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  • Denise Scott

Feeding Your Adolescent and Pubertal Child

Adolescence and puberty - those words trigger an emotional response and anxiety in parents! 


This article will help you prepare your child nutritionally for the demands on their bodies as they begin changes that eventually lead to adulthood. Establishing these eating habits before puberty makes it easier to continue them through this life-changing time.


A group of middle-school adolescents. This age requires adequate nutrients to ensure a normal puberty and growth spurt.


Girls typically enter puberty from ages 8-14 and boys from 9-15. The range of ages for pubertal onset usually depends on the family history. Girls often follow the pattern of their mother, aunts, and sisters. A trend in both earlier puberty and childhood obesity has occurred in the past few decades.


The hallmark of puberty in girls is breast budding. Underarm body odor and pubic hair can occur before this, called adrenarche, but breast budding marks the start of puberty. 


Boys have a more subtle sign - enlargement of the testicles, which is not as noticeable a change as in girls.


Girls take about four years to complete puberty, and boys take five. Menses or periods do not usually start until 2-3 years after breast budding occurs. 


Nutrition is one of the most significant factors that affect pubertal development. Being overweight or underweight can affect pubertal onset in girls. We do not see this trend in boys. A young girl must have a certain minimum weight and amount of body fat for puberty and menstruation to occur. Eating disorders and chronic diseases that cause significant weight loss can lead to delayed puberty. 


Overweight girls often enter puberty early or at the beginning of the usual age range. They also tend to have an early growth spurt and maturing of their skeleton. Often their growth is completed early so that their adult height may be compromised.


Macronutrient, micronutrient and calorie needs are increased for the growth spurt. These include calories, protein, iron, calcium, zinc, vitamin D, B12, and folate. 


In general, total calorie needs are as follows - the more active the child, the more calories needed.

Calories

Ages Females Males

9-13 1400 - 2200 1600 - 2600

14-18 1800 - 2400 2000 - 3200


Depending on the activity level, ages 12 to 18 require about 13 to 27 calories per pound of body weight.


Malnutrition during puberty, whether due to a lack of calories, a poor quality diet, an eating disorder, or chronic disease, can lead to impaired growth, thinning of bones or osteopenia, anemia, and vitamin or mineral deficiencies.


Eating a well-rounded diet, avoiding foods with saturated fats and added sugar (food and drinks), and limiting salt are all helpful.

Have your prepubertal and pubertal child aim for the following daily:


Vegetables - 3 cups

Fruit - 2 cups

Whole grains - 5-6 servings (this includes bread, pasta, cereal, rice, and tortillas)

Dairy - 3 cups

Protein - 5 ounces 

Try to include at least three food groups with each meal and incorporate a fruit or vegetable and protein for snacks. 


Adequate calcium is critical for building bone mass and preventing later osteoporosis. This is why 3 cups of dairy are needed. Unfortunately, this is also a time when girls often stop drinking milk. 


Children ages 10-18 need 

1300-1500 mg of calcium and 600-800 IU of vitamin D daily. 


A variety of dietary vitamin D sources including milk, cheese, eggs, almonds, yogurt, fatty fish, mushrooms, broccoli, and soybeans. Despite these various sources, it is still difficult to get adequate vitamin D without dairy.


This is hard to attain if they don’t drink milk or eat dairy. In this situation, a supplement is very beneficial. Also, those who are vegetarian or vegan likely need to be supplemented. Some supplements contain calcium and vitamin D and are chewable. Typically, a multivitamin does not have enough calcium, so a separate calcium supplement is needed. 


Foods other than milk and dairy that are high in calcium include:

  • Soy products - soybeans, tofu, tempeh, yogurt

  • Calcium-fortified orange juice and calcium-fortified plant milk

  • Salmon, sardines 

  • Oatmeal, blackstrap molasses

  • Tahini, almonds, and almond butter

  • Kale, bok choy, okra, broccoli

  • Collard, turnip, and mustard greens

  • Navy beans, chickpeas

  • Oranges, dried figs, papaya


Foods with vitamin D:

  • Mushrooms - the only naturally occurring plant source of vitamin D

  • Cod liver oil.

  • Rainbow trout, salmon, tuna

  • Fortified cereals

  • Fortified soy products

  • Fortified plant milk and orange juice

  • Egg yolks


If you supplement, be sure to get vitamin D3 rather than D2. Calcium carbonate supplements have more elemental calcium than calcium citrate.


Iron needs increase at menstruation due to monthly blood loss. Males need more iron for their increase in lean body mass. 


Ages 9-13 need 8 mg of iron daily. This need increases at ages 14-18 to 11 mg for boys and 15 mg for girls. 


Iron is hard to get in adequate amounts from the diet, so usually, a supplement is in order, especially once girls start menstruating. A multivitamin with iron is helpful. Keep in mind that gummy vitamins do not contain iron. If your child eats a well-rounded diet, iron alone may be enough.


Iron-rich foods:

  • Red meat, pork, poultry, and organ meats

  • Seafood

  • Beans

  • Dark green leafy vegetables, such as spinach

  • Dried fruit, such as raisins and apricots

  • Iron-fortified cereals, bread, and pasta

  • Peas

  • Lentils


Folate should be given to young women once they are of child-bearing age at 400 micrograms daily. Folate is included in a multivitamin. Getting enough from food is difficult. 


Omega-3 fatty acids benefit the brain, especially that of an adolescent. These are best obtained from seafood such as fatty fish. Additional sources include flaxseeds, chia and hemp seeds, walnuts, soy products, seaweed, omega-3 enriched eggs, and kidney beans.


Salt

Beware of too much salt intake in adolescents. Fast food and processed foods are loaded with salt and can quickly exceed the daily recommendation - no more than 2500 mg or 1 teaspoon. Excess salt intake will eventually lead to high blood pressure and is a risk factor for developing kidney stones and chronic kidney disease. Kidney stones are being seen more frequently in adolescents.


A diet rich in vegetables, fruit, whole grains, beans, and legumes will provide adequate vitamins. Such a diet is also good for the brain and learning and as protection against mental health illnesses. Some micronutrients, as mentioned, may need supplementation.


An adequate and balanced healthy diet during all stages of growth (infancy, childhood, and adolescence) is necessary for optimal growth and normal pubertal development. 


Next week I will explore the role of diet on acne, stay tuned!


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