Nutrition;+Eating+Disorders,+etc.

Adolescence and Nutrition

**__EATING DISORDERS__**

Surveys show that many adolescent girls are underweight and are dissatisfied with their body weight.2 Estimates of eating disorders vary, and they depend on the diagnostic criteria used, but studies in South Australia indicate that bulimia nervosa and anorexia nervosa may occur in about 0.5.1.0 per cent of women, while up to five per cent of women have some degree of eating disorder.3,7 Young women who diet are at most risk. Diagnosis of bulimia and anorexia nervosa is sometimes made by dentists who observe dental erosion due to the acidity of repeated vomiting attacks.

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Twenty-seven percent of girls between 12 and 18 have disorderd eating behaviours, according to a study reported in the //Canadian Medical Association Journal// (Jones, J., Bennett, S., Olmste, M. P., Lawson, M. L., & Rodin, G., 2001). Further, girls between 12 and 15 years of age are engaging in such eating behaviours as binging and purging, fasting, skipping meals, along with the use of diet pills, laxatives, and diuretics, more commonly than a decade ago. Disordered eating behaviours increase as teens get older.According to Jones of the University Health Network in Tororto, media bombardment of images of super-thin models places tremendos pessure on young girls and creates unrealistic expectations. (Lueng, K. H., MacKenize-Rivers, A., Malcomson, T, Santock, J. W., 2005. Life Span Develoment, 2nd Edition.) "I once dated a girl," reveals Jeremy, "who still in her early 20's was still suffering from her image issues of adolescence. She hid, very well I might add after years of practice, her dependancy to laxatives and varities of diet pills. Her need to keep up her "image" was overwhelming to her and to me after she broke down and told me of the stress she was livng with for all these years."

Treatment of eating disorders is difficult. However, the earlier treatment begins, the greater the chances of success. A team approach is necessary, and this should involve a general practitioner, dietitian and psychiatrist or a health professional with expertise in this area.

Anorexia nervosa does not always involve vomiting, lthough this is a common feature. Some girls simply donot eat, and boys suffering this problem often engage in excessive exercise coupled with low food intake. Bulimia, whether it occurs in conjunction with anorexia nervosa or on its own, is more likely to be noticed by dentists. Thediagnostic criteria for bulimia nervosa are:

. recurrent episodes of binge eating . feeling of lack of control over eating behaviour duringbinges . regular inappropriate behaviour to prevent weight gain such as self-induced vomiting, misuse of laxatives or diuretics, strict dieting or fasting,or excessive exercise . minimum average of two binge and compensatory episodes a week for at least three months . persistent over-concern with body shape and weight.



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**__GENERAL NUTRITION IN ADOLESCENTS__**

Adolescents who are growing and playing sport need more food than their parents do. They also have extra requirements for many nutrients, especially calcium and iron. The average adolescent boy meets his needs for these and most other nutrients, although many do not consume enough dietary fibre. The major problem for boys is their consumption of large quantities of saturated fat. Their starch intake is relatively low.

Many girls fail to consume enough iron, zinc, calcium, starch and dietary fibre. Their mean potassium intake is also towards the lower end of the desirable range. Fat intake for both boys and girls is likely to be higher than that reported, since almost everyone in the community now under-reports intake of fat and foods rich in fat. More highstarch foods, such as bread and cereals, in place of fatty foods would be nutritionally desirable. Both sexes consume a lot of sugars from sucrose added to foods as well as intrinsic sugars present in fruits, and in milk products. The Australian Dietary Guidelines suggest the consumption of only a moderate amount of sugars and foods containing added sugars. It is difficult to define moderate, but the Committee of Medical Aspects of Food Policy (COMA) recommends that no more than 11 per cent of energy should come from non-milk extrinsic sugars.

There is a strong argument that the body does not distinguish between different types of sugars, and any fermentable carbohydrate can contribute to dental decay. However, when discussing nutrition, we need to look beyond such concepts to examine the nutritional company that sugar keeps. Most breakfast cereals, flavoured milk and yoghurt, and fruits canned in syrup or concentrated juice contain nutrients with their sugar. Sweetened breakfast cereals contributed 4.2 per cent of the sugar in the boys. diets and 2.7 per cent in those of girls. Flavoured milk and yogurt and canned fruits contributed less than four grams of sugar for both boys and girls. Much of adolescents, sugar intake comes from foods with low nutritional value, such as soft drinks, cordials, ice cream, iceblocks, chocolate, spreads, cakes, confectionery, sweet biscuits, pastries and sweet buns. Many of these foods also make substantial contributions to saturated fat intake. This information is presented not specifically to damn sugar, but to point out that sugar-containing foods form a major part of adolescents. diets. Crisps and similar fatty salty snacks are also popular, and teenage boys and 12- to 15-year-old girls consume more of these foods than any other age group. Such foods also contain a lot of saturated fat.

The combined impact of foods of poor or negative nutritional value leads to a displacement of such nutritionally important foods as fresh fruits. The National Nutrition Survey found that 50 per cent of boys and 42 per cent of girls aged 12 to 15 years and 60 per cent of boys and girls aged 16 to 18 years had consumed no fruit in the 24 hours before the survey. Surveys by the Australian Horticultural Corporation have shown similarfigures. Healthy eating does not mean that any specific food needs to be eliminated. However, better nutrition means thatsome foods should be restricted to particular occasions. This philosophy complements dental education practices that suggest restricting foods with high caries potential to times when it is appropriate and possible to clean the teeth soon after eating.

Adolescents, like younger children, can accept the idea of menus. What is on the everyday lunch menu or the afternoon snack menu can be quite different from a party or holiday menu, or even what kids eat when out with friends. The everyday menu should feature such foods as fruits, vegetables, legumes, nuts, breads and cereals (with at least some being wholegrain), dairy products (low fat varieties are excellent), plus high-protein foods such as fish, lean meat or poultry. When fats and sugars are added to these basics, they should not dominate the daily diet.

Adolescence, nutrition, and eating disorders. []