Teenage diets, nutrition and

health
British Nutrition Foundation

Food a fact of life 2010

Teenagers (12-18 years)

Nutritional requirements
Dietary recommendations
Macronutrients
Micronutrients
Energy balance
Physical activity
Diet and cognitive ability
Diet and behaviour
Eating disorders
Summary - key issues

Food a fact of life 2010

Nutritional requirements
Growth and development are rapid.
Onset of puberty - characterised by a spurt in
physical growth (height and weight).
Considerable gain in muscle and bone mass.
Changes in body composition, e.g. increased
deposition of fat in girls.
Energy and nutrient requirements at their highest.

Food a fact of life 2010

A healthy diet is important for

teenagers
Eating a healthy, balanced diet can:
promote wellbeing by improving mood, energy and
self-esteem to help reduce anxiety and stress;
boost concentration and performance;
reduce the risk of ill-health now and in the future,
e.g. obesity, heart disease, cancer, and type 2
diabetes;
increase productivity/attainment and reduce days off
sick.
Food a fact of life 2010

 Food a fact of life 2010

Dietary recommendations
Teenagers should consume a variety of foods from
each of the four main food groups:
Fruit and vegetables
(33%)

Meat, fish, eggs, beans

and other non-dairy
sources of protein (12%)
Food a fact of life 2010

Bread, rice, potatoes,

pasta and other starchy
foods (33%)

Milk and dairy foods

(15%)

Macronutrients
- average intakes
(Scottish NDNS and Survey of Sugar Intake
data)
Macronutrient

Recommended
intake
(% food
energy)

Boys average
intake
(% food
energy)

Girls average
intake
(% food
energy)

Fat

35%

35.4%

35.9%

of which
saturates

11%

14.2%

14.3%

Carbohydrate

50%

51.6%

51.1%

of which added
sugars (NMES)

11%

16.7%

16.4%

Food a fact of life 2010

What about dietary fibre?

NDNS survey found average dietary fibre (NSP)
intakes to be low in teenagers:
- Boys (11-14 years) 11.6 g/day
(15-18 years) 13.3 g/day
- Girls (1114 years) 10.2 g/day
(15-18 years) 10.6 g/day
Reference values:
- 15 g/day (11-14 years)
- 18 g/day (15 years or above)

Food a fact of life 2010

Micronutrients
- percentage of older children and
teenagers with intakes below the LRNI
Vitamin

Boys
11-14
yrs

Girls
11-14
yrs

Boys
15-18
yrs

Girls
15-18
yrs

Vitamin A

8%

20%

13%

12%

Riboflavin
(B2)

6%

22%

6%

21%

Folate

1%

3%

0%

4%

Source: National Diet and Nutrition Survey 2003

Food a fact of life 2010

Micronutrients
- percentage of older children and
teenagers with intakes below the LRNI
Mineral

Boys
11-14
yrs

Girls
11-14
yrs

Boys
15-18
yrs

Girls
15-18
yrs

3%

44%

3%

48%

Calcium

13%

24%

9%

19%

Magnesium

28%

51%

11%

53%

Potassium

10%

19%

15%

38%

Zinc

14%

37%

9%

10%

Iron

Source: National Diet and Nutrition Survey 2003

Food a fact of life 2010

What about salt?

NDNS survey results - average salt intakes above
recommendations in teenagers:
- Boys (11-14 years) 6.75 g/day
(15-18 years) 8.25 g/day
- Girls (11-18 years) 5.75 g/day
(excluding salt added in cooking or at the table)
Recommended maximum daily salt intake:
- 11 years and over: up to 6 g/day.

Food a fact of life 2010

Teenagers and iron

Teenagers have increased iron requirements.
Girls need more iron than boys to replace menstrual
losses (RNI: boys 11.3 g/day, girls 14.8 g/day).
Low iron intakes (< LRNI) in 44% of girls (11-14
years) and 48% of girls (15-18 years).
9% of girls (15-18 years) were found to have poor
iron status (Hb < 12g/dl).
Lack of iron leads to an increased risk of iron
deficiency anaemia and associated health
consequences.
Teenagers who follow a vegetarian diet or restrict
food intake (e.g. to lose weight) particularly at risk.
Food a fact of life 2010

Iron absorption
Good sources: meat (especially lean red meat),
liver and offal, green leafy vegetables, pulses
(beans, lentils), dried fruit, nuts and seeds,
bread and fortified breakfast cereals.
Iron from meat sources (haem iron) is readily
absorbed by the body.
Vitamin C helps the body to absorb iron from
other sources (non-haem iron).

Food a fact of life 2010

Teenagers and calcium

Teenagers have high calcium requirements.
Around 50% of the adult skeleton is formed
during the teenage years (RNI - boys 1000
mg/day, girls 800 mg/day).
Low calcium intakes (< LRNI) found in 24% of
11-14 year-old girls and 19% of 15-18 year-old
girls.
A lack of calcium may have consequences for
future bone health e.g. increased risk of
osteoporosis.
Food a fact of life 2010

Teenagers and energy balance

Levels of overweight and obesity are increasing: 35%
of teenagers (12-15 years) are classified as
overweight or obese (Scottish Health Survey 2009).
Teenagers, especially girls, often try to control their
weight by adopting very low energy diets or smoking.
Restricted diets may lead to nutrient deficiencies and
other health consequences.
Teenagers of unhealthy weight may need guidance
on lifestyle changes to help them achieve a healthy
weight.
Food a fact of life 2010

Teenagers physical activity

Physical activity through life is important for
maintaining energy balance and overall health.
At least 60 mins of moderate-intensity physical
activity each day is recommended.
Include activities that improve bone health, muscle
strength and flexibility at least twice per week.
68% of boys and 41% of girls (13-15 year-olds)
achieve the recommended 60 mins per day
(Scottish Health Survey 2005).
Food a fact of life 2010

Diet and cognitive ability

Food eaten at school can make up a substantial
proportion of the diet and have a significant effect
on functions such as learning, memory, information
processing and mood.
Cognition represents a complex multidimensional
set of abilities and cognitive performance is affected
by many influencing factors.
Nutritional effects are difficult to measure.
Bellisle F (2004) Effects of diet on behaviour and
cognition in children Br J Nutr 92 Suppl 2: S227-32.
Stevenson J (2006) Dietary influences on cognitive
development and behaviour in children Proct Nutr Soc
65(4):361-5.
Food a fact of life 2010

Glycaemia
The brain appears to be sensitive to short-term
fluctuations of glucose supply and therefore it
might be beneficial to maintain glycaemia at
adequate levels to optimise cognition.

Food a fact of life 2010

Eating breakfast
Starting each day with breakfast will supply
energy to the brain & body.
Eating breakfast leads to improved energy and
concentration levels throughout the morning.
Breakfast consumption may improve cognitive
function related to performance in school.
Other benefits of breakfast include better nutrient
intakes and weight control.
Hoyland A et al. (2009) A systematic review of the effect of breakfast on the
cognitive performance of children and adolescents Nutr Res Rev 22(2): 22043.
Food a fact of life 2010

Fluids and hydration

Even mild dehydration (1-2%) can lead to
headaches, irritability and loss of concentration. This
level is not enough to cause feelings of thirst.
The recommendation is to drink 6-8 glasses/day (1.2
litres) to prevent dehydration. People need to drink
more when the weather is hot or when they have
been active.
All drinks count in terms of fluid intake but those
without sugar are best between meals.

Food a fact of life 2010

Diet and IQ
Brain health depends on optimal intakes of
nutrients from the diet.
Much speculation about the importance of long
chain omega-3 fatty acids to behavioural and
cognitive development, including IQ.
Supplementation studies show the best outcome
observed in children with learning disabilities.
Current recommendation is one portion of oily fish
(140g) per week.
Willatts P. (2002) Long chain polyunsaturated fatty
acids improve cognitive development J Fam Health
Care 12(6 suppl):5.
Food a fact of life 2010

Diet and mood/behaviour

There are a number of foods that have a
pharmacological effect in the body which affects
mood:
* caffeine;
* vaso-active amines, such as histamine;
* tryptophan and serotonin.
There is evidence to suggest that poor vitamin
and mineral status may be associated with poor
educational attainment and antisocial behaviour.
Food a fact of life 2010

Food additives and hyperactivity

The Southampton study suggested that
consumption of mixes of certain artificial food
colours and the preservative sodium benzoate
could be linked to increased hyperactivity in some
children. The colours are:
sunset yellow FCF (E110)
quinoline yellow (E104)
carmoisine (E122)
allura red (E129)
tartrazine (E102)
ponceau 4R (E124)

Bateman B et al.
2007

An EU-wide mandatory warning must be put on

any food and drink (except drinks with more than
1.2% alcohol) that contains any of the six colours.
Food a fact of life 2010

Eating disorders
Defined as: an eating pattern that becomes harmful
to health.
Can affect anyone but most likely young women.
It is estimated that there are 1 million people
affected in the UK, with the majority being 12 to 25
year-old women.
Trigger is multi-factorial and often linked to emotions.
New evidence to suggest genetic makeup may have
a small impact.
Food a fact of life 2010

Anorexia Nervosa
Defined as: the refusal to eat enough to maintain a
normal body weight.
Sufferers have the impression that they are
overweight and often picture themselves as being fat
even though they are already underweight.
If it occurs before puberty, anorexia may lead to
stunted growth. In teenage girls and young women,
menstrual abnormalities may occur including
amenorrhoea (the cessation of periods), which can
pose a significant risk to bone health.
Other physical symptoms include: constipation,
stomach pains; dry, patchy skin; low body
temperature and loss of hair.
Food a fact of life 2010

Anorexia Nervosa
Impact on mental health:
intense fear of gaining weight and obsessive interest in
what others are eating;
distorted perception of body shape or weight;
denial of the existence of a problem;
changes in personality and mood swings;
becoming aware of an inner voice that challenges
views on eating and exercise.
Impact on behaviour:
rigid or obsessive behaviour with eating, mood swings;
restlessness and hyperactivity;
wearing big baggy clothes;
vomiting.
Food a fact of life 2010

Bulimia Nervosa
Sufferers are obsessed with the fear of gaining weight
and undergo a recurring pattern of binge eating,
which is usually followed by self-induced vomiting.
People with bulimia often feel a lack of self-control
and have an excessive concern with their body
weight and shape.
Sufferers may also use large quantities of laxatives,
slimming pills or strenuous exercise to control their
weight.
Many bulimics have poor dental health due to regular
vomiting; vomit is acidic and can erode teeth in a
characteristic way.
Food a fact of life 2010

Bulimia
Impact onNervosa
mental health

uncontrollable urges to eat vast amounts of food;

an obsession with food, or feeling out of control with
food;
distorted perception of body weight and shape;
emotional behaviour and mood swings;
anxiety and depression; low self-esteem, shame and guilt;

Impact on behaviour
disappearing to the toilet after meals to vomit food eaten;
excessive use of laxatives, diuretics or enemas;
frequent periods of fasting;
excessive exercise;
secrecy and reluctance to socialise;
shoplifting for food;
abnormal amounts of money spent on food;
food disappearing unexpectedly or being secretly
Food
a fact of life 2010
hoarded.

Other eating disorders

Binge Eating Disorder (BED);
complusive overeating;
eating disorders in sport;
Orthorexic;
Drunkorexic.
Visit www.b-eat.co.uk for further information.
Food a fact of life 2010

Teenagers - key issues

Nutritional requirements
Dietary recommendations
Macronutrients
Micronutrients
Energy balance
Physical activity
Diet and cognitive ability
Diet and behaviour
Eating disorders

Food a fact of life 2010

Teenagers - dietary improvements

needed
More fruit and vegetables, pulses, wholegrain
foods.
More milk and diary foods.
More iron-rich foods.
More oily fish.
Less foods high in saturated fat and added sugars.
Less salt.
Food a fact of life 2010

For more information visit

www.nutrition.org.uk
www.foodafactoflife.org.uk

Food a fact of life 2010