Obesity in Adolesents

My interest in obesity in adolescents arose when I thought of my teen son and how his health may result in the future. When I looked at him, I realized he is a teen, and adolescents are at risk for obesity-induced health complications. A typical dilemma many teens face is that eating habits should mirror physical activity; thus, preventing the development of obesity, but these habits do not. Also, high rates of obesity ultimately lead to morbidity (obesity) and mortality (state of death). Knowing these basic things piqued my interest in trying to figure out the factors that are involved in teen obesity.

Many of the factors that are involved include pregnancy, diet, and decreased participation in non-sport-activities. Non-sport-activities, in particular, include watching television, playing non-physically-active sit-down video games, and involvement in other sedentary behaviors such as social media streaming. Regardless of how active adolescents are, they seem to neglect to participate in sports programs when given a choice. Even if they are in a sports program, these teens are showing overweight characteristics, regardless of program length or intensity. Furthermore, obesity is seen in our teens more often than usual; yet, we cannot stop it unless we can understand it.

To understand how obesity affects our teens, we first need to know what a teenager is. By definition, in an article written by Sacks (2003), adolescence begins when the onset of physiological change begins. [10]. This change is otherwise known as the first day of puberty, then ends when the teen has accepted and identifies oneself as an adult and begins to take on adult-like behaviors. This stage of adolescence starts roughly between the ages of 10 and 19 years. [10]. Now that we understand the meaning of youth, we can now move forward to understanding obesity concerning our children

According to Brown (2016), obesity is defined as “the body mass index (BMI) for ages greater than or equal to the 95th percentile.” [2]. A percentile is how many people on average fit into the said category. However, BMI is sometimes not used as an assessment tool anymore. Due to different body types, shapes, and heights, some say it is not accurate anymore. However, BMI can be used to assess other risk factors. For example, this tool can be used to determine how much visceral fat is around vital organs; which impairs the organs ability to work at full capacity. BMI nonetheless, should be the primary screening tool used when assessing teens weight. [2]. BMI measures accurately if the weight of a person is proportionate to the height of the person. If the weight is unproportionate, then the BMI tool assesses if the teen may be at risk for future health complications by utilizing a numerical scale. [7].

A signature sign for current and future health complications is obesity. Obesity in health and disease and all its entirety is a pandemic condition. Even worse, it is now considered a global atrocity affecting many children and teens in thousands of homes around the world, including the hungry. Countries that were once considered to have starving people are now on the top obesity charts. For example, countries like Brazil and India once thought to be too poor to feed their communities and children are currently in the top five obese countries in the world!

Many research organizations have studies that have assessed obesity in teens. Rates are increasing more rapidly than ever before. In a report conducted by the Center for Disease Control and Prevention: National Center for Health Statistics Data Brief 2015-2016, researchers found that teen obesity had risen 20.6% in the last year, and prevalence is still climbing. [4]. Also, in just the United States of America, almost every state reported a 20% increase in teen obesity. Brown (2016) writes, “data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) suggest at least 34% of US adolescents are at least overweight, and 18% are obese.” [2]. Overall, teen surveys reflect obesity has surged from 5% of our population to 18%, verifying that these statistics are accurate. [1].

Besides looking at the stats, many factors affect how our teens gain, maintain, and lose weight. Some teens are meal skipping and then binge eating later. In the late evening, they eat snacks and other unhealthy types of foods. Nutrition in general, from how we eat to what we eat to the way we eat, are critical factors in teen obesity. Furthermore, one recent report has come in that teens are actually skipping physical activity classes while in schools in exchange for a chatting and sugary beverage. [1]. These factors play a significant role in increasing health conditions.

Health conditions are observed in teens at higher rates. Specific diseases include hypertension, cardiovascular disease, sleep disorders, liver disease, insulin problems, and the way teens view their body. Body image conditions eventually lead to low self-esteem. [2]. Although teen pregnancy is not a health condition, the chances of becoming obese and staying obese throughout adulthood are enhanced when conceiving at an early age. [5]. As well, pregnancy at an early age can also increase the risk of acquiring diabetes. [6]. In addition, other health conditions observed are nutrient deficiencies.

Vitamin and mineral deficiencies are another typical traits for teen obesity. Eventually, not getting enough vitamins and minerals leads to morbidity. Morbidity eventually leads to complications that need medical attention, such as bariatric surgery. Further complications can result in mortality in teens. A common mineral deficiency in adolescents is iron deficiency. [2]. Iron deficiency is usually due to an increase in growth, which results in the demands to produce more blood very rapidly. Females are also losing blood during menstruation and teen pregnancy. So this could be a reason for female teens to experience iron deficiency.

Another nutrient deficiency that is common amongst teens is Folate. Folate deficit is observed in teens that often skip meals. [2]. Calcium deficiency is often seen more in male teens or teens who do not consume dairy products. [2]. Vitamin D deficiency is also experienced in teens. In one particular study published in the archive of Missouri Medicine, two researchers found that vitamin D deficiency is more common in obese teens than non-obese teens. [8]. Furthermore, vitamin D deficiency is also found more in African American nationalities and more in females than males or other nationalities. [2].

Reduce Obesity [3].

  • Decrease caloric intake and improve physical activity

  • Reducing television and screen time

  • Reduce Sugar Intake

Recommendations [9].

Parents should encourage their teens to:

  • Learn Portion Sizes and Eat ONLY when Hungry

  • Eat healthy snack options: Apple with peanut butter instead of candy; Nuts instead of chips

  • Participate in Physical Activity

Interventions

Eating habits should mirror physical activity, thus preventing the development of obesity. The use of electrical devices can be used for physical activity purposes instead of stationary and inactive purposes. 


Suggested Electronic Device Usage

Watch a favorite movie, read school work, or favorite books while walkingUse the electronic device like a pedometer or to log physical activity dataListen to podcasts and listen to music while working out

Food and nutrition are required for adequate growth and physiological demands of adolescents. Nonetheless, there are ways to get adequate nutrients without overeating. It is suggested that all teens be aware of their health.

Suggested Educational Know-Hows

Teens should be aware of their weight, height, and estimated energy requirements.Teens and Athletic Teens should know how much water they need and intake daily.Teens should be aware of food label ingredients, “What are you eating?”Teens should be taking a multivitamin daily.Teens should use calorie logging app to log meals.

According to Brown (2016), vitamin and mineral daily intake should be monitored. Most teens showing deficiencies lack iron, Calcium, Folate, and Vitamin D. [2]. Therefore recommended supplementation of iron, Calcium, Folate, or Vitamin D is appropriate for any lab work that shows a result lower than the reference range. Teens are now supplementing vitamins and minerals and acknowledge the benefits they can get in health by supplementation.

Therapeutic diets are often suggested to adolescents that deal with obesity and health complications due to overweight issues in their lives. Remembering to implement these diets into their lives is imperative for weight loss and sufficient reduction of health conditions.


Obesity [2].

  • Regular Physical Activity & DASH Diet

  • Hypertension and Other chronic diseases

  • DASH Diet

Diabetes Prevention [2].

  • Daily Physical Activity & DASH Diet

  • Iron Deficiency

  • Avoid Vegan Diets, Meal Skipping, and Calorie Restricted Diets

Planning a simplified menu will help teens make smarter, healthier food choices, and have an already prepared snack available. Prepare foods the night before, in a well-sealed container. Use foods that last longer and have more nutrient-dense content like:


  • Fresh Breakfast: Avocado with Lime juice and Sea Salt on toast, one egg, and tossed spinach and berries in a small amount of Oil and Vinegar (with herbs).

  • Garbanzo Bean dip with garlic cloves and onions paired with Corn Chips for snacking.

  • Fresh Lunch: shredded chicken sandwich, with lettuce, and tomato, a small amount of mayo paired with Whole Grain Nut Bread.

  • Fresh cut Red Bell Peppers and Green Apples for snacking.

  • Fresh Dinner at home: baked Acorn squash, red cut potatoes, purple onions, green leeks, herbs and seasonings (fresh), with the meat of your choice.

If You or Someone You Know Experiences:

  • Overweight

  • Experiencing Hypertension

  • Have Diabetes

  • Eating junk food

  • Skipping meals and binge eating

  • Watching tv or playing video games

  • Always on social media

  • Skipping Physical Activity classes to hang with your friends

  • Pregnant

  • Tired

Resources and Referrals

Make a Plan!

Discuss experiences and goalsDesign a comfortable Lifestyle PlanGet a Meal PlanGet the Support that is needed emotionally and physically

References:

  1. Blum, R. W. & Qureshi, F.  (2011). Morbidity and mortality among adolescents and young adults in the united states: AstraZeneca fact sheet [PDF file]. John Hopkins Bloomberg School of Public Health. Retrieved from https://www.jhsph.edu/research/centers-and-institutes/center-for-adolescent-health/_images/_pre-redesign/az/US%20Fact%20Sheet_FINAL.pdf

  2. Brown, J. E. (2016). Nutrition through the life cycle (6th Ed). Boston, MA: Cengage Learning.

  3. Gortmaker, S. L., Wang, Y. C., Long, M. W., Giles, C. M., Ward, Z. J., Barrett, J. L., Kenney, E. L., Sonneville, K. R., Afzal, A. S., Resch, S. C., & Cradock, A. L. (2015).  Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Affairs, 34(11), 1932-1939. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.0631

  4. Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2017). Prevalence of obesity among adults and youth: United states, 2015–2016 [PDF file].  Center for Disease Control and Prevention: National Center for Health Statistics Data Brief, 288(8). Retrieved from https://www.cdc.gov/nchs/data/databriefs/db288.pdf

  5. Herman, A. A. &  Yu, K. F. (1997). Adolescent age at first pregnancy and subsequent obesity. Paediatric Perinatal Epidemiology, 11(1),130-41. https://www.ncbi.nlm.nih.gov/pubmed/9018722

  6. Lemen, P. M., Wigton, T. R., Miller-McCarthey, A. J., & Cruikshank, D. P. (1998). Screening for gestational diabetes mellitus in adolescent pregnancies.  American Journal of Obstetrics and Gynecology, 178(6), 1251-1256. https://doi.org/10.1016/S0002-9378(98)70330-8

  7. Mahan, L. K. & Raymond, J. L. (2017). Krause’s food and the nutrition care process (14th Ed). St. Louis, MO: Elsevier

  8. Peterson, C. A., & Belenchia, A. M. (2014). Vitamin D deficiency & childhood obesity: a tale of two epidemics. Missouri Medicine, 111(1), 49–53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179511/

  9. Preventing Obesity in Children, Teens, and Adults. (n.d.) In Health Encyclopedia, University of Rochester Medical Center online. Retrieved  from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P07863

  10. Sacks, D. (2003). Age limits and adolescents. Paediatrics & Child Health, 8(9), 577–578.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794325/

  11. Stang J.S. & Stotmeister B. (2017). Nutrition in adolescence. In: Temple N., Wilson T.,  & Bray G. (Eds.) Nutrition guide for physicians and related healthcare professionals (2nd Ed.). Nutrition and Health. 29-39. New York, NY: Humana Press, Cham https://doi.org/10.1007/978-3-319-49929-1_4

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