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Adolescence is a stage in life that has many biological, cognitive and sociocultural changes. This stage in life is when individuals are most vulnerable and health behaviors play an important role in their future. An adolescent this day in age is bombarded with many behaviors that can affect their future such as; smoking, drug use, and sex. These behaviors can carry immediate and severe consequences but there are other health behaviors such as eating choices and physical activity that can carry risks as well (Lytle, 2002). Lytle explains that there is data that suggests that adolescent's current eating behaviors are putting them at risk for many different diseases later in life. Some of those diseases include: cardiovascular disease, cancer, osteoporosis, obesity and type 2 diabetes. Adolescents today have decreased physical activity and poor diet habits which makes nutritional issues for adolescents a very important topic that needs to be addressed (Lytle, 2002). Cardiovascular disease begins in childhood. A study completed by Kelley, Krummel, Gonzales, Neal and Fitch examined 279 children.
There hypothesis was that children who were at high risk for cardiovascular disease based on their family history would have diets that were different than the low risk children. The children's height, weight, and total cholesterol were measured and each child filled out a food frequency questionnaire. 23% of the children were at risk for cardiovascular disease and their cholesterol was significantly higher. However intakes of energy, fat, cholesterol and fiber were similar in both the high risk and low risk groups. The researchers concluded that all children whether high risk or low risk need to change their dietary patterns in order to prevent cardiovascular disease. Those at high risk need specific guidelines in order to lower their risk for the disease.
Healthcare professionals must promote the healthy benefits of healthy eating habits to both children and their families and finally it is critical that public health research address behavior modification in children (2004). Diets high in saturated fat, total fat, sodium and low in fiber are associated not only with cardiovascular disease but also some types of cancer. Also diets low in fruits and vegetables are associated with increased risk of some types of cancer. National nutrition surveillance data shows that only 34% of girls and 27% of boys aged 12-19 years fall within the recommended levels for saturated fat, and 36% of girls and 30% of boys aged 12-19 years fall within the recommended levels for total fat. Adolescent diets also exceed the recommended level of 2,400mg of sodium. National Health and Nutrition Health Survey (NHANES) III showed the range of sodium aged 12-19 years ranged from 3,000mg - 5,000mg/day for both girls and boys. The recommended intake of fiber for children aged 2-18 years is their age plus 5 grams per day.
NHANES III data suggest that aged 12-15 year olds would need to increase their fiber intake by 25%-50% and 16-19 year olds would need to double their intakes to meet the recommendations for fiber stated above (Lytle, 2002). Adolescent's high fat, high sodium and low fiber diet not only contribute to increased risk for cardiovascular disease and cancer but also put them at risk to be obese and potential develop type 2 diabetes. Childhood obesity is becoming an epidemic in the United States. The increasing prevalence of childhood obesity has led policy makers to rank it as a critical public health threat. Its rate has doubled for preschool children aged 2-5 years and adolescents aged 12-19 years, and it has tripled for children aged 6-11 years. This has all occurred in the past 30 years. Childhood obesity involves immediate and long-term risks to physical health.
For children born in the United States in the year 2000, the lifetime risk of being diagnosed with type 2 diabetes at some point in their lives is estimated at 30% for boys and 40% for girls if obesity rates level off (Koplan, Liverman & Kraak, 2005). Koplan, Liverman & Kraak also explain how dramatically the Unites States has changed over the past thirty years and how that has impacted the rise of childhood obesity. Family dynamics have changed, now both parents work and they work very long hours. Majority of meals today are not eaten as a family and are usually eaten outside the home. The school environment has changed; children have many more options at lunchtime including fast food, soda, and candy. Physical activity has decreased. Children's leisure time is spent watching television or playing on the computer. Understanding all of these things and working to modify them is essential for reducing childhood obesity (2005). Clearly the food choices of adolescents are not consistent with the Dietary Guidelines for Americans.
Children's food intake tends to be low in fruits, vegetables and calcium rich foods, and high in both total fat and saturated fat. Children's dietary habits are causing many nutritional issues that can affect their health in many negative ways. In order to develop effective nutrition interventions to change eating behaviors and ward off disease, factors influencing adolescent eating behaviors need to be understood. Story, Neumark-Sztainer & French discuss Social Cognitive Theory (SCT). "SCT provides a useful theoretical framework for understanding and describing the multiple influences that have an impact on the food behaviors of adolescence. In SCT, behavior is explained in terms of a 3-way, dynamic and reciprocal interaction between personal factors, environmental influences, and behavior.
Key concepts of SCT are self efficacy (self confidence to change a behavior), observational learning (modeling), reciprocal determinism (bidirectional influences), behavioral capability (knowledge and skills to change the behavior), expectations (beliefs about likely results of the action), functional meanings (personal meaning attached to the behavior), and reinforcement (response to a person's behavior that increases or decreases the chances of its recurrence)" (2002). Ecological perspective is another model used for understanding factors influencing eating behavior. Ecological perspective looks at the connections between people and their environments. Reciprocal determinism is central in both SCT and the ecological perspective. Reciprocal determinism means that both the behavior and the environment influence each other in both directions (Story, Neumark-Sztainer & French, 2002). Adolescent eating behavior has multiple levels of influence. There are four broad levels of influence, they are as follows; individual influences (intrapersonal), social environmental influences (interpersonal), physical environmental influences (community settings) and macrosystem influences (societal) (Story, Neumark-Sztainer & French, 2002). The following portion of this paper will examine the four levels of influence.
Story, Neumark-Sztainer & French explain how psychosocial, biological and lifestyle factors are apart of individual influences. Psychosocial factors like attitudes, beliefs, knowledge, self-efficacy, taste and food preferences, biological factors like hunger and life-style factors like cost, time demands and convenience are all considered individual factors that effect eating behaviors (2002). Social environmental influences include family and friends. Family not only provides the food but also shapes a child's food attitude, preference, values and habits. As stated before, United States families have dramatically changed over the past thirty years. Family structure is different, both parents are working, both children and parents are too busy for meals at home.
Family meals no longer exist and parents can not control what their child is eating outside of the home. Friends influence adolescent behavior in all aspects. Adolescents seek out approval among their peers. There are however not many studies that have found a strong association between eating behaviors and peer influence (Story, Neumark-Sztainer & French, 2002). Another influence that effect adolescent-eating behavior is the physical environment (community setting). One third of all eating done by adolescents is outside of the home. Children these days eat majority of their meals at school, fast food restaurants, from vending machines, and convenience stores.
Macrosystem influence (Societal) is the last of the four influences. Factors within the larger society, which can affect adolescent eating behavior, include the media, cultural norms, social norms, food production and distribution systems, and food accessibility and availability. Adolescents are consumers. Marketers have now targeted adolescents specifically. Adolescents spend about 140 billion dollars a year, 94 billion is money they have earned themselves. Boys spend $59.00 a week and girls spend $53.00 a week and 15% of the money spent is on fast foods and snacks.
Adolescents also influence their parents spending. It is estimated that adolescents spent 47 billion of family money and 19.6 billion in grocery money spent was influenced by adolescent's preferences. Marketers see adolescents as future adult spenders and really work to maintain brand loyalty (Story, Neumark-Sztainer & French, 2002). Clearly there are a mu ....
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