOR]
[DEPT OF PEDIATRICS]

2. CONTENTS
 WHY ADOLESCENT NUTRITION IS IMPORTANT?
 MY PLATE- NUTRITION REQUIREMENT
 EATING HABITS - HOME, SCHOOL AND OUTSIDE
 EATING DISORDERS
 OVERWEIGHT AND UNDERWEIGHT

3. WHY ADOLESCENT NUTRITION IS
IMPORTANT?
 PHYSICAL GROWTH- GROWTH SPURT AND PUBERTY
 COGNITIVE DEVELOPMENT- INDEPENDENT LIFESTYLE PRACTICES, INDEPENDENT FOOD
PREFERENCES
 BEHAVIORAL CHANGES- MORE INFLUENCED BY SOCIO-ENVIRONMENTAL CONDITIONS

4. MY PLATE
NUTRITION REQUIREMENT (ICMR)
ENERGY
KCAL/KG/DAY
PROTEIN
GM/KG/DAY
FAT
GM/KG/DAY
CALCIUM
MG/DAY
(ABSORPTION-
33%)
IRON
MG/DAY
(ABSORPTION-
10%)
EARLY
ADOLESCENTS
60-70 1.18 35 800 21-27
MID 55-60 1.17 40- 45 800 27-32
LATE 45-50 1.13 35- 50 800 26-28

5. GENERAL RECOMMENDATIONS
 Along with the vitamin D, it is recommended that adequate amounts of calcium i.e. 600-
800 mg/day should also be supplemented/derived from dietary sources; this may be
obtained from 2-3 servings of milk and milk products/day (ICMR)
 Increase in lean body mass also requires iron, primarily for muscle myoglobin and also
nonheme iron.
 Thus, the additional requirement during adolescence for the growth spurt (expansion of
blood volume, increase in Hb concentration and increase in muscle mass) would be 12
µg/kg for boys and 8 µg/kg for girls
 Peak bone velocity occurs during this phase and this is the most rapid phase of skeletal
development

6. INITIATIVES BY GOVT OF INDIA
 As recommended by Ministry Of Health And Family Welfare Weekly dose of 100 mg elemental iron and
500 mcg folic acid with biannual de-worming for all adolescents at 10-19 years of age
 Ministry Of Women And Child Development MWCD, has initiated Rajiv Gandhi scheme for
empowerment of adolescent girls, SABLA, where supplementary nutrition is provided to adolescent girls
(AGs) in the form of take home rations (THR) or hot cooked meals. Under SABLA, each AG will be
given at least 600 calories and 18–20 grams of protein and the recommended daily intake of
micronutrients, at Rs 5 per day per beneficiary, for 300 days in a year.

7. EATING HABITS
 AT HOME- Regular family meals at table, supervision on the quantity of food, positive
parenting, eating slowly and chewing properly up to 15-20 mins, offering vegetables at the
start of the meal when they are so hungry.
Involving child in family food shopping, food planning, and encouraging them in preparing a
healthy meal at least once a week. Making healthy snacks available for them at home.
 AT SCHOOL- age/grade based portion sizes with plenty of vegetables, regular checking of
tiffin boxes, listening to their interests in preparing lunch
Do not restrict foods from outside. Teach your child to eat when he is hungry and stop when he is
full.
 AT OUTSIDE- the number of meals consumed outside increases with age. Peers social
gatherings and parties leads to consumption of large amount of junk foods. Also pave ways for

8. JUNK FOODS
 A survey conducted by Centre for Science and Environment (CSE) on 13274 children aged between 9-14 years
documented that 93% of children eat packaged food and 68% consume packaged sugar- sweetened beverages
more than once a week; 53% consume these products at least once a day. Almost one- fourth of the schoolchildren
consume ultra processed food high in fat, salt or sugar such as burger and pizza, from fast food outlets, more than
once a week
 The major adverse effects related to intake of fruit juice and fast foods are obesity and its associated
complications, dental caries, allergies, micro-organism contamination leading to infections, and risk of cancer due
to carcinogenic and allergenic properties of some food additives
 The guidelines are meant for children with normal growth and nutritional status and may not be applicable to
children with undernutrition or other chronic systemic illnesses

9. JUNCS
 Fast food: By definition, it includes foods that are “designed for ready availability, use, or consumption and
with little consideration given to quality or significance”
 Junk food: These foods are defined as “foods (packed or non-packed, processed or non-processed) which
contains little or limited presence of proteins, vitamins, phytochemicals, minerals and dietary fibre but are rich
in fat (saturated fatty acids), salt and sugar and high in energy (calories) that are known to have negative
impact on health if consumed regularly or in high amounts”
 HFSS foods (foods high in fats, salts, or sugar):
 THE JUNCS FOODS: A NEW TERMINOLOGY
 J- Junk foods (foods high in fats, especially saturated and trans-fats, sugars and salts, and foods lacking in
micronutrients/minerals)
 U- Ultra processed foods (as defined in the fourth category of NOVA classification)
 N- Nutritionally inappropriate foods. Home-made foods can also qualify to be nutritionally inappropriate if
prepared in recycled oil, or contain high amount of sugar, fat or salt.
 C- Caffeinated/ coloured/ carbonated beverages S- Sugar sweetened beverages

10. RECOMMENDATIONS- IAP
 Alternatively, limit consumption of the JUNCS foods at home/outside and suggest to have not more than one
serving per week; serving not exceeding 50% of total daily energy intake for that age.
 Encourage intake of regional and seasonal whole fruits over fruit juices in children and adolescents.
 COFFE- one cup/day (200 mL) in adolescents (10-18 y), provided no other caffeinated products (cola,
chocolates) are being consumed.
 The Group supports Ministry of Women and Child Development recommendations of ban on sale of HFSS
foods in school canteens and in near vicinity of 200 meters (LOE 5). They also suggest expanding these
recommendations to all the JUNCS foods.
 Nutrition education initiatives should be taken to increase awareness among school children. Schools should be
motivated to organize poster-essay- competitions, debates, etc on adverse effects of the JUNCS foods, besides
teaching about healthy and balanced diet.
 Parents should themselves follow healthy eating habits and serve as role models for children thereby providing
them a nutrition sensitive and enabling environment.

11. EATING DISORDERS
Incidence- 5% in adolescent girls [5]
Continuous disturbance of food consumption that leads to either a different pattern of eating or different
absorption of food and can cause significant physical or psychological complications
 Restrictive type- ANOREXIA NERVOSA
 BULIMIC type- BULIMIA NERVOSA
 EDNOS- Eating Disorders Not Other wise Specified
 Diagnostic criteria for eating disorders found in DSM 5 cannot be applicable to adolescents because of variation
in growth pattern.

12. OVERWEIGHT AND UNDERWEIGHT
 Age-adjusted prevalence of overweight was found to be 14.3% among boys and 9.2% among girls where
as the prevalence of obesity was 2.9% in boys and 1.5% in girls. The prevalence of overweight among [1]
 The prevalence of underweight was significantly higher among boys (31.0%) than girls (24.2%)[2].

13.  [1] Goyal RK, Shah VN, Saboo BD, et al. Prevalence of overweight and obesity in Indian adolescent school going
children: its relationship with socioeconomic status and associated lifestyle factors. The Journal of the Association of
Physicians of India. 2010 Mar;58:151-158.
 [2] Bisai, S., Bose, K., Ghosh, D., & De, K. (2011). Growth Pattern and Prevalence of Underweight and Stunting Among
Rural Adolescents. Journal of Nepal Paediatric Society, 31(1), 17-24. https://doi.org/10.3126/jnps.v31i1.3640
 [3] USDA official website
 [4] Indian Academy of Pediatrics Guidelines on the Fast and Junk Foods, Sugar Sweetened Beverages, Fruit Juices, and
Energy Drinks October 2019 Indian pediatrics 56(9):849-863 DOI: 10.1007/s13312-019-1612-5
 [5] journal of adolescent health 2003