Helping Teens Eat Well

A Responsible Approach to Healthy Eating

This is an abridged and edited excerpt from Savvy Eating for the Whole Family, Whole Foods, Whole Family, Whole Life by Margaret Kocsis, MD, FAAP

Like it or not, as kids become teens and adults, the responsibility for choosing healthy foods shifts out of parents’ hands. This is often a time of conflict as teens struggle to make independent decisions while parents have trouble relinquishing control. Conflicts can be especially heated when the parent does not feel that the teen is making good decisions, or when the teen feels that the parent is being rigid. Most teens want to make their own decisions.

On the other hand, many teens try to avoid assuming the daunting responsibility of their own nutritional welfare. These folks end up falling victim to America’s vast supply of fast foods and convenience products. Foods like pizza, burgers, and fries are easy to like, easy to obtain, and socially accepted by teen peers. Without guidance, these foods will become staples in a teenager’s diet. A child who has grown up eating fruits and vegetables at the family table will be less vulnerable to the influences of our fast food nation and will likely return to healthy eating practices, but all teens need help and support from their parents to transition into savvy eating.

Teens Need Independence

By the time children become teenagers, they have developed most of their food preferences. However, in their efforts to be independent, teens often develop new eating habits that may be very different from their parents. Teens often become vegetarian for philosophical reasons, jump on the fad diet bandwagon because they have become overly concerned with their weight, or adopt ultra-strict diets in order to obtain increased athletic performance.

When a teen makes a decision about his eating habits, it’s comparable to making a decision about what activities he will participate in. Dad may have dreamed that his son would follow in his footsteps and play baseball, but his son’s passion may be swimming team, tennis, or even theater. The son’s victories in swimming would seem a little hollow without Dad’s support, just as his accomplishments in baseball would seem hollow if the son played only to please his dad. So often a child’s ambitions, tastes, and desires are very different from his parents. Nevertheless, it is important for a teen to pursue his own interests, however different. Every teen needs his parents’ support and understanding, not necessarily his parents’ agreement.

While it’s important to respect teen’s independence, it is equally important to continue to provide fruits, vegetables, healthy proteins, and whole grains as a part of a balanced diet, and insist on eating at the family table whenever possible. The parent’s job is to provide healthy food even if the teen has a history of being a picky eater. It is the teenager’s job to eat it. Unless your teen adopts an eating style that is dangerous, try to support his decision. Sometimes it’s necessary to turn to a third party, like the teen’s doctor, for guidance.

You can’t make a teenager eat what you want any more than you can a toddler.

What you can do is:

• offer a variety of healthy foods,
• let your teen serve his own plate,
•  insist on eating at the family table whenever schedules allow,
• offer him food choices and the opportunity to help plan or prepare meals
• respect his burgeoning sense of independence, and support reasonable nutritional preferences
• be alert for signs of eating disorders (excessive weight loss, preoccupation with food or weight, refusal to eat with others, social isolation, dissatisfaction with self-image, fatigue, hair loss or loss of menses, visiting the bathroom frequently and for prolonged lengths of time after meals, etc.)

What you can’t do is:

• make him eat the nutritious food you have prepared

Independent Thinkers Often Boycott Meat

If your teen refuses meat, support his decision by serving more plant-based proteins like nuts, cheese, or beans to insure that he is getting enough protein. The whole family will benefit from eating less meat.  A vegetarian diet is a healthy choice for your family members as long as you know how to get plenty of protein. Because vegetarian diets are often deficient in Calcium, iron, zinc, and B vitamins it’s wise to take a vitamin and mineral supplement and have three servings of dairy calcium or a milk substitute daily.  Families that are vegetarian due to cultural beliefs are often adept at combining proteins because they prepare traditional time-tested ethnic dishes to get adequate nutrition. First-generation vegetarians are at increased risk of nutritional deficiency and could benefit from consulting a registered dietitian.

Don’t Squelch an Adventurous Spirit

Teens often branch out and try new foods that their parents wouldn’t think of eating. If your teen decides to eat tofu, seaweed, quinoa, or wheatgrass juice, learn more about them yourself. You might find a new healthy food you like! If your teen decides to eat more fruits and vegetables to get more antioxidants, make sure you have an ample supply of healthy produce in the refrigerator even if you don’t eat them. If he decides to give up junk food, make healthy foods available. Sometimes enthusiastic teens can help the whole family to eat better. Enlist your teenager’s help in shopping, meal planning, and preparing food. These are skills that your teen will need for independent living.

Teen Eating Machines

Teens are notorious for consuming enormous amounts of food. At the peak of growth (around 11-13 for girls and 14-16 for boys) girls need to eat around 2200 calories a day, and boys need about 3000. Teens in sports often need more. That means that some teenage boys can easily eat twice as much as a small adult woman!

When hunger strikes, teens will often consume large quantities of whatever is available. If healthy foods are available when teens need to eat, then that is what they will eat. Limit how much chips, pretzels, cookies, crackers, and other junk foods you keep in the house for snacks. These foods are easy in large quantities, leaving little room for nutritious foods that growing teens need. Stock up on fruit, yogurt, nuts, whole grain cereals, skim milk, peanut butter, and whole grain bread. Let your teen know which leftovers can be eaten as snacks. A leftover salad, bean burrito, or pasta dish is a much better snack than a bag or two of chips. Teen diets are often deficient in calcium, iron, vitamin A, and vitamin C. Snacks should include at least one of these nutrients. See the table below.*

Teens Need to Fit In

Just as most teens feel the need to wear clothes that are acceptable to their peers, they may feel the need to eat in a way that is acceptable to their peers. This is not a need born of logic, but never the less an integral part of many teens’ social lives. While it is not my intent to encourage anyone to go with the flow just to gain social acceptance, it is wise to cut your teen some slack when he wants to eat pizza or fast food with his friends. As long as he is not eating fast food more than two or three times a week, and does eat at least one meal at the family table most days, allow him some freedom to choose. His diet does not need to be perfect.

Start the Day the Right Way,

Unfortunately, teens’ demanding schedules make healthy eating challenging. Middle and High school students often leave the house for school before eight o’clock. About half of those teens skip breakfast on a regular basis. Some claim there is no time to eat. Others say they just aren’t hungry first thing in the morning. Many skip breakfast because they think it will help them lose weight.

Make no mistake! Breakfast is essential. School performance, driving ability, general health, sports performance, and mood all suffer when breakfast is skipped. Daily breakfast also helps prevent obesity.

Those who have too little time to sit and eat a bowl of cereal can eat a granola bar or drink a milk (or soy) based breakfast drink. A liquid breakfast is better than no breakfast. A large percentage of teens don’t get enough calcium in their diets. Adding a calcium source (like milk, yogurt, fortified juice, or cereal bars) at breakfast puts them well on their way to getting the three or more servings of calcium-containing foods that they need each day.

Unconventional breakfasts are fine. If your teenager wants leftover pizza for breakfast, let him. While there are more nutritious things to eat, at least he is starting the day with enough calories and some protein.

Daily fast food breakfasts, however, are not acceptable. “Fast food” is a misnomer. Don’t fool yourself, nobody can get in the car, go through a busy drive-through, and eat a biscuit in less time than they can grab a yogurt from the refrigerator.

Those who aren’t hungry or are nauseated by food first thing in the morning probably need to eat breakfast even more than most folks. Those who have experienced “morning sickness” with pregnancy understand how these breakfast skippers feel. When energy needs go up as in times of teenage growth, overnight fasting causes the blood sugar to drop. Because you’re sleeping rather than eating, your body shifts to a lower metabolic state or starvation mode. The feeling of hunger is decreased, but the need for calories is not. Low blood sugar can cause some people to experience nausea.

Having a protein-containing snack like peanuts or a glass of milk at bedtime can help level out blood sugar through the night and can alleviate morning nausea. Avoiding sweets with the last meal of the day can help too. If nausea persists, start slow in the morning with a glass of milk or juice, but don’t give up on breakfast. Brainstorm with your teen and make easy options available.

Diet Dilemmas

Many teenage girls start to diet as their natural feminine curves start to develop at puberty. Because pop culture highly prizes the thin androgynous physique, many girls mistake their new curves for excess fat. While only 20 percent of teenage girls are overweight, seventy percent of teenage girls express a desire to lose weight.

Athletes often want to force their bodies to look like those on the covers of muscle and fitness magazines. These are not realistic goals for most people, and no amount of protein supplementation and fat deprivation will make most teenage bodies look like Arnold Schwarzenegger.

While athletes’ bodies do need extra calories, protein, iron, calcium, vitamins, and other nutrients, teen athletes do not need the protein supplements sold in health food stores. Unless they are on a low-protein vegetarian diet, the savvy eating plan described in Savvy Eating for the Whole Family plus a daily multivitamin with iron and calcium will provide excellent nutrition for the average teen athlete.  By consuming more calories to supply his energy needs, an athlete who eats a source of complete protein at each meal and most snacks will automatically get plenty of protein for his growing body.

If your teenager decides to go on a specific diet, don’t minimize the importance of his decision. Your child is feeling angst over some aspect of his health and body. He may need to lose some weight, or merely want a more ideal physique. If you demonstrate to your child that you cannot see things from his point of view by discounting his concerns, he will be less likely to listen to your advice or come to you for help.

If your child wants to diet, acknowledge his feelings even if you don’t agree. He may hide his dieting from you if you show him that you don’t understand the way he feels. Make sure his goals are realistic. No teen should try to live on 500 calories a day, eat only grapefruit, or shun carbohydrates entirely to lose weight. Extreme diets do not result in healthy weight loss and have great potential for harm.

Even less extreme diets can be harmful. Magazines popular with teens often promote diets that shun foods perceived to be “fattening foods”. Unfortunately, these foods are often the foods that teens need most, like calcium-rich milk, protein-rich meat, and healthy fat and protein-containing nuts.

Show your teen support by educating him as well as yourself about his nutritional needs. Any teen who decides to make a dramatic change in his diet during this critical period of growth should have a check-up with a physician.  You need to make sure that your teen’s diet is safe, then back off and let your teen eat.

When Not to Back Off

Allowing your teen the right to make his own choices does not mean that you don’t need to watch for signs of danger. Eating disorders are common, especially in girls. Anorexia Nervosa (severe weight loss resulting from unrealistic body image and extreme caloric restriction) and bulimia (characterized by binging on large amounts of food, then purging by vomiting, using laxatives or extreme dieting or exercise) commonly develop in the mid-teen years. If your child shows signs of an eating disorder, professional intervention is mandatory.

Signs of Eating Disorders

 Anorexia

• • Marked weight loss
  • Loss of menstrual periods
  • Compulsive or excessive exercising
  • Odd or obsessive eating behaviors
  • Depressed mood
  • Perceiving oneself as fat in spite of weight loss
  • Usually denies that behavior is abnormal

Bulimia

• • Frequent weight loss or gain
  • Episodes of eating huge quantities of food
  • Fear of losing control of eating, being unable to stop
  • Frequent severe dieting or fasting
  • Low self-esteem, shame
  • Awareness that behavior is abnormal
  • Depression

Both anorexics and bulimics may purge (laxative abuse or vomiting after meals) but they can be very secretive.

Supplements

Are nutritional supplements safe for teens? That depends on the supplement. A multivitamin containing no more than the recommended daily allowance (RDA) of vitamins and minerals is a safe and time-tested beneficial practice. If your teen does not eat meat on a daily basis then the supplement should contain iron. If your teen does not drink at least three servings of milk or eat at least three servings of calcium-fortified foods, the supplement should contain calcium too.

Mega doses of vitamins and minerals are risky at best. Overdoses of some vitamins and minerals like vitamin A and iron are toxic. Mega doses of other supplements have little benefit. The body can only absorb a limited amount of most vitamins and minerals. Mega doses of vitamin C, for example, is not used by the body and just make expensive urine.

Don’t be fooled by the “all-natural” claim. Just because the manufacturer claims that a product is natural it does not in any way imply that the product is safe. Cyanide and arsenic are “all-natural” as well as deadly. Most major brands of vitamins in the US are safe, but it’s a good idea to consult ConsumerLab on the internet for safety testing information.

Are herbal supplements and remedies safe? Some are; some aren’t. Be sure to let your doctor know if you are taking any herbs or supplements. Traditionally trained physicians are knowledgeable about common supplements, but if a supplement you want to take is new or less common, make sure you talk with your doctor and give him or her time to research your supplement before starting an alternative remedy.

Steroid muscle-building hormones (like androstenedione) and amphetamines (uppers or pep pills) are dangerous and should not be used. Many nutritional supplements marketed to athletes as performance enhancers have been shown to be contaminated with steroids and toxic chemicals like lead. Others just don’t deliver the desired results. Remember, the government does not regulate dietary supplements’ safety or health claims. Buyer beware!

 

Summary

The teen years can be challenging. It is a time to make sure you maintain communication with your child and refrain from making judgments. Your teen has the best chance of developing and continuing healthy eating practices if you follow these guidelines:

• • Be aware that teens need to make independent decisions that reflect their social, ethical, and taste preferences. It is time for you to gradually render control.
  • Teens’ preferences are often very different from their parents. Support their decisions, however different from yours, as long as they are safe.
  • You cannot force a teen to eat well, but it is your job to provide him with nutritious food and a Family Table on a daily basis.
  • Provide breakfast daily.
  • Teens have special nutritional needs including an increased need for calcium, iron, calories, and vitamins A and C. Provide snacks and meals with these issues in mind.
  • Teens face a great deal of social and emotional pressures that affect their nutrition. Be understanding of their desire to diet, but make sure that their goals are realistic and that dieting teens are seen by a health professional at least annually.
  • Be alert for signs of eating disorders.

 

*Examples of foods high in nutrients that teens need

High iron foods	High calcium foods	Foods high in Vitamin A	Foods high in vitamin C
Beans Iron-fortified cereals Chicken, beef, pork Nuts and sunflower seeds Dried plums and apricots	Skim milk Yogurt Fortified soy or pea milk Fortified fruit juice Fortified tofu cheese	Orange or yellow fruits like cantaloupe, apricots, mangoes, and nectarines Orange or yellow vegetables like carrots and squash Tomatoes Watermelon Red bell peppers broccoli	Broccoli and other dark green veggies Peppers Oranges and other citrus fruits Melons Berries Potatoes (not chips or fries)

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