JOURNAL OF ADOLESCENT HEALTH 2992;13:389-391
CONFERENCE PROCEEDINGS
JANE MITCHELL
REES, M.S.,
R.D.
Common Food Behaviors and Attitudes of Adolescents A number of the determinants of dietary habits among adolescents in the United States (see Fi,:ure 1) presently encourage them to use cornmenially prepared products rather than food cooked at home (I). The national food distribution system sells highly processed foods to teenagers 24 hours a day in fast food franchises and mini markets, and now also in gas stations and in bulk at discount markets (2). The media target this group with food advertising so effective it qualifies as entertainment (3,4). Developmentally ready to accept information from sources outside their families, with large amounts of money to spend (2), teenagers buy trend-setting rather than traditional foods. Meanwhile, family eating patterns, foundations of dietary habits in earlier years (5), are less influential during adolescence. Though all Americans are spending less time cooking and eating at home (6), teenagers miss more family meals than mothers or younger children, in part because they are becoming more independent. Missing meals coupled with between-meal eating, traditionally called “snacking,” is therefore characteristic of their eating behavior (1). Several studies have shown that between-meal eating provides many of the required nutrients to adolescents and that the type of food chosen is more important than when or where it is eaten (7-10); however, less regular eating patterns also foster unhealthy eating hab-
its by many teenagers. In one survey for example, adolescents said they did not have enough time or self-discipline to make themselves eat healthfully. They also said they did not feel they had to think about health and that it was inconvenient to try to get healthy meals (11).
Nutritional Value of Convenience Foods While some convenience foods in the United States are adequately balanced in nutritive content, many are not. Burgers, for example, vary by 400% in energy valutl, containing as much as 1800 mg sodium, and made up of from 35% to 66% fat (12). A triple cheeseburger alone has 35% of the total daily energy recommended for a 15- to 18-year-old male and 52% of that for a female the same age. Many microwavable food products are reasonable in total energy value but ladened with sodium and as much as 73% fat (13). Sugar is the only ingredient in fruit snacks
Internal factors
ly unil and
cultural norms and values
of
From the Division of Adolescent Medicine, Departmettt Pediatrics, University of Washington, Seattle, Washington. Address reprint requests to: Jane Rees, M.S., R.D.. CDMRC WI20, University of Washington, Seattle, WA 98195. This paper was presented at the 5th Congress of the International Association fir Adolescent Health, /uly 3-6, Montreux, Switzerlartd. Manuscript accepted February 3, 1992.
- Physlologql needs and characlensllcs
famtly characleristlcs
Life-style
1
+ Individual food behavior
offactorsinfluencing adolcsceut food behavior. Developed by Story, M: University ofMinnesota, 1984 (1).
Figure 1. Schematic diagram
0 Society for Adolescent Medicine, 1992 Published by Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, NY 10010
389
390
REES
and the main ingredient in many cereals. Both products are marketed as food not candy.
Food Consumed Overall nutritional patterns are influenced by the trends in fast food consumption. Cheese use is increasing over other dairy products because it is included in hamburgers and pizza. Oils are being increasingly used in fried foods, salad dressings, and baked goods. Soft drinks are preferred to milk or coffee. Vegetable use is increasing because french fried potatoes and salad bars are popular. Americans are using more chicken and less beef, more low fat, than whole, milk, and more synthetic sweeteners, while the amount of energy-producing sweeteners has also slightly increased. Fewer eggs are consumed and use of grains and cereal is stable (14).
Foods Preferred by Adolescents The favorite foods of adolescents are soda, milk, steak, hamburgers, pizza, spaghetti, chicken, french fries, ice cream, oranges, apples, and bread, in decreasing order. Their favorite snacks are potato chips, corn chips, cookies, candies, and ice cream (15). A hamburger, french fried potatoes, and a soft drink are often called a meal in the United States.
Nutritional Problems of Adolescents’ Diets Lack of variety in the preferred group of foods accounts for the nutritional imbalances usually found by dietary surveys among adolescents. These consist of excesses of total energy, total and saturated fat, as well as cholesterol, salt, and sugar (16). The inadequacies are of folic acid, Vitamins (B6,A, and C), minerals (iron, calcium, and zinc), and fiber (17).
Related Societal Issues Although it is true that the immediate heahh of many teenagers will not be affected by these dietary imbalances, several other factors increase the risk to health resulting from poor eating habits. Modem life in the United States requires less energy output with previously fit children decreasing in their level of fitness (18). Presently only 50% of youth are involved in regular vigorous exercise (19). More than 50% of females ages 6-17 years and 30% of males the same age cannot do a single pull-up. Energy intake is not balanced by energy output resulting in accumulation of body fat (20). Many adolescents are
JOURNAL OF ADOLESCENT HEALTH Vol. 13, No. 5
using and abusing alcohol and drugs (21). Adolescent substance abusers have additional dietary imbalances resulting from their snacking to the exclusion of consumption of milk, fruits, and vegetables (22). This eating pattern, coupled with the vitamin-leaching effect of alcohol over time leads to the nutritional disorders seen in adult abusers.
Future Developments It seems that concern for health can have some impact on the food producer (23). The McLean Burger has 25% fat compared with 35% in the previously described regular McDonald burger. It is a mixture of extremely lean beef with an additive that holds water and makes the meat more palatable. Critics point out that many people order cheese and add mayonnaise, which diminishes the positive effect. The positive effects of the special foods are often small. Having artificial sweeteners has not diminished the craving for sugar. Americans now use both (14). Nonfat “fats” are soon to be a part of the food supply. These are proteins made to have the taste and textural qualities of fat (24). Commuter foods art? coming on the market because so many people eat in the cars. As many as 25% of Americans are said to eat breakfast on their way to work or school (2). People use special mugs and plastic drinking containers so they can drink as they drive, and may soon have special trays and sophisticated equipment to improve the efficiency of eating “on the go.” The increased availability of foods prepared to be microwaved (or “nuked” as the teenagers say) and the direct marketing of food to children, is shown by frozen dinners designed to appeal to them. One such product contains miniature hot dogs with buns, french fried potato puffs, baked beans, and a cookie, with over 1000 mg of sodium per serving. Eighty percent of households and workplaces now have microwaves and many of the users are children (25). One prediction is that by the year 2000, home cooking will be done only as a hobby in the United States (2). Growing multinational control of food production is another recent development. Dairy, baking, frozen, and fast-food companies, which have been providing basic American foods for decades are now owned by corporations based in the United Kingdom and Switzerland taking influence over the foods supplied to adolescents further from concerned parents and health-care professionals (25).
RECENTLYDEVELOPED FOODS IMPACT DIETS
July 1992
In conclusion it is clear that health professionals dealing with future nutritional developments can focus on 1) communicating with food producers about the need for healthy foods, 2) helping teenagers adopt healthy eating behaviors, and 3) strengthening the resolve of families to have meals together. Supported by Grant #MCS-000970 from the Maternal and Child Health Bureau
References 1. Story M. Adolescent lifestyle and eating behavior. In: Mahan LK, Rees JM, eds. Adolescent Nutrition. St. Louis: Times/ Mirror Mosby, 198477-103. 2. Butkus SN. Update: Children and food. Washington State University Foods & Nutrition Newsletter, Puyallup, WA: Research and Extension Center. 1992 (in press). 3. Morton HN. A survey of the television viewing habits, food behaviors and perception of food advertisements among South Australian year 8 high school students. J Home Econ Assoc Australia 1990;22:34-6. Jacobson MF. Hey teens! This ad’s for you. Nutrition Action Healthletter. 1989; September:8. Satter E. Feeding relationship: Prevention and intervention. J Ped 1991;117(Suppl):l81-90. Community Nutrition Institute. Poll finds families eating together at dinner time. Nutrition Week 1990; December 21:6. Bigler-Doughten S, Jenkins MR. Adolescent snacks: Nutrient density and nutritional contribution to total intake. J Am Diet Assoc 1987;87:1678-9. 8. Franz MJ. Fast food facts: Nutritive and exchange values for fast-food restaurants. Wayzata, MN: Diabetes Center Incorporated Publishing, 1990. 9. Leverton, RM. The paradox of teenage nutrition. J Am Diet Assoc 1968;53:13-6. 10. McCoy H, Moak S, Kenney MA, et al: Snacking patterns
11. 12. 13. 14. 15.
16.
17.
391
and nutrient density of snacks consumed by southern girls. J Nutri Ed 1986;18:61-66. Story M, Resnick MD. Adolescents’ views on food and nutrition. J Nutr Educ 1986;18:188-92. The best, the worst, and (some of the) rest. Nutrition Action Healthletter, 1989; September:ll. Fat city. Nutrition Action Healthletter, 1990;17 December:!1 . Liebman 6. The changing American diet. Nutrition Action Healthletter 1990;17 May:8-9. Story M. A perspective on adolescent lifestyle and eating behavior. [National Dairy Council] Nutrition News 1989;52:13. Portnoy B, Christenson GM. Cancer knowledge and related uractices: Results from the National Adolescent Student Health Survey. J Sch Health 1989;59:218-24. Gong E, Heald FT. Diet, nutrition, and adolescence. In: Shils M, Young VR, eds. Modern Nutrition in Health and Disease, 7th edition. Philadelphia: Lea and Febiger, 1988:969-81.
18. Raunikar RA, Strong WB. The status of adolescent physical fitness. Ado1 Med: State of Art Rev 1991;2:65-77.
19. American Medical Association and American Dietetic Association. Targets for adolescent health: Adolescent nutrition and physical fitness. Chicago, American Medical Association 1991:4.
20. Dietz WH. You are what you eat-What
you eat is what you are. J Adolesc Health Care 1990;11:76-81.
21. Farrow JA. Adolescent chemical dependency. In: Farrow JA, ed. Adolescent medicine. Med Clin N Am 1990;74;1265-74.
22. Farrow JA, Rees JM, Worthington-Roberts BS. Health, developmental, and nutritional status of adolescent alcohol and marijuana abusers. Pediatrics 1987;79:218-23.
23. Leaner hamburger undergoes trial by taste. New York Times 1991; April 21:l. 24. Lynch PM. Sugar and fat substitutes. Diabetic Educator 1990; 16:101-5. 25. Butkus SN. Grocery store trends. Washington State University Foods & Nutrition Newsletter. Puyallup, WA, Research and Extension Center, December 1990-January 1991.
CONFERENCE PROCEEDINGS
JANE MITCHELL
REES, M.S.,
R.D.
Common Food Behaviors and Attitudes of Adolescents A number of the determinants of dietary habits among adolescents in the United States (see Fi,:ure 1) presently encourage them to use cornmenially prepared products rather than food cooked at home (I). The national food distribution system sells highly processed foods to teenagers 24 hours a day in fast food franchises and mini markets, and now also in gas stations and in bulk at discount markets (2). The media target this group with food advertising so effective it qualifies as entertainment (3,4). Developmentally ready to accept information from sources outside their families, with large amounts of money to spend (2), teenagers buy trend-setting rather than traditional foods. Meanwhile, family eating patterns, foundations of dietary habits in earlier years (5), are less influential during adolescence. Though all Americans are spending less time cooking and eating at home (6), teenagers miss more family meals than mothers or younger children, in part because they are becoming more independent. Missing meals coupled with between-meal eating, traditionally called “snacking,” is therefore characteristic of their eating behavior (1). Several studies have shown that between-meal eating provides many of the required nutrients to adolescents and that the type of food chosen is more important than when or where it is eaten (7-10); however, less regular eating patterns also foster unhealthy eating hab-
its by many teenagers. In one survey for example, adolescents said they did not have enough time or self-discipline to make themselves eat healthfully. They also said they did not feel they had to think about health and that it was inconvenient to try to get healthy meals (11).
Nutritional Value of Convenience Foods While some convenience foods in the United States are adequately balanced in nutritive content, many are not. Burgers, for example, vary by 400% in energy valutl, containing as much as 1800 mg sodium, and made up of from 35% to 66% fat (12). A triple cheeseburger alone has 35% of the total daily energy recommended for a 15- to 18-year-old male and 52% of that for a female the same age. Many microwavable food products are reasonable in total energy value but ladened with sodium and as much as 73% fat (13). Sugar is the only ingredient in fruit snacks
Internal factors
ly unil and
cultural norms and values
of
From the Division of Adolescent Medicine, Departmettt Pediatrics, University of Washington, Seattle, Washington. Address reprint requests to: Jane Rees, M.S., R.D.. CDMRC WI20, University of Washington, Seattle, WA 98195. This paper was presented at the 5th Congress of the International Association fir Adolescent Health, /uly 3-6, Montreux, Switzerlartd. Manuscript accepted February 3, 1992.
- Physlologql needs and characlensllcs
famtly characleristlcs
Life-style
1
+ Individual food behavior
offactorsinfluencing adolcsceut food behavior. Developed by Story, M: University ofMinnesota, 1984 (1).
Figure 1. Schematic diagram
0 Society for Adolescent Medicine, 1992 Published by Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, NY 10010
389
390
REES
and the main ingredient in many cereals. Both products are marketed as food not candy.
Food Consumed Overall nutritional patterns are influenced by the trends in fast food consumption. Cheese use is increasing over other dairy products because it is included in hamburgers and pizza. Oils are being increasingly used in fried foods, salad dressings, and baked goods. Soft drinks are preferred to milk or coffee. Vegetable use is increasing because french fried potatoes and salad bars are popular. Americans are using more chicken and less beef, more low fat, than whole, milk, and more synthetic sweeteners, while the amount of energy-producing sweeteners has also slightly increased. Fewer eggs are consumed and use of grains and cereal is stable (14).
Foods Preferred by Adolescents The favorite foods of adolescents are soda, milk, steak, hamburgers, pizza, spaghetti, chicken, french fries, ice cream, oranges, apples, and bread, in decreasing order. Their favorite snacks are potato chips, corn chips, cookies, candies, and ice cream (15). A hamburger, french fried potatoes, and a soft drink are often called a meal in the United States.
Nutritional Problems of Adolescents’ Diets Lack of variety in the preferred group of foods accounts for the nutritional imbalances usually found by dietary surveys among adolescents. These consist of excesses of total energy, total and saturated fat, as well as cholesterol, salt, and sugar (16). The inadequacies are of folic acid, Vitamins (B6,A, and C), minerals (iron, calcium, and zinc), and fiber (17).
Related Societal Issues Although it is true that the immediate heahh of many teenagers will not be affected by these dietary imbalances, several other factors increase the risk to health resulting from poor eating habits. Modem life in the United States requires less energy output with previously fit children decreasing in their level of fitness (18). Presently only 50% of youth are involved in regular vigorous exercise (19). More than 50% of females ages 6-17 years and 30% of males the same age cannot do a single pull-up. Energy intake is not balanced by energy output resulting in accumulation of body fat (20). Many adolescents are
JOURNAL OF ADOLESCENT HEALTH Vol. 13, No. 5
using and abusing alcohol and drugs (21). Adolescent substance abusers have additional dietary imbalances resulting from their snacking to the exclusion of consumption of milk, fruits, and vegetables (22). This eating pattern, coupled with the vitamin-leaching effect of alcohol over time leads to the nutritional disorders seen in adult abusers.
Future Developments It seems that concern for health can have some impact on the food producer (23). The McLean Burger has 25% fat compared with 35% in the previously described regular McDonald burger. It is a mixture of extremely lean beef with an additive that holds water and makes the meat more palatable. Critics point out that many people order cheese and add mayonnaise, which diminishes the positive effect. The positive effects of the special foods are often small. Having artificial sweeteners has not diminished the craving for sugar. Americans now use both (14). Nonfat “fats” are soon to be a part of the food supply. These are proteins made to have the taste and textural qualities of fat (24). Commuter foods art? coming on the market because so many people eat in the cars. As many as 25% of Americans are said to eat breakfast on their way to work or school (2). People use special mugs and plastic drinking containers so they can drink as they drive, and may soon have special trays and sophisticated equipment to improve the efficiency of eating “on the go.” The increased availability of foods prepared to be microwaved (or “nuked” as the teenagers say) and the direct marketing of food to children, is shown by frozen dinners designed to appeal to them. One such product contains miniature hot dogs with buns, french fried potato puffs, baked beans, and a cookie, with over 1000 mg of sodium per serving. Eighty percent of households and workplaces now have microwaves and many of the users are children (25). One prediction is that by the year 2000, home cooking will be done only as a hobby in the United States (2). Growing multinational control of food production is another recent development. Dairy, baking, frozen, and fast-food companies, which have been providing basic American foods for decades are now owned by corporations based in the United Kingdom and Switzerland taking influence over the foods supplied to adolescents further from concerned parents and health-care professionals (25).
RECENTLYDEVELOPED FOODS IMPACT DIETS
July 1992
In conclusion it is clear that health professionals dealing with future nutritional developments can focus on 1) communicating with food producers about the need for healthy foods, 2) helping teenagers adopt healthy eating behaviors, and 3) strengthening the resolve of families to have meals together. Supported by Grant #MCS-000970 from the Maternal and Child Health Bureau
References 1. Story M. Adolescent lifestyle and eating behavior. In: Mahan LK, Rees JM, eds. Adolescent Nutrition. St. Louis: Times/ Mirror Mosby, 198477-103. 2. Butkus SN. Update: Children and food. Washington State University Foods & Nutrition Newsletter, Puyallup, WA: Research and Extension Center. 1992 (in press). 3. Morton HN. A survey of the television viewing habits, food behaviors and perception of food advertisements among South Australian year 8 high school students. J Home Econ Assoc Australia 1990;22:34-6. Jacobson MF. Hey teens! This ad’s for you. Nutrition Action Healthletter. 1989; September:8. Satter E. Feeding relationship: Prevention and intervention. J Ped 1991;117(Suppl):l81-90. Community Nutrition Institute. Poll finds families eating together at dinner time. Nutrition Week 1990; December 21:6. Bigler-Doughten S, Jenkins MR. Adolescent snacks: Nutrient density and nutritional contribution to total intake. J Am Diet Assoc 1987;87:1678-9. 8. Franz MJ. Fast food facts: Nutritive and exchange values for fast-food restaurants. Wayzata, MN: Diabetes Center Incorporated Publishing, 1990. 9. Leverton, RM. The paradox of teenage nutrition. J Am Diet Assoc 1968;53:13-6. 10. McCoy H, Moak S, Kenney MA, et al: Snacking patterns
11. 12. 13. 14. 15.
16.
17.
391
and nutrient density of snacks consumed by southern girls. J Nutri Ed 1986;18:61-66. Story M, Resnick MD. Adolescents’ views on food and nutrition. J Nutr Educ 1986;18:188-92. The best, the worst, and (some of the) rest. Nutrition Action Healthletter, 1989; September:ll. Fat city. Nutrition Action Healthletter, 1990;17 December:!1 . Liebman 6. The changing American diet. Nutrition Action Healthletter 1990;17 May:8-9. Story M. A perspective on adolescent lifestyle and eating behavior. [National Dairy Council] Nutrition News 1989;52:13. Portnoy B, Christenson GM. Cancer knowledge and related uractices: Results from the National Adolescent Student Health Survey. J Sch Health 1989;59:218-24. Gong E, Heald FT. Diet, nutrition, and adolescence. In: Shils M, Young VR, eds. Modern Nutrition in Health and Disease, 7th edition. Philadelphia: Lea and Febiger, 1988:969-81.
18. Raunikar RA, Strong WB. The status of adolescent physical fitness. Ado1 Med: State of Art Rev 1991;2:65-77.
19. American Medical Association and American Dietetic Association. Targets for adolescent health: Adolescent nutrition and physical fitness. Chicago, American Medical Association 1991:4.
20. Dietz WH. You are what you eat-What
you eat is what you are. J Adolesc Health Care 1990;11:76-81.
21. Farrow JA. Adolescent chemical dependency. In: Farrow JA, ed. Adolescent medicine. Med Clin N Am 1990;74;1265-74.
22. Farrow JA, Rees JM, Worthington-Roberts BS. Health, developmental, and nutritional status of adolescent alcohol and marijuana abusers. Pediatrics 1987;79:218-23.
23. Leaner hamburger undergoes trial by taste. New York Times 1991; April 21:l. 24. Lynch PM. Sugar and fat substitutes. Diabetic Educator 1990; 16:101-5. 25. Butkus SN. Grocery store trends. Washington State University Foods & Nutrition Newsletter. Puyallup, WA, Research and Extension Center, December 1990-January 1991.
