May 2008

Food for Thought
Nutrition and Exercise Advice for Teens

By Peggy K. Yen, PHH, RD, LDN and Alan K. Lake, M.D.

According to the National Institutes of Mental Health, the teenage brain is a “work in progress - complicated and not easily understood.” Parents of teenagers know that their health habits are a work in progress, too. There’s an extra urgency to intervene on eating and activity with this age group because most obese teens will become obese adults. Parents need to marshal all the resources available – including themselves, extended family, school staff, coaches, peers, and community members – to help their teens adopt and maintain habits that keep them at a healthy weight.

Teens and Activity

From ages 9 to 19, there’s a striking change in physical activity habits, especially for girls, whose activity drops by 80 percent, on average. Despite Title IX opportunities for girls’ athletic participation, most teen girls are not active in sports. Text messaging, computer and TV time, shopping and eating at the mall and relaxing in the privacy of their own rooms replace dance class, gymnastics, sports teams, swimming and summer camp. Dr. Maureen Black, at the University of Maryland, has demonstrated the value of encouraging active dance programs through her research on ways to improve the physical activity of teen girls.

Some other reasons that teen physical activity decreases: few students walk to school, in contrast to the two-thirds who did in 1965, and few U.S. high schools require daily gym class.

Teens and Food

Irregular schedules and hanging out with peers make snacks a major source of calories for teens. Their inclination to consume sports and energy drinks or to adopt vegetarianism can also challenge parents’ knowledge about food. Almost one-third of teenagers eat fast food every single day, adding 500 calories or more to their daily intake. Vending machine snacks and drinks supply “meals” to many teenagers whose school schedules don’t allow enough time to purchase and eat a healthy lunch. After school, vending machines and fast food contribute excess fat, caffeine, sugar and calories.

Most school districts are trying to improve nutrition education and school lunch choices and provide adequate lunch periods. For example, a la carte salads were available in just half of high schools in 2000, but that figure increased to three-quarters last year. Many schools have eliminated the French fry option. A third of states, including Maryland, have legislated junk food out of vending machines during school hours, a critical beginning.

Forging Healthy Habits

Teens can choose foods and activities for themselves once parents stress the importance of regular physical activity and healthy eating. The benefits need to be described in terms meaningful to teens, such as looking better, feeling stronger, reducing stress and having more energy. Better health isn’t the big motivator for teens that it is for parents.

Help create opportunities for activities that your teen enjoys; if it’s not fun, she’s not likely to maintain it. Some teens prefer a gym membership or exercise videos. Others may walk dogs for the extra spending money and a dose of physical activity. Whatever they choose, help them by providing transportation, if possible, and supporting a schedule that makes the activity doable. If your teen participates in sports, ask her about the advice she’s getting from coaches and peers on eating and exercise. Remember the opposite side of the coin, too. It’s desirable to limit sedentary activities, such as TV watching, most video games and computer use to less than two hours a day.

When it comes to food, find reliable sources for nutrition and food information to supplement what you teach your kids about making healthy choices.

The Nemours Foundation offers a parents’ website at www.kidshealth.org, and a separate site for teens at www.kidshealth.org/teen. The cooking tips for teens are a “stealth” method for improving nutrition and might inspire a budding chef or encourage a little help cooking dinner at home. The reliable information on exercise and fad diets provides a resource independent of parents.

The government site at www.girlshealth.gov is teen-oriented, with a Teen Survival Guide, short quizzes, a vegetarian eating section and a section for parents.

Tap the fun side of learning about eating habits by directing your teen to http://foodpsychology.cornell.edu/tipsheet.htm. Teens as well as parents will enjoy reading about moviegoers who eat a larger serving of popcorn when it’s served in a giant-sized container, even when the popcorn is stale, and similar tales from the food psychology lab at Cornell University. You can even join their Consumer Camp to learn about the psychology of restaurant eating.

For busy parents, there’s a local resource at www.thescramble.com. Chevy Chase mother of two, Aviva Goldfarb, provides an inexpensive meal planning service with family-friendly recipes that are quick to prepare and lower in fat with more fruits, vegetables and whole grains than many families are used to serving.

Take the portion distortion quiz with your teenager at http://hp2010.nhlbihin.net/portion to learn how today's portions compare to those we ate 20 years ago, a significant factor in determining the amount of food people eat in restaurants and at home.

Parents and Families are Key

Nurture your teen in her attempts to make good health choices by developing a family commitment to healthy meals, less reliance on fast food and staying active. Sure, teenagers are seeking independence, but don’t underestimate your value as a role model for good choices related to eating and physical activity, as well as for smoking, alcohol use and other potentially hazardous behavior. Teenagers are quick to notice parents' inconsistencies and often learn more from what you do than what you say about eating and activity
Also, be on the lookout for disturbed behaviors your teen may exhibit, such as extreme overeating or restriction of food intake or excessive concern about body weight or shape that may indicate an eating disorder in both boys and girls. A booklet describing symptoms, causes and treatments for eating disorders is available at www.nimh.nih.gov/health/publications (choose the topic “eating disorders”).

The Cost of Teen Obesity Demands Action

The impact of being overweight in adolescence is great. Nearly one-third of overweight teens are clinically depressed, versus eight percent of healthy weight teens. Overweight teens are more likely to be bullies or to be the victims of bullies. Teenagers who develop Type 2 diabetes, usually due to overweight, lose nearly 20 years of their projected life spans. Blood pressure, blood lipids and rates of polycystic ovary syndrome and sleep apnea are all higher in overweight teens, with significant life long implications for impaired metabolic and cardiovascular health. As teen girls move toward adulthood, marriage and family, an important consideration is the effect of being overweight at the time of conception and during pregnancy. Obesity creates an intrauterine environment impacting a child’s life-long risk for early heart disease, stroke and diabetes.

Starting now to improve your teen’s health habits breaks the cycle and provides a long-term family benefit.

Peggy K. Yen and Alan M. Lake are members of the Taskforce on Prevention of Childhood Obesity, Maryland Chapter, American Academy of Pediatrics, Montgomery County Medical Association.