Guest Blog: Teenagers: A Critically Overlooked Group

September 28, 2020

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Children, Community, Lifestyle Tips, Nutrition Tips, Schools

A fantastic guest blog from registered naturopathic nutritional therapist, Lorna Driver-Davies (Head of Nutrition at Wild Nutrition Ltd.) Lorna Driver-Davies has worked for a decade as a registered naturopathic nutritional therapist, integrating functional medicine practice with her knowledge of botanicals as a herbal medicine dispenser. In that time, Lorna has supported countless teenagers in her clinical practice, and is passionate about how nutrition can make a huge difference to their development and wellbeing.

The increased nutritional requirements during adolescence are comparatively ‘undervalued’ in light of the focus placed upon the importance of good nutrition before conception, foetal development, infancy and early childhood. We are acutely aware of the need to meet dietary requirements during these early stages to help prevent physical issues, disease and short-falls in cognition and psychological development but it shouldn’t stop there. Awareness of, and meeting, the increased nutritional needs of adolescents are of paramount importance and are neatly summarised by the British Nutrition Foundation in this statement; ‘Growth and development are rapid during teenage years, and the demand for most nutrients is relatively high’. Adolescent nutrition deserves greater attention than it is currently receiving.

Specific nutritional needs of adolescents

As children shift into their teenage years, their nutrient requirements shift to meet the demands of the physical morph in their appearance and change in internal chemistry. Their relationship and interaction with the outside world increases and there is less sole parental control over food and meal choices. Teenagers begin to exert their own preferences over food and become influenced by friends, other adults and the media.

There are some specific factors to consider:

Hormonal shifts and onset of puberty and menarche in girls. This in itself brings changes in physical weight, mood fluctuations and development of pimples or acne.
The adolescent skeleton goes through the most rapid change that it will ever do at any other life stage and peak bone mass is acquired at this stage. This results in an increased demand for calcium, phosphorus, magnesium and vitamin D. Phosphorus which is needed for the normal growth and development of bone in children and NRV’s (Nutrient Reference Value) increase from childhood and indeed, decrease again after age 19. Calcium requirements (as NRV’S) nearly double for teenage boys from childhood and increase for teenage girls too.
Iodine which is needed for the normal growth in children, increases in requirement from age 11 onwards.
Iron contributes to normal cognitive development of children. Iron requirements also increase during adolescence to help with growth and muscle development. After menstruation begins, girls need more iron than boys to replace menstrual losses.
During adolescence there is an increased need for the following nutrients and roles: muscles: protein, zinc and iron. Haemoglobin: iron, folate, b12, copper. Energy synthesis: B vitamins.
Teenagers will experience periods of rapid growth (in comparison to pre-adolescence) that may be accompanied by a profound effect on appetite. If energy needs are not met, the growth spurt may be delayed or reduced.

There are also extra considerations specific to adolescence itself:

Greater prevalence to eating disorders. As their body’s change, so too does self-awareness and increased sensitivity on how their body appears to others. One report showed that over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives. It’s also important to note that teenagers will easily swing between over and under eating and this in itself leads to a discussion on how this affects dietary status. Girls tend to diet more and exercise less while boys tend to eat more and exercise more.
Changes in hormones combined with more liberal and less regulated access to stimulants such as coffee, energy drinks and sweeter foods (that may have been previously limited by parents) may give way to blood sugar fluctuations.
Stress and pressures increased from school and socially, especially around academic or sport performance.
Teenager’s brains go through significant change that also influences their behaviour. The part of the brain called the amygdala which influences behaviour has been shown to be especially sensitive and reactive in teenagers, which researchers feel partly explains the more emotional, fearful, aggressive, and even depressive behaviour teenagers may exhibit more than adults.
Parents and teachers will report teenagers are prone to poor concentration. Teenager’s brains have been found to be extra active in the pre-frontal cortex of the brain, and this is associated with less effective use of the brain and can affect concentration during tasks.
Some teenagers gravitate to late nights and going to bed late, compromising good sleep during a life stage when growth is intensified and energy output is increased. This could lead to a discussion on how lack of sleep in teenagers may affect their development and key systems like the nervous system and adrenal gland function.

Additional dietary considerations:

Dietary autonomy and more influence from the world around them:

Teenagers make more of their own meal choices and may favour less desirable food, which become more accessible to them via increased independence and pocket money.
School canteen meals are not always ideal (even if the teen is a well-rounded eater who enjoys healthy foods, these kinds of foods may not be available to the teen while at school).
Social pressures to eat certain foods that are deemed more socially acceptable by peers.
Teenagers asserting their own food preferences to specifically exert their control within the family home.
Teenagers who may previously have been good about eating vegetables and wholesome meals in childhood may now become increasingly resistive to those types of meals. They may favour commercial foods products over ‘traditional’ and ‘home-made’.
Potentially more influenced by media and celebrity diets/food bloggers e.g fashionable green juices, skipping breakfast, ‘carbs are bad’ etc.
Newly concerned (especially girls) at the fat content and calorie levels in foods.
Teenagers may begin to develop their own ethical questions around eating certain foods such as eggs, meat, dairy etc. When teenagers decide to go on a special diet, without intervention and advice, they may miss significant macro and micro nutrient groups.
A potential increase in sugar in the diet.

UK National Diet & Nutrition Survey

The National Diet and Nutrition Survey (NDNS) is designed to assess the dietary habits and nutritional status of adults and children in the UK. The survey is unique as it provides the only source of high quality data on dietary intake and nutritional status in a representative sample of the population. Their latest report ‘What do older children (11-18 years) in the UK eat’? shows us that there are real gaps in teenage nutrition and evidence of unhealthy food choice consumption. The below summarises the reports latest findings:

Summary of 2008 to 2011/2012 UK National Diet & Nutrition Survey (NDNS)

Key findings:

Teenagers eat 2.9 portions of fruit and vegetables – below recommended 5 a day.
Teenagers eat 14 grams of oily fish compared to recommended 140 grams (1 average sized fillet of salmon is around 220 grams)
Calcium recommended intake for boys and girls is 1,000mg and 800mg respectively. Research showed boys were achieving an average intake of 889mg and girls 670mg.
Folate recommended intake for boys and girls is 233mcg and 186mcg respectively. Research showed boys ate a daily average of 200mcg and girls 186mcg.
Teenagers eat 5% over the recommended intake on non-milk sugars (fruit juice, sucrose, glucose etc).
Teenagers consume very low levels of nuts and seeds in comparison to other foods in an average day.
Teenagers consume high levels of pasta, rice, pizza and other cereals
Riboflavin inadequate in comparison to ‘adequate’ for other B vitamins.
Iron: 46 % of girls had intakes below the LRNI.
Girls age 11-18 below LRNI for: vitamin A, riboflavin and folate.
Deficiency risks in all age groups (including adolescences), for vitamin D.
Evidence of intakes below the LRNI in a substantial proportion of older children – for some minerals, particularly magnesium, potassium and selenium.

The report also commented that in comparison to previous survey, iron and folate were lower than in previous surveys. This is a concern when we understand how iron and folate are so essential for health. Low folate in teenagers is an extra risk if those teens were to fall pregnant in their late teens or very early twenties, many of which are unplanned. This increases the need to support teenage nutrition not just for their own development but the health of their offspring our next generation.

General recommendations:

I recommend extra magnesium and gentle calming and adaptogenic herbs for those teens who are prone to stress, emotional outbursts and general hormonal imbalances.
Teenagers who spend extensive time indoors may benefit from extra vitamin D supplementation.
I also find palatable green smoothies a way of squeezing in extra fruit and vegetables and indeed protein into their diet – by adding a whey, brown rice or hemp protein powder since protein is essential for healthy bones in adolescence.
Oily fish should be given twice per week and supplemented if a teenager does not eat fish as well as adding nuts and seeds to family meals and snacks.

Adolescents have an increased need for specific nutrients and at the same time, amongst the average population those needs are not always being met. Hopefully this critical life stage will begin to receive the same attention as those pre-conception and early years of childhood do.