ABOUT THE AUTHOR
Paul Salter, MS, RD, LD, CSCS
Paul is a Registered Dietitian and Sports Nutrition Consultant with Renaissance Periodization. He's the
former Nutrition Editor for Bodybuilding.com and former Sports Dietitian for IMG Academy, which is a
prep boarding school for elite youth athletes and training facility for Collegiate, Professional, and
Olympic athletes alike.
The past few years, Paul has worked 1:1 with 800+
men and women, helping them to transform their
lives while collectively losing thousands of pounds of
body fat and building hundreds of pounds of muscle.
His passion is sustainable weight-loss and he's known
by many for taking a detailed and long-term
approach to pre- and post-diet weight maintenance
phases. He appreciates being compensated in peanut
butter.
ABOUT THE AUTHOR
Dr. Jen Case, PhD, RD, CSCS
Dr Jennifer Case holds a PhD is Human Nutrition and is a Registered Dietitian (RD). Jen is also a
Certified Strength and Conditioning Specialized and Brazilian Jiu Jitsu Black Belt. She is currently a
nutrition
and
fitness
consultant
for
Renaissance
Periodization and works with athletes and active
individuals of all ages. When not working with clients or
training in her beloved sport of jiu jitsu, Jen enjoys
exploring her creative side through glassblowing and
stained glass.
TABLE OF CONTENTS
INTRODUCTION
1
ADOLESCENT DEVELOPMENT AND STAGE OF READINESS
11
TALKING ABOUT FOOD
20
FUELING THE ADOLESCENT, AND CONSEQUENCES OF LONG-TERM ENERGY RESTRICTION
34
BUILDING A PREMIUM FUEL PLATE
50
HYDRATING YOUR ADOLESCENT
71
ADDRESSING WEIGHT CHANGE
90
FOSTERING A HEALTHY HOUSEHOLD
114
NUTRITION SUPPLEMENTS AND ERGOGENIC AIDS
125
FAQS AND SPECIAL TOPICS
137
CHAPTER 1
INTRODUCTION
By reading this book, you’re taking a big step towards better understanding the
nutritional needs of adolescents. You’re also equipping yourself with winning strategies
for instilling a foundation of healthy eating that will support the adolescent’s optimal
growth, development, and performance, be that athletic, academic, or otherwise.
When we say “adolescent”, specifically, our discussion targets ages nine through
seventeen, which we break down further into pre- and post-puberty in later chapters,
and discuss the impact puberty has on nutrition needs. While much of what we discuss
can (and should) absolutely be applied to children younger than nine, we made this our
cut-off for this text because this is when nutrient needs and strategies to discuss
nutrition begin to change.
Children have sponge-like minds, and are very observant of the behaviors surrounding
them. In fact, they’re so absorbent and observant, that the likelihood of them turning a
commonly observed behavior into a habit of their own is quite high.
Research examining the relationship between the weight (or BMI) of parents and that of
their children suggests that one’s weight may have a larger influence than believed. For
instance, a study published in the journal Obesity sought to determine the impact that
having at least one obese parent has on children very early on in life.1 Children with
obese parents gained significantly more weight between 0 and 24 months and showed
signs of higher appetite scores. Moreover, in a study published in the Journal of
Pediatrics, researchers analyzed several risk factors that increase the likelihood that a
child would become obese, and observed that “the strongest direct effect on childhood
overweight was parental overweight.” 2
1
Such findings are not meant to scare you, or increase the already considerable pressure
on you as a parent, or to imply that overweight parents “teach” their children to also
become overweight, as the complex interplay of nature and nurture is the likely culprit
for the described phenomenon.
It’s important to note that it may not be specifically the parent’s weight in these studies
that had a negative influence on the children’s weight, but rather the parents eating,
exercise, and lifestyle habits - being overweight or obese was likely a consequence of
poor habits.
That said, statistics like these certainly illustrate the correlation between
the weight, and hence the overall health, of parents and their children.
And, while we’re all endowed with unique genetics that will play a part in
our - and our children’s - health and appearance, the practices that help
ensure a lifelong habit of healthy eating are largely applicable to the
majority of us. While the cited studies are instructive, they remain
inconclusive, as they do not provide us with the contribution of genetics
to the body weights of the adolescents studied. Further complicating
matters, studies that directly examine the effect of the home
environment tend to show very small effects of that environment on the
body weight and health of teens. That said, small doesn’t mean
negligible, and may well be worth pursuing from an “every little bit helps”
standpoint.
Yes, this book will detail how to optimally fuel the adolescent, but it will also emphasize
that healthy eating habits that, when successfully instilled, will continue to serve the
adolescent for decades to come and may have a positive influence on their ability to
maintain a healthy weight as they approach and enjoy adulthood.
2
The Purpose of this Book
The purpose of this book is to
provide you, the parent, guardian, or
coach - aka role model - with
pertinent nutrition information about the adolescent based on age, size, maturity, and stage of
readiness. No less important, it also aims to provide you with techniques and strategies for effectively
communicating this information to an adolescent. And trust us when we say this will prove challenging!
In this book, you’ll learn, among other things:
● How energy and nutrient needs are impacted by growth and puberty
● How to navigate nutrition-related conversation and questions from the adolescent
● How to foster a household of healthy eating
● How to use several tools and strategies to potentially foster some change in your athlete’s eating
habits
● How to build a premium fuel plate and premium snack
● How to fuel the adolescent athlete for specific types of workouts and sport practices and
competition
● How to navigate conversation related to sports nutrition supplements
And, yes, we will talk plenty about getting through to those picky eaters!
It’s my hope that this book helps you better educate and fuel the adolescents, so that they may, in
turn, experience the multitude of benefits associated with healthy eating and optimal performance, be
that on the court, in the classroom, or while simply enjoying this tumultuous but exciting time in their
lives. And, during this time, you, as their guardian, have the opportunity to potentially help shape some
3
their eating habits for the better. Embrace this opportunity and attack it with love, tenderness, and
tenacity!
Your Role As The Parent,
Guardian, or Coach
Guardian, or Coach
As a parent, guardian, or coach, and
also as a role model, you have the
potential opportunity to positively
shape some of the eating habits of adolescents for years to come. At this time, however, research
examining the impact of a parent’s eating habits on the long-term eating habits of children indicates
that such effects are likely small, but the acute impact is undoubtedly significant. In other words, while
you might not have a ton of control over what eating habits your kids will adopt as adults, you do have
a lot of control about what they eat when they are kids under your care; and that time is almost
certainly highly impactful on their development.
At this stage in life, adolescents are highly malleable, and seek information from a variety of sources think peers, coaches, celebrities, professional athletes, peer’s parents, and the oh-so-reliable internet.
You are in a unique position to provide them with reliable information that will help them learn how to
fuel appropriately to support growth, a healthy lifestyle, and, of course, optimal performance in
athletics, academics or most other pursuits. And, hey, although we cannot definitively say this will help
them grow up to be Registered Dietitians and masters of healthy eating, we can say that providing a
positive influence now is better than not providing one at all!
It’s always important to recognize the motives and goals of each information outlet you may
encounter, so you can help the adolescent assess the quality and relevancy of the information being
provided by any given source.
4
In other words, “But Tom Brady is doing it!” isn’t a sufficiently good justification for your sixteen-yearold to ditch dairy.
What follows is a list of the most common sources for nutrition advice consulted by young people
(particularly those involved in organized sports):
Coaches
Those who coach typically get involved
for two reasons: to positively influence
young lives, and to win. Typically, it’s a
combination of the two, but as your
athlete ages, there’s a natural shift
towards the focus on winning. This is
often reflected in the way a coach
discusses nutritional strategies. Although they may have the best of intentions, the advice provided –
whether solicited or not – isn’t necessarily accurate, reliable, or, to be “tried at home”.
Take the sport of wrestling, for instance. Coaches are most concerned with teaching basic technique
and rules of the sport to their young athletes. But, as early as middle school, coaches are already
discussing cutting weight as a means to be more competitive. As we’ll discuss in detail later on, this can
be a downright dangerous practice that risks jeopardizing a young athlete’s long-term potential in the
sport, and even physical development.
(Note: Fortunately, large youth wrestling organizations are beginning to implement standard practices
that objectively determine the minimum weight at which each athlete can wrestle, based on a
preliminary weight and body composition assessment completed in a hydrated state. This is a major
step in the right direction for a sport previously characterized by dangerous weight cutting practices.)
5
For the record, we’re by no means singling out coaches, and, on the contrary, want to thank you for all
you do! The reality is that some coaches do take the desire to win too far, making the overzealous
coach worth mentioning as a potential source of bad information.
Peers
The adolescent’s peers are typically as
ignorant as he or she on topics of
nutrition,
or,
worse
yet,
terribly
misinformed by an unreliable source –
think older kids – and on a mission to
spread that info to anyone who’ll listen.
And all-too-eager fellow adolescents
who will try anything to be in the “in” crowd certainly will. No wonder use of synthetic human growth
hormone and steroids has risen exponentially among high school students the past 20 years.4,5
Professional Athletes
Most professional athletes are in the
spotlight far more than they care to be.
As a result, their every bite is under a
microscope, for the world to see. Given
that many an adolescent athlete aspires
to play professionally at some point,
these athletes are major role models for
them. And when an athlete speaks out about his or her nutritional beliefs or has them dissected on
television or social media, you better believe your aspiring athlete will know about it.
Take Marshawn Lynch, former running back for the Seattle Seahawks and Oakland Raiders and his
infatuation with Skittles. He has been seen eating skittles on the sideline during games and is officially
sponsored by Skittles. Probably not the best idea for already hyper, moodswing-prone young athletes
to be eating Skittles all day long…
6
Parents of Peers
These days, everyone is a nutritionist.
The
internet
has
made
nutrition
information wildly available, and this has
led
to
incorrect
misguided
and
downright
information
getting
disseminated like wildfire. Surely, the
parents of your child’s classmates mean
well, but are their nutritional pointers appropriate, or even safe, for the adolescent?
Again, it isn’t our intent to attack your school’s or neighborhood’s healthy eating crusaders, but rather
to recommend weariness of today’s internet-educated, self appointed nutritionists. Often times, folks
will resort to the first article they find on Google, or trust a poorly cited news story when making a
nutrition decision. The convictions of those “playing nutritionist” with nutrition information presented
by the media or gathered online can range from the kind that’s not advisable for anyone, to the kind
that may be applicable to only some groups, not including that of adolescents. So, just because a shot
of wheatgrass is helping the forty-four mother of three through the day, doesn’t mean your thirteenyear-old needs it.
And, an adolescent’s susceptibility to bad information may be further compounded by an overly
aggressive presentation of it. You know the type: someone who’s constantly crusading to expose
everyone they meet to their beliefs, those on nutrition included. Your twelve-year-old swimmer
doesn’t need to eat an organic, carbohydrate-free, meatless Monday kind of diet (unless of course she
chooses to, but that’s a different story…)
The point is that, in today’s day and age, you are up against a tough slew of competitors vying for
control of the adolescent’s eating habits. That’s why getting a firm grasp on your own nutrition, and
then taking the necessary steps to build and foster a foundation of healthy eating habits for the
adolescent is critical at this time in both your lives. Fortunately, by the time you finish this book, you’ll
7
be well-armed to mount an impeccable defense against the “nutritional noise” barageing the
adolescent’s ears.
What This Book Is Not
This book is not an individual meal
plan for you or the adolescent.
Although we will share sample
recipes and daily meal plans, these will be provided to illustrate specific points within the text, and to
show you examples of what an adolescent’s daily intake might look like. Please do not simply mimic
this plan, as doing so would remove all individualization, and thereby yield a sub-optimal solution for
the adolescent’s nutritional needs.
Furthermore, information presented doesn’t supplant or substitute information from a medical
professional. This includes the adolescent’s primary care physician, and any other part of their medical
team. If you’re seeking personalized nutrition coaching or information regarding the adolescent’s
needs, please reach out to us and we will put you in touch with one of our Registered Dietitians.
8
LIABILITY DISCLAIMER
This book reflects the knowledge, research, and ideas of two registered dietitians. Any
user (whether you, your child, your sister, your neighbor, or any other recipient) of this
book should always consult their physician and/or regular healthcare practitioner before
beginning a new fitness program, diet, or supplement regimen. You should not rely on
the information contained within this book as a substitute or replacement for
professional medical advice, diagnosis, or treatment. If you have any concerns or
questions about your health, you should always consult a physician and/or other
healthcare professional first. Do not disregard, avoid or delay obtaining medical or
health related advice from your physician and/or other healthcare professional because
of something you may have read in this book, any other Renaissance Periodization
product, Renaissance Periodization website, or any other form of Renaissance
Periodization content.
We are not doctors and we do not claim to help cure, render aid, provide interaction,
diagnose, prognose or provide treatment of any kind for any condition or disease. The
use of the information provided through this book is solely at your own risk. The
publisher and the authors disclaim responsibility for any adverse effects resulting
directly or indirectly from the information contained in this book.
9
REFERENCES
1. Fuemmeler, B. F., Lovelady, C. A., Zucker, N. L., & Østbye, T. (2013). Parental obesity moderates the
relationship between childhood appetitive traits and weight. Obesity, 21(4), 815-823.
2. Agras, W. S., Hammer, L. D., McNicholas, F., & Kraemer, H. C. (2004). Risk factors for childhood
overweight: a prospective study from birth to 9.5 years. The Journal of pediatrics, 145(1), 20-25.
3. McLoone, P., & Morrison, D. S. (2012). Risk of child obesity from parental obesity: analysis of repeat
national cross-sectional surveys. The European Journal of Public Health, 24(2), 186-190.
4. Steroid Abuse Moves Into the Scholastic Arena. (2008, April). Education Digest, p. 52.
5. Abuse, N. I. (2006). Anabolic Steroid Abuse. Washington DC: US Department on Health and Human
Services, National Institutes of Health.
10
CHAPTER 2
ADOLESCENT DEVELOPMENT AND
STAGE OF READINESS
There are three major variables that will influence how to optimally fuel the adolescent,
as well as how to approach specific nutrition topics. These are the adolescent’s:
1. Physical Development
2. Cognitive Development
3. Social-Emotional Development
To properly ascertain his or her state of readiness for nutrition education or behavior
change suggestions, you must first assess the adolescent’s holistic development across
these three types.
Often, we are guilty of making assumptions about a youth’s stage of readiness for
handling nutritional changes or recommendations based on his or her age. While age is
a guideline that governs physical, cognitive, and social-emotional development, not
every adolescent develops in all three of these areas precisely in step with the chart in
the pediatrician’s office.
So, rather than assume your adolescent is ready for in-depth nutrition conversations
because she’s thirteen, your job is to assess her development in each of the
aforementioned dimensions, to get a good sense of her holistic readiness for receiving
nutrition education.
11
Below, we’ve categorized development into three distinct age groups:
1. Early Adolescence: Pre-Puberty
2. Middle Adolescence: During Puberty
3. Late Adolescence: Post-Puberty
To help you better understand what to expect of the adolescent during each age range,
we will now describe the agreed-upon norms for physical, cognitive, and socialemotional development in each respective section.
12
Early Adolescent:
Pre-Puberty
Age: 10-13
Physical Development
Note: In Chapter 5, we’ll discuss
specific energy and nutrient needs
pre- and post-puberty, as well as how puberty impacts the adolescent’s needs. In this section, we’ll start
by presenting a brief overview of expected signs of physical development pre- and post-puberty.
Up until puberty, boys and girls are similar in height and weight. Most adolescents can expect to gain
five to seven pounds and one to three inches per year. So, before puberty hits, so long as the
adolescent isn’t significantly above or below average height and weight for his or her age, normal
development is likely taking place. (Of course, if the adolescent is in fact drastically above or below the
norm in height or weight, the adolescent’s physician and possibly a Registered Dietitian should be
involved, in order to rule out or treat possible health conditions and potentially recommend changes to
the adolescent’s nutrition.) More information about appropriate growth, height, and weight for your
adolescent’s age can be found on the Center for Disease and Control’s website.
Cognitive Development
Before puberty, the adolescent is going to have a difficult time grasping future-oriented concepts. For
instance, the thought of eating whole grain bread for its lifelong health benefits is a bit mind-boggling
for a prepubescent child. By and large, he or she simply cannot comprehend this type of long-term
planning.
As he or she ages, however, the ability to think long-term expands. At this point, the young person is
caught up in the present, and is continuing to develop his or her ability to think abstractly (a
noteworthy tip for effectively presenting nutrition information to young people of this age group, but
more on that in a bit).
13
Social-Emotional Development
Social-emotional development during the prepubescent years is characterized by an intensified
struggle for identity, an increased desire to “be normal”, and also by learning how to manage peer
pressure and social influence.
A challenging age, to say the least!
As the adolescent works to uncover him or herself, and figure out how the beliefs and behaviors of
peers inform who he or she wants to be, you’ll likely experience a greater push for independence, and
testing of house rules. This may manifest as frequent fighting over meal and snack choices, or even
strong requests to prepare his or her own food. It’s important to be supportive during this stage of
development, especially in light of the double whammy of intense internal and external pressure
young people experience during its course.
Middle Adolescence:
Puberty
Age: 13-15
Physical Development
Girls typically hit puberty at least 12
months before boys. On average,
girls experience it between the ages of 10 and 12, and boys between the ages of 12 and 14. Puberty is
characterized by the development of secondary sex characteristics, such as body and facial hair in
males, and breast and hip development in females. Both genders will experience major growth spurts,
increased perspiration and an increased production of oil in the hair and on the skin.
14
Girls will begin menstruating, and will typically experience a major growth spurt six to twelve months
before the onset of their first menstrual cycle. Boys will experience growth in their testicles and penis,
a deepening of their voice, and an increase in overall muscle mass.
Cognitive Development
During puberty, your young adult will continue to experience a greater capacity for future-oriented and
abstract thinking. This is when he or she will also begin to understand the importance of goal setting,
and the positive impact that doing so can have on his or her life.
This is an exciting time!
At this stage of development, your young adult may be ready to take on a bit more detail and goaloriented discussion regarding his or her nutritional habits. Finally, the seeds of healthy eating habits
you’ve been patiently and diligently planting up until now are beginning to take root. At last, now is
your chance to start making your nutritional knowledge stick!
Social-Emotional Development
The latest mighty challenge facing your young adult in this stage will be to adjust to his or her new
body.
For girls, this may prove particularly difficult, as her once slim physique develops into a fuller figure,
with wider hips and breasts. To complicate matters, social acceptance also becomes a top priority
during this time. The conflation of these two realities have a major impact on nutrition and exercise
habits. As such, it’s vital to understand what your pubescent child is going through, so you may choose
the appropriate tone, wording and information to present about nutrition. To lend a hand with this,
Chapter 7 details how to address weight change goals with the adolescent.
15
Late Adolescence:
Post-Puberty
Ages: 16-18
Physical Development
Boys typically experience a longer
growth spurt than girls, and may
continue growing until they are 21. Girls, on the other hand, are typically fully developed by age
seventeen. After their initial growth spurt, females and males continue to develop into their respective
adult bodies, though rate of growth drastically slows compared to the rate during the initial growth
spurt.
Cognitive Development
Your young adult will now develop greater capacity for abstract thought and reasoning, as well as a
stronger interest in, and concern for, the future. He or she will also begin to learn the skill of impulse
control, or saying to him or herself: “That cookie can wait”. It’s at this stage that you can help your
young adult practice the oh-so-valuable skill of delaying instant gratification, by not using food as a
reward. (Importantly, we’re certainly not recommending to wait until late adolescence to avoid using
food as reward! On the contrary, we recommend doing so from a young age, as we’ll discuss down the
road.)
But, late adolescence is the stage of readiness when your young adult gains the ability to cultivate
saying “no” in the short term, in favor of long-term or delayed success. In respect to nutrition, he or
she will learn to say “no” to frequent offerings of dining out, fast food, desserts, and even alcohol, out
of the desire to mitigate the adverse effects such indulgences can have on his or her academic or
sports performance, physical wellbeing, and waste line.
16
Social-Emotional Development
As your young adult enters the late teenage years, he or she will likely have a firmer sense of self. Even
still, consistent emotional stability may continue to be lacking, and a preoccupation with the way
others see him or her will likely persist. Additionally, he or she will begin to exert more independence.
Stage of
Adolescents*
Physical Development
Cognitive Development
Social-Emotional
Development
Difficult time grasping
future-oriented
concepts.
Characterized by an
increased struggle
learning who he or she
is, trying to be normal,
and learning how to
manage peer pressure
and social influence.
Up until puberty, boys
and girls are similar in
height and weight.
EARLY
Adolescence:
Pre-Puberty
MIDDLE
Adolescence:
Puberty
LATE
Adolescence:
Post-Puberty
Most adolescents can
expect to gain five to
seven pounds and one
to three inches per
year.
Development of
secondary sex
characteristics
Greater capacity for
long-term thinking and
abstract thought.
Females experience
first menses
Betted understanding
of long-term planning
Girls typically continue
growing until age 17
whereas boys may
grow until age 21
Greater ability for
abstract thought and
reasoning
Stronger interest in
the future
17
Feel out of comfort
zone adjusting to
maturing body and
trying to find social
acceptance.
Continue
development of
emotional stability
Firmer sense of self
Assessing Stage of Readiness
The purpose of the above sections was to give you an overview of traditional stages of development
pre-, during, and post-puberty. An aggregate assessment of the adolescent’s physical, cognitive and
social-emotional maturity during each phase of his or her adolescence serves as a better guide than his
or her biological age for when and how to address specific nutrition subjects with him or her.
For instance, a nine-year-old will struggle to appreciate the benefits of saying “no” to nightly candy
before bed. Your sixteen-year-old, however, can likely grasp the merits of delayed gratification. But
again, this is a rough age-based group of observations and guidelines, that are more fluid than set in
stone, and so, again, assessing each particular adolescent’s readiness is key.
For example, your eleven-year-old daughter may not yet be able to fully grasp the concept of longterm consequences, but perhaps she’s beginning to show curiosity about goal setting. Say you’re
looking to help her reduce the number of nighttime treats she comes to expect during the week. First,
you need to recognize her stage of readiness for this nutritional goal.
If you take the approach of informing her about the implications that nightly ice cream now may have
on her health in ten, five or even a couple of years, you’ll likely strike out. Conversely, if you suggest
that reducing the number of nighttime treats each week to a number of her choosing will help her feel
better, perform better or like her body better, she will be far more eager to take action to meet or
exceed this goal.
In this latter scenario, you both win.
18
REFERENCES
1. Stages of Adolescent Development. (2008). American Academy of Child and Adolescent’s Facts for
Families. Retrieved from:
https://www.prearesourcecenter.org/sites/default/files/content/6._stages_of_adolescent_develo
pment.pdf
19
CHAPTER 3
TALKING ABOUT FOOD
Talking about food with your sugar-fueled, emotionally-charged youth may prove to be
more challenging than squatting double your bodyweight. The language, tone and
manner you assume, as well as how you initiate conversations about the adolescent’s
nutrition all matter. When trying to elicit positive change in the adolescent’s eating
habits, the information you disseminate and your approach to doing so may have longlasting ripple effects.
At the end of the day, you’re talking to a vulnerable, impressionable adolescent.
This fact notwithstanding, it’s quite common for adults to fall into approaching the
adolescents in their lives as, well, other adults. With older teenagers especially, it’s all
too easy to assume a comparable level of maturity to yours, and place demands and
expectations on them that are similar to those you place on yourself. But, no matter
how mature a young adult may seem,
pushing their emotional and cognitive
boundaries may backfire and set the stage for unhealthy habits and thoughts regarding
food and themselves.
One small tweak to your mindset and approach to conversing about nutrition with the
adolescent can stem from remembering that, for him or her, food is fun. Sure, to
sensible, responsible adults, food is some part fun but large part fuel. But, to the
adolescent, food is primarily a source of pleasure, and often a social pleasure, shared by
family and friends.
20
Do not take the fun out of food for him or her.
This is especially true in prepubescent adolescents, who aren’t going to be concerned
about the nuances between food choices or give much thought to the long-term health
implications of the choices they’re making today. In your prepubescent adolescent’s
eyes, a cookie is a cookie, and cookies taste good. He or she wants it now, and has no
care for the consequences of “a cookie habit” years down the road (or even minutes
down the road, for that matter)!
Equally important to remember is that the adolescent is still in the prime of discovering
new foods and learning how foods taste, and make him or her feel once eaten. This
period of discovery often lasts into the early adult years. Your awareness of this can help
you steer clear of harsh restrictions, negative connotations, and poor word choice, all of
which can zap the fun out of food for a a young person, dampening the healthy desire to
experience its many forms. And, without exposure to a variety of foods, especially those
packed with great-for-them nutrients, a young person’s list of present day and lifelong
healthful favorites may be shorter than it could be. More on this in later chapters.
In this one, we’ll teach you how to talk about nutrition with the adolescent, and
recommend certain approaches while cautioning against others, to help foster a healthy
relationship with food. (Later, in Chapter 8, we will talk in detail about how you can set
the tone for a healthy household so that it becomes a way of life for all family
members.)
21
How To Start Talking
About Nutrition
Kids are notoriously, sometimes
annoyingly, curious. It’s likely you’ve
been grilled by yours about your
grocery store selections, food prep choices, personal food preferences, and the like.
“Mom, why did you choose the yellow peppers?”
“Mom, how come George gets to have cereal for dinner?”
“Dad, what’s this green leafy thing?”
“Dad, how come you never help mom make dinner?”
When your child is young and in the prime of his or “why” phase, you have a golden opportunity to
begin sharing valuable nutrition nuggets (while you’re also sharing chicken nuggets or something else)
with them. Stay patient in the face of the barrage of questions. Once you’ve mastered this, share some
of the wisdom behind your food choices.
For instance, I (author Paul Salter) remember asking my mom during my adolescent years why she
always bought whole wheat bread. “But mom,” I’d say, “Matt’s mom always gives us bologna and
cheese on white bread and it tastes so much better!” Although my mom abstained from diving into the
many nutritional benefits that whole wheat has over white bread, she did provide me with a concise
and consistent answer: whole wheat was the healthy version of white, and was better for me, she’d
convey with a smile.
22
Although I didn’t yet grasp the benefits of choosing high-fiber carbohydrates over lower-fiber options, I
did recognize and appreciate the meaning of the word “healthy”, and that was enough to answer my
question. Short and sweet, yet, impactful. Any more information likely would’ve been information
overload… even for a future Registered Dietitian!
The good news here is that you don’t have to prepare a nutrition curriculum for younger children.
Instead, let him or her “why” away, thereby driving early conversations about nutrition. In lieu of that
curriculum, focus on being a role model at this stage. Your child will pick up eating habits from you and
other family members, as well as their peers. And, as they observe, mimic and make sense of the many
eating habits, preferences and choices around them, it’s only a matter of time before they come to you
with nutrition questions.
And when they do, make sure you take off your lab coat before answering. Do your curious nine-yearold a favor and spare them lectures on glycogen replenishment, muscle protein synthesis, or antiinflammatory foods. More often than not, a simple answer will be exactly what they’re looking for.
If you are prepared to address a young adolescent’s questions succinctly and supportively, you will do a
lot towards solidifying yourself as a trusted, reliable source of nutrition information, to whom the child
can turn with questions on nutrition for years to come.
Choose Your Words Wisely
While your adult mind enables you to recognize generalizations, overlook sarcasm, and see past
misinformation, the adolescent is likely still unable to do any of these well. As such, when loaded word
choices and labels such as “bad” or “you should never…” are thrown around, undesired consequences
can ensue. Unbeknownst to you, the word you use to label a food or characterize an action can have
dramatic influence on the adolescent’s conceptualizations of and relationship with food.
An example I personally experienced firsthand on multiple occasions when I worked with elite
adolescents at IMG Academy was the labeling of certain foods as “bad.” When low carbohydrate diets
23
burst on to the seen, the media and various internet sources were advocating that carbohydrates were
the culprit behind the obesity epidemic. Seemingly overnight, those who had very limited interest or
experience in nutrition before this fad were now a self-proclaimed nutritionists, advocating the low
carbohydrate diet for... everyone.
One athlete with a history of a poor relationship with food told her coach she wanted to lose weight.
His response? “Well, you always have granola bars in your tennis bag, Vicky*. Stop eating so many
carbohydrates. They’re bad for you.”
*Note: The name of this athlete has been changed to protect her identity.
Believing coach to be a trusted source of nutritional guidance, Vicky took his advice to heart, and, as
adolescents are want to do, took it too far. After ten days of reducing her carbohydrates, she’d lost
weight and, according to her, “felt better.” Predictably, she continued cutting carbohydrates from her
diet.
A few weeks later, I found Vicky and another tennis coach sitting in my office one afternoon. The coach
informed me that Vicky had been complaining of fatigue, and that her performance on the court was
suffering as a result. When I had her step on the scale (hiding the reading from her), I noticed that
she’d lost 18 pounds since the start of the season!
When I inquired about what Vicky had been doing differently with her nutrition, she told me she’d
stopped eating fruit, bread, and pasta. When I asked why, she explained that she stopped eating
carbohydrates because she heard they were “bad.”
This example - which, by the way, is one of many of its nature that fellow dietitians and I encounter illustrates how much young people trust the advice of adults in their lives, and how literally they may
take your advice.
With this in mind, whenever discussing food and food choices with adolescents, keep language soft
and positive. Definitive statements, negativity, or statements that imply food as a reward or invoke
24
guilt should be avoided. It bears repeating - and remembering - that the adolescent is not as practiced
as you are at discerning generalizations or sarcasm, and will take your suggestions literally at least up
until his or her teenage, if not early adult, years.
Avoid speaking in terms of absolutes as well. In other words, stay away from words such as never,
always, no one, and everyone. Instead, focus on more flexible, softer (and, in actuality, more accurate)
language, such as often, frequently, most, few, and usually. This will help to reduce the likelihood that
the adolescent will draw a false and/or harmful association between a food or food group and its
impact on health and performance.
Examples of using absolute words in a sentence discussing food include:
“Tommy, [insert food or food group] is always a bad idea.”
“Allison, you should never eat [insert food or food group].”
Example of similar statements with softer language:
“Tommy, [insert food or food group] may not be the best choice
for you right now. Let’s look at a few other options…”
“Allison, it’s best to limit [insert food or food group] because…”
Another common pitfall I observed when working with adolescents was the use of guilt trips by adults
about certain eating behavior(s) of an adolescent.
“Did you really eat [insert food or food group] last night?”
“You ate how many [insert food or food group] last night?”
25
While frustration with less than healthful eating habits is entirely understandable, the problems with
venting it to this tune are manyfold. Firstly, the adolescent may not recognize the issues with the
eating behavior in question, making the statement disorienting from the get-go. Secondly, such
rhetorical questions do a poor job of communicating your concern about the behavior in question, let
along the degree of your concern. Imagine learning that the adolescent ate not one, not two, but four
oatmeal cream pies last night, as evidenced by the wrappers in the trash can (a quantity I may or may
not have occasionally consumed in a single sitting in my younger years)! Rather than make a passive
aggressive remark, find an appropriate time to bring it up lightly.
For instance, in scenarios similar to the one described, consider anchoring the conversation in whether
or not the adolescent was / is feeling hungry. You might start by inquiring if he or she got enough to
eat at dinner last night. Maybe you’ll learn that, for reason XYZ, he or she in fact did not enough, which
would help explain the late evening binging.
It’s also very important to categorize potentially unhealthy eating behaviors as one-time offenses
versus recurring patterns. Once you’ve done that, recognize that the former will happen; I had dozens
of eating contests with my friends growing up. If indeed you start to notice a pattern of troubling
eating behavior, then you need to intervene appropriately. More on that later, but, for now, we can’t
reiterate enough that guilt is a powerful emotion that can leave a lasting mark on an adolescent’s
relationship with the food(s) in question, or worse yet, internalized as unhealthy feelings of shame, and
should hence be avoided at all costs.
26
Using Food As A Reward
“Tommy, you can’t have ice cream unless you finish your broccoli.”
“Allison, if you don’t knock it off, no cookies after dinner for you.”
If such conditionals sound familiar, that’s because it’s fairly common to use food as a reward for a
desired change in behavior. Unfortunately, what may seem like an insignificant, “in the moment”
bribe, may actually plant the seeds for an unhealthy relationship with food down the road.
It’s no coincidence that plenty of us, adults, rationalize “cheat” meals or indulgences by the fact that
we worked out earlier that day, or use similar “bargaining” psychology. It’s likely that the seed for such
reward-motivated thinking about food and exercise was planted in childhood, and continued to be
watered into adulthood; there is certainly no shortage of enticing “indulge: you earned it” messages in
the way tasty food is marketed today.
According to a study published in Eating Behaviors, of the 122 adults surveyed about their childhood
eating habits, those who recalled their parents using food as a reward to better manage behavior were
more likely to participate in chronic dieting and restrictive behaviors 1; typically not a recipe for good
long-term physical or mental health.
27
Moreover, teaching an adolescent that food is a reward only if he or she does or changes a certain
behavior may be teaching them to rely on food to manage their emotions. This tactic leverages the
fact that food is a source of pleasure, and if repeatedly subjected to it, he or she may begin to think of
food as something that “makes me feel better”, and begin to use it for coping with stress, anxiety, or
sadness.
Since most foods dangled as reward are calorie-dense and nutrient-poor, a reward-based system may
only increase the desire for such foods, which increases the likelihood of consuming more calories than
needed on a regular basis.
So, next time you’re dealing with a cranky 10-year-old who refuses to do what you ask, consider taking
the time to identify non-food rewards that will motivate him or her to change his or her behaviors.
A few examples include:

Play date or sleepover with friends

Special time with parents or grandparents

Sitting at the head of the table for dinner

Trip to the one of their favorite destinations: batting cages, driving range, park, zoo, pool, you
name it

Time off from chores

(A little!) more screen time (computer, tablet, TV, video games)
Sidestepping food as a reward may seem insignificant, but helping to ensure the absence of a reliance
on food for emotional control is invaluable.
28
No Food Should Be Off Limits
That’s right: no one food should ever be off limits. Period.
Restricting a food or food group only increases the desire to eat it, which is as true for most age group,
but is especially so during those rebellious adolescent years. Besides being highly likely to backfire,
restriction is also likely to lay a foundation for unhealthy eating habits.
In a study published in The American Journal of Clinical Nutrition, researchers had seven-year-old girls
eat a standard lunch followed by unlimited access to snacks afterward. 2 Those who reported not being
able to eat those types of foods at home ate significantly more of them, and also reported negative
feelings about doing so. Furthermore, a study published in The American Journal of Clinical Nutrition
found that when parents take a restrictive approach with their children’s eating habits, their children
develop a habit known as “eating in the absence of hunger.” As suggested by the term, this is a
tendency to eat foods resembling those foods that are “off limits” at home when given the
opportunity, despite not being hungry.3 It appears, then, that restriction may teach children and
adolescents how to override natural satiety and appetite management cues in favor of partaking in
some of those forbidden foods. This behavior, in turn, can increase the likelihood of obesity for those
children and adolescents.
To prevent such unintended and undesirable consequences, moderation should always be a
foundational pillar for balanced, healthy eating. And there may be no better time to reinforce this
pillar than during childhood and adolescent years. This is an opportunity to expose the adolescent to as
many foods as possible, and to also allow them to start learning about the impact said foods have on
how they feel. It also pays to remember that the constant activity and high-calorie needs for
supporting growth make youth a great time to enjoy the occasional treat.
They’re kids. Let them be kids.
29
That said, if you see reason to impose some limitations on ice cream, go for it! But making it
completely off limits, or, as previously covered, only allowing them to have it because they were
“good”, are not recommended approaches.
Talking About Specific Foods
As we discussed before, your adolescent will likely have a plethora of questions about specific foods
and nutrients. How you answer these questions will not only help frame how he or she thinks about
food, but can help him or her build associations between healthy foods and positive, desired
outcomes.
The most effective answers and presentation thereof will differ depending on the adolescent’s age,
maturity, and stage of readiness. Put another way, there’s no one-size-fits-all silver bullet for most
adolescent nutrition questions, so, just because a given approach works well with your 15-year-old
daughter does not mean it will work with your 9-year-old son.
The reason is simple: there is a drastic difference in overall maturity, general comprehension, and
interest in nutrition between these ages.
Below, we’ve outlined the most effective approaches to specific nutrition topics with your adolescent,
customizing it for each age group that comprises adolescence. Of course, let’s keep in mind that the
stage of the adolescent’s readiness and emotional maturity should ultimately dictate your approach to
such conversation.
30
Prepubescent
Adolescents: Ages 8-11
The language you use to talk about
nutrition with prepubescents should
be soft, simple, and fun.
One effective analogy for this age group is that of food as the fuel used in cars: a substance that
enables us to “go” and give us the energy we need to function. Beyond this, we can subtelly allude to
the fact that some types of fuel are more premium, or better for us, but that’s typically the extent of
nutritional information a prepubescent adolescent will be bothered to digest.
The following are some suggestions on how to speak to this age group about…
PROTEIN
CARBOHYDRATES
HEALTHY FATS
Helps you grow big
and strong
Helps you to build
muscle (This
typically works best
if you flex your
biceps. No joke.)
Help you to grow
big and strong
Give you energy
Makes you smarter!
(Cognitive
development)
Help you go fast
FRUITS AND
VEGETABLES
Help you to grow
big and strong
Keep you healthy
If the above recommendations appear elementary, that’s because they are. You need to keep language
soft, messaging simple, and outcomes positive when discussing food with this age group.
31
Post-pubescent
Adolescents: Ages 12-17
As the adolescent begins to mature
physically, you’re presented with an
opportunity to take the conversation
about proper nutrition to the next level. As always, this will depend on an adolescent’s stage of
readiness, emotional maturity, and cognitive development, but now is generally the time you can begin
describing the function of each major nutrient, and introducing the concept that some food options
are typically better for the adolescent’s health than others. It’s still best, however, to allow the
adolescent to lead the conversation and ask the questions.
Helpful talking points for this age group include…
PROTEIN
CARBOHYDRATES
HEALTHY FATS
Fuel source for your
muscles and your
brain
Helps to rebuild
and repair muscles
Necessary to help
you recover from
physical activity,
and improve
athletic
performance
Help to enhance
recovery and
positively impact
brain function
Some types of
carbohydrates are
“better” than others,
due to their more
positive impact on
energy levels
Some types of fats
ate “better” than
others, and some
work against the
body
Important for
recovery: restore
energy levels and
decrease soreness
FRUITS AND
VEGETABLES
Keep you healthy
and help you fight
off colds
Help you continue
to grow
Enhance brain
function
Improve energy
levels
A distinct difference between the prepubescent age group and this one is that you can now explicitly
introduce portion control to the conversation. We’ll discuss this in more detail in chapter five.
32
REFERENCES
1. Puhl, R. M., & Schwartz, M. B. (2003). If you are good you can have a cookie: How memories of
childhood food rules link to adult eating behaviors. Eating Behaviors, 4(3), 283-293.
2. Fisher, J. O., & Birch, L. L. (2002). Eating in the absence of hunger and overweight in girls from 5 to
7 y of age. The American journal of clinical nutrition, 76(1), 226-231.
3. Birch, L. L., Fisher, J. O., & Davison, K. K. (2003). Learning to overeat: maternal use of restrictive
feeding practices promotes girls' eating in the absence of hunger. The American journal of clinical
nutrition, 78(2), 215-220.
33
CHAPTER 4
FUELING THE ADOLESCENT, AND
CONSEQUENCES OF LONG-TERM
ENERGY RESTRICTION
After reading this chapter, you’ll have a better understanding of your adolescent’s
energy needs and how those needs change with age. Furthermore, you’ll learn how
chronic energy restriction can delay growth and impact development, and understand
specific macronutrient and micronutrient needs throughout adolescence.
Total energy needs are highest during adolescence compared to any other time in life.
Furthermore, growth rates during this time are second only to the “changing by the
day” first year of life! Nutrient needs and physical growth are tightly intertwined: as an
adolescent grows, his or her energy needs also continue to increase. Meeting their
requisite needs is essential for the achievement of optimal growth and development,
and failure to do so can inhibit physical and cognitive development, not to mention
sport performance.
Simply put, your adolescent needs fuel around the clock. Yes, it’s “normal” for them to
be hungry an hour or two after a meal, and an hour or two after that, particularly during
their peak growth phase.
34
Energy Needs
Before Puberty
If you endeavored to do your own
discovery on the estimated needs of
prebuscents,
you’d
find
a
hodgepodge of recommendations that instruct you to estimated based on height, weight, age, gender,
or, simply give you an estimated range. To save you the trouble, we took the liberty of doing this for
you, and summarized our findings below.
Estimated Energy Needs From Various Sources
Age Guidelines
UK Kids and Nutrition*
Food and Agriculture
Organization*
U.S. Dietary
Guidelines*
4-6
1,500 – 1,700
1,700 – 1,900
1,200 – 1,400
7-9
1,700 – 1,900
1,900 – 2,100
1,400 – 1,800
* The above values were adopted from a plethora of sources and adjusted to provide a more finite
range:
● http://www.kidsandnutrition.co.uk/how-many-calories-does-your-child-need.html
● http://www.fao.org/docrep/003/AA040E/AA040E07.htm
● https://health.gov/dietaryguidelines/2015/guidelines/appendix-2/
The reason there’s so much discrepancy is that there’s an overwhelming amount of variability in
individual prepubescent youth needs. If you’re one who is keen on abiding by the numbers, then keep
the following in mind as a loose framework, but keep in mind that the living, breathing adolescent’s
feeling of hunger or satiety should always trump statistics.
35
The Impact of Puberty
Up until puberty, energy needs are fairly similar between boys and girls. However, with the onset of
puberty, energy needs and rate of growth rapidly change as several biological changes take place.
Besides being a time when energy and nutrient needs are highest compared to any other time save the
first 12 months of life, it’s also the time when nutritional needs between genders become pronounced.
Conventional wisdom has it that a girl’s first menses commences the start of puberty, and marks the
start of the growth spurt that will transform her into an adult, and therefore also marks the start of a
significant energy and nutrient needs change. In reality, girls often experience their peak rate of
growth six to twelve months prior to their first menses, and will continue growing for another couple of
years after. This complicates meeting the female adolescent’s energy needs, as you may not connect
the increased hunger and fatigue she may experience months before her first period with a failure to
keep up with her rapidly increasing energy needs.
At the age of ten, but as early as eight, it’s wise to become more keenly aware of a girl’s energy and
reported levels of hunger. She may be in the midst of her peak growth as early as that, and ensuring
that she is not operating at a deficit during this time is crucial, as we will discuss shortly.
Boys typically experience puberty at least a year later than girls. Until this point, energy and nutrient
needs remain relatively unchanged throughout their childhood. But, once biological changes begin
taking place, energy and nutrient needs sharply increase, becoming noticeably gender dimorphic.
On average, boys are of larger stature and possess more lean body mass than girls, and have higher
energy and nutrient needs as a result. Incidentally, basal metabolic rate, which is the number of
calories you expend in a 24-hour period, has a direct relationship to the amount of lean body mass one
has, meaning that boys of this age will begin to average a faster metabolism than their female peers,
which also spells higher energy and nutrient needs. Moreover, these needs are further increased by
the fact that boys often experience more total growth than girls during their peak growth years, and
also continue to experience it over a longer period of time.
36
As previously mentioned, there are simply too many variables to consider when trying to assess energy
(calorie) needs among growing adolescents based on age. To overcome this limitation, one
recommendation to best estimate calorie needs is to use the adolescent’s height. The chart below
shows an example of what this may look like.
Age
11-14
15-18
Gender
Calories / Inch
Females
14
Males
15.9
Females
13.5
Males
17
*Adapted from a collection of research and summarized in “Nutrition Needs of Adolescents” by Mary
Story and Jaime Steng.1
Please note that these estimates are based upon the assumption of light to moderate activity levels.
Those who are more physically active, adolescents, for example, may require additional energy, and
hence nutrients, to meet their needs.
To better understand your adolescent’s energy needs, monitor his or her appetite, growth (both height
and weight), and energy level fluctuations, particularly in school and during sport. Although it may
seem unbelievable at times, when the adolescent reports that he or she is hungry, we encourage you
to listen, and provide them with premium snack choices (or meal, if it’s time). It’s also recommended
to get a firm understanding of expected changes in height and weight during these years, so you can
flag any unexpected changes in either.
37
Specific Macronutrients
Needs
Protein Needs
Your adolescent’s protein needs are
dictated by the amount of protein
required for maintenance of existing lean body mass and accrual of additional lean body mass during
the adolescent growth spurt.
Protein requirements are highest for 11 to 14-year-old females and 15 to 18-year-old males,
corresponding to the usual timing of increases in height for each gender. When protein intake is
chronically inadequate, reductions in height, reduced accumulation of lean body mass, and delays in
sexual maturation may occur.
If an adolescent is eating every few hours and has a foundation of healthy eating habits, he or she is
likely meeting his or her protein needs, estimated to be between 0.50 – 1.00 grams of protein per
pound of bodyweight for both genders. This equates to roughly 20 – 30% of total calories in
adolescents’ diets being supplied by protein.
Carbohydrate Needs
Unlike for adults, there are no definitive recommendations for carbohydrate intake for adolescents.
That said, a loose guideline of at least 50% of calories being supplied by carbohydrates is advised. And
this large slice makes sense, given the high energy expenditure of (active) adolescents, coupled with
the already high demand for carbs needed to support their growth.
The majority of your adolescent’s carbohydrates should come from high-fiber, nutrient-dense options,
which are also known as “complex” carbohydrates. We refer to these carbohydrates as “premium”
38
carbohydrates, because of the positive impact they have on various health parameters, energy levels,
and appetite management.
“Regular” carbohydrates, also known as “simple” carbohydrates, are nutrient-poor and low in fiber.
Frequent consumption of these types of carbohydrates can negatively impact various health
parameters such as bodyweight, and lead to subpar energy levels, fatigue, and poor focus.
(We’ll dig into specific carbohydrate sources in Chapters 5 and 6.)
Fat Needs
Similar to carbohydrate recommendations, no definitive recommendations exist for fat intake in youth
populations, but it’s suggested that they get no more than 30% of total of their calories from fat, and
no more than 10% from saturated fat, specifically. Regarding the latter, it bears remembering that
adolescents who are involved in sports should avoid unnecessary fat, which may be counterproductive
to their performance and recovery, by displacing calories from they would otherwise get from
carbohydrates, which would aid in both.
Specific Micronutrient Nutrient Needs
Below, you’ll find information on specific vitamins and minerals, consuming which helps ensure that an
adolescent will achieve maximal growth and development. These also happen to be substances that
play a crucial role in optimal growth, development, and sport performance, but are unfortunately often
under-consumed by adolescents.
Most adolescents’ nutritional needs can be met with a food-first approach. In other words, obtaining
the following through supplementation should only be considered with the approval of the
adolescent’s physician.
39
Calcium
Calcium requirements are highest during childhood and adolescent years compared to any other time
(pregnancy and lactation for females notwithstanding). Calcium plays an integral role in bone
formation and growth; over 98% of calcium stores are found in bone. Failing to meet daily calcium
needs may therefore stunt growth and increase the risk of fractures and bone breaks.
Unfortunately, the vast majority of youth, and girls in particular, are not meeting their daily calcium
needs.2 It’s likely that this under-consumption is related to the changing taste preferences of
adolescents, who are discovering other beverage options, such as juice and sodas, which end up
supplanting milk as a first choice.
Daily calcium needs for adolescents between 9 and 18 years old are estimated at 1,300 milligrams per
day. Excellent sources of calcium can be found in the chart below, with the respective amount of
calcium each food provides per serving.
40
Selected Food Sources of Calcium 2
Milligrams (mg)
per serving
Percent DV*
Yogurt, plain, low fat, 8 ounces
415
42
Mozzarella, part skim, 1.5 ounces
333
33
313–384
31–38
Cheddar cheese, 1.5 ounces
307
31
Milk, nonfat, 8 ounces**
299
30
Soy milk, calcium-fortified, 8 ounces
299
30
Milk, reduced-fat (2% milk fat), 8 ounces
293
29
Milk, buttermilk, low fat, 8 ounces
284
28
Milk, whole (3.25% milk fat), 8 ounces
276
28
Orange juice, calcium-fortified, 6 ounces
261
26
Tofu, firm, made with calcium sulfate, ½ cup
253
25
Salmon, pink, canned, solids with bone, 3 ounces
181
18
Cottage cheese, 1% milk fat, 1 cup
138
14
Tofu, soft, made with calcium sulfate, ½ cup
138
14
Ready-to-eat cereal, calcium-fortified, 1 cup
100–1,000
10–100
Frozen yogurt, vanilla, soft serve, ½ cup
103
10
Kale, fresh, cooked, 1 cup
94
Food
Yogurt, fruit, low fat, 8 ounces
41
*Adopted from: U.S. Department of Agriculture, Agricultural Research Service. 2011. USDA National
Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home
Page, http://www.ars.usda.gov/ba/bhnrc/ndl.
A guideline to follow that helps to ensure your adolescent is meeting daily calcium needs is to aim for a
minimum of three servings of dairy per day. If the adolescent has difficulty handling the lactose found
in dairy products, consider purchasing lactose-free options, prioritizing Greek yogurt and whey protein
isolate, which have very little lactose, as well as dark leafy greens. If doing without dairy is an
unappealing option, there is also the route of consulting the adolescent’s physician about a
prescription that will enable him or her to metabolize the lactase enzyme.
Vitamin D
Vitamin D deficiency is the most common nutrient deficiency in the United States today. This is largely
due to the fact that vitamin D is found in very little food, its main source instead being sunlight
exposure. Vitamin D plays a plethora of roles in the body, but most notably facilitates the absorption of
calcium. If the adolescent is not getting enough vitamin D (which can be confirmed by a simple blood
test), he or she will be at greater risk for bone fracture and breakages. Furthermore, lack of vitamin D
may negatively impact muscle strength, recovery, and sleep quality. Lastly, preliminary research
suggests that vitamin D deficiency may increase one’s risk for weight gain and even some types of
cancers, such as breast, prostate, and pancreatic.
Iron
Iron needs and iron turnover are highest in adolescence than any other time during the lifespan, and
further increase during peak growth years. The good news is that iron requirements are satisfied by a
large majority of adolescents, with the exception of girls, ages 14 – 16, who repeatedly fail to meet
their elevated iron needs, which are further increased by monthly losses from their menses.4
Iron’s primary role is the transport of oxygen, via the bloodstream, to where it is most needed in the
body. When iron needs are not met, fatigue, shortness of breath, cold limbs, and headaches ensure; all
side effects of the heart working overtime to pump oxygen-rich blood throughout the body.
42
There are two types of iron: heme-iron and non-heme iron. Heme-iron is found in animal-based foods,
and is the more bioavailable form of the two. Non-heme iron, meanwhile, is found in plant-based
foods, and isn’t absorbed or utilized as well by the human body. It’s fine to prioritize both heme and
non-heme sources for your adolescent, but, if instructed by his or her physician to boost iron intake,
increase heme sources of iron.
Iron needs can be met through a well-balanced diet with a special focus on iron-rich foods. Adolescents
who are runners would do well to adopt this focus, because significant amounts may be lost due to a
phenomenon known as foot-strike hemolysis, which is the literal breakage of red blood cells (and
subsequent loss of iron) due to repeated high-impact foot strikes.
Sources of Heme-Iron
Sources of Non-Heme Iron
Beans
Red meat
Lentils
Pork
Legumes
Poultry
Nuts
Seafood
Seeds
Fish
Fortified cereals
Iron Needs
Age
Male
Female
4-8
10 mg
10 mg
9 - 13
9 mg
9 mg
14 - 18
11 mg
15 mg
Adapted from: National Institute of Health Fact Sheets For Professionals. Retrieved from:
https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/.
43
If an adolescent presents with recurring signs and complaints of fatigue, then it may be beneficial to
schedule a blood test to assess iron stores. To ensure the fatigue is related to iron status, a blood test
should be completed before considering supplementation.
If your adolescent stands to benefit from supplementation, it’s critical to recognize that many nutrients
interact with iron, either inhibiting or enhancing its absorption. For instance, both caffeine and calcium
compete with the same receptors as iron, decreasing absorption. Have your adolescent avoid taking
their supplementation (or iron-rich foods) with foods that are high in caffeine or calcium. For instance,
do not supplement at breakfast if serving milk and cereal, or pair steak with a glass of milk at dinner. To
actually enhance absorption, pair iron-rich foods and supplementation with foods high in vitamin C,
such as fruit or vegetables.
Research shows that iron supplementation may be taken with food or on an empty stomach. Try both
to establish which option works best for your adolescent.
Note: If the adolescent leads a vegetarian lifestyle, it’s important to test his or her iron levels, to see if
supplementation is necessary to meet his or her iron needs, given that the best sources of iron are
found in animal-based foods. More on vegetarian adolescent nutrition in Chapter 10.
Zinc
Zinc plays a major role in growth and development, sexual maturation, and immune function.
Suboptimal intake has been confirmed in adolescent populations by multiple studies, particularly in 14
– 16 year olds.5 As such, it’s important to ensure that your adolescent is being provided with a wellbalanced diet that features the zinc sources listed below. Zinc needs increase post-puberty, during the
peak growth years, and are higher for males than females. Failure to meet zinc needs may interrupt
normal growth, development, and maturation.
44
Zinc Needs
Age
Male
Female
9 - 13
8 mg
8 mg
14 - 18
11 mg
15 mg
Adapted from: National Institute of Health Fact Sheets For Professionals. Retrieved from:
https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/.
Sources of Zinc
Red meat
Poultry
Crabs, lobster, oyster
Beans
Nuts
Fortified grains
B-Vitamins
The collective group of B vitamins is referred to as “the energy vitamins”. These vitamins play a
profound role in helping to harvest the energy from the food you eat and turn it into a usable form for
the body. Fortunately, B vitamins are found in a plethora of foods, most notably whole grains, beans,
lentils, nuts, seeds, leafy greens, and a variety of animal meats. If your adolescent is eating wellbalanced meals (even just a majority of the time), it’s likely he or she is meeting their B vitamin needs.
Note: If your adolescent follows a vegetarian diet, he or she may be at risk for vitamin B12 deficiency,
which is primarily found in animal-based products. Discussing supplementation with his or her physician
is recommended.
45
Consequences of Severe
And Prolonged
Energy Restriction
The combination of heightened
activity and increased energy needs
due to growth can make meeting
your adolescent’s energy needs demanding. Despite the fact that they may seem as if they’re always
eating, they may still may be shorting themselves.
As the parent, guardian, or coach, it’s your responsibility to keep a mindful eye on the eating habits of
the adolescent(s) in your care, as well as changes in their height, weight, and physical appearance, to
identify red flags for undereating. Such red flags include consistently-reported hunger and fatigue, a
decline in sports performance, impaired recovery or snack or meal avoidance. Likewise, signs of weight
loss or slowed growth as evidenced by where they fall in terms of weight and height for their age on
CDC growth charts should also be cause for concern.
Severe and prolonged calorie restriction can lead to the following consequences:
Stunted growth
Delayed onset of puberty
Menstrual irregularities, or delayed menstrual cycle
Poor bone health
Vitamin and mineral deficiencies
Increased injury incidence
Increased risk of disordered eating, or a diagnosed eating disorder
46
If you adolescent is an athlete, it’s wise to be aware that some sports promote a calorie-restrictive
culture more than others. Examples of those that do include wrestling, gymnastics, volleyball, rowing,
martial arts, and equestrian. Athletes of these sports are expected to have a very lean physique, and as
a result, harsh and inappropriate diet recommendations are often part of the “norm” within these
athletic circles.
In addition to the many physical consequences associated with severe and prolonged energy
restriction, there are the likely psychological consequences. Many lifelong habits are shaped during the
adolescent years. If your adolescent diets frequently or exhibits recurring anxiety about his or her
weight or body image, these tendencies are likely to be carried into adulthood.
Some research has even linked dieting during adolescence with low self-esteem.7,8 This is concerning
and ironic, seeing as how low self-esteem is often what leads adolescents to diet in the first place. Yet,
instead of being a remedy for low self-esteem, dieting may only exacerbate it.
Another major concern for this age group is the occurrence of diagnosed eating disorders and
disordered eating, for which youthful dieting may lay the foundation. Dieting has been shown to be the
precursor for diagnoses such as anorexia and bulimia and studies suggest that dieters have a five to
eighteen times elevated risk for developing an eating disorder compared to non-dieters.9,10
More problematic still is the lifelong increased risk for weight gain over time for those who first tried
dieting in their teens. A study published in the journal Pediatrics followed over 15,000 children ages 9 –
14 over a three-year period, and observed that dieters gained significantly more weight than nondieters during this time.11
It would appear that dieting may have a few significant outcomes as it relates to cultivating a teen’s
relationship with food, and attitudes about his or her body. In Chapter 7, we’ll detail how to address
weight change with your adolescent, and how to navigate the conversation when he or she tells you
that he or she wants to lose weight.
47
REFERENCES
1. Story, M. & Steng, J. (2005). Nutrition Needs of Adolescence. Retrieved from:
http://www.epi.umn.edu/let/pubs/img/adol_ch3.pdf. Accessed on January 31, 2018.
2. Department of Health and Aging et al. The 2007 Australian children’s nutrition and physical activity
survey. Commonwealth of Australia, 2008. Retrieved from:
https://www.health.gov.au/internet/main/publishing.nsf/Content/8F4516D5FAC0700ACA257BF00
01E0109/$File/childrens-nut-phys-survey.pdf. Accessed March 17, 2018.
3. Adopted from: U.S. Department of Agriculture, Agricultural Research Service. 2011. USDA National
Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home
Page, http://www.ars.usda.gov/ba/bhnrc/ndl .
4. Fogelholm, M. (1995). Indicators of vitamin and mineral status in athletes' blood: a
review. International journal of sport nutrition, 5(4), 267-284.
5. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin
K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon,
Vanadium, and Zinc : a Report of the Panel on Micronutrients . Washington, DC: National
Academy Press; 2001.
6. Kopp-Woodroffe, S. A., Manore, M. M., Dueck, C. A., Skinner, J. S., & Matt, K. S. (1999). Energy and
nutrient status of amenorrheic athletes participating in a diet and exercise training intervention
program. International journal of sport nutrition, 9(1), 70-88.
48
7. Cameron, J. W. (1999). Self-esteem changes in children enrolled in weight management
programs. Issues in Comprehensive Pediatric Nursing, 22(2-3), 75-85.
8. Stice, E., Cameron, R. P., Killen, J. D., Hayward, C., & Taylor, C. B. (1999). Naturalistic weightreduction efforts prospectively predict growth in relative weight and onset of obesity among
female adolescents. Journal of consulting and clinical psychology, 67(6), 967.
9. Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R. Onset of adolescent eating disorders: Population
based cohort study over 3 years. BMJ. 1999;318:765–8.
10. Patton GC, Johnson-Sabine E, Wood K, Mann AH, Wakeling A. Abnormal eating attitudes in London
school girls – a prospective epidemiological study: Outcome at twelve month follow-up. Psychol
Med. 1990;20:383–94.
11. Field AE, Austin SB, Taylor CB, et al. Relation between dieting and weight change among
preadolescents and adolescents. Pediatrics. 2003;112:900–6
49
CHAPTER 5
BUILDING A PREMIUM FUEL PLATE
The past few chapters have been dedicated to discussing adolescents’ nutritional needs,
and helping you prepare to talk to him or her about specific nutrition topics. Next, we’ll
begin discussing precisely how to fuel an adolescent, and itemize actionable strategies
you can implement immediately to this end.
This chapter will detail how to go about building a premium fuel plate to ensure an
adolescent is receiving nutrition that supports optimizing growth and development, and,
for adolescents, sport performance.
50
Portions Versus
Calorie Recommendation
To reiterate this recurring point
because
we
feel
it
can’t
be
overstated: us parent, guardians,
coaches, and most importantly, role models, need to always remember that we’re not working with
mini adult, but rather with an adolescent. Therefore, a focus on calorie math and macronutrients that
is effective for most adults is likely to be counterproductive for most adolescents.
Having spent significant time educating adolescents on nutrition, I’ve only employed specific
macronutrient or caloric recommendations on a handful of occasions. And these occasions came when
working with the rarer adolescents who were clearly ahead of the curve in terms of maturity.
For 99% of adolescents, framing the conversation in terms of portions is your best bet. It’s worth
pointing out here that the calorie estimations you can find online from various credible sources
significantly differ. Another reason to use portions over numbers, and, of course, to always listen to the
adolescent(s) expressions of hunger or satiety to best meet his or her needs.
When discussing portions, we will be using the adolescent’s hands in place of measuring cups and
spoons and food scales, to help make the topic fun and convenient to talk about. Another benefit of
using hands is that his or her individual hand size is unique to him or her, thus ensuring that his or her
portion sizes are, too. Using your hand to portion out carbohydrates may result in an excessive amount
for your nine-year-old daughter, or not enough for your sixteen-year-old son, who’s growing (and
eating) like a weed!
Let’s look at specific portions for protein, carbohydrates, fruits, vegetables, and fats. We’ll also learn
what each specific hand-sized portion equates to in terms of grams of each macronutrient.
51
Building A Premium
Plate: Meal Time
What you (or your adolescent)
prepares on his or her plate should
vary
somewhat
depending
on
whether he or she is eating a meal or a snack. For the sake of simplicity, when I refer to “meals” I am
talking about traditional breakfast, lunch, and dinner. When I refer to “snacks” I am referring to midmorning, mid-afternoon, and evening mini-refuels.
Let’s begin our discussion with meals.
Regardless of whether your adolescent is a couch potato or an active athlete, he or she needs to have
the following on his or her plate:
1
Premium Protein
2
Premium
Carbohydrates
3
Fruits and Vegetables
4
Healthy Fat
Think of these as the pillars of performance nutrition for your adolescent, which should, as such, be
prioritized at every meal. No longer will a grilled cheese sandwich or bowl of cereal cut it. The
combination of these three foundational nutrients and foods groups will help to optimize energy,
focus, and recovery, while simultaneously supporting growth. What changes, however, is the portion
of each component, depending on the level of activity planned for a specific day.
52
Premium Protein
Role: Protein plays an integral role in overall growth and development. Beyond muscle growth and
recovery, it’s implicated in all of the following:
Protein serves as an essential structural component for cells in your body
Protein fights off germs and foreign invaders serving as immune system cells
Proteins comprise hormones and enzymes
Proteins comprise white and red blood cells, and antibodies
Protein supports appetite management
What’s a “Premium” Protein?
“Premium” is used to describe any protein that is lean and high quality. When we use “high-quality” to
describe a protein, we’re referring to a “complete” protein, or one that contains all nine essential
amino acids.
Amino acids are the building blocks of protein. There are 20 in total, but nine that the body is unable to
make and must get from food, commonly termed the “essential” amino acids. Without all 20 amino
acids present, protein doesn’t optimally perform its intended functions, from which muscle growth,
recovery and development may all suffer as a result. All animal meats are complete proteins, whereas
most plant-based proteins are incomplete (missing one or more essential amino acid). Soy-based
products and quinoa are unique in that they are plant-based complete proteins.
What’s a Serving Size?
A portion of premium protein is equivalent to the size of the adolescent’s palm, making the portion
unique to him or her. Adolescents needs a palm-sized portion of protein at each meal throughout the
day.
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Premium Protein Sources
Chicken and turkey breast (without skin)
Pork Tenderloin
Lean Beef (filet mignon, steak sirloin, flank steak)
Lean Ground Meats (90/10 or leaner)
Eggs (yolks and whites)
Fish (salmon, tuna, mackerel, tilapia, cod)
Seafood
Low-Fat Dairy (Greek yogurt, milk, cheese)
Whey and Casein protein
Soy-Based Products (tofu, edamame, seitan)
Beef
and Vegetable Protein Powders
Premium Carbohydrates
Role: Carbohydrates are the body’s primary energy source. Carbohydrates provide fuel for the heart,
nervous system, muscles, and brain.
What’ a “Premium” Carbohydrate?
“Premium” is used to describe high-fiber, nutrient-dense carbohydrates that have a positive impact on
health, energy, and recovery. A nutrient-dense carbohydrate is one that provides a large number of
vitamins and minerals per bite (or serving). These carbohydrates are rich in a combination of the B
vitamins, Vitamin C, vitamin A, calcium, and iron.
What’s a Serving Size?
A portion of premium carbohydrates is equivalent to the size of the adolescent’s fist.
54
Premium Carbohydrates
Brown and Wild Rice
Lentils
Quinoa
Peas
Whole-Grain Pasta
Corn
Bread and Tortillas
Popcorn
Oats
Whole-Grain Cereals
Beans
Fruits
Legumes
and Vegetables
Premium Fats
Role: Dietary fat supports all of the following:
Dietary fat helps with the absorption of fat-soluble vitamins and the transport of
nutrients throughout your body
Dietary fat helps cells throughout your body send signals and communicate with one another
Dietary fat possesses anti-inflammatory properties
Dietary fat plays a role in enhancing cognitive function and preventing cognitive decline with age
Dietary fat plays a role in regulating body temperature and cushions your organs and joints
And it tastes great! Dietary fat should not be restricted, as it’s vital for adolescents’ growth and
development. However, as we’ll discuss below, some sources are far better than others.
What’ a “Premium” Fat?
“Premium” is used to describe nutrient-dense sources of fat that work for the body instead of against
it, also known as unsaturated fats. (Saturated fats are okay in moderation; up to 10 percent of total
calories as we previously discussed).
55
What’s a Serving Size?
A serving of premium fat depends on the fat source. For nut and seed butters as well as premium oils,
a serving is the size of the adolescent’s thumb. For nuts and seeds, it’s best that the adolescent
measure out a portion the size of half of his or her palm.
Healthy Fats
Unsaturated Fats
Saturated Fats
Salmon and Other Fatty Fish
Grass-Fed Beef
Olive and Canola Oil
Egg Yolks
Oil-Based Salad Dressings
Animal Meats
Walnuts
Coconut Oil
Almonds
Butter
Flax and Chia Seeds
Dairy
Avocado
Olives
Building A Premium
Fuel Plate: High
Activity Days
A “high activity day” is one that
features any form of structured
exercise or sport, including practice,
conditioning, workouts, games or any prolonged activity that keeps your adolescent moving. On these
days, your athlete’s calorie and energy needs are significantly higher compared to a day without
56
structured exercise or sport. This will be reflected in every meal throughout the day to ensure he or
she meets his or her needs to optimal performance, energy, recovery, and growth.
Below you’ll find a photo representing how portions of premium protein, premium carbohydrates, and
fruits and vegetables should be portioned per plate on a high activity day.
Protein: Each meal and snack should include a palm-size portion of premium protein. This amount of
protein is sufficient to maximize the growth and the benefits protein provides to muscle, and is also an
amount unique to the adolescent. The amount of protein provided per palm-size portion will vary
depending on the adolescent’s size and age, but general estimates are as follows:
12 – 18 grams for adolescents ages 9 – 12
18 – 30 grams for adolescents ages 13 – 17
Carbohydrates: Your adolescent’s meals should contain two fistfuls of premium carbohydrates at each
meal on a high activity day. (Remember this is an estimation tool, so you probably shouldn’t let your
adolescent stick his or hands directly into the quinoa salad you’ve prepared!)
57
At first glance, this may seem like an alarming amount of carbohydrates, but it’s important to
remember that an adolescents’ energy needs are already high due to their rate of growth, particularly
during puberty. And, energy needs increase further on high activity days. Consistent intake of the
requisite amount of carbohydrates is necessary to fill their fuel tank before and after exercise, as well
as to support their growth.
Fruits and Vegetables: The remainder of an adolescent’s plate should include two fistfuls of
vegetables. Don’t worry: we’ll discuss how to sneak vegetables into the meal and how to conqueror
picky eaters in a later section.
Grilled steak, sweet potato,
steamed broccoli
Salmon, brown rice,
steamed carrots
Spinach and cheese omelet,
bowl of oatmeal with fresh fruit
Although you do not need to create a beautiful, precisely portioned plate as shown above, do keep in
mind that adolescents eat with their eyes first, so presentation is important. You may also consider
having your adolescent build his or her own plate to enhance the likelihood of the meal getting eaten
(more on this tactic in a bit)!
58
Building A Premium
Fuel Plate: Low
Activity Days
On days that an adolescent does not
have a workout, practice, game or
other active pass time planned, it’s
important to slightly adjust his or her plate to account for the reduction in energy expenditure. As you
might have guessed, this reduction will come from carbohydrates, but it’s still imperative that they do
eat carbohydrates at all of their meals.
Protein: Each meal and snack on low activity days should still include a palm-size portion of protein.
Carbohydrates: Your adolescent’s meals should contain one fistful of premium carbohydrates at each
meal on a low activity day. They still need plenty of carbohydrates to support their high levels of
energy expenditure and growth needs, but not quite as much compared to a high activity day.
59
Fruits and Vegetables: The remainder of your adolescents plate should include two to three fistfuls of
vegetables. What you reduce in the form of carbohydrates may be compensate for with vegetables.
Start with your usual two servings and if your adolescent is still hungry offer a third serving of
vegetables.
Grilled steak, sweet potato,
steamed broccoli
Salmon, brown rice,
steamed carrots
Spinach and cheese omelet,
bowl of oatmeal with fresh fruit
On low activity days, roughly half of an adolescent’s plate should be composed of fruits and vegetables,
another 25% should be filled with premium carbohydrates, and the remaining 25% with premium
protein.
Building A
Premium Snack
Snacking should be an essential part
of an adolescent’s day; you should
expect him or her to have two to
three snacks daily. These mini-meals are critical for ensuring that an adolescent has the appropriate
amount of fuel to meet his or her energy needs and maximize health, growth, and performance.
As aforementioned, “snacks” fall in between meals, and their purposes is to hold over a hungry
adolescent until his or her next meal. You should plan to make sure your adolescent is eating a mid-
60
morning snack (after breakfast, between lunch), a mid-afternoon snack (after lunch, before dinner),
and a nighttime snack (after dinner, before bed).
Premium Snack Components:
1. Premium Protein
2. Premium Carbohydrate OR Premium Fat
Similar to meals, all snacks must contain a premium source of protein – a palm-size portion will suffice
here as well. Additionally, your adolescent's snack should contain either a fist-size portion of premium
carbohydrates or a standard serving of premium fat. There’s no wrong choice between the two. The
point is to provide them with quality, nutrient-dense fuel. However, if your adolescent reports feeling
tired, low on energy, or has multiple high activity sessions that day, it’ll be optimal to favor
carbohydrates at snack time. For adolescents who participate in sports, a carbohydrate-based snack is
best prior practice or games, as a higher fat snack could cause an upset stomach during activity.
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Greek yogurt plus fruit
String cheese plus handful of
nuts
Peanut butter and a large glass
of milk
Premium Protein Snacks: beef jerky, lean deli meat, low-fat cheese sticks, low-fat Greek yogurt, lowfat cheese, low-fat milk, any lean animal meat (think leftovers)
Premium Carbohydrate Snacks: whole-wheat bread, whole-wheat tortillas or whole-wheat bagels,
whole-grain crackers, popcorn, fruit, vegetables
Premium Fat Snacks: almonds, walnuts, pecans, pistachios, peanuts, sunflower seeds, avocado, eggs*,
nut butters, high-fat dairy*
*Both eggs and dairy provide protein and fat. The fat found in these foods is saturated fat.
Final Word on Snacks: These guidelines apply just as much on low activity days as on high activity days.
Remember: adolescents need the consistent fuel. Adjustments to account for changes in energy
expenditure are taken care of at meal times.
62
Post-Workout Nutrition
Strategies
The goal of the post-workout meal should accomplish the following:
Rebuild and repair damaged muscle
Refuel carbohydrate stores
Replenish lost fluids and electrolytes
Translation: the post-workout meal should prioritize premium protein, premium carbohydrates, and
ample fluids and electrolytes. Fortunately, if you follow what we recommended above when it comes
to building a premium meal, you’ll notice that all criteria are indeed satisfied. We do urge you and your
adolescent to pay special attention to rehydration and replenishment of sodium at this meal, as he or
she lost a significant amount of both in his or her sweat.
Do your best to help the adolescent eat his or her post-workout meal within 60 minutes of finishing the
high activity session. If a long commute or other plans stand in the way of eating a sit-down meal postworkout, consider packing a travel-friendly post-workout meal, so he or she may eat it in on the go.
Examples of balanced travel meals include:
63
Turkey, cheese, spinach on whole wheat bread
with 12 ounces of chocolate milk
Whey protein, a piece of fruit, a small bag (or
serving) of pretzels
How To Turn An
Adolescent Into A Fruit
And Vegetable Eater
Sadly, we do not have a secret
supplement to make your adolescent
eat more fruits and vegetables
(though if RP ever develops one, we’ll certainly let you know!) What we can offer are specific strategies
that have helped get the pickiest of the pickiest to eat more fruits and vegetables… whether they
realized it or not.
We’ll share those strategies with you in this section, but let’s first quickly recap why each is so darn
important for an adolescent:

Fruits and vegetables provide a vast array of vitamins and minerals

Are a good source of fiber, and also contain several other health-boosting nutrients, such as
antioxidants and phytonutrients

The vitamins and minerals found in them have a profound impact on health, growth, maturation,
performance, and recovery.
64
Any or all of the above is good ammo to deploy when adolescents inevitably (and repeatedly) ask why
they have to eat their vegetables.
But, as compelling as all of these reasons might be, one of the key takeaways from this book is that
actions - specifically, your actions as the adult role model - speak much louder than words.
As such, the first step to enhancing your adolescent’s fruit and vegetable intake is for you to assess,
and possibly also increase, your own. For a young person who looks up to you and is wired to copycat
your behavior, seeing you eat a starch-laden plate absent of any vegetables, followed by sugary
desserts night after night will up the odds that he or she will follow suit. On the contrary, seeing you
load up on the salad and a side of broccoli (to name just a couple of the multitude of veggie options)
and opt for a fruit salad for dessert at least most of the time, might also up the odds that he or she will
follow suit.
General Strategies To Increase Fruit and Vegetable Consumption
Curiosity is synonymous with childhood. Leverage his or her innate desire to explore new ground by
allowing an adolescent to select a few different fruit and vegetables the next time he or she joins you
at the grocery store. Making the adolescent feel like part of the process is a more effective strategy
than simply dictating that he or she must eat this or that, because trying something he or she selected
gives them a sense of control and personal investment.
Moreover, just bringing him or her to the produce section presents a wide variety of fruits and
vegetables for them to see, but also touch and smell (... now you know why it’s recommended you
always wash your fruit and vegetables before eating)! Engaging the senses may pique his or her
interest in new and different fruit or veggies, and may even result in the adolescent choosing his or her
new favorite!
Next, allow and even encourage the adolescent to participate in washing and preparing the selected
items, which will offer further expose and intrigue. Not only can cooking together serve as prime
bonding time, but you might also use this opportunity to “lightly” educate the adolescent about the
65
health benefits, origins and common preparations of the food(s) in front of him or her. In the worst
case, he or she won’t love it, but that just means another opportunity to bring them to the store next
week and try again! If you continue to help your adolescent discover these irreplaceable edibles, he or
she will find his or her favorites yet!
Fruit Recommendations
It’s likely you don’t have any hassle getting your adolescent to eat naturally sweet fruit. But if fruit isn’t
your adolescent’s “thing”, consider the following strategies to boost daily fruit intake:
1. Let Them Choose a Fruit: As suggested, allow your
adolescent to select the fruit of the week at your next
grocery store trip. Bring them along and let them scan their
options; smell, touch, and observe each fruit until they
arrive at one to try this week. Including them in the
selection process may enhance the likelihood the enjoy the
fruit because it’s one they picked, for both trying
themselves and sharing with the family.
2. Make Smoothies: Let your adolescent pick out a specific fruit or combination of fruits for a
smoothie. Mixed frozen fruits work well. Experiencing fruit in a different state (like frozen and/or
blended) may turn them on to it moving forward.
3. Present the Fruit in a Different Form: Rather than presenting it fresh, try presenting the fruit
canned, cooked, or mixed with other fruits or mediums, like sugar-free Jell-O or yogurt. For
instance, you can bake apples or roast peaches, or serve the fruit cut or peeled instead of in its
natural whole form.
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A Final Word on Fruit: When selecting fruit, keep your focus on fresh, frozen, or canned - in water fruit (in that order of preference). Fruit canned in juice or syrup and dried fruit, feature an unnecessary
amount of added sugar.
Make Vegetables Less of A Hassle
These same strategies are also recommended for increasing
vegetable consumption. Including your adolescent in the
selection and preparation process and presenting them with
a large variety of vegetables to choose from will go a long
way towards increasing the likelihood that he or she actually
eats those veggies.
But we don’t have to tell you that vegetables are a tougher
sell than fruit, and may not be an adolescent’s first (or even
last) choice, even when these tactics are employed. When that’s the case, implement one or all of the
strategies below to increase the likelihood that he or she is reaping the many benefits that vegetables
provide:
1. Cook Them: Because cooking breaks down the starch in vegetables into simple sugars, and thereby
yields a sweeter tasting vegetable than its raw counterpart, cooking veggies may be enough to help
an adolescent stomach them. Methods such as roasting, grilling, or steaming work well here.
Convenience Tip: Purchase veggies that you can steam directly in the bag. Microwave for the
recommended amount of time and, voila! Sweeter cooked vegetables in no time!
2. Scramble Them: Start your adolescent’s day off on a high note by incorporating a handful of
vegetables into his or her egg scramble or omelet. Stuff his or her favorite turkey and cheese
omelet with sautéed peppers and onions, or, consider adding a handful of spinach or sliced
broccoli. The fluffiness and flavor of the eggs and other favorite ingredients will mask the strong
67
taste of these vegetables, which will instead simply provide a much more agreeable layer of texture
in this presentation.
3. Blend Them: Another easy option to “sneak” vegetables into an adolescent’s day is to throw a
handful of spinach into his or her morning or after-school smoothie. It is important to warn them
that this will change the color of their smoothie to a brownish-green color, but that they won’t
taste the spinach whatsoever. You may consider a colored cup to help avoid the almost inevitable
“Ew, it’s green!”
You’re probably better off starting with spinach instead of kale or Swiss chard, which are a lot
more bitter than subtle, easily masked spinach. Here again, don’t miss the opportunity to let the
adolescent press that “blend” button and watch the fruit and vegetable tornado inside!
4. Hide Them: A great way to take their lunchtime or after-practice sandwich to the next level is to
sneak a few crunchy veggies for added flavor and texture. A handful of greens or a few slices of
tomatoes, peppers, pickles, or cucumbers is an easy way to increase their vegetable intake, as the
taste will be largely masked by the bread, meat, and cheese.
How Many Servings Per Day?
While a minimum of six, “eater’s fist-sized” servings of vegetables a day is the goal, we recognize that
this it’s a lofty one. Adjusting for picky eaters, let’s slice that six in half and aim for three servings of
vegetables per day, and two (or more) servings of fruit on top of that. A helpful fact is that fruit works
well as part of the premium carbohydrate serving at meal or snack time.
Key Takeaway: Aim for five daily servings of fruits and vegetables (in total).
Putting It All Together
Below are samples of how to fuel an adolescent on a high vs a low activity day.
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High Activity Day Meal Plan
Meal
Foods
Portions
Breakfast
(1) English muffin
(1) slice low-fat cheese
(2) slices Canadian bacon
(1) slice tomato
(1) handful spinach
(1) handful berries
(1) palm-size portion of protein
(2) fistfuls of carbohydrates
(2) fistfuls of vegetables
Mid-Morning Snack
(2) low-fat string cheese
(1) orange
(1) palm-size portion of protein
(1) fistful of carbohydrates
Lunch
(2) slices whole-wheat bread
(1) slice of cheese
(4) slices of turkey
(1) handful spinach
(1) handful of carrots
(1) tbsp. mayo
(1) apple
(1) palm-size portion of protein
(2) fistfuls of carbohydrates
(2) fistfuls of vegetables
Mid-Afternoon Snack
12 oz. glass of milk
(15) whole-grain crackers
(1) palm-size portion of protein
(1) fistful of carbohydrates
Dinner
(1) scoop ground turkey chili
(1) cup rice
(2) handfuls house salad
(2) tbsp. Italian dressing
(1) handful tortilla chips
(1/4) cup low-fat cheese
(1) palm-size portion of protein
(2) fistfuls of carbohydrates
(2) fistfuls of vegetables
Nighttime Snack
(1) Chobani Greek yogurt
(2) tbsp. almond butter
(1) palm-size portion of protein
(1) serving of fat
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Low Activity Day Meal Plan
Meal
Foods
Portions
Breakfast
Fruit and Yogurt Smoothie
(1) cup milk
(1/2) cup Greek yogurt
(1/2) cup oats
(2) handfuls spinach
(1) handful berries
(1) handful ice
(1) palm-size portion of protein
(2) fistfuls of carbohydrates
(2) fistfuls of vegetables
Mid-Morning Snack
(2) lean turkey deli meat
(1) low-fat string cheese
(1) Apple
(1) palm-size portion of protein
(1) fistful of carbohydrates
Lunch
(2) slices whole-wheat bread
(1) slice of cheese
(4) slices of turkey
(1) handful spinach
(1) handful of carrots
(1) tbsp. mayo
(1) apple
(1) palm-size portion of protein
(2) fistfuls of carbohydrates
(2) fistfuls of vegetables
Mid-Afternoon Snack
(12) turkey pepperonis
(12) whole-grain crackers
(1) palm-size portion of protein
(1) fistful of carbohydrates
Dinner
(1) palm of salmon
(1) cup couscous
(2) handfuls house salad
(2) tbsp. Italian dressing
(1) palm-size portion of protein
(2) fistfuls of carbohydrates
(2) fistfuls of vegetables
Nighttime Snack
(12) ounces of low-fat milk
(2) tbsp. peanut butter
(1) palm-size portion of protein
(1) serving of fat
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CHAPTER 6
HYDRATING YOUR ADOLESCENT
Fluids needs and healthy hydration habits often get lost in the shuffle of navigating
palatable food choices for your adolescent. But, in actuality, hydration is as, if not more,
important than nutrition, in optimizing everything from the adolescent’s cognitive and
physical development to his or her sport performance potential.
Adolescent fluid needs depend on age, gender, weight, and physical activity, but may
also be influenced by temperature, altitude, humidity of their surroundings, and
uniforms or gear worn during sports. Research into adolescent fluid needs has produced
mixed results, but a summary of key recommendations can be found below:
The U.S. Department of Agriculture recommends that male adolescents get at least 2.4
to 3.3 liters of water per day, and female adolescents at least 2.1 to 2.3 liters per day.
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Similarly, the Recommended Daily Allowance (RDA) and Adequate Intake (AI) values for
total water are as follows for adolescent boys and girls:
Kids Total Daily Beverage and Drinking Water Requirements:
Age Range
Gender
Total Water
(Cups/Day)
4 to 8 years
Girls and Boys
5
Girls
7
Boys
8
Girls
8
Boys
11
9 to 13 years
14 to 18 years
And the Holiday-Saegar equation, considered the gold standard for determining fluid
needs for adolescents amongst medical professionals, estimates fluid needs based on
the following equations and parameters:
●
For children 24 - 44 pounds, the daily fluid requirement is 33 fluid ounces + two
ounces per pound for every pound over 22 pounds.
●
For children > 44 pounds, the daily fluid requirement is 51 fluids ounces + one ounce
for every pound over 44 pounds, up to a maximum of 84 fluid ounces
These recommendations provide a spectrum on which your adolescent’s hydration
needs fall. It’s important to note, though, that these recommendations are based on
minimal activity, and hence fail to account for the increased physical activity of highly
active adolescents, such as youth athletes.
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In this chapter, we’ll focus on specific hydration strategies throughout the day, address
key times when hydration is most important, and pinpoint strategies that you can use to
enhance an adolescent’s hydration habits.
As discussed in the context of food choices, here too, you need to model healthy
hydration habits for your adolescent by practicing them firsthand. If he or she sees you
only drinking diet soda and Gatorade, or not drinking much of anything, it’s likely he or
she will mimic your behavior.
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Adults Versus Youth
Hydration Needs:
Big Differences
The most obvious difference in fluid
needs
between
adults
and
adolescents is the difference in size.
However, this difference can become quite insignificant once his or her growth spurt kicks in! Our
focus should instead be on the difference between adult and pre-puberty adolescent needs, which are
dictated by factors other than size.
For one thing, adolescents have a much more challenging time handling temperature extremes,
particularly heat, as compared to adults. For this reason, being keenly aware of their fluid intake habits
and choices is critical in hot and humid conditions. This lower ability to maintain optimal body
temperature when navigating temperature extremes also puts adolescents at increased risk for hypo
and hyperthermia.
For the latter in particular, this greater risk stems from adolescents having a less efficient sweating
mechanism than that of adults. This age group produces less sweat per sweat gland versus those of
adults, which translates to a weaker cooling mechanism for the adolescent body. Less sweat means
that the body’s core temperature remains elevated longer and to a higher degree, which, coupled with
the fact that adolescents generate more heat per unit of body mass than adults, puts them at greater
risk for heat-related illness.
Another compounding factor is that adolescents lose more sodium per milliliter of sweat compared to
adults. This is potentially concerning because low sodium levels can lead to a condition called
hyponatremia (literally “very low concentration of sodium”), which can in turn lead to severe
consequences, including, disorientation, headaches, dizziness, vomiting, and muscle weakness. And if
left untreated, these symptoms can quickly progress to seizures, brain swelling, coma, and even death.
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In summary, adolescents are more likely to overheat in the first place, and also have a less efficient
mechanism than adults for cooling themselves, which puts them at an increased risk for heat
exhaustion and illness.
Consequences of
Dehydration
An adolescent is subject to the same
dehydration-induced symptoms that
you are, except that he or she may
experience them more quickly and to a greater degree due to his or her inability to optimally maintain
body temperature.
Common signs and symptoms of dehydration include:
Headaches
Impaired exercise performance
Nausea
Fatigue
Impaired coordination, balance,
Vomiting
Lightheadedness
and reaction time
Muscle cramps
Dizziness
These consequences may be experienced with as little as 1-2% dehydration relative to his or her body
mass, which makes it more important to remain keenly aware of his or her hydration habits.
Sadly, that’s easier said than done, as adolescents often fail to realize that they’re performing
suboptimally or haven’t in fact had a sip of fluid in three hours. That’s where you come in, serving as a
source of recurring reminders and instilling a foundation of healthy hydration habits.
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Strategies To Promote
Optimal Hydration
1. Make fluid a focal point of each
meal and snack
Serve a beverage with each meal
and snack throughout the day. This may include low fat milk during breakfast and snack time,
followed primarily by water at other meals. Regardless of whether you serve these beverage
choices or different ones, the key point here is to make sure that fluid is treated like another
required macronutrient instead of an afterthought.
2. Always carry a water bottle with you during activities
Whether you’re in the car, at the park, or running errands, ensure that you have a drink readily
available for your adolescent (and yourself). This can be as simple as bringing an extra water bottle
in your purse (or gym bag) or giving your adolescent one to hold on to. Start encouraging your
adolescent to pack a water bottle from a young age, to help ingrain this vital habit.
3. Pack water in your adolescent’s lunch or to take to school
Once you put that water bottle (or two!) in your adolescent’s backpack or lunch, it’s important that
you remind (or show) him or her that you included it, so they’re more likely to remember it.
Including a sticky note reminder in his or her lunch to “drink your water” can be quite effective.
(And, if you want to amuse and/or embarrass them, a big heart and some smiley faces on the note
will do the trick.)
4. Offer more than just water
Most adolescents are turned off by water because it’s boring. Why drink that when there are
hundreds of sweet-tasting (and mostly much less healthy) options staring back at them from
vending machines, restaurants, and convenience / drug / grocery stores? To work around water’s
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blandness, striving to offer a variety of beverage choices will improve the likelihood that the
adolescent drinks more, which is the ultimate goal. Other healthy options include milk, liquid
yogurt drinks, and flavored or fruit-infused waters.
Water
Milk
Calorie-free Fruit-flavored
Drinks
It’s also a good practice to pay attention to the temperature of the fluids being served to an
adolescent. He or she is picky enough that even the slightest “weirdness” in a drink’s temperature can
turn him or her off to it. If a beverage is supposed to be, or is preferred to be, cold – think a sports
drink during practice – then make sure it’s presented cold. The National Athletic Trainer’s Associations
recommends cool beverages be between 50 – 59 degrees Fahrenheit.1
Note: The food your adolescent eats also provided fluid, specifically fruit and vegetables, which are
comprised of 90% or more water. As such, promoting optimal hydration means including ample fruit
and vegetables too.
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Can I Serve My
Adolescent Juice?
Although juice is marketed as a
nutrient-dense, healthy option for
children, it’s often loaded with sugar
and is therefore a suboptimal choice for hydration. Juice on occasion is fine, as these are children, after
all, and complete restriction is a recipe for disaster. However, when serving them juice, seek out lowsugar versions. These options typically have 50% less sugar as compared to traditional juice, but all of
the vitamins and minerals.
Believe it or not, but too much juice can have a dehydrating effect. When the body is overwhelmed by
a large amount of sugar at once, it pulls fluid from muscle stores to help dilute, digest, and absorb it,
which has a dehydrating effect. And, as your dentist will remind you, sugary drinks negatively impact
your dental health. This is true for any sugary drink, such as soda, lemonade, or sweet tea. On top of all
of this, some juice, like apple, can cause diarrhea when consumed in large amounts, which would
actually increase an adolescent’s risk of dehydration.
Should My Adolescent
Drink Soda?
For similar reasons to those stated
above, soda should be served as a
treat, not a regular occurrence. A
consideration not applicable to other drinks but specific to soda is its caffeine content. Currently,
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research is limited on the specific impact of caffeine in adolescents and how well they are able to
tolerate it (and at what doses). But we do know that, because they’re still growing, adolescents’ bodies
may not be well-equipped to handle the stimulant effects of caffeine, which has been tragically
evidenced in multiple caffeine-linked deaths in teens over the years (more on this coming up). While
most sodas contain caffeine, besides those labeled “caffeine-free” there are also naturally caffeine-free
options, such as Sprite, Sunkist, and diet A&W root beer.
Note: More on caffeine in Chapter 9: Sports Nutrition Supplements and Ergogenic Aids
Replace regular soda with diet to reduce the intake of unnecessary sugar. Most parents, and rightfully
so, are concerned with the potential impact of the artificial sweeteners found in diet soda. To date,
research on the matter is in its infancy, and has produced conflicting results. Many purport that
ingestion of artificial sweeteners may negatively affect cognitive development and increase the
likelihood of developing an attention-related disorder, while some studies show no such impact when
regularly ingesting artificial sweeteners.
The takeaway is this: artificial sweeteners are found in a variety of foods today, and are abundant in
foods marketed to children. “Moderation is key” are good words to live by - and teach your adolescent
to live by - in regards to artificial sweeteners. While an occasional diet soda is not harmful, five a day
may not be the best idea.
Should My Adolescent
Drink Soda?
Energy drinks have made a big
splash in the news over the last ten
years, and for all the wrong reasons.
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These products offer sickening amounts of caffeine in combination with multiple other stimulants, and
are, alarmingly, marketed specifically to adolescents, and, even more specifically, to adolescents
interested in extreme sports or video games.
Energy drinks are dangerous for your adolescent because of the synergistic effect between the
multiple stimulants found in them. It’s important to remember that caffeine has a much more
significant impact on your adolescent’s growing body than it does on your full-grown one. A large
amount of caffeine in conjunction with other stimulants can quickly overwhelm a growing body, and
lead to serious medical consequences and even death.
In 2017 alone, there were dozens of energy drink-related deaths, with cause of death being cardiac
arrest. And that doesn’t include the dozens, if not hundreds, more that went unreported, or for those
where the impact of energy drinks was unknown.
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Worse yet, not all energy drinks disclose the exact amount of caffeine or other ingredients they
contain, staging only that they contain a “proprietary blend.” If you’re like us, this lack of transparency
might leave a bad taste in your mouth, and, with any luck, your adolescent’s.
Monitoring Your
Adolescent’s
Hydration Status
Rather than having your adolescent
aim for a specific number of fluid
ounces per day (especially if on the
younger end), focus on consistent fluid intake throughout the day. To ensure that your adolescent is
drinking enough, you may be able (and willing!) to occasionally monitor the color of his or her urine. A
well-hydrated adolescent will have urine that is “light like lemonade”, while a dehydrated adolescent’s
will be “dark like apple juice.” If you and your adolescent aren’t the squeamish type, these two simple
phrases may prove to be memorable liquid intake guidelines for your adolescent. Once you feel your
adolescent is ready, consider sharing these phrases with him or her, so that he or she may begin to
monitor his or her own hydration, and adjust it accordingly.
If you notice, or your adolescent shares with you, that his or her urine color is “clear like water” this is
something to address. “Clear like water” is a sign that your adolescent is drinking too much fluid
relative to his or her electrolyte levels. If your adolescent is the active, athletic type, and all he or she
drinks during exercise or sport is water, the “clear pee” phenomenon is somewhat expected. When
this happens, offer a salty snack, such as bread, dairy, crackers, or pretzels, or a low-calorie sports drink
to increase electrolyte levels in the body.
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Hydrating Your Youth
Athlete: Before, During,
And After Workouts
The recommendations below are for
structured, sport-specific exercise,
which may include practices, lifting
and conditioning workouts, or games and competitions.
Before Exercise:
First off, youth athletes should begin all exercise well hydrated. To ensure this, begin prioritizing
hydration at least two hours prior to the adolescent’s exercise session. At this time, give him or her
with 8 – 12 ounces of fluid. As workout time approaches, have him or her consume another 4 – 8
ounces, preferably around the one-hour mark. As you begin driving or readying for the workout, offer a
friendly reminder to drink from his or her water bottle. Water is an appropriate beverage at this time,
however, as we will discuss below, beginning to sip on a sports drink is okay, too.
During Exercise:
Consistent hydration is a must during exercise.
Specifically, help ensure that your adolescent drinks 5 – 8 ounces every fifteen to twenty minutes. But,
rather than providing him or her with specific consumption amount recommendations, encourage him
or her to sip regularly throughout. In your younger athletes, encouraging sips is often enough to start
ingraining this habit. That said, depending on the format of the workout, sports practice or game, this
may prove difficult. All you can do is make friendly reminders about hydration as opportunities present
themselves during your athlete’s workout.
What your adolescent should drink next is dependent upon the duration and type of exercise he or she
is completing. First, we’ll look at duration.
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To assess your adolescent’s beverage needs, follow the “One Hour Rule.” If his or her exercise session
is less than one hour, water throughout will suffice. If exercise lasts longer than one hour, then he or
she will greatly benefit from a sports drink.
During exercise, your adolescent is losing fluid and sodium (as well as other minerals) in his or her
sweat, and also burning carbohydrates as fuel. The longer exercise lasts, the more depleted these
stores become. If he or she doesn’t replenish the fluid, sodium, and carbohydrates lost, performance
will suffer, and the risk for dehydration-related symptoms (dizziness, headaches, cramps, nausea, and
poor performance) increases. A sports drink can help prevent this by replenishing what is lost during
exercise, which water alone cannot do.
Regardless of your opinion on sports drinks, it’s important to recognize that they have a place, and this
is it. Starting with a lower-calorie sports drink to cut back on the sugar is always an option. If you don’t
feel comfortable using one of the popular sports drinks for whatever reason, you can make your own
workout drink to serve in its place (and have your adolescent help).
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At Home Sports Drink
Net Carbs
Sodium
Potassium
7
2
63
¼ Cup Apple Juice
2 Dashes of Salt
194
Squeeze of Fresh Lemon Juice
Water
Total Recipe
7
196
63
Directions:
1. In a shaker bottle add apple juice, salt and lemon juice.
2. Fill to the top with water.
3. Shake well and enjoy!
Besides duration, we should also factor in exercise type and intensity in selecting “during-exercise”
beverages. Two hours of back and forth soccer practice will have a much different impact on your
athlete’s energy and fluid needs than two hours at the batting cages. Being at your adolescent’s every
session would enable you to better gauge its intensity and determine appropriate hydration, but,
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“helicopter parent alert” aside, in reality this just isn’t possible. As such, packing plenty of water and a
low-calorie sports drink (typically half the sugar) is a safe bet.
Initially, allow your athlete to choose the type of hydration he or she prefers during the workout, but
make sure you understand the nature of these workouts, so you can present or suggest optimal
hydration options for them going forward.
After Exercise:
Rehydration following a workout is just as important as hydration beforehand and during, as this is the
time to replenish the lost fluid and electrolytes, which is best done sooner than later. Consistent
hydration should therefore be encouraged following the workout. You want to make sure he or she has
consumed at least 24 ounces of fluid within two hours of exercise. Likewise, ensure that the recovery
meal features a salty component like canned beans, canned vegetables or canned soup, dairy or bread
products, baked crackers or chips, or a light sprinkling of salt on the meal, to replenish the sodium lost
during exercise.
Older adolescent athletes may cooperate with being weighed in before and after a few workouts. This
can allow you to quantify average workout-induced weight loss, and encourage him or her to consume
at least 16 ounces of fluid for every pound lost. For example, if he weighs in at 141 pounds and weighs
out at 138 pounds, he should consume 48 ounces of fluid in the next two hours.
As touched on, besides a focus on fluid replenishment, we also need to keep replenishment of those
electrolytes top of mind. A super-hydrated state in the absence of sodium, the primary electrolyte lost
in sweat, may lead to a condition known as hyponatremia, which is characterized by the following signs
and symptoms:
Headaches
Vomiting
Muscle weakness and spasms
Seizures
Dizziness
Coma and death
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To steer very clear of the above, encourage your athlete to salt his or her meal following exercise, and
don’t hesitate to include saltier foods.
Adolescent Hydration
And Cognitive
Performance
Dehydration can negatively impact
concentration, short-term memory
and recall, reaction time, basic
arithmetic, and mood. In other words, dehydration doesn’t exactly set your adolescent up for
academic success. Given that these side effects may present with as little as 1-2% dehydration, it’s
crucial not to neglect fluid intake, but to strongly and consistently encourage that your adolescents
drink throughout his or her school day.
Discussing Sports
Drinks Further
Sports
drinks
are
specifically
marketed to athletes. Although they
serve a valuable purpose when
consumed appropriately, as described - during exercise lasting more than one hour - misuse can have a
negative impact on health, weight, body composition, and dental health.
It’s important that you clearly communicate the intended use of sports drinks to your adolescent
pretty soon after they reach adolescence (versus in their late teens). Regular consumption of sports
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drinks throughout the day is a recipe for unwanted weight gain. To help offset your athlete’s desire for
something sweet between meals, consider making a homemade fruit-infused drink that provides a
strong fruit flavor while sparing the extra calories.
Fruit-Infused Water Recipe Ideas
Fresh strawberries with fresh
bruised mint leaves
Lemon, lime and orange slices
with a sprig of fresh rosemary
How Much Should My
Adolescent Drink
Each Day?
Rather than overwhelm yourself
and your adolescent with precise
fluid
recommendations
when
hydrating, focus on helping him or her developing consistent hydration habits throughout the day.
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Besides presenting him or her with drinks when he or she is in your case, initiate an open dialogue
about eating and drinking habits, and use these conversations to answer your adolescent’s questions
or mentally flag undesirable habits, to which you can then offer alternatives.
If that fails, you can always continue to monitor - or ask them about - the color of their urine. It’s a
dirty job, but sometimes the parent has to do it (and, hey, this line of questioning may just get the
adolescent to happily divulge their eating and drinking habits instead)!
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REFERENCES
1. Casa, D. J., Armstrong, L. E., Hillman, S. K., Montain, S. J., Reiff, R. V., Rich, B. S., ... & Stone, J. A.
(2000). National Athletic Trainers' Association position statement: fluid replacement for
athletes. Journal of athletic training, 35(2), 212.
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CHAPTER 7
ADDRESSING WEIGHT CHANGE
Whether they let you know it or not, you’re in a very influential position when working
with prepubescent adolescents. If and when they come asking questions about weight
loss, it’s wise to redirect the focus to healthy eating and subtle changes in food choices
and behaviors. You can accomplish this by focusing on how said change(s) can positively
influence the adolescent’s energy, performance, recovery, health and - the one that’s
likely to resonate most with this age group - growth.
Furthermore, take the conversation away from words and goals such as “weight loss,”
“lose fat,” and “gain weight,” and focus on terms and goals such as “feeling better,”
“getting stronger,” “playing/performing better,” and “growing.” This softer language
makes for a much more neutral conversation which may help prevent inadvertently
nudging the adolescent towards taking any extreme measures.
Weight change tends to be an emotional subject, especially for already emotional
adolescents, so it’s imperative that you proceed with soft language and utilize the steps
and strategies outlined below, as always with consideration to the adolescent’s age (as,
for example, older adolescents will be better able to grasp the benefits of positive body
composition changes and the role nutrition plays in these, while younger ones may not).
In this chapter, we will look at the prevalence of body image issues among adolescents –
both girls and boys – and then discuss constructive ways to talk about body image and
weight change with your adolescent.
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Discrepancies In Body
Perception and
Body Image
Adolescents face an overwhelming
amount of pressure from society,
social media, and their peers when
it comes to bodyweight and body image expectations. This pressure is exacerbated by a lack of
familiarity with and anxiety about their changing bodies. This inner and outer pressure puts
adolescents in a vulnerable position in regards to body topics, wherein so much as a perceived critical
remark can catalyze negative thoughts about their bodies. These thoughts can in turn quickly snowball
into obsessive behavior with regard to food and exercise for both girls and boys.
All told, the teenage years may be some of the most challenging years of a lifetime, emotionally,
mentally, and physically. Between ever-changing hormones, continued praise for a socially acceptable
physique, and social media’s bombardment with scantily clad “role models”, you, as your adolescent’s
true role model and support system have your work cut out for you. As you read on, keep in mind that
self-esteem issues are the biggest impetus for extreme weight-loss behaviors and the driver behind
feeling the need to “diet.”
Weight Loss and Body
Image: Teenage Girls
The pressure to achieve the ideal
physique starts at a younger age
than we may realize. A 2011 study
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reported that 40 – 60% of girls ages six to twelve were concerned about their weight.1 And a slew of
research conducted and published by the National Eating Disorders Organization in the ‘90s found the
following 2:
42% of first through third grade girls want to be thinner
81% of 10 year olds are afraid of being fat
51% of 9 and 10-year-old girls feel better about themselves if they are on a diet
46% of 9-11-year-olds are "sometimes" or "very often" on diets,
and 82% of their families are "sometimes" or "very often" on diets
The same 2011 study mentioned above, which surveyed 6,728 boys and girls, also found that, of those
girls who participated, 45% reported having been on at least one diet, and 13% admitted to some form
of disordered eating. Participants in 10th – 12th grade had the highest reported incidence of disordered
eating.1 Another study found that nearly half of teenage girls use unhealthy weight control behaviors,
including skipping meals, fasting, purging, and even smoking cigarettes.3 And a 2007 study published by
the Center for the Advancement of Health surveyed over 8,000 adolescent girls and boys found that
girls who diet are twice as likely to smoke cigarettes as those girls who do not diet. 4
But, if we take a moment to think about these astounding statistics, we may come to see that,
unfortunately, they shouldn’t be so shocking. Young girls are exposed to the “ideal” physique from a
very young age, when they begin playing with dolls such as Barbie. Barbie has been one of the most
popular toys for young girls for decades.
Many people have estimated what Barbie would look like in terms of her body measurements if she
were a full-grown woman. Measurement estimates provided suggest a nearly impossible hourglass
figure (some refer to is as borderline anorexic), with large breasts, thin legs, and small feet. This is what
young girls are made to believe the “perfect woman” looks like.
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Note: Fortunately, today, Barbie has four body types to represent beauty in women of all shapes and
sizes.
As a result of the constant pressure surrounding girls, many resort to extreme weight loss behaviors,
which may include severe calorie or food group restriction, laxatives, diuretics, weight loss
supplements, obsessive exercise, or intentional starvation.
It’s crucial to recognize the body image challenges your adolescent is likely facing at this age, and keep
these at the forefront of your mind when broaching the sensitive subject of body image. It’s also
important to be aware of the many red flags of disordered eating, which we’ll soon cover.
Statistically, most female adolescents will struggle with body image or bodyweight issues at least once
in their adolescent years. When navigating these conversations, do your best to keep positive
reinforcement ready, suggestions positive, and word choice soft.
Boys Have Body Image
Issues, Too
Girls aren’t alone in feeling insecure
and
lacking
body
confidence.
A recent study published JAMA
Pediatrics, found that “nearly 18 percent of adolescent boys are highly concerned about their weight
and physique.” Echoing this finding, in the last 30 years, the number of boys reporting some form of a
body-dissatisfaction issue has tripled!5
Like girls, boys are presented with messaging about the ideal body type for men from a very young age.
Superheroes and toys such as GI Joe all boast muscular, chiseled physiques. A sculpted chest, large
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biceps, and a six-pack therefore become synonymous with “manliness” and the belief that males who
don’t have these aren’t “real men” can begin to creep in at a young age.
This insecurity about their body size and resulting obsessive thoughts and behaviors centered around
getting bigger has been labeled a kind of body dysmorphia disorder. It’s estimated that at least a
quarter of normal-weight adolescent boys perceive themselves as underweight. This thinking leads to
increased use of steroids and other potentially dangerous muscle-building tactics, and can negatively
impact self-esteem and ability to control emotions. Furthermore, body dysmorphia disorder may even
put these boys at an increased risk for a variety of unhealthy states, such as depression, binge-drinking,
and recreational drug use.
It’s also important to note that there’s a rise in teenage boys with diagnosed eating disorders. A 2005
study entitled “Eating Disorders in Men: Update” estimated that 10% of anorexia nervosa and bulimia
nervosa patients were men.6 A 2007 study published in Biological Psychiatry estimated that 25% of
bulimia nervosa cases were male, and the National Institute of Mental Health reports that roughly one
million men struggle with an eating disorder, cautioning that this may even be an underestimate.7
Why Is Your Adolescent
Seeking Weight Change?
When
your
adolescent
first
mentions his or her desire to
actively work to change his or her
eating habits or weight, it’s important to pose some or all of the following questions to help root out
the “why” behind this change in behavior:
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Why does he or she want to gain weight?
Why does he or she want to lose weight?
Who told he or she that she should gain weight?
Who told he or she that she should lose weight?
What is he or she hoping weight loss will accomplish?
What is he or she hoping weight gain will accomplish?
Identifying the driving force behind the desired change will not only serve to clue you into his or her
aspirations or insecurities, but will also help identify the source(s) of influence for said change. Once
you discover both of the personal and external catalysts, these can inform your navigation of ensuing
related conversation(s) with your adolescent.

For instance, does your 13-year-old lacrosse athlete, who’s yet to hit puberty, want to gain weight
to keep up with his peers who are in the midst of their peak growth phase?

Does your 17-year-old running back want to gain weight because his football coaches told him it’ll
be necessary to compete at the next level?

Does your 16-year-old daughter want to lose weight after overhearing a peer call her “fat”?
Assessing the validity of the goal will enable you to help your adolescent both weed out unworthy or
possibly damaging pursuits, and to apply the most effective methodology for achieving worthy ones.
For instance, in the case of the running back who informed you that his coach recommended he gain
weight, your first step should be to speak directly with the coach to learn more about his
recommendation, and what a realistic weight goal for your adolescent should be. Once you and the
coach have reached a mutual understanding with your adolescent's best interests in mind, you can
begin discussing specific nutrition strategies, to help him begin working toward his goal.
In the case of your daughter, however, you’ll want to tread quite differently. First, you’ll need to
address the comment and the context in which it was made. You’ll want to reinforce that high school
boys (or girls) can be real you-know-whats, and help her internalize the reality that only the opinion of
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people she loves and cares about matters (and, even then, within reason). Without going off on a
psychologist-esque tangent, the point here is to first address the source of the comment, and then
provide positive encouragement and grounding words to lighten and reframe the situation. Once the
adolescent is amenable to making change for the right reasons, you can then take the opportunity to
suggest that you two work together to both make healthier decisions when it comes to nutrition and
exercise.
The majority of the following discussion centers around healthy weight loss, but there is a section
dedicated to healthy weight gain, too, as you’ll find that common in adolescent boys (and some girls).
As you read on, bear in mind that having an accurate understanding of the reason behind the
adolescent’s desire to make either type of bodyweight change better equips you to assist him or her
with taking the next steps to do so.
Discussing Healthy
Weight Loss
At this point, you have a clear
understanding as to why your athlete
wants to lose weight. Now, it’s time
to discuss expected outcomes and realistic goals with your adolescent. You can start this discussion at
the scale.
While it helps to reinforce that the number on the scale does not define your adolescent or any
person, he or she likely has a specific weight goal in mind.
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“I want to be 125 pounds,” says your tall 16-year-old daughter who plays softball.
“I want to be 185 pounds,” says your skinny 15-year-old son (who plays video games).
The first step towards helping an adolescent make the nutrition changes that will help them attain
their goals is to help them understand that chasing some goals is inefficient and counterproductive.
Explain to them that how they feel and perform, be that in sports, class or the upcoming piano recital,
are far more important than any number on the scale. Proceed to underscore that feeling and
performing well at a number 10 pounds higher is the far better alternative to feeling and performing,
well, like crap, at their desired weight. Such discussions will help pave the way for a long-term pattern
of making wellness-oriented food choices in favor of restrictive, short-term behaviors in service of
chasing an arbitrary number.
Note to parents: When preaching body confidence and long-term wellness over
short-term, superficial goals, make sure to practice what you preach! If your
adolescent see you as being preoccupied with appearances and/or weight, the
odds that your words alone will inspire them to do - and think - differently are
very slim (no pun intended). By contrast, leading a healthy, balanced lifestyle that
emphasizes physical (and psychological) wellness and perseverance over looks or
numbers will inspire them to follow in your footsteps.
Once you’ve removed scale-driven thoughts from both of your minds, focus on one aspect of your
adolescent’s day that can be adjusted slightly to begin working toward his or her goal. For instance, if
your daughter wants to lean out to improve her confidence and sport performance, assess her bedtime
eating habits may be a good place to start. If the family-size bag of chips in the pantry is making its way
to her room after dinner each night, that’s low-hanging fruit for improving her eating habits and
helping her reach her goal. (And, speaking of fruit, some would be a great replacement option for
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those chips!) But, before imposing this starting point on her, first ask for her preference, giving her the
opportunity to identify an eating habit, meal or snack that may be improved. Your buy-in on her
suggested starting place will help her feel supported, and tackling the manageable improvement she
identified will fuel further successes towards her larger goal.
Additional times of day that can commonly use some improvement include:
Breakfast:
Is your adolescent making poor choices or skipping breakfast altogether?
Daytime Snacks:
Is your adolescent relying on the vending machine or packing nutritious
options from home?
Lunch:
Do you play a role in him or her packing lunch?
Bedtime Snack:
What is your adolescent gravitating toward after dinner?
Healthy weight loss will come as a result of small changes and consistency. There’s no need for calorie
counting, macronutrient math, precise portion control, or any restrictive methods. Instead, the optimal
approach is to identify one potential area for change and to dedicate his or her (and your) time and
energy to that area until it evolves into a healthy habit. Then you can move on to the next area for
another small win.
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Making Weight For
Weight-Based Sports
If you’re working with a gymnast,
rower, wrestler, martial artist, or
weight lifter, to name a few weight
class or aesthetic-focused sports, he or she will likely be met with peer or even coach-derived pressure
of achieving or maintaining a certain weight to stay competitive in the sport. All too often, the dream
of competitive dominance takes precedence over the adolescent’s short and long-term health, which
happens just as much at the hands of the parents and coaches as the youth athletes themselves.
Extreme measures such as borderline starvation, intentional dehydration, use of laxatives and
diuretics, spitting to expel saliva, exercising in multiple layers of clothing or trash bags, or spending
prolonged periods in the sauna are employed to drive drastic weight loss in a very short amount of
time. Though some adolescent athletes would disagree, the feeling of euphoria upon making weight
doesn’t begin to justify the potential health risks of rapid weight loss.
Some of these are severe dehydration, stunted physical and cognitive development, and an unhealthy
relationship with food, exercise, and body image from a young age. Not to mention that these
practices have a negative impact on performance in the very sport the weight loss for.
“But my adolescent needs to cut weight… what should I do?”
Firstly, you, your athlete, and his or her coach should determine a healthy, competitive weight for him
or her. Once all three of you need to be on board with the agreed-upon weight goal, you can
effectively work together to develop a measured and sustainable weight loss strategy.
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As well-informed coaches will tell you, significant weight loss should not be sought in-season, as calorie
restriction will be detrimental to performance. Instead, slow and steady weight loss should be a
primary focus during the off-season, and should incorporate health-(and success)-oriented principles
we discussed, like picking and tackling one small change at a time.
With younger adolescents, it’s likely that a simple change or two in eating behaviors (and possibly a
broader change in the family’s behaviors) will provide plenty of impetus for the desired weight loss. As
previously discussed, there shouldn’t be an increased focus on calories or macronutrients, but rather a
focus on food choices and appropriate portions.
Some sample behaviors to focus on include:
Choose fruit over chips and candy
Keep bedtime treats to four nights per week (versus seven)
Choose more vegetables instead of carbohydrates when going back for
seconds (or thirds) at dinner
Older adolescents (who exhibit sufficient overall maturity for their age) may benefit more from precise
portion control that involves a focus on serving size(s) per meal and per day than from a few simple
swaps. An example goal for this age group may be to reduce daily fat intake by one serving, or to
choose another serving of vegetables when still feeling hungry after dinner.
The troubling fact is that adolescents involved in weight and physique-based sports are at a greater risk
for developing eating disorders or disordered eating behaviors compared to those involved in other
sports. The following section will detail the differences between eating disorders and common
disordered eating behaviors, and itemize specific red flags to be on the lookout for.
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Red Flags of Disordered
Eating Behaviors
Did you know that nearly all eating
disorders
develop
during
the
adolescent years? To help prevent
your adolescent from taking a turn down this sad and dangerous road, it’s critical that you’re aware of
several warning signs of potential disordered eating.
When we refer to “eating disorders” we’re referring to anorexia nervosa and bulimia nervosa, the two
most commonly diagnosed eating disorders. However, we’ll also define binge-eating disorder, as well
as orthorexia, both of which fall under the umbrella of disordered eating. What’s the difference
between an eating disorder and disordered eating? Eating disorders are diagnosed mental conditions
that are only diagnosed after a person meets a specific set of criterion. Disordered eating, on the other
hand, is a general term to describe unhealthy or obsessive eating behaviors. While these may not meet
the specified criterion for a true medical diagnosis, they’re equally important to recognize, as they can
be just as dangerous and unhealthy as “full blown” eating disorders.
Anorexia Nervosa: Anorexia nervosa is an eating disorder in which a person is obsessed with weight,
body shape, and food intake to the point of self-imposed starvation. In other words, this psychological
disorder is characterized by an all-consuming fear of becoming fat. To prevent weight gain and/or
continue to lose weight, anorexics will severely restrict food intake or exercise excessively, and are
typically seriously resistant to treatment (largely due to the belief that anyone who recommends a
change in their behavior is maliciously trying to thwart their progress -- a distrust that comes with this
disorder’s territory). Not surprisingly, a person with anorexia is often frail and noticeably thin for his or
her frame.
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Bulimia Nervosa: Bulimia is characterized by a cycle consisting of two distinct phases: binging and
purging. A person with bulimia nervosa has recurrent and frequent episodes of eating unusually large
amounts of food, regarding which he or she experiences a lack of control. This binge-eating is followed
by a compensatory behavior, such as forced vomiting, excessive use of laxatives or diuretics, fasting,
excessive exercise, or a combination of these behaviors. Unlike anorexics, bulimics may present with a
normal weight or even be slightly overweight.
Binge-Eating Disorder: The the most common eating disorder in the United States, binge-eating
disorder is one whose sufferers also loses control over their eating, but unlike bulimics, do not use
compensatory behaviors afterward. People with binge-eating disorder are often, but not always,
overweight.
Orthorexia: This is an obsession with eating “healthy” or “clean” foods. A person who has orthorexia
goes out of his or her way to avoid “unhealthy” foods, which is ironically accompanied by an
unhealthily restrictive approach to portion control and food selection. Although this is not formally
characterized as an eating disorder, it’s a significant type of disordered eating.
Eating Disorder Red Flags
1. Chronic comparison to others
Does your adolescent talk about looking like a celebrity, athlete, or peer around the clock? If so, it’s
important to chime in early on, and counter this “body hero worship” with positive encouragement
and compliments about his or her own body aesthetic and its capabilities.
2. Denies or avoids compliments or praise
Avoiding praise or actively rejecting it may be a sign that your adolescent is not happy with his or
her current physique. Be aware of this behavior and be quick to intervene to identify the reason
behind his or her avoiding compliments.
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3. Preoccupation with body image
If your adolescent is constantly obsessing with how he or she looks, you need to take notice. This
may be expressed in consistent wardrobe changes, rapid change in clothing style, always looking in
the mirror, recurring talk about specific body parts or areas, etc.
4. Linking food with feelings of guilt or anxiety
If you hear a negative association between food and how your adolescent feels at any time, you
need to quickly intervene to help him or her change the nature of such thoughts. Equating specific
foods or food groups to shame, guilt, or anxiety is an abnormal thought pattern, which can and
likely will lead to abnormal - read “disordered” - behavior. Turn the conversation positive and steer
it away from black and white thinking. Try emphasizing that weight gain or other side effects of
overeating don’t happen overnight, no matter how many oatmeal cream pies he or she had last
night. Remind him or her that moderation, good health and wellbeing all go hand in hand. And,
most of all, assure him or her that he or she is more than the sum of his or her parts, and is liked
and loved for who he or she is, not what he or she eats.
5. Specific food or food group avoidance (becoming a picky eater)
As disordered eating habits develop, it’s likely that your adolescent may begin avoiding certain
foods or food groups as they slowly work towards eating less and less. This is often the beginning of
anorexia nervosa. Be keenly aware of this.
6. Constant dieting behaviors and obsession with weight
If your adolescent is always concerned about his or her weight (obsessing over the scale or about
the reflection in the mirror) and constantly “dieting”, you need to take notice and dive in. He or she
likely needs education and help with reframing his or her attitudes about him or herself and food.
7. Social withdrawal
If your adolescent is spending less and less time with family and friends, especially when meals are
shared or food is served, this may be a warning sign of a poor relationship with food and body
image.
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8. Major change in clothing style or wearing baggy clothes
A major change in clothing style may reflect his or her desire to hide him or herself because he or
she feels ashamed of his or her body.
9. Deceptive behavior around food
Constantly playing with food on the plate, eating painfully slowly, or continuously stating a lack of
hunger are red flags worth further investigation.
10. Goes MIA after meals
If your adolescent is consistently hard to find after meals, this may be a red flag that he or she is
purging in some way.
11. Major uptick in exercise habits
If your adolescent is spending considerably more time exercising than he or she used to, initiate a
conversation to learn why, so you can vet his or her new-found motivation and/or methodology for
unhealthy tendencies.
Our disclaimer for the above is that these are potential warning signs, and not definitive diagnostic
material. Keep in mind that adolescents often display odd eating behaviors as they navigate their
teenage years. You should recognize when they occur, but be more concerned if you notice a pattern
of behavior rather than the occasional one-off. These possible red flags should serve as springboards
for discussions on nutrition and body image with your adolescent. If you’re involved and perceptive in
your observations and such follow-up discussions, you’ll be able to discern whether you’re dealing with
a more typical adolescent “phase”, or the beginnings of disordered eating behavior. As unsettling as
the latter may be, catching it early so you can enlist the help of medical and mental health
professionals is a far better option than turning a blind eye to a potential red flag, which will allow the
problem to take root in your adolescent’s mind, and body.
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The Female
Athletic Triad
As a case-in-point of what chronic
prolonged energy restriction can do,
we can look to the female athlete
triad. This term refers to the interrelationship between low energy availability (with or without an
eating disorder), menstrual dysfunction, and decreased bone mineral density, which trifecta is
unfortunately common among female athletes.
Energy Deficiency With or
Without Disordered Eating
Menstrual Disturbances /
Amenorrhea
Bone Loss / Osteoporosis
Energy Deficiency With or Without Disordered Eating
A chronic calorie deficit is the main cause of the triad, as this deficit significantly impacts menstrual
regularity and bone health. This energy deficit may or may not present alongside an eating disorder or
disordered eating.
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An energy deficit is common in female athletes due to the synergistic impact of societal pressure to be
thin and the increased energy demands of the sport. Most teenage female athletes grossly
underestimate the number of calories they burns during training. Combined with a propensity to
restrict calories due to (real or perceived) social pressure, a chronic calorie deficit may develop.
Menstrual Irregularities and Amenorrhea
As a result of sustained calorie restriction, a female’s menstrual cycle may become irregular or stop
altogether. We’re not talking about normal occurrences of being a few days early or late on occasion,
typically caused by fluctuations of stress levels or sleep duration (after all, being stressed out and sleep
deprived often comes with the territory of being a modern teen). But if you notice that she is
consistently irregular or misses her menses altogether, there’s reason for concern, which should be
channeled into scheduling an appointment with her physician. If she is in a calorie deficit for too long,
she may lose her period altogether, which is known as amenorrhea, a condition with serious
repercussions for both fertility and bone health.
Bone Loss and Osteoporosis
By decreasing estrogen levels and increases calcium depletion from the bones, amenorrhea increases
the risk for osteopenia or osteoporosis, which are characterized by significant thinning of the bones
and loss of bone mineral density. This detriment, in turn, increases a woman’s risk for bone fractures
and breakages, and may seriously impact her competitive career.
Hyper-competitive females participating in weight class or aesthetic-focused sports, or those with a
type-A personality are most at risk for the triad. The first signs of trouble will likely present in her
eating behaviors, specifically as any of the red flags we previously discussed. Failure to recognize these
early warning signs may lead to eventual menstrual irregularities, followed by poor bone health.
If you suspect signs of disordered eating, chronic calorie restriction, or note menstrual irregularities,
the first step is to schedule an appointment with your adolescent’s physician, who will conduct a
thorough medical exam and assess nutrient needs and lab results before determining a course of
action. In parallel, it’s wise to also connect with a local registered dietitian who can help the adolescent
start eating to appropriately meet her needs while maintaining a healthy weight.
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Healthy Weight
Gain
If determined that your adolescent
should in fact gain weight, same as
with weight loss, your job is to help
ensure that he or she approaches this goal in a healthy way. Common behaviors that arise from a goal
of wanting to gain weight include increased reliance on fast food, use of protein powders, bars, preworkout supplements, weight-gainer shakes, and even testosterone boosters or steroids. As you may
have guessed, none of these are habits that will help build a foundation of healthy eating as such, or
healthy weight gain in particular.
Build A Foundation of Healthy Eating
Whatever your adolescent’s goal, establishing a foundation of healthy eating is paramount. The
building blocks of that foundation are lean proteins, high-fiber carbohydrates, healthy fats, and ample
fruits, vegetables, and dairy. Again, whether the adolescent’s goal is to lose, gain or maintain, any goalspecific diet should be constructed from these core components. Once these are ingrained, for the
purposes of this section, you and your adolescent can begin to implement specific weight gain
strategies.
Premium Weight Gain Snack
Earlier in this book we discussed what your adolescent’s premium fuel plate and basic snack should
look like. A weight gain snack, however, is a little different, in that each one should contain a premium
protein, a premium carbohydrate, and a premium fat.
Example snack combinations include:
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Beef jerky, a handful of nuts, a
piece of fruit
A turkey and cheese wrap with
half an avocado
A bowl of high-fiber cereal (with
whole milk) and spoonful of
peanut butter
After reviewing some of the examples above, you may view those combinations as “meals” rather than
“snacks. It’s best not to get locked into traditional “snack” versus “meal” foods dichotomy. Instead,
focus on ensuring that the adolescent has all necessary components to support the goal of healthy
weight gain. Remember, food is their literal fuel for muscle growth. As such, what matters most is that
he or she is refueling often enough, and choosing high-quality fuel when so doing.
Include Calorie-Dense Options
One major reason adolescents struggle to put on weight is that they reach a point of fullness before
they’re able to consume the number of calories they need to obtain the necessary surplus to drive
weight gain. Energy demands are likely at or just below the highest they’ll ever be for his or her size at
this time, so, their baseline energy needs are already high enough.
Calorie-dense foods are those that provide substantial calories per bite. These foods can still provide
great nutritional value, too, so long as you and your adolescent are making wise decisions. Examples of
calorie-dense foods include: nuts and seeds, nut and seed butters, avocado, olive and canola oil, oats,
whole-wheat pasta, whole-wheat bagels and tortillas, dried fruit, and homemade shakes and
smoothies.
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Weight Gainers
The
fact
supplements
that
weight
are
gainer
specifically
marketed to adolescent boys is a
testament to the popularity of the weight gain goal for this demographic. Unfortunately, what you end
up paying for is a large vat of whey protein concentrate mixed with a copious amount of sugar. And
moreover, a serving size is often three to four scoops, which means you’ll need to buy another vat of
sugar in a few short weeks. Rather than wasting your money on weight gainer shakes, make your own
at home.
Combining premium protein, carbohydrates, and fats will ensure that you’re still providing your
adolescent with a nutrient-dense snack, but one that’s heavy on necessary, not empty, calories.
Start with a base other than water, like fruit juice or milk, which will provide the added calories your
adolescent needs. From there, select a protein source. Milk, Greek yogurt, and whey protein work very
well. When choosing carbohydrates, consider oats, and frozen or fresh fruit. And, lastly, consider
adding nut butter, flax seed, or avocado to further increase the shake’s caloric density.
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Weight Gain 1: Tropical Mass Shake
1.25 Cups Plain Greek Yogurt
Protein
Net Carbs
Fat
25
9
14
2 Cups 100% Orange Juice
50
1 Cup Fresh or Frozen Strawberries
9
1/3 Cup Frozen Avocado Chunks
6
Water, as needed
Total Recipe
25
68
20
Directions:
Add everything to a blender and blend until smooth, adding water
to reach desired consistency.
Weight Gain 2: Monkey Mass Shake
Protein
Net Carbs
1.5 Cups Skim Milk
13
18
Roughly Half a Scoop of Protein Powder
12
3 tbsp Peanut Butter
Fat
23
2 Fresh Medium Bananas
50
Water, as needed
Total Recipe
25
68
23
Directions:
Add everything to a blender and blend until smooth, adding water to
reach desired consistency.
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Whey Protein Supplements
A whey protein supplement can be an invaluable tool for helping your adolescent gain weight, though,
not likely for the reason he or she thinks. He or she may think that, to build more muscle, he or she
must eat even more protein. Although eating enough protein is crucial to optimizing muscle growth,
simply eating more than enough doesn’t result in becoming more muscular.
That said, having whey protein handy will serve two important purposes to support your adolescent’s
goal of weight gain. Firstly, it serves as a convenient source of high quality protein that may help him
consume (enough) protein at times when he would otherwise go without it. For instance, if your
adolescent typically has no appetite after a workout, he or she may find it easier to drink a shake
versus eating whole foods, which will have a positive impact on muscle growth and recovery. Secondly,
whey is a travel-friendly snack that can supplement typically carbohydrate-laden on-the-go choices,
thereby further supporting muscle growth and repair.
When used appropriately, that is, primarily during or immediately after exercise, whey protein is
simply another source of high quality protein, comparable to eggs, chicken, or beef, but sometimes
more convenient due to its powdered form.
Protein Bars and Ready-To-Drink Shakes
It’s not unusual for adolescents to think that bars and shakes are all that is missing from his or her
weight gain plan. Although these options can serve as occasional on-the-go meal replacements or
supplementary sources of calories, they shouldn’t be the foundational pillars of an adolescent’s diet.
Instead, they should enhance an already sound groundwork of healthy eating, and be used as
necessary to increase the adolescent’s calorie intake or supplement a typical meal during a busy day.
Times when these may come in handy include snack time during a school day, before or after exercise,
or as an evening snack in lieu of a sitdown one.
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REFERENCES
1. Smolak, L. (2011). Body image development in childhood. In T. Cash & L. Smolak (Eds.), Body Image:
A Handbook of Science, Practice, and Prevention (2nd ed.). New York: Guilford.
2. Eating Disorders and their Precursors. The National Eating Disorders Organization. Adapted by
Creighton University. Retrieved from:
https://www.creighton.edu/fileadmin/user/StudentServices/StudentSuccess/EatingDisorderStatisti
cs.pdf. Accessed January 30, 2018.
3. Neumark-Sztainer, D. (2005). I'm, like, SO fat!: helping your teen make healthy choices about eating
and exercise in a weight-obsessed world. Guilford Press.
4. Centers for the Advancement of Health. (2007). Teenage Girls Starting A Diet, Twice As Likely To
Start Smoking. ScienceDaily. ScienceDaily, 1 September 2007.
www.sciencedaily.com/releases/2007/08/070831142351.html.
5. Field, A. E., Sonneville, K. R., Crosby, R. D., Swanson, S. A., Eddy, K. T., Camargo, C. A., ... & Micali, N.
(2014). Prospective associations of concerns about physique and the development of obesity, binge
drinking, and drug use among adolescent boys and young adult men. JAMA pediatrics, 168(1), 3439.
6. Weltzin, T. E., Weisensel, N., Franczyk, D., Burnett, K., Klitz, C., & Bean, P. (2005). Eating disorders in
men: Update. The journal of men's health & gender, 2(2), 186-193.
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7. Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating
disorders in the National Comorbidity Survey Replication. Biological psychiatry, 61(3), 348-358.
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CHAPTER 8
FOSTERING A HEALTHY HOUSEHOLD
In the beginning of this book, we discussed the role you play as a role model in
potentially developing and positively shaping the nutrition habits of your adolescent.
We briefly discussed how observant adolescents are, particularly the prepubescent
ones, and how much your habits and choices impact theirs.
Having explored the adolescent’s nutrient needs and strategies for discussing - and
fostering healthy changes in - nutrition and body image, we’ve come full circle to the
discussion of you as a role model. Specifically, we’ll now discuss the nutritional
environment in which your adolescent’s eating habits mature and take shape, also
known as “home”, as well as how these habits may positively influence lifelong eating
habits. As part of this discussion, we hope to provide you with specific tools for
cultivating a healthy household amidst the hustle and bustle of daily life.
As you review the strategies discussed in this section, please note that, while they may
help you positively influence your athlete’s eating habits, this is by no means
guaranteed. Yes, it’s possible that your child will take little or none of these strategies
with them into adulthood, but that isn’t as gloomy as it might first sound. Whatever
happens once they’re grown, healthy, fitness-conscious eating during the adolescent
years promotes healthier, happier, and more athletically accomplished kids while they
are in your care. And, if we can do even a bit on the side of permanent habit change
they can take with them through life, we’ll take all we can get!
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Make Family Meal Time
A Priority
As far back as I can remember, my
family and I ate dinner together
almost every night. My siblings and I
had our assigned (“favorite”) seats, and my parents created a routine to help ensure we were all
served in a timely fashion. Sure, this was an opportunity to connect and bond with my parents and
siblings, but it was also a foundational habit that shaped my eating behaviors.
Not only did my parents use family meals as opportunities to expose us to a wide variety of food,
particularly fruits and vegetables, but, importantly, these meals gave us kids the chance to see my
parents eating those foods, too. Lucky for us, not only were our role models there to encourage us as
we tried our first bites of a number of new foods, but, from a young age, we saw our parents
essentially practicing what they preached. So, as I heard “Paul, take a few bites of your cauliflower”, I
was simultaneously seeing them eating that same cauliflower in that very moment.
(Such observations may also explain why I enjoy dipping my fries in ketchup mixed with mayonnaise…
thanks, dad!)
I may not have always liked the menu (one time I asked to be excused from dinner to use the
bathroom and was caught spitting out my broccoli…), but these family meals were defining moments
in shaping my relationship with food.
So, it’s from a personal place that I make the strong recommendation to make family meal time a
priority.
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Even if sharing a meal together isn’t feasible every single night of the week, making it happen as often
as possible may provide ample opportunities for teaching about and discussing the merits of healthful
food and nutrition, not to mention memories that last a lifetime.
Research published in the journal Pediatrics observed the family eating habits of over 180,00 youth and
adolescent boys and girls, and found that, in households that ate at least three family meals together
each week experienced “a reduction in the odds for being overweight (12%), eating unhealthy foods
(20%), and risk of disordered eating (35%), as well as an increase in the odds for eating healthy foods
(24%).” 1
Furthermore, several studies have shown that regular family meals are strongly associated with
increased consumption of fruits, vegetables, whole grains and other healthy food choices, while also
being linked with decreased consumption of fried or fatty foods, soft drinks or other less healthy foods.
Children and adolescents growing up in homes where communal meals are had may also be less likely
to develop childhood obesity. Incidentally, of teens who eat with their family fewer than three times a
week, 20% get Cs or lower on their report cards, according to a National Center on Addiction and
Substance Abuse report1, while only 9% of teens who eat frequently with their families do this poorly
in school.
Missing a family meal is not going to send your adolescent into a sugar-filled being, nor is it going to
lead to him bringing home a “C” on his next assignment. However, prioritizing family meal time may
offer excellent opportunity to not only bond and make memories, but also to model healthful eating,
and provide sounds answers to his nutrition, exercise, or general health questions.
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Grocery Shop
Together
We’ve already discussed the upsides
of allowing your adolescent to
participate in food shopping with
you, but it bears repeating. Sure, doing so may not be all roses (or heirloom tomatoes, for that matter),
especially at times when you feel stressed and pressed for time, and when your adolescent is being,
well, an adolescent. Even still, remind yourself that these experiences may help cultivate a positive
relationship with food, and use the time together to catch up and catch your respective breath,
possibly while breathing in some dill or basil.
Keep in mind also that a trip to the grocery store opens up a brand new world to your adolescent,
who’s likely used to just those staples that you typically bring home. Here, the young woman can see
how the foods she knows fit in with other, similar foods, discover alternate varieties of familiar foods,
and stumble upon completely new and different choices. Besides being fun and even exhilarating and
exposing him or her to a new world of possible flavors and cuisines, the grocery store is a perfect
setting for nutrition education and exploration. Likewise, seeing a food in different form, like raw or
unprocessed, may suddenly entice the adolescent to try it.
Why does repeated and new exposure matter?
For one thing, toddlers and adolescents alike are still likely to explore new items with their mouths.
Exposing them to a variety of nutrient-dense foods from a young age may help you to hook them while
they’re young. As they get older, the opportunity to touch, smell, taste and see new foods provides a
major impetus to try them, and possibly love them. And it’s the repeated exposure that may lead to a
positive change in the relationship with said food.
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For instance, in support of repeated exposure to food, a 2003 study published in the European Journal
of Clinical Nutrition offered children pieces of sweet red pepper and asked them to rate how much
they liked it.2 Each day for the next eight school days, they were then invited to eat as much of the
pepper as they wanted. On the final day, the kids were again asked to rate how much they liked it.
By the end of the experiment, the children rated the pepper more highly and were eating more of it,
and even more than another group of children who were offered a reward for eating the pepper.
These results suggest that a little more exposure and a little less "You can leave the table once you
finish your broccoli!" will teach kids to enjoy new foods, even if they don't at first.
Also, a trip to the grocery store may be a valuable teaching moment to show him or her how to read
and interpret food labels. Showing an adolescent how to read a nutrition label and actually comparing
two similar products to identify the healthier option are a great exercise. Such coaching will prepare
your adolescent to make smart food choices when they don’t have you by their side to guide them.
This can also help arm older adolescents with the knowledge and confidence required to make good
nutrition choices when they go off to college.
Prepare Newly Purchased
Food and Meals
Togethers
Seeing something through from
beginning to end yields a special and even addictive - kind of pride
and joy. So, venturing to the grocery store with you, picking some intriguing foods and then helping
prepare and serve them to the family that same night may leave your adolescent with this awesome
feeling of “end to end” accomplishment (among other great tastes) in their mouth.
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Relatedly, when your adolescent chooses a new food such as an exotic in-season fruit or an obscure
locally grown vegetable, prioritize including it in an upcoming meal, so he or she can continue to feel
involved. If you are unsure how to prepare it, look it up! Walk your adolescent through all of the
preparation steps, including washing, cleaning and cutting, followed by some tips and tricks for cooking
that particular type of food on that medium, be that searing it on the grill, seasoning it on the stove top
or drizzling it in its own juices in the oven. Hassle (and potentially strange taste) or not, remember that
engaging your adolescent in food selection and prep may help pave that foundation of a healthy
lifelong kinship with food.
To this end, stay patient and encouraging during the process, and, once served, make sure you and the
rest of the family all try your adolescent’s creation, and keep the mood light and complimentary.
Play your cards right, and he or she may want to do it all over again another night (to your delight
and/or dismay)!
Pack Lunches
Together
The desire to ensure that your
adolescent’s lunch features only
healthy,
responsible
choices
notwithstanding, it’s important to fight to the urge to pack it for him or her. Instead, allow the
adolescent to participate, and select at least one item. This may again increase his or her sense of
efficacy about making food choices, and again increase the likelihood that the food chosen is actually
eaten.
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A sound approach is for you and him or her to agree on a few different foundational elements of each
lunch, and, from there, hand you adolescent the decision-making power on at least one element of it
every day. For instance, you may agree on the following foundational blueprint:
A lean protein sandwich (on a whole grain roll, bread, or tortilla, of course!)
A serving of fruit
A serving of vegetables
A snack or “treat”
If your adolescent is most interested in the snack or “treat” component, ask him or her to choose
another element first, and also provide consistent, gentle reminders to save the snack or “treat” for
last, to enhance the likelihood that all other nutrient-dense options get eaten.
Openly Discuss Food
And Nutrition
While our moms were right that
there’s no need to talk with our
mouths full, we certainly can, and
should, seize chances to discuss food and nutrition (in between bites, perhaps)! Supplementing the
actual act of eating with conversation about food is especially beneficial for younger adolescents, who
are actively contextualizing their experiences, and might enjoy the extra explanations. So, explain why
you prepared what you did for dinner, and never hesitate to include a nutritional information nugget
or three. The more an adolescent is exposed to sensical, consistent facts and health-oriented attitudes
from a young age, the more likely he or she may be to embrace good eating habits down the road.
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Taking the time to share some nutrition tidbits about each meal, highlighting the benefits of choosing
one food over another at the grocery store, and offering a fun fact about a component of his or her
daily lunches may all go a long way, for a long time to come.
#FamilyGoals
Make healthy eating a family affair,
and turn it into some family fun
while you’re at it. A strategy that
may help you foster a fun family approach to healthier eating is a sticker-based system that tracks one
or more components of a family’s eating habits. One family with a seven and a nine-year-old used this
strategy to track the number of meals eaten as a family each week, and/or the number of servings of
vegetables eaten by each member each day.
WEEKLY MEAL INTAKE
SUN
MON
TUE
WED
THURS
FRI
SAT
Dad







Mom







Daughter







Son







On the refrigerator, in plain sight, the parents hung a printed calendar to track family meals, and a
handwritten (by the nine-year-old) chart to track daily vegetable intake each week. Each time the
family sat down together for a meal, one of the adolescents put a sticker on the calendar. If the family
got at least six stickers per week, everyone got a prize. Additionally, each person in the family put a
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sticker next to his or her name on the vegetable tracker for every vegetable consumed that day.
Anyone with at least three daily veggies for six out of seven days got a prize.
This incentive-based program was fun, educational, and drove all family members to increase the
number of family meals and veggies they were having, and to reap the benefits of both.
In this case study, the children and the parents found themselves having fun, and the parents had the
added pleasure of knowing that their adolescents were eating so well.
To try this at home, a list of non-food-based rewards can be found for review in Chapter 3.
Small Changes
Add Up
Remember, small steps add up over
time and can turn into greater
strides toward a healthier lifestyle.
So, don’t expect for your family’s eating culture to do a 180 turnaround overnight, but rather focus on
one small area for improvement at a time, and work to instill healthier habits around it. Once your
tribe gets into the groove of the new and improved eating behavior, move onto the next, helping your
adolescent(s) feel personally invested in shaping each new routine, which will in turn help them
internalize it.
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It’s Never Too Late
To Start
If you’re trying to make a positive
change in your family’s eating habits
by the time your children are in mid
or late adolescence, don’t despair. It’s never too late to begin cultivating better eating (and drinking!)
habits, even if your teenager makes you feel otherwise. Stick with it, and sooner or later, that sulky
fifteen-year-old might just want to join you on your next grocery store trip or start voluntarily choosing
water over neon bright sports drinks. (Warning: the teenage angst may not go away for some years
yet, improved diet or no.)
If your own nutrition needs improvements, “be the change”, and share what you’re learning and how
eating better makes you feel with your adolescent. If your nutrition is already in good shape, as you
strategize improving theirs, rather than attempt a sudden, swooping overhaul. employ the earlier
recommendation to optimize one specific eating habit in your adolescent’s day. Sometimes, replacing
their Toaster Strudel breakfast with a balanced one can also send healthful ripple effects through the
rest of their day.
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REFERENCES
1. Hammons, A. J., & Fiese, B. H. (2011). Is frequency of shared family meals related to the nutritional
health of children and adolescents? Pediatrics, 127(6), e1565-e1574.
2. Wardle, J., Herrera, M. L., Cooke, L., & Gibson, E. L. (2003). Modifying children's food preferences:
the effects of exposure and reward on acceptance of an unfamiliar vegetable. European journal of
clinical nutrition, 57(2), 341.
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CHAPTER 9
NUTRITION SUPPLEMENTS AND
ERGOGENIC AIDS
The purpose of this chapter is to provide you with a brief overview on the purpose,
potential health consequences, and recommendations on supplements commonly
discussed and taken by adolescents. This chapter is not meant to serve as an in-depth
overview of each supplement, but rather as an informal overview of some popular ones,
the reasons they’re sought out, and potential complications and health risks of each. For
more information on sports nutrition supplements, check out the Renaissance
Periodization Diet Book.
A survey published in Clinical Nutrition assessed the supplement habits of 1,248
students between the ages of 16 and 20 across five different major universities.1 Results
indicated that 66 percent reported using a dietary supplement and reasons for use were
to enhance muscle strength, performance, or endurance. The supplements reported
being taken included protein, amino acids, herbal supplements, caffeine, creatine, and
combination products.
Moreover, the American Academy of Pediatrics conducted a large review of sports
nutrition supplement use among adolescents, and concluded that protein, creatine, and
caffeine were the most commonly used ingredients, the use of which increased with
age.2 However, as we’ll discuss, steroid, prohormone, and synthetic human growth
hormone use is on the rise, and something you need to be keenly aware of as well,
especially if raising or mentoring youth athletes.
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Protein and Amino Acid
Supplements
As
aforementioned,
common
misbelief
there’s
a
among
adolescents that they need to eat
more protein in order to build muscle. As a result, they’re eager to get their hands on everything from
protein bars to supplements to amino supplements in the hopes that regularly consuming these
products will significantly improve muscle mass. We’re here to tell you that this isn’t the case.
Providing whey protein to your adolescent is safe. Whey protein is the one of two primary proteins
found in cow’s milk. It also a high quality protein that contains all nine of the essential amino acids.
Protein powders and supplements may serve as excellent meal replacements and help to supplement
regular meals on the go or at times of reduced appetite, but by no means are they an essential or
necessary part of a healthy diet. Likewise, recent research suggests that there’s not enough research to
support the notion that amino acids alone play a critical role in aiding muscle growth. 3
Communication with your adolescent on this subject should revolve around discussing the true
benefits of protein, and, more broadly, of healthy eating habits as such, developing which is a
prerequisite for most efficiently reaching any body composition goals. In other words, the job is to
convince the adolescent that, while protein powder can be a useful addition to their diet, it’s shouldn’t
be its epicenter.
Creatine
Creatine is the most extensively studied sports nutrition supplement available. It’s been purported to
enhance muscle strength and size and to provide particular benefit to those in strength and power
sports (while being unlikely to provide significant benefit for endurance athletes).
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Creatine helps to provide plenty of cellular energy to the working muscles, so that they can accomplish
more work at higher intensities, and do harder work over time. The body produces it naturally in
minuscule amounts via in the liver, kidneys, and pancreas, and supplementation has been shown to
elicit its benefits by providing additional ATP (energy) to muscle cells during short bursts of energy. All
of that being said, while creatine ne supplementation has been extensively researched in adults, there
is little research on its effects in adolescents. That doesn’t seem to stop adolescents from using it,
though, as evidenced by a study published in Journal of Sports Science and Medicine, which found that
62% of junior high and high school athletes have used creatine to improve performance and recovery. 3
The International Society of Sports Nutrition has also published a large position stand on creatine
supplementation in 2007, and concluded that creatine supplementation is safe for high school-aged
athletes so long as the following criteria are met 4:
1. The athlete is past puberty and is involved in serious, competitive training that may
benefit from creatine supplementation
2. The athlete is eating a well-balanced, performance-enhancing diet
3. The athlete and his/her parents understand the effects of creatine supplementation
4. The athlete's parents are aware of and approve the teen’s usage of supplemental
creatine
5. Creatine supplementation can be supervised by the youth athlete’s parents, trainers,
coaches, and/or physician
6. Quality supplements are used
7. The athlete does not exceed recommended dosages
Monitoring creatine supplementation in your adolescent is one way to help prevent health
complications that may arise as a result of taking too much, such as dehydration, diarrhea, persistent
nausea, increased blood pressure, and muscle cramps. Importantly, despite your teen’s claims to the
contrary, there’s absolutely no need for him or her to do a “loading phase,” characterized by taking 20
grams per day for five to seven days.
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Instead, dosing should be carried out as follows:
3 grams per day Athletes weighing less than 150 pounds
5 grams per day Athletes weighing above 150 pounds
As always, it’s best to facilitate open conversation about creatine with your adolescent, and that you
specifically discuss the purpose and safe practices for it. Alarmingly, a study published in the Journal of
the International Society of Sports Nutrition linked an increased propensity for body image issues and
steroid use to use of creatine at an early age.4 This finding underscores the importance of using this
supplement appropriately and under your supervision, as well as keeping it out of the hands of
adolescents under sixteen years old.
Caffeine
Caffeine
is
a
central
nervous
stimulant that increases alertness
and focus and has been shown to
have a positive impact on cognitive and physical performance. Roughly one third of adolescents in
junior high and high school are estimated to have used or currently use caffeine to improve sports
performance, and many others are likely doing so to improve academic performance, or because it’s
“the thing to do” with their friends at the local diner of coffee shop. 5,6
The major concern with caffeine use in adolescents is the uncertainty about how they’ll respond. In
adults, 1,000 milligrams per day has been shown to have a toxic effect, and anything approaching
5,000 milligrams per day may cause death. For reference, an 8 ounce cup of coffee contains roughly 95
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milligrams of caffeine. There is very little research into the effects of caffeine on adolescents, and,
given that their bodies are still maturing, there’s reason to believe that they cannot metabolize as
much caffeine as an adult per day, even when they’re of comparable stature to an adult.
Aside from the consumer’s age and stature, other potential
considerations for caffeine intake include:
How quickly the caffeine is absorbed
How quickly the caffeine is metabolized
How quickly the caffeine is excreted from the body
What has he or she eaten recently
How well hydrated is he or she
Too much caffeine, which, again, may be far for the adolescent than it would
take for you, less may lead to any of these undesirable consequences:
Increased heart rate
Trembling limbs
Increased anxiety and nervousness
Irregular heart beat
Headaches
Nausea or vomiting
The biggest obstacle to controlling caffeine for adolescents is its widespread availability. As we
discussed earlier, caffeine is found in sodas, teas, energy drinks, and even pre-workout supplements,
all of which are readily available and specifically marketed towards teens. This heightens the
importance of communicating the potential dangers of caffeine intake to your adolescent, and
agreeing on some ground rules for his or her caffeine consumption.
Below, you’ll find a chart detailing recommended upper limits for caffeine intake based on weight. This
chart has been adapted from Health Canada.7
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Health Canada’s Guidelines On Daily Caffeine Limits
Age Range
Daily Caffeine Limit
Children 4-6 years old
45 mg
Children 7-9 years old
62.5 mg
Children 10-12 years old
85 mg
Teenagers 13-19 years old
2.5 mg per kg body weight
54 kg
120 lbs
135 mg
58 kg
130 lbs
145 mg
63 kg
140 lbs
160 mg
68 kg
150 lbs
170 mg
72 kg
160 lbs
180 mg
77 kg
170 lbs
195 mg
81 kg
180 lbs
205 mg
Adults 20 years
≤ 400 mg caffeine
Women:
Pregnant, breastfeeding, or
planning to become pregnant
≤ 300 mg caffeine
Prohormones, Testosterone Boosters, and Steroids
Let’s begin with a few key definitions:
Testosterone Boosters: Testosterone boosters are supplements that act to stimulate the body’s own
production of testosterone. These may be pills, powders, or herbs.
Prohormones: Prohormones lie somewhere between testosterone boosters and steroids in terms of
effectiveness. Prohormones are compounds that act as precursors to steroids, and are, in fact,
essentially the building blocks thereof… or at least that’s what we used to think. We are now fairly
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confident that nearly all the “prohormones” ever sold are actually just steroids, plain and simple, under
a new, fancy branding.
Steroids: Anabolic steroids are synthetic compounds designed to resemble the testosterone naturally
produced by the body, and mimic its positive impact on growth and recovery. Steroid
use also
increases the body's ability to build muscle and burn fat.
Synthetic Human Growth Hormone: Human growth hormone is naturally produced in the pituitary
gland, and plays a vital role in cell regeneration, growth, and maintaining healthy tissue. Synthetic
human growth hormone mimics these properties of human growth hormone, and is used to enhance
cell regeneration and muscle recovery to improve physique and performance. Although hGH is
available, it’s significantly more expensive than steroids. However, it’s something you should be aware
of. If your child is talking about it, there needs to be a clear understanding about how they plan to fund
this supplement, let alone a confirmation that what they’re taking is in fact true hGH.
Prevalence of Use
In Adolescents
In 2002, the National Institute of
Drug Abuse published a study on the
prevalence of steroid use in junior
high and high school-aged children.8 The study, which collected survey information, reported that 2.5%
of eighth graders, 2.5% of tenth graders, and 4% of twelfth graders admitted to using steroids at some
time in their life. The same study, which has been tracking steroid habits of youth since 1991, also
reported a noticeable increase in steroid use amongst this population in recent years.
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Both before and after this study, several other studies have looked at the prevalence of steroid use in
adolescents. Although it’s very tough to elicit accurate, definitive results, each has shown that
adolescents are indeed taking steroids, and their availability may be more prevalent and the number of
adolescents partaking higher than we would expect.
Understanding and sharing with your adolescent the potential consequences of using these substances
should be on the modern parent’s to-do list, especially so for parents of youth athletes.
Why Are Adolescents Using Performance-Enhancing Drugs?
The short answer: to build muscle, recover better, and ultimately increase performance. Users can
expect to experience a rapid increase in muscle mass and simultaneous decrease in fat mass, which has
a positive impact on strength, speed, power, and recovery. Unfortunately, the list of positives
associated with using performance-enhancing drugs is far shorter than their potential dangerous
consequences.
Consequences of Use
The following chart details gender-specific as well as general consequences related to prohormone and
steroid use:
Boys
Girls
General
Baldness
Growth of facial hair and
hair under the armpits
Increased acne
Development of breasts
Increased fluid retention
Deepened voice
Shrinkage of testicles
Breast reduction
Closing of growth plates – may stunt
growth for those not done growing
Infertility
Menstrual irregularities
Increase in “bad” cholesterol and
decrease in “good” cholesterol
Increased frequency of mood swings
Increase in aggressive behavior
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Testosterone boosters may not present nearly the same level of concern as prohormones and steroids
(provided that they re indeed testosterone boosters, and not one of the former substances
masquerading as such). In many cases, these may turn out to be expensive sugar pills, or oral steroids,
which may be even more toxic than traditional injectable steroids.
Note: Both steroids and prohormones are illegal, which you should be sure to share with your
adolescent, along with the likely consequences of being “busted” for their use by the authorities.
The use of any of the above anabolic agents has the potential to put your adolescent’s health, growth,
development, and, for the youth athlete, playing career at risk. To minimize the likelihood of use,
consistent, “straight talk” education should be provided to adolescents.
Third Party
Testing
The supplement industry is a moneydriven, unregulated branch of the
health and fitness industry that
deserves little trust. When it comes to selecting nutrition supplements for your adolescents, it’s
important that you’re choosing high quality, third-party-tested brands.
When a supplement is third-party tested, you can be sure that an independent company has vetted it,
not only for purity and quality, but to confirm that the ingredients and claims on its label are actually
what the supplement provides. You can identify such supplements by the seal or logo on its packaging.
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The two most popular third-party-testing companies in the supplement industry are Informed Choice
and NSF for Sport. When selecting sports nutrition supplements for your adolescent, you’ll want to
look for either of these logos:
For a complete and up-to-date list of third-party-tested sports nutrition supplements, please visit the
NSF for Sport Certified Supplement List or Informed Choice Certified Product List. These are brands
that meet the collegiate and professional drug testing guidelines by which your youth athlete will need
to abide, should he or she play at the next level.
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REFERENCES
1. Lieberman, H. R., Marriott, B. P., Williams, C., Judelson, D. A., Glickman, E. L., Geiselman, P. J., ... &
Mahoney, C. R. (2015). Patterns of dietary supplement use among college students. Clinical
Nutrition, 34(5), 976-985.
2. LaBotz, M., & Griesemer, B. A. (2016). Use of performance-enhancing substances. Pediatrics,
e20161300.
3. McDowall, J. A. (2007). Supplement use by young athletes. Journal of sports science &
medicine, 6(3), 337.
4. Buford, T. W., Kreider, R. B., Stout, J. R., Greenwood, M., Campbell, B., Spano, M., ... & Antonio, J.
(2007). International Society of Sports Nutrition position stand: creatine supplementation and
exercise. Journal of the International Society of Sports Nutrition, 4(1), 6.
5. Schneider, M. B., & Benjamin, H. J. (2011). Sports drinks and energy drinks for children and
adolescents: are they appropriate?. Pediatrics, 127(6), 1182-1189.
6. Temple, J. L. (2009). Caffeine use in children: what we know, what we have left to learn, and why
we should worry. Neuroscience & Biobehavioral Reviews, 33(6), 793-806.
7. Canada and caffeine
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8. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE, MiechRA. Monitoring the Future: National
Survey Results on Drug Use, 1975–2013, Vol. I: Secondary School Students. Ann Arbor, MI:Institute
for Social Research, The University of Michigan; 2014.
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CHAPTER 10
FAQS AND SPECIAL TOPICS
This section addresses some of the common questions and requested topics we receive
from parents of adolescents. Though we hope that many of these have already been
addressed within specific chapters of this book, the following key questions warrant
more detail and elaboration.
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Should I Force My
Adolescent To Finish
His Or Her Plate?
The adage that a child should clean
his or her plate before being allowed
to leave the table or enjoy dessert
was born in less certain and abundant times, during which the focus was more on salvaging harder-tocome-by food so as not to go hungry than on eating healthy.
But, mostly for better, times have changed.
Today, food is significantly more available and readily accessible. And portion sizes have increased
three-fold. That same “clean your plate” mentality has the potential to disrupt healthy eating habits
and to lead to childhood obesity.
The main issue with this recommendation is that it forces children to ignore bodily appetite cues in
favor of eating to fulfill an external goal. The trouble is, reliance on environmental indicators such as
the amount of food on the plate or the time of day to regulate food intake dulls our ability to discern
true hunger and fullness, and is, therefore, an undesirable habit.
To answer the original question: no, you shouldn’t force your adolescent to finish his or her plate.
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How To Navigate
The Appetite Issue
We know you desperately want your
adolescent to eat to support his or
her
growth,
not
to
mention
performance in all of his or her endeavors. Be that as it may, sometimes he or she may just not be
hungry. And it’s not terribly important whether this is because he or she had a big meal earlier,
snacked too close to dinner or isn’t interested in what’s being served: it happens, and it’s okay.
The first strategy to consider is to allow your adolescent serve him or herself as much or little as he or
she wants, instead of piling undesired food on his or her plate. Of course, your guidance and mandate
that he or she needs to choose one of every premium nutrient being offered is important, but allow
him or her to choose the amount he or she is in the mood for. And, if appetite picks up, he or she can
always go back for more!
Conversely, you may consider taking charge of portioning out his or her food, but beginning with “trialsize” portions. Try using smaller plates and bowels so that an overwhelming amount of food isn’t
served from the get-go. Again, if he or she is still hungry, he or she can always have seconds.
Your gentle nudges should come from a place of encouragement rather than control. Persuade your
athlete to have on more bite of or to give “food x” one more try. If he or she refuses, simply drop it and
make a mental note that perhaps this food isn’t in line with their current preferences. Or, again, he or
she isn’t hungry, in which case you can try it again in a few days or weeks.
Lastly, don’t focus on an isolated incident, but rather seek out a pattern. If your adolescent expresses a
disinterest in dinner once a month, it’s nothing to worry about. Now, if he or she expresses it multiple
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times per week, you may consider reassessing the size and timing of his or her meals and snacks
leading up to dinner, or investigate other potential causes for this behavior.
This is also the time to involve him or her in shopping, preparing, and cooking with you, so that you
may both learn what he or she is more likely to eat at meal times. And, if you have cause for concern
about disordered eating or a full-blown eating disorder, don’t wait to get your adolescent assessed by
medical professionals.
Help! My Adolescent
Won’t Eat Anything!
Firstly, it’s not your fault! Secondly,
take deep breath.
Your adolescent’s taste buds are constantly changing. These continuous changes are influenced not
only by physiology, but by environmental factors as well. If big brother Tommy declares at dinnertime
that he thinks broccoli is disgusting, then little sister Allison is likely to agree, even if she just told you
yesterday that she liked broccoli.
All you can do is stay the course of expanding your adolescent’s food horizons by creating an
environment in which new foods are routinely introduced, and trying them is encouraged. And, as
we’ve reiterated, making him or her your food shopping and food prep partner in crime is one more
way to combat his or her picky eating habits.
Another thought on the latter is to prepare healthy finger food upon returning from the grocery store
together, so that your adolescent can immediately reap the rewards of his or her participation (rather
than waiting for dinner some hours later, by which point their excitement about the shopping they
helped do may have waned). Sliced fruit and vegetables, cheese cubes, sliced deli meat, raw nuts, and
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whole grain crackers can all do the trick in seconds. Eating with his or hands promotes a relaxed, novel
atmosphere, and may also increase the likelihood that he or she tries something new. And continuing
to present colorful, diverse foods in visually appealing ways will help your adolescent like what he or
she sees, which is often a prerequisite for liking what he or she tastes (or even being enticed to taste it
in the first place).
Fruit, Cheese and Lean Meat
White Crackers
Help! My Adolescent
Is Always Hungry!
Some days – or what may feel like
years – it may seem like your
adolescent is eating everything in the
house.
“I went to the grocery store two days ago!” you exclaim after opening a nearly empty fridge or pantry.
There are many reasons your athlete may present with constant hunger. The first reason is that he or
she is experiencing a growth spurt. As your adolescent transitions through puberty and into his or her
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peak growth years, his or her calorie needs increase significantly (we’re talking by over 500 calories per
day during the peak growth years). The rapid rate of physical and cognitive development that
adolescents undergo - sometimes coupled with hours of sport or high physical activity per day demands that he or she is eating every few hours to keep up. So, when your daughter tells you she’s
hungry an hour after eating a good-sized, balanced lunch, she’s probably not kidding.
Expect a phase during which it appears that your adolescent is never satisfied. This is normal. To
support her increasing needs, keep plenty of nutrient-dense snacks on hand, such as fresh fruit and
vegetables, nuts and seeds, nut butters, low fat fairy, or whole grain crackers.
Note: Please don’t feel as though you need to slave away in the kitchen for hours each day to ensure
your child is well fed. Consider pre-cut fruit and vegetables, microwave-safe steamable carbohydrate
and veggie bags, and other done-for-you healthy options!
Outside of your adolescent’s growth spurt, he or she may present with periods of constant hunger
because previous meals and snacks weren’t filling, because he or she is dehydrated, or because he or
she hasn’t eaten enough recently. Below are a few principles you can follow to help ensure that he or
she is meeting his or her energy needs, and that he or she is hungry for the right reasons.
1. Follow the 3 X 3 Rule
Your adolescent should be eating three traditional meals and three snacks every day. This breaks
down into eating every two to three hours throughout the day.
2. Prioritize Premium Carbohydrates
Premium carbohydrates are high in fiber, which slows digestion and has a positive impact on
appetite suppression and energy levels over the next few hours. If you allow your adolescent to
prioritize low fiber carbohydrates throughout the day, get ready to hear that he or she is hungry on
an hourly basis, as the lack of fiber in these foods will fail to satiate them for long (not to mention
that these foods are also often high in sugar and low in nutrients).
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3. Fruits and Vegetables First
If your adolescent tells you he or she is hungry despite having just eaten, offer them another
serving of fruit or vegetables. If he or she is truly hungry, your offer will be gladly accepted. If he or
she is hungry after the fruit or vegetables, move on to premium carbohydrates or fat to satisfy his
or her hunger. If your adolescent fights you on another serving of fruit or vegetables, he or she may
just be bored or testing you.
4. Double-Down on Hydration
Dehydration can lead to false feelings of hunger. If you’re not in the know about how much he or
she has had to drink today, this is worth asking, but it can’t hurt to put some fluids in his or her
hands, whatever the answer. Suggest he or she start with a small bottle of water or a glass of milk.
If he or she is still hungry in 15 minutes, you can then consider a small snack.
5. Don’t Hesitate to Talk About “Why” He or She is Hungry
An adolescent may be hungry because he or she is bored, stressed, sad, or saw his older sibling eat
a heck of a lot more than he did! Ask your adolescent whether he or she is really hungry, and if the
answer appears to be a genuine “yes”, ask what he or she thinks the reason may be.
Food Sensitivities
And Testing
If it seems like food sensitivities are
more common than ever before, it’s
because
they
are..
but
not
necessarily for the reasons you may think. The rise in the “oh-my-gosh gluten is making me gain
weight” phenomenon has shined the light on the potential that some foods truly can cause discomfort
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even in the absence of an allergy (as confirmed by testing). Now more than ever before, allergy and
intolerance testing is more common, accessible, and affordable than ever.
If you notice your adolescent not responding well to a particular food, before you bother with an
allergy test, simply remove it for a few months from his or her diet. Of course, if a rash, fever, or other
serious symptom occur, absolutely call your physician.
Common food sensitivities and allergies include:
Eggs
Peanuts
Cow’s milk
Tree nuts
Soy
Shellfish
Wheat
You may find that if you remove a certain food for a few months and then reintroduce it, possibly in its
cooked form if previously served raw, or vice versa, your adolescent may handle it just fine after the
break.
Help Me Navigate
The Cereal Aisle!
Cereal brands do an excellent job of
marketing their cereals to young
audiences. All it takes is a picture of
the most popular cartoon character, and your adolescent is immediately drawn to that bright, shiny
box. The problem is, more often than not, that cereal is nutrient-poor and loaded with sugar.
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To be fair, cereal has vastly improved the last ten years. Most brands, even the ones notorious for
being high in sugar, are now using whole grains in their recipes, to provide a slight boost in nutrients.
This is a great start, but often insufficient. To help you choose the best cereal options for your
adolescent while also ensuring that he or she will still eat them, we recommend implementing the 6:1
rule:
STEP 1
Identify the amount of total carbohydrates (in grams)
STEP 2
Identify the amount of total/dietary fiber (in grams)
Note: If it has zero grams of fiber, it’s not a premium option, and you may
want to put it back on the shelf and not bother with Step 3.
STEP 3
Quick math: carbs divided by fiber (round for a whole number ratio)
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The higher the ratio, the higher the sugar content of the cereal. The lower the ratio, the less sugar and
the more fiber there is per serving.
This strategy is meant to aid you in identifying the cereal with the lowest ratio, ideally a ratio of 6:1. In
the real world, and when dealing with taste-oriented adolescents, this ratio may be too much to ask. In
lieu of chasing it, let your adolescent choose two or three cereals, and then gently nudge him or her in
the direction of the one with the lowest ratio. And, when you think he or she is ready to grasp it, teach
the 6:1 ratio to your adolescent (and don’t be surprised if you subsequently overhear him or her
sharing it with siblings, friends or teammates in wise, authoritative tones).
Note: The 6:1 ratio can easily go beyond cereal selection and be applied to that of cereal bars, snacks,
or bread!
How Do I Fuel My
Adolescent On
Game Day?
WOOO! Game time!
To
optimize
your
adolescent’s
performance on game day, keep the following recommendations in mind. For hydration-specific
recommendations in the hours before, during, and following a game, please review Chapter 6.
1. The Pre-Game Meal
This meal should come two to three hours before your adolescent’s game. It should be low in fat
and fiber, to limit the risk of an upset stomach during competition. It should be composed of the
following:
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A palm-sized portion of premium protein
One fistful of vegetables
Two fistfuls of premium carbohydrates
12 – 16 ounces of fluid
It’s important you do not serve your adolescent something new or out of the ordinary on this day,
to decrease the possibility of an adverse reaction. Going through a fast food drive through on the
way to an away game is a great example of this kind of game day Russian roulette.
Instead of letting it ride with respect to your young athlete’s digestion, stick with a few staple foods
that you know your adolescent likes and tolerates well.
2. The Pre-Game Snack
Depending on the nature of the sport, he or she may benefit from a small carbohydrate snack,
about 30 minutes before the game. This may come in the form of whole food or it may just be
starting to sip on his or her intra-game beverage. This snack is all the more vital for replenishing the
carbohydrates burned during a moderate intensity and/or lengthy warm-up, or as a result of
playing in a hot or humid climate.
If your youth athlete has multiple games in a single day, it’s important that you prepare plenty of
food ahead of time. You want to emphasize lean protein and carbohydrates with very small
amounts of fat and fiber for the meals and snacks between games. If he or she has back to back
games or performances (think a tournament, a soccer or football scrimmage jamboree or a day of
gymnastics), this is one scenario where those lower fiber carbohydrate options are actually
advisable due to their faster digesting nature, which will reduce the likelihood of your adolescent
experiencing an upset stomach mid-game.
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Great game-day options to pack:
Lean deli meat
Tortillas
Low fat string cheese
Plain White Bread
Low fat Greek yogurt
Rice cakes
Whey protein
Chewy granola bars
Beef jerky
Fig Newtons
Fresh and dried fruit
Pretzels
Note: Make sure you invest in a small cooler to properly store the game day meals and snacks you
and your adolescent choose.
During such a jam packed day of athletics, it’s important that your adolescent is eating roughly every
three hours. It’s also likely that this type of day will not present him or her with the opportunity to eat
a full-fledged meal, so make sure you pack plenty of game-day friendly options. Sandwiches and wraps
work great! Also, pack 150% of what you think you’ll need. Plans - and your athlete’s appetite - may be
less than predictable on days like these.
How Do I Fuel My
Vegetarian Adolescent?
While the principles and strategies
presented in this book apply to the
vegetarian adolescent as well, there
are a few nutrients he or she needs to be sure to get to meet his or her daily needs.
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Protein: Make sure your adolescent is getting high quality protein at each meal and snack. If your
adolescent will eat dairy, eggs or fish, this isn’t nearly as challenging. If he or she does not, focus on
complete, plant-based proteins (those that provide all nine essential amino acids) - which are limited to
soy, tofu and quinoa - or on pairing two complementary proteins, also referred to as forming a
complementary protein.
Common complementary protein pairings include:
Rice and beans
Peanut butter on whole grain bread
Pita bread and hummus
Iron: Heme-iron, the type of iron best absorbed by the body, is found in animal-based foods. If your
adolescent is a vegetarian or vegan, you will want to inform his or her physician, so that he or she may
monitor your adolescent’s iron levels closely.
Calcium: Calcium is most abundant in animal-based foods. If your adolescent is abstaining from all
meat and dairy products, focus on ample leafy greens to ensure his or her daily needs are met, and
also consider informing your physician for monitoring or supplementation.
B12: Vitamin B12 is also most abundant in animal-based foods. If your adolescent is abstaining from all
meat and dairy products, again, consider informing your physician for monitoring or supplementation.
Total Calories: It’s common for vegetarian and vegan adolescents to be at or slightly below normal
weight for their age and height. A vegetarian and vegan lifestyle often removes many calorie-dense
foods unless those are explicitly sought out. Be mindful of his or her eating habits, and frequently
check in on his or her energy levels to confirm that he or she is indeed eating enough.
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Veganism Versus Vegetarianism: Where They Differ
If your adolescent is a vegan, don’t assume you can simply follow vegetarian guidelines to help him or
her meet their nutrition needs. Remember, although both vegetarians and vegans don’t eat meat, a
differentiating factor between the two is that vegans abstain from all animal products and byproducts.
There are several animal-based ingredients that “sneak” their way into common foods that are often
overlooked and make a food non-vegan friendly. For instance, gelatin, which is a mixture of proteins
produced by partial hydrolysis of collagen extracted from the skin, bones, and connective tissues of
animals may be found in dairy-free yogurt, treats, and candies. Vegetable-based soups may be made
with animal broth, and fried foods fried in animal lard. It’s imperative that you triple check ingredient
lists and ask questions when dining out to ensure you help your adolescent stay the course of their
intended plan.
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IN CLOSING
At times, the only thing harder than being an adolescent is being the parent, coach or
care taker of one (or more)!
Between their flowing hormones, growing desire for independence and increased
susceptibility to peer pressure, and your desire to protect and steer them towards good
choices during this trying time, even the most devoted of role models can find
themselves feeling overwhelmed and helpless.
With respect to that, we truly hope you can find encouragement in this running theme
of this book: no matter how much like adults they may dress, talk or behave, don’t let
them fool you; they aren’t. At this age, especially on the older end of the adolescent
spectrum, they may be very smart, perceptive and even wordly kids, but kids they still
are. And, under that facade of know-it-all self sufficiency, they’re often kids who, now
more than ever, need their parents and other adult role models to help them navigate
the many stressors and the information overload they’re subjected to.
Know that nutritional guidance is definitely no exception to this rule, and remember this
through the eye rolls, the slamming doors, the snotty “I’m not five anymore!”
exclamations. Yes, they’re still kids, and hence still testing boundaries, and testing you.
And, at this age especially, trying to push you away, to see whether you’ll give up or
fight for them.
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And so, remember that every “annoying” reminder, every unsolicited “nutrition fun
fact” or grudging trip to that grocery store or healthy choice on your own plate is telling
your adolescent(s): “ I choose to fight for you, even if that means fighting with you. I
won’t let you - or myself - off the hook so easily, because I care about your health,
development and wellbeing too much to throw up my hands in despair and give up. I
want you to fuel your growing body with premium fuel, so you can grow into your best
self. Try as you might, you can’t push me away.”
Trust us when we say, whether they show it or not, they’ll eat it up. And, if you stay the
course, sooner or later, they will start eating up those veggies!
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