Dietary Guidelines for adolescents (13-19 years)

Dietary Guidelines for adolescents are helpful, Overweight, and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health (WHO).

Prevalence for Dietary Guidelines for adolescents :

In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. Overall 340 million children and adolescents aged 5-19 were overweight or obese in 2016 globally (Source – WHO).

Nowadays, childhood obesity is an epidemic in India. With 14.4 million obese children, India has the second-highest number of obese children in the world, next to China.

At this time, the prevalence of overweight and obesity in children is 15%. Also, in private schools catering to upper-income families, the incidence has shot up to 35-40%, indicating a worrying upward trend (Source – Narayana health).

Risk factors for obesity:

• Physical inactivity, and sedentary behaviour
• Poor dietary habits
• Family characteristics parenting style – parents’ lifestyles also play a role.
• Environmental factors such as school policies, demographics, and parents’ work-related demands further influence eating and activity behaviours.

Assessment of Weight:

Childhood overweight and obesity in children aged 2 to 18 are defined by percentiles of BMI.

The standard formula to calculate BMI is the weight (lbs) ÷ [height (inch)]² x 703

The metric formula to calculate BMI is weight (kg) ÷ [height (cm)]²

Then this BMI is plotted on the growth chart to calculate the BMI percentile.

Weight Status Category	Percentile Range
Underweight	Less than the 5th percentile
Healthy Weight	5th percentile to less than the 85th percentile
Overweight	85th to less than the 95th percentile
Obesity	95th percentile or greater

In addition, there are other non-invasive measures to define the degree of obesity include waist circumference, waist-to-hip ratio to assess upper body fat predominance, and skinfold thickness.

Apart from these, non-invasive parameters, other validated parameters for measuring the degree of obesity also exist. These methods are also used to define body composition: water, fat, protein, mineral content of the human body.

Also, such direct methods of body fat content include Dual Energy X-ray Absorptiometry (DEXA) and Bioelectric Impedance Analysis (BIA). The use of such methods especially in childhood and adolescence is limited and currently used only for scientific purposes.

Dietary goals for adolescents:

• To prevent further weight gain and reach a realistic target BMI.
• To maintain a lower weight for a long term.
• A nutritionally adequate and balanced diet is essential for optimal growth and development.
• Achievement of adequacy in all nutrients and prevention of deficiency diseases.

Dietary Guidelines for adolescents (13-19 Years)

• Energy: The energy requirements are different for boys and girls because of their growth rate, body composition and physical activity level.

Age group	Energy as per RDA 2020
Boys (13-15 years)	2860 kcal
Girls (13-15 years)	2400 kcal
Boys (16-18 years)	3320 kcal
Girls (16-18 years)	2500 kcal
Boys (19 years)	2110 kcal (sedentary)
Girls (19 years)	1660 kcal (sedentary)

For instance, a healthy weight loss (0.5 kg/week and 10 % body weight loss) requires a gradual decrease in calories. As a result, calorie restriction of about 500-600 kcal/day brings weight loss of 0.5 kg/week.

• Protein: Particularly to support growth, 15-20 % total energy should come from protein or protein requirement of 0.8 g/kg body weight as per RDA 2020.

DO’S:

• Firstly and most importantly I recommend nutritionally healthy diet through a wise choice of foods from all the food groups rather than refined and processed food (for instance – cereals, pulses, milk, meat, fruits and vegetables, fats and sugar).
• Take diet with good quality protein and consume cereal-pulse, cereal-milk and cereal-meat/egg combinations (mutual supplementation).
• Also, green leafy vegetables, seasonal vegetables and fruits should be consumed in plenty which will provide vitamins and minerals like iron, calcium, vitamin C, beta-carotene and are also rich in dietary fibre.
• Milk and its products should be taken in adequate amounts as this is the best source of calcium.
• Also, keep a check on the total fat consumption. Fried and bakery should be consumed in moderation and not as a part of daily diet.
• Simultaneously, frequent meals like 5-6 meals in a day is also important.
• On the whole, in addition to consumption of a nutritious well-balanced diet, appropriate lifestyle practices and involvement in physical activity such as games/sports should be encouraged among children and adolescents.

DON’Ts:

• Avoid junk food, fast food and highly processed foods.
• Please Avoid extreme diets meant for weight loss as they may be dangerous for health.
• Avoid too-much fat and sugar rich foods and beverages.
• Abstain from smoking, chewing tobacco and drinking alcohol.
• Avoid skipping meals, especially breakfast

Dealing with children having obesity:

• During childhood and adolescents days, family plays an important role in helping child build healthy eating, drinking, physical activity, and sleep habits.
• Parents should be a good role model indeed for their children. They should consume healthy foods and drinks, and choose active pastimes to encourage their children.
• They should discuss how about benefits of physical activities and certain foods and drinks may help their bodies get strong and stay healthy.
• Subsequently, chat about how to make healthy choices about food, drinks, and activities at school, at friends’ houses, and at other places outside your home.
• Also, promote portion control.
• Similarly, make simple changes to one’s daily routine.
• For instance, take the stairs, park at the furthest spot, get off the bus stop, and walk the rest of the way.
• In addition, attitude should be positive and supportive.
• In fact, avoid using food as a punishment or as a reward.
• Moreover, when managing children’s behaviour select incentives, rewards, and consequences that do not involve food.
• Last but not least, their screen time should be reduced and sleep for 7-8 hours is essential for their health.

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