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1

Hunt, Melanie M., Helen K. Berry, and Pamela P. White. "Phenylketonuria, adolescence, and diet ,." Journal of the American Dietetic Association 85, no. 10 (October 1985): 1328–34. http://dx.doi.org/10.1016/s0002-8223(21)03799-8.

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2

Henriksson, Pontus, Magdalena Cuenca-García, Idoia Labayen, Irene Esteban-Cornejo, Hanna Henriksson, Mathilde Kersting, Jeremy Vanhelst, et al. "Diet quality and attention capacity in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study." British Journal of Nutrition 117, no. 11 (June 14, 2017): 1587–95. http://dx.doi.org/10.1017/s0007114517001441.

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AbstractAdolescence represents an important period for the development of executive functions, which are a set of important cognitive processes including attentional control. However, very little is known regarding the associations of nutrition with components of executive functions in adolescence. Thus, the aim of this study was to investigate associations of dietary patterns and macronutrient composition with attention capacity in European adolescents. This cross-sectional study included 384 (165 boys and 219 girls) adolescents, aged 12·5–17·5 years, from five European countries in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Attention capacity was examined using the d2 Test of Attention. Dietary intake was assessed through two non-consecutive 24 h recalls using a computer-based self-administered tool. Three dietary patterns (diet quality index, ideal diet score and Mediterranean diet score) and macronutrient/fibre intakes were calculated. Linear regression analysis was conducted adjusting for age, sex, BMI, maternal education, family affluence scale, study centre and energy intake (only for Mediterranean diet score). In these adjusted regression analyses, higher diet quality index for adolescents and ideal diet score were associated with a higher attention capacity (standardised β=0·16, P=0·002 and β=0·15, P=0·005, respectively). Conversely, Mediterranean diet score or macronutrient/fibre intake were not associated with attention capacity (P>0·05). Our results suggest that healthier dietary patterns, as indicated by higher diet quality index and ideal diet score, were associated with attention capacity in adolescence. Intervention studies investigating a causal relationship between diet quality and attention are warranted.
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Zamora, Astrid, Karen Peterson, Martha Maria Téllez-Rojo, Alejandra Cantoral, Peter Song, Maritsa Solano-González, Adriana Mercado-García, Erica Fossee, and Erica Jansen. "Prenatal Diet in Relation to Sleep Health of Offspring During Adolescence: Evidence From the ELEMENT Study." Current Developments in Nutrition 5, Supplement_2 (June 2021): 833. http://dx.doi.org/10.1093/cdn/nzab046_130.

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Abstract Objectives Maternal diet during gestation has been linked to sex-specific differences in infant sleep; however, the impact on sleep into adolescence is unknown. We sought to examine the relationship between maternal diet patterns and sex-stratified offspring sleep health during adolescence among a Mexico City cohort. Methods Data from 309 mother-adolescent dyads were analyzed. Prenatal diet patterns were formed by principal component analysis derived from a food frequency questionnaire collected over the third trimester. Sleep variables were derived from 7-day actigraphy data from adolescents aged 9–17 years. Linear regression was employed to examine sex-stratified associations between tertiles of the diet patterns with adolescent sleep, adjusting for confounding factors. Results Three diet patterns included: the Prudent Diet (PD), high in lean proteins and vegetables; the Transitioning Mexican Diet (TMD) high in Mexican and “Westernized” foods; and the High Meat & Fat Diet (HMFD), high in meats and high-fat dairy products. The mean (SD) offspring age was 15.1 (1.9) years, and 52.4% of the sample was female. The mean (SD) sleep duration was 8.4 (1.4) h/night. Adjusted analyses showed an association between PD adherence and earlier sleep midpoint among female offspring, the offspring of mothers in the highest tertile of PD had a 0.70 h (95% CI: −1.2, −0.20; p = 0.01) earlier sleep midpoint (p, trend = 0.01). Additional associations were detected between TMD prenatal adherence with shorter sleep duration and earlier sleep midpoint among both sexes. For example, female and male offspring of mothers in the highest tertile of TMD had 0.80 h (95% CI: −85.0, −10.6; p = 0.01) (p, trend = 0.0043) and 0.54 h (95% CI: −66.1, 1.3) (p, trend = 0.03) shorter sleep duration, respectively. HMFD prenatal adherence was associated with less fragmented sleep in a non-linear manner among females and was non-linearly associated with an earlier sleep midpoint among males. Conclusions Sex-stratified analyses demonstrated that findings were more robust between multiple diet patterns and shorter sleep, earlier sleep timing, and less fragmented sleep among female offspring, thus indicating that maternal diet during pregnancy may impact female offspring's sleep health in adolescence. Funding Sources US EPA, NIEHS, NHLBI, and the National Institute of Public Health/Ministry of Health of Mexico.
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Mayank Jain, Girish Ganesh Joag, and Kshirsagar V Y. "Prevalence of Folic Acid And Vitamin B12 Deficiency in Anemic Adolescents." International Journal of Research in Pharmaceutical Sciences 11, no. 3 (August 7, 2020): 4630–35. http://dx.doi.org/10.26452/ijrps.v11i3.2747.

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Adolescents may enjoy nourishment trends, macrobiotic weight control plans and semi-starvation regimens in calories, nutrients and minerals. Protein need in a juvenile for every unit body weight is higher than that of grown-up; however, not exactly a quickly developing newborn child. Adolescence has higher nutrient and mineral needs contrasted and individuals all things considered other life stages. A community-based cross-sectional study of 200 school going anaemic adolescents of age group 10 – 19 years. A predesigned semi-organized survey was readied dependent on the audit of writing on Adolescent iron deficiency. The study included 200 anaemic adolescents belonging to two schools, 89 were males, and 111 were females. Male: female ratio was 1.25:1. Among a total of 200 participants, 122 anaemic adolescents belonged to early adolescence. The mean age of anaemic adolescent participants of this study was 13.19 years with a standard deviation of 1.23. among the participants, 137 anaemic adolescents took a vegetarian diet, and 63 anaemic adolescents took a mixed diet. There were three participants underweight according to BMI classification, and 190 had normal range of BMI, 132 adolescents had moderate anaemia (Hb- 8.0 to 10.9 ). Majority of 66.5%(133/200) had Vitamin B12 deficiency anaemia, 72.5%(145/200) had folic acid deficiency anaemia, and 58.5% (117/200) had combined Vitamin B12 and folic acid deficiency anaemia. Prevalence of anaemia in adolescent is a significant public health concern. Supplementation with not only iron and folic acid but also Vitamin B12 may be need of the day. Besides supplementation adequate education regarding quality food, cooking practices and health education is also necessary to be emphasized in adolescents.
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Landge, Jyoti A., and Gajanan D. Khadkikar. "Lifestyle and nutritional status of late adolescent in an urban area of Western Maharashtra: cross sectional study." International Journal Of Community Medicine And Public Health 7, no. 8 (July 24, 2020): 3027. http://dx.doi.org/10.18203/2394-6040.ijcmph20203373.

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Background: Prevalence of overweight and obesity is rapidly increasing among adolescent age. One of the reasons is change in lifestyle and behavior practices. Adolescent population and health of adolescents have a special concern. In late adolescence there is transition from school to college or university. This transition to college life often worsens lifestyle and dietary habits among late adolescents. Present study was carried out to assess lifestyle and nutritional status of late adolescent.Methods: A cross sectional study were carried out involving 140 late adolescent students of 17-19 years after obtaining permission from college principle using preformed questionnaire. Subsequently anthropometric measurements like weight in kg and height in meters, waist and hip circumference in centimetre were measured using standard assessment measures.Results: Out of 140 students 51 (36.4%) were boys and 89 (63.6%) were girls. Mean age of the students was 18.13±0.79 years. Overall prevalence of overweight and obesity was 49 (35%) and 29 (20.7%) respectively. No significant difference in BMI for boys and girls. Waist circumference and waist hip ratio was more in girls compared with boys. More than half 53.6% had mixed diet pattern. Among study participants 55.7% have green leafy vegetables in their diet and 62.8% have fruit in their diet. Most frequent unhealthy diet practice was intake of junk food 85% followed by fast food.Conclusions: High prevalence of obesity and overweight in late adolescent indicate an urge to start primordial and primary intervention since childhood.
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Belmaker, Elaine, and Jerome D. Cohen. "The advisability of the prudent diet in adolescence." Journal of Adolescent Health Care 6, no. 3 (May 1985): 224–32. http://dx.doi.org/10.1016/s0197-0070(85)80023-1.

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7

Partridge, Stephanie R. "Current dietary advice and challenges for adolescents." British Medical Bulletin 135, no. 1 (June 3, 2020): 28–37. http://dx.doi.org/10.1093/bmb/ldaa015.

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Abstract Background The major risk factors driving the global burden of disease are diet related. Adolescence presents a window of opportunity for establishing healthy dietary trajectories. Yet around the world, adolescents experience many barriers that prevent them from consuming diets that would give them the foundation for long, healthy and productive adult lives. Sources of data A narrative literature search of most relevant original, review and meta-analyses, restricted to English was conducted in Medline, Web of Science and PubMed up to December 2019 together with published papers known to the author concerning the current dietary advice and challenges for adolescent nutrition. Areas of agreement Adolescence is a critical period of growth and development and adequate nutrition is essential. Sufficient population data indicate adolescents are not meeting dietary recommendations and are a vulnerable population group for malnutrition in all its forms. Areas of controversy Despite extensive studies on dietary risk factors and the global burden of disease and population data demonstrating inadequate nutritional intake in adolescent populations, few effective interventions and policies have been scaled up to support adolescent nutrition. Growing points Improving the diets of adolescents, especially vulnerable adolescents from low- and middle-income countries and socioeconomically disadvantaged backgrounds, has the potential to impact individuals, societies and economies. Areas timely for developing research Future research should focus on vulnerable adolescent populations by addressing food environments, food insecurity and ensuring effective programmes and strategies are integrated within broader adolescent health strategies and implemented into government policies.
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Shaluhiyah, Zahroh, Ratih Indraswari, and Aditya Kusumawati. "Factors Influence on Dietary Intake and Practices of Adolescent Girls Aged 15-19 in Rural Area Central Java." Amerta Nutrition 5, no. 2 (June 21, 2021): 105. http://dx.doi.org/10.20473/amnt.v5i2.2021.105-114.

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Background: Dietary habits formed during adolescence have been shown to track into adulthood. Establishing healthy eating behaviours among adolescents, therefore, has both short- and long-term health benefits..Objectives: This study aims to identify dietary habits among adolescent girls aged 15-19 in rural area and its influence factorsMethod: This is a quantitative study with cross-sectional approach, involved 93 adolescent girls aged 15-19 in Jatipurwo village who were selected randomly. Data was collected by enumerators using structure questionnaires that has been validated in other village before. Univariate, bivariate using Chi-Square and multivariate (logistic regression) were employed to analyze data.Results: The eating behavior of adolescent girls were categorized as unhealthy and unbalanced diet. It was shown with insufficient level of energy including low adequacy of carbohydrate, protein and fat. The average height of adolescents was 155 cm. Most adolescents have LILA less than 23.5cm. As Low socioeconomic family income tends to have eating habits with low nutritional value both in quantity and quality as well as food variations. Lack of food availability at the family level makes teens have poor diet. It is recommended that the need for increased food security at the family level and provide awareness to adolescents about healthy eating.
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Diethelm, Katharina, Nicole Jankovic, Luis A. Moreno, Inge Huybrechts, Stefaan De Henauw, Tineke De Vriendt, Marcela González-Gross, et al. "Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study." Public Health Nutrition 15, no. 3 (September 22, 2011): 386–98. http://dx.doi.org/10.1017/s1368980011001935.

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AbstractObjectiveSince inadequate food consumption patterns during adolescence are not only linked with the occurrence of obesity in youth but also with the subsequent risk of developing diseases in adulthood, the establishment and maintenance of a healthy diet early in life is of great public health importance. Therefore, the aim of the present study was to describe and evaluate the food consumption of a well-characterized sample of European adolescents against food-based dietary guidelines for the first time.DesignThe HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study is a cross-sectional study, whose main objective was to obtain comparable data on a variety of nutritional and health-related parameters in adolescents aged 12·5–17·5 years.SettingTen cities in Europe.SubjectsThe initial sample consisted of more than 3000 European adolescents. Among these, 1593 adolescents (54 % female) had sufficient and plausible dietary data on energy and food intakes from two 24 h recalls using the HELENA-DIAT software.ResultsFood intake of adolescents in Europe is not optimal compared with the two food-based dietary guidelines, Optimized Mixed Diet and Food Guide Pyramid, examined in this study. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk (and milk products), but consume much more meat (and meat products), fats and sweets than recommended. However, median total energy intake may be estimated to be nearly in line with the recommendations.ConclusionThe results urge the need to improve the dietary habits of adolescents in order to maintain health in later life.
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De Vriendt, Tineke, Els Clays, Inge Huybrechts, Ilse De Bourdeaudhuij, Luis A. Moreno, Emma Patterson, Dénes Molnár, et al. "European adolescents’ level of perceived stress is inversely related to their diet quality: the Healthy Lifestyle in Europe by Nutrition in Adolescence study." British Journal of Nutrition 108, no. 2 (November 4, 2011): 371–80. http://dx.doi.org/10.1017/s0007114511005708.

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As stress is hypothesised to influence dietary behaviour, the relationship between perceived stress and diet quality in European adolescents was investigated. Within the Healthy Lifestyle in Europe by Nutrition in Adolescence study, adolescents (n 704, aged 12–17 years) from schools in five European cities (Ghent, Stockholm, Zaragoza, Athens and Vienna) completed a 2 d 24 h dietary recall assessment and an Adolescent Stress Questionnaire. Measurements and information were taken on height, weight, pubertal stage, parental education level, the level of moderate-to-vigorous physical activity (MVPA) and sleep duration. The Diet Quality Index for Adolescents (DQI-A) was calculated from the dietary data, which comprised three components reflecting dietary diversity, quality and equilibrium. Hierarchical linear models were performed to investigate the relationship between the adolescents' level of perceived stress and the DQI-A and its components, adjusting for relevant covariates (age, BMI z-score, pubertal stage and parental education). These models were additionally adjusted for MVPA or sleep duration. In both boys and girls, perceived stress was a significant independent negative predictor for their overall DQI-A. This inverse relationship was observed for all dietary components, except for dietary diversity in boys, and it was unaltered when additionally adjusted for MVPA or sleep duration. The observed inverse relationship between stress and diet quality within these European adolescents supports the hypothesis that stress influences dietary behaviour, thus emphasising the need for preventive stress-coping strategies for adolescents.
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Mesías, Marta, Isabel Seiquer, and M. Pilar Navarro. "Is the Mediterranean diet adequate to satisfy zinc requirements during adolescence?" Public Health Nutrition 15, no. 8 (January 5, 2012): 1429–36. http://dx.doi.org/10.1017/s1368980011003429.

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AbstractObjectiveTo evaluate Zn utilization and status among a sample of Spanish boys consuming a diet based on Mediterranean patterns.DesignDietary Zn balance was assessed by means of Zn intake in food and Zn output in faeces and urine as measured by flame atomic absorption spectrophotometry. In addition, biomarkers of Zn status were analysed.SettingProvince of Granada, Spain.SubjectsTwenty healthy male adolescents aged 11–14 years, selected based on medical questionnaire, physical examination and nutritional survey of food habits and lifestyle.ResultsMean Zn intake was 11·36 (se 0·31) mg/d, 76% of the recommended value for Spanish adolescents. Zn absorption (2·53 (se 0·55) mg/d) was close to the value of 3·0 mg/d required for the growth spurt. Zn status biomarkers and growth parameters were within the normal values for this age group.ConclusionsAlthough a diet based on Mediterranean patterns is associated with factors which can affect Zn absorption, such as high consumption of phytate, its consumption in adequate amounts allows Zn status to be maintained during adolescence. Due to the importance of Zn in preventing growth and behavioural disorders among adolescents, long-term intervention trials to investigate the suitability of the Mediterranean diet with respect to Zn requirements at this time of life are needed.
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Aura, Annamari, Marjorita Sormunen, and Kerttu Tossavainen. "The relation of socio-ecological factors to adolescents’ health-related behaviour." Health Education 116, no. 2 (February 1, 2016): 177–201. http://dx.doi.org/10.1108/he-03-2014-0029.

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Purpose – The purpose of this paper is to identify and describe adolescents’ health-related behaviours from a socio-ecological perspective. Socio-ecological factors have been widely shown to be related to health behaviours (smoking, alcohol consumption, physical activity and diet) in adolescence and to affect health. The review integrates evidence with socio-ecological factors (social relationships, family, peers, schooling and environment). Design/methodology/approach – The data were collected from electronic databases and by manual search consisting of articles (n=90) published during 2002-2014. The selected articles were analysed using inductive content analysis and narrative synthesis. Findings – The findings suggest that there was a complex set of relations connected to adolescent health behaviours, also encompassing socio-ecological factors. The authors tentatively conclude that socio-ecological circumstances influence adolescents’ health-related behaviour, but that this review does not provide the full picture. There seemed to be certain key factors with a relation to behavioural outcomes that might increase health inequality among adolescents. Practical implications – School health education is an important pathway for interventions to reduce unhealthy behaviours among adolescents including those related to socio-ecological factors. Originality/value – Some socio-ecological factors were strongly related to health behaviours in adolescence, which may indicate an important pathway to current and future health. This paper may help schoolteachers, nurses and other school staff to understand the relationships between socio-ecological factors and health-related behaviours, which may be useful in developing health education to reduce health disparities during adolescence.
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Maier, Janne H., and Ronald Barry. "Associations among Physical Activity, Diet, and Obesity Measures Change during Adolescence." Journal of Nutrition and Metabolism 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/805065.

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Background. Obesity in youth is highly prevalent. Physical activity and diet are influential in obesity development. However, there is a knowledge gap regarding links between activity and diet quality and their combined influence on obesity during adolescence.Objectives. We used five years of data from 2379 adolescent girls in the National Heart Lung and Blood Institute Growth and Health Study to evaluate the association between physical activity and diet quality during adolescence and to assess both as correlates of obesity.Design. Diet, activity, and body composition measures were evaluated pairwise for correlation. A canonical correlation analysis was used to evaluate relationships within and between variable groups. All statistics were examined for trends over time.Results. We found positive correlations between physical activity and diet quality that became stronger with age. Additionally we discovered an age-related decrease in association between obesity correlates and body composition.Conclusion. These results suggest that while health behaviors, like diet and activity, become more closely linked during growth, obesity becomes less influenced by health behaviors and other factors. This should motivate focus on juvenile obesity prevention capitalizing on the pliable framework for establishing healthy diet and physical activity patterns while impact on body composition is greatest.
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Matsumoto, Mai, Yoichi Hatamoto, Ayumi Masumoto, Azusa Sakamoto, and Shinji Ikemoto. "Mothers’ Nutrition Knowledge Is Unlikely to Be Related to Adolescents’ Habitual Nutrient Intake Inadequacy in Japan: A Cross-Sectional Study of Japanese Junior High School Students." Nutrients 12, no. 9 (September 13, 2020): 2801. http://dx.doi.org/10.3390/nu12092801.

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Dietary habits in adolescence persist into adulthood; thus, it is important to identify the factors that influence adolescent diet and establish a healthy diet. This study aimed to examine the association between mothers’ nutrition knowledge and their children’s nutrient intake inadequacy among Japanese junior high school student–mother dyads. The participants were 288 students and their mothers. Data regarding mothers’ nutrition knowledge were obtained using a validated, self-administered general nutrition knowledge questionnaire for Japanese adults (JGNKQ). Participants were categorised into two groups according to the mothers’ total JGNKQ scores. Adolescents’ dietary habits during the preceding month were assessed using a brief self-administered diet history questionnaire. Inadequacy of each nutrient intake was assessed using the cut-point method, which showed that 14 nutrients were below “estimated average requirement (EAR)” and five nutrients were outside the range of “tentative dietary goal to prevent lifestyle-related diseases (DG)”. In the habitual daily nutrient intakes and the proportion of nutrient intake inadequacy of the students, no differences were observed according to mother’s nutritional knowledge level. Our findings suggest that mothers’ nutrition knowledge may not be directly associated with adolescents’ nutrient intake among Japanese junior high school student–mother dyads.
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Fossee, Erica, Astrid Zamora, Karen Peterson, Alejandra Cantoral, Wei Perng, Martha Maria Téllez-Rojo, and Erica Jansen. "A Prospective Study of Prenatal Maternal Dietary Patterns and Offspring Adipokine Levels During Adolescence." Current Developments in Nutrition 5, Supplement_2 (June 2021): 745. http://dx.doi.org/10.1093/cdn/nzab046_042.

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Abstract Objectives Maternal diet during pregnancy has been associated with offspring adipokine levels related to insulin resistance and hyperlipidemia during infancy. However, whether this relationship persists into adolescence is unknown. We examined the association between maternal prenatal diet patterns with adolescent leptin and adiponectin levels a Mexico City cohort. Methods Data from 379 mother-adolescent dyads from the Mexico City ELEMENT cohort were analyzed. Diet patterns were derived from principal component analysis of food frequency questionnaire data collected during pregnancy trimesters. Adolescent serum leptin and adiponectin were measured at ages 10–17. Information on maternal covariates was measured during pregnancy. Multiple linear regression was used to examine overall and sex-stratified associations between quartiles of diet patterns with leptin and adiponectin, adjusting for maternal marital status, education, and parity. Results Three maternal diet patterns were identified: Prudent Diet (PD), high in fish and vegetables, the High Meat & Fat Diet (HMFD), high in pork and processed meats, and the Transitioning Diet (TD), high in corn tortillas and sugar beverages. At follow-up, the mean (SD) of leptin and adiponectin were 24.3 (18.2) ng/ml and 11.7 (3.9) ng/ml. A significant positive association was demonstrated between first trimester TD scores and adipokines in girls. In a multivariate-adjusted model, compared to girls in the lowest quartile (Q1) of the TD pattern, the highest quartile of the TD pattern (Q4) had 10.39 ng/mL higher leptin (95% CI: 3.1, 17.6; p for trend = 0.0024). In addition, compared to girls in the lowest quartile (Q1) of the TD pattern, those in the third quartile (Q3) of the TD pattern had 1.86 ng/mL lower adiponectin (95% CI: −3.5, −0.2; p for trend = 0.168). Associations were mostly consistent across all trimesters. Conclusions During pregnancy, a Transitioning Diet pattern was positively associated with leptin and non-monotonically inversely associated with adiponectin in females. Findings suggest maternal diet patterns during pregnancy may influence offspring leptin and adiponectin levels in adolescent girls. Funding Sources Funded by grant P01ES022844.
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Hildebrand, Hailey, Elinor Simons, Anita L. Kozyrskyj, Allan B. Becker, and Jennifer L. P. Protudjer. "Calcium Intake in Children with Eczema and/or Food Allergy: A Prospective Cohort Study." Nutrients 11, no. 12 (December 12, 2019): 3039. http://dx.doi.org/10.3390/nu11123039.

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Eczema and food allergy may impact diet. Using data from a cohort of Manitoba children born in 1995, we examined calcium intake, defined as the frequency and quality of calcium products consumed (with the exception of cheese), amongst Manitoba adolescents (12–14 years) with eczema or food allergy in childhood (7–8 years) or adolescence. At both ages, children were assessed by a physician for eczema and food allergy. Adolescents completed food frequency questionnaires. Calcium intake was defined as 1+ vs. <1 weekly. Linear and logistic regression was used as appropriate, with adjustments for confounders. Overall, 468 adolescents were included, of whom 62 (13.3%) had eczema only in childhood, 25 (5.3%) had food allergy only, and 26 (5.6%) had eczema and food allergy. Compared to children without eczema, those with eczema only had poorer calcium intake in adolescence (β −0.44; 95%CI −0.96; 0.00). Girls, but not boys, with eczema in childhood had poorer calcium intake in adolescence than girls without eczema (β −0.84; 95%CI −1.60; −0.08). These patterns persisted even if children experienced transient vs. persistent eczema to adolescence. Similar but non-significant trends were found for food allergy. Childhood eczema is associated with significantly lower calcium intake and consumption in adolescence. These differences persist to adolescence, even if a child “outgrows” their allergic condition.
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Drenowatz, Clemens, and Klaus Greier. "Association of Sports Participation and Diet with Motor Competence in Austrian Middle School Students." Nutrients 10, no. 12 (November 29, 2018): 1837. http://dx.doi.org/10.3390/nu10121837.

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Physical activity and diet are important contributors to overall health and development in adolescents. There remains, however, limited research on the combined association of sports participation and dietary pattern on motor competence, which is crucial for an active lifestyle during and beyond adolescence. The present study, therefore, examined the association between sports participation, dietary pattern, and motor competence in 165 middle school students (55% male) between 11 and 14 years of age. Body weight and height were measured, and motor competence was determined via the German motor test during regular Physical Education (PE). Further, participants completed a food frequency questionnaire and reported their engagement in club sports. Of the total sample 20% were overweight/obese and 49% reported participation in club sports, with no differences between boys and girls. Interaction effects of sports participation and dietary pattern on motor competence were limited, but sports participation and healthy diet were independently associated with higher motor performance. Healthy dietary choices, along with participation in club sports, therefore, should be promoted in adolescents in order to facilitate motor development. As adolescence is a crucial time for the establishment of lifelong behaviors, such efforts could facilitate a healthy lifestyle throughout adulthood.
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Lawless, Megan, Lenka Shriver, Jessica Dollar, Susan Calkins, Susan Keane, Lilly Shanahan, and Laurie Wideman. "Dietary Restraint in Adolescence Predicts Diet Quality in Young Adulthood." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1323. http://dx.doi.org/10.1093/cdn/nzaa059_040.

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Abstract Objectives Establishing a diet that follows the Dietary Guidelines for Americans has been associated with lower risk of mortality from cardiovascular disease and cancer. Some research has shown that individuals’ desire for weight control is an important factor in determining food choices. The aims of this study were to 1) examine dietary restraint in adolescence as a predictor of overall diet quality in young adulthood and 2) compare selected dietary components by levels of restraint. Methods Data were collected from participants enrolled in a longitudinal study in NC, the Right Track Health Study (n = 112). Dietary restraint was assessed using the 21-item subscale of the Three Factor Eating Questionnaire. Three 24-hour dietary recalls were collected to estimate dietary intake and Healthy Eating Index 2015 (HEI-2015) scores were calculated to determine diet quality. Multiple linear regression tested the association between restraint and diet quality, adjusting for sex, race, Body Mass Index-for-age percentiles and disinhibition in adolescence. Using the mean value for restraint (score of 6.64), “high restraint” and “low restraint” groups were created, and the specific HEI-2015 component scores were compared using t-tests. Level of significance was set at P &lt; 0.05. Results Overall, participants consumed a poor-quality diet (HEI-2015 score = 50.24 ± 13.56). Higher restraint in adolescence (mean age 16.59 ± 0.39 years) was associated with higher total HEI-2015 score in young adulthood (mean age 18.74 ± 0.51) (β = 15.39 (95% CI: 3.44, 27.34) P = 0.01). The high restraint group had significantly higher HEI-component scores for total vegetables, greens and beans, total fruit, whole fruit, seafood and plant proteins, and added sugars. There were no differences between the two groups in the remaining HEI-2015 component scores (e.g., whole grains, fatty acids, sodium). Conclusions Higher dietary restraint in adolescence predicts better overall diet quality in young adulthood. Nevertheless, young adults in our sample failed to meet the federal dietary guidelines. Interventions aimed at improving diet quality should consider an individual's level of dietary restraint to better tailor nutrition advice. Funding Sources This research was supported by funding from NIH-NICHD and NIH-NIDDK.
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Souza, Aline F. P., Luana L. Souza, Lorraine S. Oliveira, Aline Cordeiro, Eliete Souza, George E. G. Kluck, Georgia C. Atella, Isis H. Trevenzoli, and Carmen C. Pazos-Moura. "Fish oil supplementation during adolescence attenuates metabolic programming of perinatal maternal high-fat diet in adult offspring." British Journal of Nutrition 121, no. 12 (April 3, 2019): 1345–56. http://dx.doi.org/10.1017/s0007114519000771.

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AbstractPerinatal maternal high-fat diet (HFD) increases susceptibility to obesity and fatty liver diseases in adult offspring, which can be attenuated by the potent hypolipidaemic action of fish oil (FO), ann-3 PUFA source, during adult life. Previously, we described that adolescent HFD offspring showed resistance to FO hypolipidaemic effects, although FO promoted hepatic molecular changes suggestive of reduced lipid accumulation. Here, we investigated whether this FO intervention only during the adolescence period could affect offspring metabolism in adulthood. Then, female Wistar rats received isoenergetic, standard (STD: 9 % fat) or high-fat (HFD: 28·6 % fat) diet before mating, and throughout pregnancy and lactation. After weaning, male offspring received the standard diet; and from 25 to 45 d old they received oral administration of soyabean oil or FO. At 150 d old, serum and hepatic metabolic parameters were evaluated. Maternal HFD adult offspring showed increased body weight, visceral adiposity, hyperleptinaemia and decreased hepatic pSTAT3/STAT3 ratio, suggestive of hepatic leptin resistance. FO intake only during the adolescence period reduced visceral adiposity and serum leptin, regardless of maternal diet. Maternal HFD promoted dyslipidaemia and hepatic TAG accumulation, which was correlated with reduced hepatic carnitine palmitoyl transferase-1a content, suggesting lipid oxidation impairment. FO intake did not change serum lipids; however, it restored hepatic TAG content and hepatic markers of lipid oxidation to STD offspring levels. Therefore, we concluded that FO intake exclusively during adolescence programmed STD offspring and reprogrammed HFD offspring male rats to a healthier metabolic phenotype in adult life, reducing visceral adiposity, serum leptin and hepatic TAG content in offspring adulthood.
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GREENE, LUCY C., ALAN LUCAS, M. BARBARA E. LIVINGSTONE, P. S. ERASMUS G. HARLAND, and BRIAN A. BAKER. "Relationship between early diet and subsequent cognitive performance during adolescence." Biochemical Society Transactions 23, no. 2 (May 1, 1995): 376S. http://dx.doi.org/10.1042/bst023376s.

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Huang, Yi-Jung, Shu-Li Lee, and Li-Min Wu. "Health-Promoting Lifestyle and Its Predictors in Adolescent Survivors of Childhood Cancer." Journal of Pediatric Oncology Nursing 38, no. 4 (February 17, 2021): 233–41. http://dx.doi.org/10.1177/1043454221992322.

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Background: Cancer survivors are at increased risk of long-term adverse effects related to the disease or treatment. Thus, it is important for cancer survivors to adopt a health-promoting lifestyle (HPL). This study aims to: (1) describe health behavior self-efficacy (HBSE) and HPL of adolescent survivors of childhood cancer, (2) examine the relationships between HBSE, HPL, and various demographic factors, and (3) identify determinants of HPL among adolescent survivors of childhood cancer. Method: A descriptive cross-sectional study was conducted with adolescent survivors of childhood cancer, ranged in age from 11 to 19 years ( n = 82). Participants were recruited from pediatric oncology follow-up clinics at two medical centers in southern Taiwan. Data for each participant were collected from questionnaires assessing HBSE and HPL. Results: Only 61% of the adolescent survivors were considered as normal weight. The exercise was the lowest scoring HBSE subscale. Factors associated with better HPL included: education level, HBSE, well-being, and a healthy diet. Specifically, survivors diagnosed with cancer during adolescence exhibited significantly greater self-efficacy with stress management ( F = 3.20, p = .04) compared with those diagnosed at pre-school ages. HBSE scores for well-being and a healthy diet were significant predictors of HPL, accounting for 43.8% of the total variance observed. Discussion: Our findings suggest that the age of diagnosis of childhood cancer significantly modulates the frequency of health-promoting behaviors of adolescent survivors. Thus, interventions designed to enhance adolescents’ well-being and the management of a healthy diet may enhance HPL in survivors of childhood cancer.
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Kracht, Chelsea L., Jean-Philippe Chaput, Corby K. Martin, Catherine M. Champagne, Peter T. Katzmarzyk, and Amanda E. Staiano. "Associations of Sleep with Food Cravings, Diet, and Obesity in Adolescence." Nutrients 11, no. 12 (November 30, 2019): 2899. http://dx.doi.org/10.3390/nu11122899.

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Background: Sleep and dietary intake/quality can contribute to excess weight gain, but food cravings may influence these relationships. This cross-sectional study examined the relationship of adolescents’ sleep characteristics with dietary intake/quality and obesity and whether food cravings mediated these relationships. Methods: Sleep measures were calculated based on 24-h accelerometry, and height and weight were directly measured to calculate body mass index (BMI) z-scores. Food cravings were assessed by the Food Craving Inventory (FCI). Dietary intake and quality were calculated based on dietary recalls. Multivariable linear regression was used to examine the associations among sleep, food cravings, dietary intake/quality, and obesity, adjusting for confounders. Results: In total, 256 adolescents (ages 10–16 years) had complete data; 42% were non-White and 45% were boys. Sleep efficiency was inversely associated with sweet cravings and FCI-28. Sleep duration, meeting the sleep duration guidelines, and fruit/vegetable cravings were each positively associated with dietary quality. Sleep duration was negatively associated with BMI z-score. Mediation models were not performed as no sleep parameter was associated with both cravings and dietary intake/quality or BMI z-score. Conclusions: Associations existed among poor sleep, quantity and quality, with more frequent food cravings and worse dietary quality. Sleep may underlie adolescent obesogenic behaviors.
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Munguia-Izquierdo, Diego, Carmen Mayolas-Pi, Carlos Peñarrubia-Lozano, Federico Paris-Garcia, Javier Bueno-Antequera, Miguel Angel Oviedo-Caro, and Alejandro Legaz-Arrese. "Effects of Adolescent Sport Practice on Health Outcomes of Adult Amateur Endurance Cyclists: Adulthood Is Not Too Late to Start." Journal of Physical Activity and Health 14, no. 11 (November 1, 2017): 876–82. http://dx.doi.org/10.1123/jpah.2017-0010.

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Background: We investigated the effects of adolescent sport practice on the training, performance, and health outcomes of adult amateur endurance cyclists and compared health outcomes of 3 adult groups: amateur endurance cyclists who practiced sports during adolescence, amateur endurance cyclists who did not practice sports during adolescence, and inactive individuals. Methods: In 859 (751 men and 108 women) adult cyclists and 718 inactive subjects (307 men and 411 women), we examined adolescent sport practice, current training status, quality of life, quality of sleep, anxiety and depression, and cardiometabolic risk: body mass index, physical activity, physical fitness, adherence to Mediterranean diet, and alcohol and tobacco consumption. Results: Independent of gender, no significant differences in training, performance, or health outcomes were observed between amateur endurance cyclists who practiced sports during adolescence and those who did not. Independent of gender, cyclists reported significantly better health outcomes than inactive individuals in all variables, except depression. Conclusions: Training, performance, and health outcomes did not differ between adult amateur endurance cyclists who practiced sports during adolescence and those who did not, but their health outcomes were significantly improved compared with inactive individuals, except for depression.
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Gawlińska, Kinga, Dawid Gawliński, Ewelina Kowal-Wiśniewska, Małgorzata Jarmuż-Szymczak, and Małgorzata Filip. "Alteration of the Early Development Environment by Maternal Diet and the Occurrence of Autistic-like Phenotypes in Rat Offspring." International Journal of Molecular Sciences 22, no. 18 (September 7, 2021): 9662. http://dx.doi.org/10.3390/ijms22189662.

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Epidemiological and preclinical studies suggest that maternal obesity increases the risk of autism spectrum disorder (ASD) in offspring. Here, we assessed the effects of exposure to modified maternal diets limited to pregnancy and lactation on brain development and behavior in rat offspring of both sexes. Among the studied diets, a maternal high-fat diet (HFD) disturbed the expression of ASD-related genes (Cacna1d, Nlgn3, and Shank1) and proteins (SHANK1 and TAOK2) in the prefrontal cortex of male offspring during adolescence. In addition, a maternal high-fat diet induced epigenetic changes by increasing cortical global DNA methylation and the expression of miR-423 and miR-494. As well as the molecular changes, behavioral studies have shown male-specific disturbances in social interaction and an increase in repetitive behavior during adolescence. Most of the observed changes disappeared in adulthood. In conclusion, we demonstrated the contribution of a maternal HFD to the predisposition to an ASD-like phenotype in male adolescent offspring, while a protective effect occurred in females.
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Benetou, Vassiliki, Afroditi Kanellopoulou, Eleftheria Kanavou, Anastasios Fotiou, Myrto Stavrou, Clive Richardson, Philippos Orfanos, and Anna Kokkevi. "Diet-Related Behaviors and Diet Quality among School-Aged Adolescents Living in Greece." Nutrients 12, no. 12 (December 11, 2020): 3804. http://dx.doi.org/10.3390/nu12123804.

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Prevalence of diet-related behaviors (i.e., breakfast consumption, eating with the family) and their association with a 17-point diet quality score, constructed on the basis of reported frequency (in days/week) of vegetable, fruit, sweets and sugar-sweetened beverages consumption, was investigated among 3525 adolescents (51.5% girls) aged 11, 13 and 15 years, who were participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) cross-sectional study, during 2018. Almost one-third (32.9%) of the sample had breakfast ≤1 day/weekdays, 20.2% rarely ate with the family, 26.1% had a meal while watching TV ≥5 days/week, 31.7% had a snack in front of a screen ≥5 days/week and 24.1% ate in fast-food restaurants at least once/week. Multivariable ordinal logistic regression revealed that eating breakfast ≤1 day/weekdays compared to 4–5 days/weekdays (Odds ratio (OR): 1.56, 95% con-fidence interval (CI): 1.34–1.82), eating rarely with the family compared to almost every day (OR: 1.35, 95% CI: 1.13–1.60) and eating in fast-food restaurants ≥2 times/week vs. rarely (OR: 4.59, 95% CI: 3.14–6.70) were associated with higher odds of having poor diet quality. High frequency of having meals/snacks in front of a screen/TV was also associated with poor diet quality. Efforts to prevent or modify these behaviors during adolescence may contribute to healthier diet.
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Sajjan, Saraswati V., Neeta P N, and Poonam P. Shingade. "Knowledge and practice regarding menstrual hygiene among urban adolescents- A cross-sectional study." Indian Journal of Forensic and Community Medicine 8, no. 2 (July 15, 2021): 120–24. http://dx.doi.org/10.18231/j.ijfcm.2021.024.

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Adolescence is the significant period in the life of a woman. Menstrual disturbances are the commonest presenting complaint in adolescent age group and unhygienic practices during menstruation can lead to untoward consequences like pelvic inflammatory disease and even infertility. To study the knowledge and practice regarding menstrual hygiene among adolescents. This is a cross-sectional study conducted from October 2018 to December 2018 among 100 adolescent girls who attended adolescent clinics at Urban Health Training centre of KBNU Medical College, Kalaburagi. The mean age of participants was 16.2 ± 2.1 SD. only 26% of participants were aware about menstruation before menarche. Majority (91%) of participants had knowledge about use of sanitary pads during menstruation but only 78% used them. The most common reason for non usage was the cost of pads (68%). The method of disposal was satisfactory among 62% of participants and 84% of participants change their pads /cloth pieces 2-3 times per day. Restriction of diet during menstruation was seen in 40% and 30% missed school during their periods. Although there was good knowledge regarding menstrual hygiene among adolescent girls, practice needs to improve. Health education sessions at urban health clinics and schools involving mothers of these adolescent girls can aid to overcome socio cultural practices of restricting movement and diet restrictions during menstruation.
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Li, Jianghong, Therese O'Sullivan, Sarah Johnson, Fiona Stanley, and Wendy Oddy. "Maternal work hours in early to middle childhood link to later adolescent diet quality." Public Health Nutrition 15, no. 10 (November 29, 2011): 1861–70. http://dx.doi.org/10.1017/s1368980011003053.

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AbstractObjectivePrevious studies on maternal work hours and child diet quality have reported conflicting findings possibly due to differences in study design, lack of a comprehensive measure of diet quality and differing ages of the children under investigation. The present study aimed to prospectively examine the impact of parental work hours from age 1 year to age 14 years on adolescent diet quality.DesignMultivariate linear regression models were used to examine independent associations between parents’ work hours at each follow-up and across 14 years and adolescent diet quality at age 14 years. A diet quality index was based on the international literature and Australian recommendations, consisting of six food groups and nine nutrients.SettingPerth, Western Australia.SubjectsChildren (n 1629) participating in the Western Australian Pregnancy Cohort (Raine) Study.ResultsCompared with children of mothers in full-time employment, children of mothers who were not employed in early childhood up to age 5 years had a higher average diet quality score at age 14 years, independent of maternal and family socio-economic status. Across 14 years the number of years the mother worked full time and increasing average weekly hours were associated with lower diet quality. Father's work hours had little association with adolescent diet quality.ConclusionsHaving a mother stay at home in early to middle childhood is associated with better diet quality in adolescence. Support may be beneficial for families where the mother returns to full-time employment before the child reaches 8 years of age.
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Gruber, Maria, Daniel König, Julika Holzhäuser, Deirdre Maria Castillo, Victor Blüml, Rebecca Jahn, Carmen Leser, Sonja Werneck-Rohrer, and Harald Werneck. "Parental feeding practices and the relationship with parents in female adolescents and young adults with eating disorders: A case control study." PLOS ONE 15, no. 11 (November 19, 2020): e0242518. http://dx.doi.org/10.1371/journal.pone.0242518.

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Objective Perceived parental influence on diet in early adolescence in the context of the parental relationship had previously not been studied in a clinical sample. The aim of this study was to investigate a possible association between eating disorders and characteristics of the relationship with parents and the parental feeding practices in early adolescence. Methods 21 female adolescents and young adults with an eating disorder (ED)–bulimia nervosa or anorexia nervosa–and 22 females without eating disorder (healthy control; HC), aged between 16 and 26, were assessed via self-report questionnaires for problematic eating behaviour, relationship with parents, perceptions of parent’s feeding practices at the age of 10–13 years and personality. Statistical evaluation was performed by means of group comparisons, effect sizes, regression analyses and mediator analyses. Results Adolescent and young adult females with ED reported more fears/overprotection and rejection/neglect by their mothers and less self-responsibility in terms of eating behaviour during adolescence than did the HC. The relationship with the fathers did not differ significantly. Females who perceived more cohesion, rejection/neglect and fears/overprotection by the mother were more likely to suffer from an ED. Rejection/neglect by both parents were associated with less self-acceptance of the young females with even stronger effect sizes for the fathers than the mothers. Harm prevention in the young females was a partial mediator between fears/overprotection and the drive for thinness. Conclusions The parental relationship is partly reflected in the self-acceptance and self-responsibility in eating of the adolescent and young females, both of them are particularly affected in EDs. Stressors in the parent-child relationship should be targeted in treatment of eating disorders. Nutritional counselling for parents might be useful in early adolescence.
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Alfiah, Elma, Andi Mukramin Yusuf, Andi Mukramin Yusuf, Amalina Ratih Puspa, and Amalina Ratih Puspa. "Status Anemia dan Skor Diet Quality Index (DQI) pada Remaja Putri di SMP Ibnu Aqil, Bogor." JURNAL Al-AZHAR INDONESIA SERI SAINS DAN TEKNOLOGI 6, no. 1 (March 31, 2021): 16. http://dx.doi.org/10.36722/sst.v6i1.467.

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<p><strong>Anemia is a global health problem, which occurs in both developed and developing countries. The Indonesian Basic Health Research showed that the prevalence of anemia in adolescent girls aged 15-24 years was 48.9% in 2018. This study aimed to analyze the anemia status and diet quality index (DQI) of adolescent girls. The study was a cross-sectional conducted at Ibnu Aqil Junior High School, Ciomas District, Bogor from March to September 2019. The number of students involved as respondents in this study was 84 students. The results show that the prevalence of anemia in adolescent girls was 16.7%, with the mean Diet Quality Index (DQI) score indicating a low diet quality category (55.9 out of 100). There was no significant relationship between hemoglobin levels and DQI scores, but several indicators such as variations in protein source groups, fiber adequacy, iron adequacy, calcium adequacy, total fat moderation, and saturated fat moderation on adolescent girls who suffered anemia showed lower values than with those who didn’t suffer from anemia. The high prevalence of anemia could be caused by poor diet quality aspects, thus diet-based intervention should be the strategic solution to solve this problem. The high prevalence of anemia could be caused by poor diet quality aspects, thus diet-based intervention should be the strategic solution to solve this problem.</strong></p><p><strong><em>Keyword - </em></strong><em>Adolescence, Anemia, Diet quality, DQI, Supplementation</em></p>
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Raeside, Rebecca, Stephanie Partridge, Anna Singleton, and Julie Redfern. "Cardiovascular Disease Prevention in Adolescents: eHealth, Co-Creation, and Advocacy." Medical Sciences 7, no. 2 (February 24, 2019): 34. http://dx.doi.org/10.3390/medsci7020034.

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Cardiovascular disease (CVD) is the leading cause of death globally. Early atherosclerotic changes can begin to occur early in life and though adolescence. The prevalence of modifiable CVD risk factors, namely, smoking, poor diet quality, excessive alcohol intake, physical inactivity, and overweight and obesity can exacerbate the early onset of atherosclerosis. There is a need to improve modifiable risk factors during adolescence to prevent progression to CVD in later life. Electronic health (eHealth) behaviour change interventions are a potential solution for adolescents to improve CVD risk factors, given adolescents are digital frontrunners and digital technology is wide-reaching. The process of co-creating eHealth behaviour change interventions with adolescents is a promising strategy to improve intervention effectiveness and engagement. Additionally, effective youth advocacy is an emerging strategy for CVD prevention in adolescents. This narrative review evaluates published eHealth behaviour change interventions targeting cardiovascular disease risk factors in adolescents, which utilize a co-creation process, describe the emerging role of advocacy in CVD prevention for adolescents and provide recommendations for future interventions.
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Larson, Nicole, Jayne Fulkerson, Mary Story, and Dianne Neumark-Sztainer. "Shared meals among young adults are associated with better diet quality and predicted by family meal patterns during adolescence." Public Health Nutrition 16, no. 5 (August 3, 2012): 883–93. http://dx.doi.org/10.1017/s1368980012003539.

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AbstractObjectiveTo describe shared meal patterns and examine associations with dietary intake among young adults.DesignPopulation-based, longitudinal cohort study (Project EAT: Eating and Activity in Teens and Young Adults).SettingParticipants completed surveys and FFQ in high-school classrooms in Minneapolis/St. Paul, MN, USA in 1998–1999 (mean age = 15·0 years, ‘adolescence’) and follow-up measures online or by mail in 2008–2009 (mean age = 25·3 years, ‘young adulthood’).SubjectsThere were 2052 participants who responded to the 10-year follow-up survey and reported on frequency of having shared meals.ResultsAmong young adults, the frequency of shared meals during the past week was as follows: never (9·9 %), one or two times (24·7 %), three to six times (39·1 %) and seven or more times (26·3 %). Having more frequent family meals during adolescence predicted a higher frequency of shared meals in young adulthood above and beyond other relevant sociodemographic factors such as household composition and parental status. Compared with young adults who never had family meals during adolescence, those young adults who reported seven or more family meals per week during adolescence had an average of one additional shared meal per week. Having more frequent shared meals in young adulthood was associated with greater intake of fruit among males and females, and with higher intakes of vegetables, milk products and some key nutrients among females.ConclusionsNutrition professionals should encourage families of adolescents to share meals often and establish the tradition of eating together, and work with young adults to ensure that healthy food and beverage choices are offered at mealtimes.
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Schneider, Bruna Celestino, Samuel Carvalho Dumith, Silvana Paiva Orlandi, and Maria Cecília Formoso Assunção. "Diet and body fat in adolescence and early adulthood: a systematic review of longitudinal studies." Ciência & Saúde Coletiva 22, no. 5 (May 2017): 1539–52. http://dx.doi.org/10.1590/1413-81232017225.13972015.

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Abstract Adipose tissue is a vital component of the human body, but in excess, it represents a risk to health. According to the World Health Organization, one of the main factors determining excessive body adiposity is the dietary habit. This systematic review investigated longitudinal studies that assessed the association between diet and body fat in adolescents and young adults. Twenty-one relevant papers published between 2001 and 2015 were selected. The most used method for estimating body fat was the body mass index (15 studies). Diet was most commonly assessed by estimating the consumption of food groups (cereals, milk and dairy products) and specific foods (sugar-sweetened beverages, soft drinks, fast foods, milk, etc.). Ten studies found a direct association between diet and quantity of body fat. During adolescence, adhering to a dietary pattern characterized by high consumption of energy-dense food, fast foods, sugar-sweetened beverages and soft drinks, as well as low fiber intake, appears to contribute to an increase in body fat in early adulthood. The findings of the present study suggest that the frequent consumption of unhealthy foods and food groups (higher energy density and lower nutrient content) in adolescence is associated with higher quantity of body fat in early adulthood.
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Devi, Karthiga, and Jothi Priya. "DELETERIOUS FUNCTIONAL IMPACT OF ANEMIA ON ADOLESCENTS: A SURVEY STUDY." Asian Journal of Pharmaceutical and Clinical Research 9, no. 5 (September 1, 2016): 150. http://dx.doi.org/10.22159/ajpcr.2016.v9i5.12825.

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ABSTRACTObjective: To access the physical work capacity and cognition of underprivileged anemic adolescent, hemoglobin (Hb) of subjects was assessed forthe adolescence under 17-20 years of age by undergoing survey.Methods: This is a cross-sectional study, conducted in students of 1st year of Saveetha Dental College. The general information about age, Hb level(Sahli’s method), knowledge about anemia, status of menstruation, and regarding the consumption of various diet factors were recorded on astructured questionnaire. Due to feasibility and cost effectiveness, Hb estimation was done by Sahli’s hemoglobinometer.Results: Our study proved that now a days adolescence is not much more prone to anemia. And mostly 40% of adolescence were having mild anemia.This mild anemia can be improved by dietary intake and bioavailability of iron, nutritional supplementation of iron and folic acid (IFA) tablets, andfortification of edible dietary items with iron. This difference was statistically significant (Chi-square value 4.848, p<0.001).Conclusion: The study was mainly done for adolescence awareness on anemia. Iron deficiency anemia occurs most frequently in adolescence becauseaccelerated physical growth both in boys and girls and menstruation and dieting for fear of obesity in female teenagers. The prevalence of anemianecessitates pragmatic intervention to improve the dietary intake, nutritional supplement of IFA tablets.Keywords: Adolescence, Dietary factors, Knowledge about anemia.
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Berge, Jerica M., Megan R. Winkler, Nicole Larson, Jonathan Miller, Ann F. Haynos, and Dianne Neumark-Sztainer. "Intergenerational Transmission of Parent Encouragement to Diet From Adolescence Into Adulthood." Pediatrics 141, no. 4 (March 6, 2018): e20172955. http://dx.doi.org/10.1542/peds.2017-2955.

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Potischman, Nancy, Christine A. Swanson, Robert N. Hoover, Louise A. Brinton, Helen A. Weiss, Ralph J. Coates, Marilie D. Gammon, Donna Brogan, Kathleen E. Malone, and Janet L. Stanford. "Diet During Adolescence and Risk of Breast Cancer Among Young Women." JNCI: Journal of the National Cancer Institute 90, no. 3 (February 4, 1998): 226–33. http://dx.doi.org/10.1093/jnci/90.3.226.

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Ashkenazi, S., R. Weitz, I. Varsano, and M. Mimouni. "Vitamin B12 Deficiency Due to a Strictly Vegetarian Diet in Adolescence." Clinical Pediatrics 26, no. 12 (December 1987): 662–63. http://dx.doi.org/10.1177/000992288702601211.

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Yeste, Diego, and Antonio Carrascosa. "Management of obesity in childhood and adolescence: From diet to surgery." Endocrinología y Nutrición (English Edition) 59, no. 7 (August 2012): 403–6. http://dx.doi.org/10.1016/j.endoen.2012.08.007.

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Azadbakht, Leila, Fahime Akbari, and Ahmad Esmaillzadeh. "Diet quality among Iranian adolescents needs improvement." Public Health Nutrition 18, no. 4 (May 12, 2014): 615–21. http://dx.doi.org/10.1017/s1368980014000767.

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AbstractObjectiveDiet in adolescence is important not only because of adolescents’ rapid growth but also due to its influence on future chronic diseases. On the other hand, dietary quality indices are noteworthy and useful approaches to evaluate dietary intakes. Thus the present study was conducted to assess dietary quality indices in adolescents.DesignCross-sectional.SettingsThe data were collected from schools in Isfahan, Iran.SubjectsFemale students (n 265) aged 11–13 years were enrolled using systematic cluster-random sampling in Isfahan (Iran). Dietary intakes were assessed by a validated FFQ. Diet quality indices including dietary diversity score (DDS), the Healthy Eating Index (HEI) and mean adequacy ratio (MAR) across ten nutrients were calculated.ResultsMean DDS, HEI score and MAR were 6·15 (sd 1·61) out of 10 points, 63·90 (sd 19·86) out of 100 points and 1·32 (sd 0·61), respectively. Mean nutrient adequacy ratio of all nutrients was above 1 except for vitamin D (0·53 (sd 0·51)). Those in the highest tertile of DDS had the most favourable anthropometric variables in comparison to the lowest tertile. There were no significant associations between HEI score and BMI, central or abdominal obesity and blood pressure. Those in the highest tertile of MAR had higher BMI, waist circumference and hip circumference.ConclusionsDiet quality of Isfahani adolescents needs improvement. It may imply the necessity of implementing nutritional instructive policies in this age group and their parents.
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Winpenny, Eleanor M., Anne-Laura van Harmelen, Martin White, Esther MF van Sluijs, and Ian M. Goodyer. "Diet quality and depressive symptoms in adolescence: no cross-sectional or prospective associations following adjustment for covariates." Public Health Nutrition 21, no. 13 (May 16, 2018): 2376–84. http://dx.doi.org/10.1017/s1368980018001179.

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AbstractObjectiveAdolescence is a critical period for development of depression and understanding of behavioural risk factors is needed to support appropriate preventive strategies. We examined associations between adolescent diet quality and depressive symptoms, cross-sectionally and prospectively, in a large community cohort, adjusting for behavioural and psychosocial covariates.DesignProspective community-based cohort study (ROOTS).SettingSecondary schools in Cambridgeshire and Suffolk, UK.SubjectsStudy participants (n 603) who completed 4 d diet diaries at age 14 years and reported depressive symptoms (Moods and Feelings Questionnaire (MFQ)) at 14 and 17 years of age.ResultsDiet data were processed to derive a Mediterranean diet score (MDS) and daily servings of fruit and vegetables, and fish. At age 14 years, a negative association between fruit and vegetable intake and MFQ score was seen in the unadjusted cross-sectional regression model (β=−0·40; 95 % CI −0·71,−0·10), but adjustment for behavioural covariates, including smoking and alcohol consumption, attenuated this association. Fish intake and MDS were not cross-sectionally associated with MFQ score. No prospective associations were found between MDS, fruit and vegetable intake or fish intake and later MFQ score.ConclusionsDiet quality was not associated with depressive symptoms in mid-adolescence. Previously reported associations in this age range may be due to confounding. Further longitudinal studies are needed that investigate associations between adolescent diet and depression across different time frames and populations, ensuring appropriate adjustment for covariates.
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Ardiaria, Martha, Erin Ratna Kustanti, Ria Purnawian Sulistiani, and Etika Ratna Noer. "Efek integrated nutrition programme terhadap profil lipid dan komposisi tubuh pada remaja obes." Jurnal Gizi Klinik Indonesia 15, no. 3 (January 25, 2019): 95. http://dx.doi.org/10.22146/ijcn.31594.

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The effect of integrated nutrition programme on lipid profile and body composition among adolescent obesityBackground: Obesity is a serious public health issue increasingly in the adolescent. Obesity in adolescence will continue into adulthood and lead to later health problems. The adolescent has high food dense calories which high fat and low in fiber that can trigger obesity. Integrated Nutrition Programme (INP) is an intervention model for obesity with an emphasis on a low-calorie diet, low fat, high fiber, moderate physical activity, and nutrition counseling.Objective: This study aimed to evaluate the effect of INP on lipid profile and body composition in obese adolescents.Methods: Quasi-experimental study pre-post trial design with a total of subjects 18 obese adolescents. Duration of intervention in subjects for four weeks with a hypocaloric diet, low fat, high fiber, and prepared by a dietician. Moderate exercise and dietary counseling were conducted on the subject regularly. Bodyweight (BW) and waist circumference (WC) were monitored once a week. Food record intake is done before and during the intervention.Results: The mean weight loss of 1.55 kg. There is a difference in mean BW, WC, and BMI (p<0.01), whereas there were no significant differences in lipid profiles and body composition between before and after the intervention.Conclusions: INP can significantly affect weight loss, BMI, and WC as well as a significant increase in physical activity.
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Altavilla, Cesare, Annabelle Joulianos, José Miguel Comeche Guijarro, and Pablo Caballero Pérez. "Adherence to the Mediterranean diet, is there any relationship with main indices of central fat in adolescent competitive swimmers?" Archivos de Medicina del Deporte 38, no. 2 (April 26, 2021): 113–18. http://dx.doi.org/10.18176/archmeddeporte.00034.

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Introduction: The relationship between adherence to the mediterranean diet and central fat of adolescent competitive swimmers is under-studied. The fat component is interesting because of its relationship to the horizontal floatation and speed during the swimming performance. An accumulation of central fat is considered a negative factor for health and performance. This study aimed to check the degree of adherence to the mediterranean diet and its relationship with some indices of central fat in competitive adolescent swimmers. Material and method: A cross-sectional descriptive study was carried out. 74 adolescent swimmers participated in the study (males n= 34, 14.5 ± 1.3 y.o., females n= 40, 13.6 ± 1.2 y.o.). The swimmers completed the KIDMED questionnaire to assess their adherence to the mediterranean diet. A II level ISAK anthropometrist carried out the anthropometric data collection at the beginning of the evening swimming session. Results: The swimmers showed a medium adherence to the mediterranean diet. Male and female swimmers showed similar KIDMED index score (males 8.09 ± 1.5, females 7.23 ± 2.2). Age seems to be a detrimental factor in the adherence to the mediterranean diet during adolescence. Female swimmers showed a significant lower waist/hip ratio compared to males (-0.028; p = 0.01). The adherence to the mediterranean diet was not correlated with the anthropometric measures of central fat. Conclusions: Regardless of the adherence to the mediterranean diet, elevated swimming activity maintains indices of central fat in healthy values. Despite there was no correlation between adherence to the mediterranean diet and the anthropometric measures of central fat, there are reasons related to health to improve healthy eating habits of adolescent competitive swimmers.
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42

Franco Poveda, Kristy, Martha Holguín Jiménez, Geny Rivera Salazar, and Mercy Gordillo Ojeda. "Nutritional assessment of Nursing in pregnant adolescents." Espirales Revista Multidisciplinaria de investigación 3, no. 29 (June 3, 2019): 48. http://dx.doi.org/10.31876/er.v3i29.590.

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Introductionthe stage of adolescence is a vital process to become adults, where physiologically many changes are going to occur and eating habits will significantly influence this process. Pregnant women should maintain a balanced, varied and sufficient diet to avoid future nutritional complications related to inadequate intake, producing imperfections in fetal growth and development. Objectiveto assess the nutritional status of pregnant adolescents and identify the socio-psycho-cultural and intrafamilial factors that influence it. Materials and methodsQuantitative, descriptive and transversal. Technique: Observation and Direct Survey. Instrument: Questions questionnaire and direct observation matrix directed to pregnant teenagers. Resultspregnant adolescents between 17 to 19 years of age who were in the second trimester of pregnancy, with complications characterized by low weight, anemia, preeclampsia and gestational diabetes. Discussionthey live in precarious conditions or in an environment of violence, so that the maintenance of pregnancy or the growth of the infant will become difficult.Conclusions The pregnant adolescent is considered high risk due to the complications involved from the anato-physiological structure.
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Abdullahi, A., M. K. Anigo, A. O. Owolabi, U. Alhassan, A. B. Sallau, M. I. Awal, Y. S. Abubakar, et al. "NUTRITIONAL STATUS OF ADOLESCENTS OF DANKANDE COMMUNITY OF KADUNA METROPOLIS." FUDMA JOURNAL OF SCIENCES 5, no. 2 (July 7, 2021): 351–57. http://dx.doi.org/10.33003/fjs-2021-0502-624.

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Studies on the nutritional status of adolescents in Dankande community of Kaduna metropolis were carried out. Adolescence is a period between 10 to 19 years of age. This period is a critical period where a healthy diet is needed for proper growth, development, academic performances and human capital development. A validated semi-structured questionnaire was used to assessed socio-demographic characteristic of the adolescent caregivers and dietary pattern of the adolescent while weight, height and BMI were used to assess the anthropometry indices of adolescent. 37.2% of adolescents were between age 10-14 years while 62.8% were between 15-19 years. Also, 5.1% of the adolescents were married, 88.5 were single and 6.4% windowed. (19.2%) of adolescents has no formal education, (2.6%) completed primary school, (29.5%) uncompleted primary school, (2.6%) completed Junior Secondary School, (19.2%) uncompleted Junior Secondary School, while (1.3%) completed Senior Secondary and (25.6%) did not complete Senior Secondary respectively. However, on average (35.9%) of adolescent were dieting and (64.1%) were not dieting while (32.1%) were concerned about their weight and (67.9%) were not concerned about their weight. Few adolescents were losing control of their weight (24.4%) while the majority had their weight in check (75.6%), they engaged in physical activity (85.9%), while many adolescents spent more than two hours per day watching tv/games (69.2%). 17.9% engage in smoking while (5.1%) are involved in drinking alcohol, beer or wine. The nutritional status of adolescents of Dankande community of Kaduna state (56.4%) is good when compared with the national average
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Béghin, L., L. Dauchet, Tineke De Vriendt, M. Cuenca-García, Y. Manios, E. Toti, M. Plada, et al. "Influence of parental socio-economic status on diet quality of European adolescents: results from the HELENA study." British Journal of Nutrition 111, no. 7 (December 13, 2013): 1303–12. http://dx.doi.org/10.1017/s0007114513003796.

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Diet quality is influenced by socio-economic and geographical factors. The present study sought to assess whether adolescents' diet quality is affected by their parents' socio-economic status and whether the relationship between these factors is similar in northern and southern Europe. Data collected in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries were analysed. Dietary intake data were recorded via repeated 24 h recalls (using specifically developed HELENA Dietary Intake Assessment Tool software) and converted into an adolescent-specific Diet Quality Index (DQI-AM). Socio-economic status was estimated through parental educational level (Par-Educ-Lev) and parental occupation level (Par-Occ-Lev) as reported by the adolescents in a specific questionnaire. The DQI-AM data were then analysed as a function of Par-Educ-Lev and Par-Occ-Lev in northern European countries (Austria, Belgium, France, Germany and Sweden) and southern European countries (Greece, Italy and Spain). We studied a total of 1768 adolescents (age 14·7 (sd 1·3) years; percentage of girls: 52·8 %; 1135 and 633 subjects from northern and southern Europe, respectively). On average, the DQI-AM score was higher in southern Europe than in northern Europe (69·1 (sd 0·1) v. 60·4 (sd 2·8), respectively; P< 0·001; Δ = 12·6 %). The DQI was positively correlated with both paternal and maternal Par-Educ-Lev. However, this association was more pronounced in northern Europe than in southern Europe (P interaction = 0·004 for the mother and 0·06 for the father). The DQI was also positively correlated with Par-Occ-Lev (all P trends < 0·01), but this correlation was independent of the geographical area (P interaction = 0·51 for the mother and 0·50 for the father). In conclusion, Par-Educ-Lev and Par-Occ-Lev are associated with diet quality in adolescents in Europe. However, this association differs between northern Europe and southern Europe.
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Donizzetti, Anna Rosa. "La percezione del rischio in adolescenza: costruzione e validazione di strumenti di rilevazione." PSICOLOGIA DELLA SALUTE, no. 2 (November 2009): 145–62. http://dx.doi.org/10.3280/pds2009-002010.

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- If compared to other periods of life, adolescence is characterized by a tendency to implement more likely behaviours that can be harmful to health. The implementation of such behaviours stems from a complex system of assessments, in which the perception of risk is an important, though not exclusive (Petrillo, 2008), factor. To measure adolescence risk perception a question have been used to detect self-reported perceptions and another question for hetero-reported ones. In order to get less general and more suitable measures for this type of target five scales were constructed, referring to different spheres of behaviour (diet, exercise, consumption of alcohol and cigarettes, sexuality), through which subjects were asked to evaluate six possible negative outcomes for themselves and their friends, derived from each behaviour. The scales were administered to 1.107 students of Naples, almost equally distributed by gender (male 40.6% and 59.4% females) and with an average age of 15.7 years. The exploratory and confirmative factor analysis, conducted on each scale of perceived risk, self and hetero reported, showed monodimensional structures, with satisfactory psychometric properties.Key words: personal risk perception, risk perception of peers, adolescents, healthy behaviour, unrealistic optimism, detection scalesParole chiave: percezione del rischio personale, percezione del rischio dei coetanei, adolescenza, comportamenti salutari, ottimismo irrealistico, strumenti di rilevazione
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46

Lubaczeuski, Camila, Luciana Mateus Gonçalves, Jean Franciesco Vettorazzi, Mirian Ayumi Kurauti, Junia Carolina Santos-Silva, Maria Lúcia Bonfleur, Antonio Carlos Boschero, José Maria Costa-Júnior, and Everardo Magalhães Carneiro. "Vagotomy Reduces Insulin Clearance in Obese Mice Programmed by Low-Protein Diet in the Adolescence." Neural Plasticity 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/9652978.

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The aim of this study was to investigate the effect of subdiaphragmatic vagotomy on insulin sensitivity, secretion, and degradation in metabolic programmed mice, induced by a low-protein diet early in life, followed by exposure to a high-fat diet in adulthood. Weaned 30-day-old C57Bl/6 mice were submitted to a low-protein diet (6% protein). After 4 weeks, the mice were distributed into three groups: LP group, which continued receiving a low-protein diet; LP + HF group, which started to receive a high-fat diet; and LP + HFvag group, which underwent vagotomy and also was kept at a high-fat diet. Glucose-stimulated insulin secretion (GSIS) in isolated islets, ipGTT, ipITT, in vivo insulin clearance, and liver expression of the insulin-degrading enzyme (IDE) was accessed. Vagotomy improved glucose tolerance and reduced insulin secretion but did not alter adiposity and insulin sensitivity in the LP + HFvag, compared with the LP + HF group. Improvement in glucose tolerance was accompanied by increased insulinemia, probably due to a diminished insulin clearance, as judged by the lower C-peptide : insulin ratio, during the ipGTT. Finally, vagotomy also reduced liver IDE expression in this group. In conclusion, when submitted to vagotomy, the metabolic programmed mice showed improved glucose tolerance, associated with an increase of plasma insulin concentration as a result of insulin clearance reduction, a phenomenon probably due to diminished liver IDE expression.
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Haslinda, Lilly, Yanti Ernalia, and Sri Wahyuni. "Citra tubuh, Perilaku Diet, dan Kualitas Hidup Remaja Akhir Mahasiswa Fakultas Kedokteran Universitas Riau." Jurnal Ilmu Kedokteran 9, no. 2 (December 29, 2017): 95. http://dx.doi.org/10.26891/jik.v9i2.2015.95-98.

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Late adolescence (17-20 years) is when a child has made a career decision in the future. Body image in adolescentsassociated with eating disorders and psychological problems such as depression. Nutritional status is well alignedwith the quality of life of adolescents. This study aims to determine the body image, dietary behavior, and quality oflife in the period of late adolescence students of the Faculty of Medicine, University of Riau. This study was a crosssectionalanalytical study conducted at the end of the 87 teenage students of the Faculty of Medicine, University ofRiau. Selection of the subject of research conducted with total sampling. Measurements made with the body imagequestionnaire silhouettes body image, dietary behavioral data with the questionnaire (eating attitude test) / EAT-26,and the data Quality of Life with WHO-QOL questionnaire. Furthermore, the data presented descriptively. Of the 87respondents there were 25.3% (22) male subjects and 74.7% (65) female subjects. Based on BMI, there are morenutritional status (overweight and obesity) of 27.6%, less nutritional status (underweight) 17.2%. Based on abdominalcircumference there are 25.3% subjects felt obesity there are 51.7% research subjects who felt dissatisfied with herbody image. A total of 36.8% of research subjects perceive their bodies emaciated, 19.5% perceive overweight and1.2% obese perceived body image. A total of 9.2% of the subjects experienced the possibility of eating behaviordisorders. There are 43.7% of research subjects who have less quality of life.
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48

Boldt, Kevin, Graham MacDonald, Venus Joumaa, and Walter Herzog. "Mechanical adaptations of skinned cardiac muscle in response to dietary-induced obesity during adolescence in rats." Applied Physiology, Nutrition, and Metabolism 45, no. 8 (August 2020): 893–901. http://dx.doi.org/10.1139/apnm-2019-0726.

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Childhood obesity is a major risk factor for heart disease during adulthood, independent of adulthood behaviours. Therefore, it seems that childhood obesity leads to partly irreversible decrements in cardiac function. Little is known about how obesity during maturation affects the mechanical properties of the heart. The purpose of this study was to evaluate contractile properties in developing hearts from animals with dietary-induced obesity (high-fat high-sucrose diet). We hypothesized that obesity induced during adolescence results in decrements in cardiac contractile function. Three-week-old rats (n = 16) were randomized into control (chow) or dietary-induced obesity (high-fat high-sucrose diet) groups. Following 14 weeks on the diet, skinned cardiac trabeculae fibre bundle testing was performed to evaluate active and passive force, maximum shortening velocity, and calcium sensitivity. Rats in the high-fat high-sucrose diet group had significantly larger body mass and total body fat percentage. There were no differences in maximal active or passive properties of hearts between groups. Hearts from the high-fat high-sucrose diet rats had significantly slower maximum shortening velocities and lower calcium sensitivity than controls. Decreased shortening velocity and calcium sensitivity in hearts of obese animals may constitute increased risk of cardiac disease in adulthood. Novelty Cardiac muscle from animals exposed to an obesogenic diet during development had lower shortening velocity and calcium sensitivity than those from animals fed a chow diet. These alterations in mechanical function may be a mechanism for the increased risk of cardiac disease observed in adulthood.
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49

Branca, Francesco. "Physical activity, diet and skeletal health." Public Health Nutrition 2, no. 3a (March 1999): 391–96. http://dx.doi.org/10.1017/s1368980099000531.

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AbstractDiet and physical exercise concur in the determination of skeletal mass at the end of adolescence and in the conservation of it during adult life. The functional demand imposed on bone is a major determinant of its structural characteristics. Stress applied to a skeletal segment affects the geometry of the bone, the microarchitecture and the composition of the matrix. The stimulatory effect occurs when the skeleton is subjected to strains exceeding habitual skeletal loads, and the intensity of load is more important than the duration of the stimulus.Physical activity leads to greater bone density in children and adolescents and, to a minor extent, in adults. Weight bearing activities, such as walking, have a greater effect than non weight bearing activities, such as cycling and swimming. Reduction of loads as in bed resting or in space flights leads to bone loss. Intense training may cause damage, promptly repaired, as in stress fractures observed in army recruits. Female athletes may experience oligo-amenorrhea, though they still have a positive bone balance.There is an important interaction between the mechanical demands and the availability of nutrients to manufacture bone tissue. The increase in bone density in post-menopausal women is positively related to calcium intake when calcium supplementation is accompanied by exercise. When mechanical demands are low, such as during immobilisation, the intestinal calcium absorption is reduced. Calcium intake should also be analysed in the light of other dietary factors affecting the balance between absorption and excretion, and in combination with a number of other minerals, trace elements and bioactive substances with an impact on bone metabolism.
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Bettinelli, Maria Enrica, Elena Bezze, Laura Morasca, Laura Plevani, Gabriele Sorrentino, Daniela Morniroli, Maria Lorella Giannì, and Fabio Mosca. "Knowledge of Health Professionals Regarding Vegetarian Diets from Pregnancy to Adolescence: An Observational Study." Nutrients 11, no. 5 (May 23, 2019): 1149. http://dx.doi.org/10.3390/nu11051149.

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The number of people adopting vegetarian diets is constantly increasing, and many among them are young parents who decide to share their diet with their children. The aim of this study was to investigate health professionals’ knowledge regarding the adoption of vegetarian diets from pregnancy to adolescence. A cross-sectional survey was conducted. The administered questionnaire, which was based on the recommendations of the most up-to-date guidelines, included two macro areas: The first investigated the sociodemographic and professional profile of the interviewees and the second addressed the knowledge of the participants regarding vegetarian diets. A total of 418 health professionals in Italy were interviewed, of whom 65.8% were nursing staff. Among the participants, 79.9% had not attended a nutrition course in the previous five years. A correct definition of a vegetarian/vegan diet was provided by 34.1% of the participants. The answers regarding knowledge of nutrients were correct in 20% of cases, whereas correct answers to questions assessing knowledge of the risk and benefits of a vegetarian diet and the adoption of a vegetarian diet throughout the life cycle were given by 45% and 39.4% of the participants, respectively. A significant correlation between the items of the second macro area that investigated the knowledge and dietary habits of the participants was found for seven items. The results of the study indicate that health professionals do not have complete and exhaustive knowledge about vegetarian diets and lack information on health outcomes and the adoption of a vegetarian diet throughout the different life cycles and nutrients. Improving pre- and in-service learning opportunities in vegetarian nutrition for health professionals is strongly advisable.
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