Promoting Optimal Diets

The findings of the studies shown in Tables 3 and 4 reveal that most adolescents in the developed world are likely to be receiving adequate energy and protein to support growth. The intakes of micronutri-ents found in subgroups of the population may not be high enough to ensure optimal health but it is difficult to interpret the effects of these without appropriate biochemical data. For iron, there is good evidence of clinical deficiency in low iron consumers, particularly girls but for other nutrients, biochemical evidence is scarce. Longitudinal studies that attempt to link early diet with the incidence of later disease are a valuable tool and seem to suggest that high intakes of fruit, vegetables, folate, and n-3 polyunsaturated fatty acids (present in oily fish) are dietary indicators that relate to important aspects of health later in life. Despite these scientific findings, health messages relating to fruit and vegetables seem to have fallen on deaf ears. The NDNS showed that 70% of children had eaten no citrus fruit during the week of the dietary survey. Around 60% had eaten no green leafy vegetables or tomatoes, valuable sources of vitamins and minerals.

Since energy intake is the main predictor of micro-nutrient intakes, it makes sense to ensure that adolescents avoid restricting energy. Yet this finding needs to be considered against a background of rising obesity in the adolescent population. There is strong evidence that adolescence is the time when substantial reductions in physical activity are seen and such a trend, combined with lower energy intakes, could result in larger numbers of children failing to meet their individual nutrient requirements.

The key to tackling this lies as much with physical activity as it does with dietary intervention. Energy intakes need to be maintained at a level suitable for optimal micronutrient uptake while, at the same time, energy expenditure should be increased to ensure energy balance. A wide range of foods encompassing the main food groups will ensure a nutrient-dense diet. Special conditions in adolescence, such as pregnancy, lactation, and sports training, may increase requirements above normal and merit manipulation of the diet to favor food groups known to be important sources of certain nutrients.

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