Taking things to the "extreme" isn't outlandish—it is remarkably commonplace for many of today's teens. Various activities and consumer goods are labeled "extreme," from sports to cosmetics. Even dietary habits can be "extreme." Extreme eating describes the eating habits of many teens who seem to have lost their balance when it comes to choosing an appropriate diet. Going overboard in one or more areas of the diet, such as cutting out entire food groups, fervently following the latest fad diet or weight loss plan, or regularly consuming a single food or type of food to excess could all be characterized as extreme eating behaviors.
Nutritional Needs vs. Real Life
The "perfect" diet most likely does not exist, yet many people of all ages could benefit by improving their food choices. And, for teenagers (and children), an inadequate diet can lead to difficulty in achieving optimal growth and development and can contribute to lifelong health-related problems.
"Ideally, the teen years are a time of growth that is fueled by good nutrition. Ironically, the nutrients that teens often lack are the most important ones for this period," noted Sheah Rarback, R.D., spokesperson for The American Dietetic Association. According to Ms. Rarback, calcium, iron and zinc are of particular concern in the teen diet. "Teens who don't get enough calcium are putting their bones at risk later in life," she added. "In addition, both boys and girls need more iron during the teen years to support increasing muscle mass and a larger blood supply-and girls need to be aware that they lose iron with their monthly period." Ms. Rarback also noted evidence indicating that many teens have low consumption of zinc, which is important for optimal development and sexual maturation during the rapid growth period of adolescence.
So, where do teens' diets fall short? As in the adult population, teens generally have little variety in their diets, eat high amounts of fat and tend to take in fewer nutrient-dense foods. Also, fruit and vegetable consumption is lagging among teens. According to the 1997 National Risk Behavior Survey from the Centers for Disease Control and Prevention (CDC), just over 29 percent of students surveyed had eaten the recommended five or more servings of fruits and vegetables during the day preceding the survey.
Foods for Fueling Fitness
A healthful diet that fuels fitness is necessary for all athletes—and even more so for active, growing teens. "Teens often get the message that fat is bad for them. In response, they may mistakenly limit animal and milk products and calorie-dense snacks, which are an essential part of their training diets," said Susan Kundrat, M.S., R.D., a sports nutritionist and consultant to high school athletic teams and coaches.
For some, participation on a school or community sports team serves as the impetus to shape up or lose weight. According to Ms. Kundrat, "Teaching young athletes that 'thin' doesn't always equal 'fit' is key." Ms. Kundrat points out that the pressure on teen athletes to perform can be great, and that extreme and unhealthy eating behaviors are sometimes seen by teens as a solution to better performance—especially for girls. "Young girls who participate in power-related sports such as volleyball, rowing, basketball or golf must learn to be comfortable with a body that is often heavier and more muscular than their peers," noted Ms. Kundrat.
Dieting to Excess
There are probably as many reasons why teens begin to diet, as there are methods to diet. Maintaining an appropriate body weight is an admirable goal for anyone. But, the problem that often crops up among teens who diet is that they sometimes use extreme measures to achieve weight loss and many times have unrealistic body images. Fasting or skipping meals, following the latest fad diets, taking diet or "water" pills (diuretics) or exercising fanatically are not safe nor even the most effective methods for losing body fat. What's more, teens often fail to see that achieving a more healthful and attractive physique is not measured solely by numbers on a scale. "If a teen wants to lose weight, he or she should look to the Food Guide Pyramid for guidance. Choosing more of the lower-fat options from the grains, fruit, vegetable and protein groups of the Pyramid will provide the energy and nutrients teens need without extra calories," advised Ms. Rarback. "Even more essential is to get moving. [Physical activity] helps with weight, mood and energy level, which are all important."
When dieting leads to an eating disorder such as anorexia nervosa, bulimia nervosa or binge eating, the health consequences—physical and psychological—can be devastating. The American Psychiatric Association estimates that eating disorders affect between one and four percent of adolescents and young adults. Yet, eating disorders are not triggered solely by the desire to be thin, according to Amy Tuttle, R.D., L.S.W., a nutrition therapist at The Renfrew Center in Philadelphia. "Certain family dynamics along with the challenge of developing a separate self identity contribute to disordered eating," says Ms. Tuttle.
The "I Don't Eat That" Factor
Statements such as "I don't eat animal products," or "I don't eat dairy foods" exemplify the way some teens segment their diets and sometimes eliminate entire categories of foods. If teens do not take care to include sufficient amounts of macronutrients—fat, carbohydrate and protein-food avoidance can be detrimental to health and nutritional status.
Vegetarianism is a growing movement in many age groups, and adolescents are no exception. According to Jo Ann Hattner, M.P.H., R.D., a clinical nutritionist at Stanford University Medical Center, teen vegetarians face dietary dilemmas beyond those of adult vegetarians. "The diets of adolescent vegetarians can be quite low in protein and trace minerals, particularly on a vegan diet." Therefore, those teens need to incorporate a variety of protein sources into their diets to get all the essential amino acids. She goes on to suggest that "Educating teens about the importance of a variety of protein sources is essential in order to get this vital nutrient into the diet. Soy products and a variety of canned beans and peas are quick and easy ways to boost protein intake." Ms. Hattner advises teens who are considering becoming vegetarians to make an appointment with a registered dietitian to learn how to make good nutritional choices to reduce the chances of deficiencies in calcium, iron, zinc and vitamin B12.
| Milk, that staple of childhood, is often consumed in less than recommended amounts among teens. Less milk can translate into less calcium.
According to U.S. Department of Agriculture surveys, roughly 9 out of 10 girls and nearly 7 out of 10 boys, ages 12 to 19, are not getting the recommended amount of calcium. "Even though teens may have reached their full height, they are still developing about half the bone mass their bodies will need for a lifetime," said Connie Weaver, Ph.D., professor and head of the Department of Foods and Nutrition at Purdue University. The National Academy of Sciences recommends that teens and children ages 9 to 18 consume 1,300 mg of calcium per day—the equivalent of four servings of dairy products.
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How can we help teens temper extreme eating behaviors? The answer isn't simple. Just as there are many types of people in the world, there are many ways to bring about change in people. The key, summarized Ms. Hattner, is in finding the proper motivating force for each teen. "We can motivate teens to eat right by focusing on those things that are important to them—be it athletics and performance, height and body image or beautiful hair, nails and skin," she said. "Unfortunately long-term nutritional goals—such as osteoporosis prevention—don't work with teens, but other goals do." Balance, variety and moderation are not "sexy" concepts, but learning how to achieve them can go a long way toward helping teens live longer, healthier lives.
