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Cited by 597Nutrition, Health and Food BehaviorObesity, Physical Activity, DietAdolescent Health and Behaviors

Nutrition in adolescents: physiology, metabolism, and nutritional needs

Open access
Das, Jai K., Salam, Rehana A., Thornburg, Kent L., Prentice, Andrew M., Campisi, Susan, Lassi, Zohra S., Koletzko, Berthold, Bhutta, Zulfiqar A.·2017·Annals of the New York Academy of Sciences
DOI 10.1111/nyas.13330
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Abstract

Adolescence is the period of development that begins at puberty and ends in early adulthood. Most commonly, adolescence is divided into three developmental periods: early adolescence (10-14 years of age), late adolescence (15-19 years of age), and young adulthood (20-24 years of age). Adolescence is marked by physical and sexual maturation, social and economic independence, development of identity, acquisition of skills needed to carry out adult relationships and roles, and the capacity for abstract reasoning. Adolescence is characterized by a rapid pace of growth that is second only to that of infancy. Nutrition and the adolescent transition are closely intertwined, since eating patterns and behaviors are influenced by many factors, including peer influences, parental modeling, food availability, food preferences, cost, convenience, personal and cultural beliefs, mass media, and body image. Here, we describe the physiology, metabolism, and nutritional requirements for adolescents and pregnant adolescents, as well as nutrition-related behavior and current trends in adolescent nutrition. We conclude with thoughts on the implications for nutrition interventions and priority areas that would require further investigation.

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Crossref · 10.1111/nyas.13330

Cites

89 of 89 references verified0 citation errors · 0 not checkable

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Claims the paper makes

20 of 74 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Height velocity peaks at Tanner stage B3 between 11 and 12 years of age.

    “Height velocity peaks at B3 between 11 and 12 years of age.30”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [30] 30. Fellmeth, G.L., C. Heffernan, J. Nurse, et al. 2013. Educa- tional and skills-based interventions for preventing relation- ship and dating violence in adolescents and young adults. Cochrane Database Syst. Rev. 6: CD004534. source

      The Background and Discussion passages address adolescent dating violence and participants’ ages, not physical growth. Searches for peak height velocity and Tanner stage B3 found no passage in our copy addressing the claimed timing. (LLM, conf=0.75)

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  • Premisecitation

    Behaviors such as smoking, drinking, and illicit drug use are closely related to physiological and nutritional aspects.

    “behaviors, such as smoking, drinking, and illicit drug use, often begin during adolescence and are closely related to physiological and nutritional aspects.64,65”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [64] 64. World Health Organization. 2014. Health for the world's adolescents: a second chance in the second decade. http:// apps.who.int/adolescent/second-decade/. Accessed Novem- ber 24, 2016.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [65] 65. Swanson, S.A., S.J. Crow, D. Le Grange, et al. 2011. Preva- lence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Arch. Gen. Psychiatry 68: 714-723. source

      The Results (Age at Onset; page unavailable) give adolescent onset ages for eating disorders, not for smoking, drinking, or illicit drug use. Searches for those behaviors and for links to physiological or nutritional aspects found no passage addressing the attributed claim. (LLM, conf=0.75)

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  • Premisecitation

    For a lactating mother, her micronutrient status determines the health and development of her breast-fed infant, especially during the first 6 months of life.

    “For a lactating mother, her micronutrient status determines the health and development of her breast-fed infant, especially during the first 6 months of life.47,48”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [47] 47. Ward, D., A. Drahota, D. Gal, et al. 2008. Care home versus hospital and own home environments for rehabilitation of older people. Cochrane Database Syst. Rev. 4: CD003164. doi: 10.1002/14651858.CD003164.pub2. source

      The Implications for research section discusses comparing care-home, hospital, and own-home environments for rehabilitation of older people; no page number is provided in our copy. Searches for lactating mothers, maternal micronutrients, breastfeeding, and infant development found no passage addressing the claim. (LLM, conf=0.78)

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    • cites [48] 48. Rich-Edwards, J.W., A. Fraser, D.A. Lawlor & J.M. Catov. 2014. Pregnancy characteristics and women's future cardiovascular health: an underused opportunity to improve women's health? Epidemiol. Rev. 36: 57-70. source

      The review’s Implications for research and Search methods sections concern rehabilitation settings for older people, not maternal or infant nutrition (page numbers unavailable). Searches for lactating mothers, micronutrient status, breastfeeding, and infant development found no passage addressing the claim. (LLM, conf=0.78)

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  • Premisecitation

    Prepregnancy obesity and excessive weight gain during pregnancy dramatically increase the risk for preeclampsia among adolescents.

    “However, prepregnancy obesity and excessive weight gain during pregnancy dramatically increase the risk for preeclampsia among adolescents.50,51”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [50] 50. Baker, A.M. & S. Haeri. 2012. Estimating risk factors for development of preeclampsia in teen mothers. Arch. Gynecol. Obstet. 286: 1093-1096. source
    • cites [51] 51. Timpka, S., C. Macdonald-Wallis, A.D. Hughes, et al. 2016. Hypertensive disorders of pregnancy and offspring cardiac structure and function in adolescence. J. Am. Heart Assoc. 5: pii: e003906. source

      The Methods (Statistical Analyses; page unavailable) list prepregnancy BMI as a covariate, but do not report whether it increases preeclampsia risk. Searches for prepregnancy obesity and gestational weight gain found no passage assessing their effects on preeclampsia risk among pregnant adolescents. The paper instead examines cardiac outcomes in adolescent offspring exposed to maternal preeclampsia. (LLM, conf=0.76)

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    It has become increasingly clear that several conditions in pregnancy predispose both mother and offspring for later disease, including hypertension, cardiovascular disease, and type 2 diabetes.

    “It has become increasingly clear that several conditions in pregnancy predispose both mother and offspring for later disease, including hypertension, cardiovascular disease, and type 2 diabetes.49”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [49] 49. Bellamy, L., J.P. Casas, A.D. Hingorani & D.J. Williams. 2007. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ 335: 974. source

      The Discussion (page not available in our copy) reports increased later hypertension and cardiovascular disease among women with a history of pre-eclampsia. The paper does not establish later disease in offspring or an increased risk of type 2 diabetes, and it addresses pre-eclampsia rather than several pregnancy conditions. Its Introduction also leaves open whether the cardiovascular association reflects a shared cause or damage during pregnancy, so the claim's causal wording is stronger than the source supports. (LLM, conf=0.88)

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  • May combine two claims. 25
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    Premisecitation

    Age of menarche varies between populations, ranging from 11.0 to 14.1 years, with a mean of 12.6 years, and has decreased significantly over the last century.

    “Age of menarche varies between populations, ranging from 11.0 to 14.1 years, with the mean of 12.6 years, and this has decreased significantly over the last century.28”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [28] 28. Parent, A.S., G. Teilmann, A. Juul, et al. 2003. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr. Rev. 24: 668-693. source

      “Age references in well-off conditions” (p. 5) documents differences between populations, but gives 12.0–13.5 years for Western Europe; it does not give the claimed 11.0–14.1-year range or a cross-population mean of 12.6 years. “Secular trends” (pp. 6–7) reports a marked historical decline, but says more recent trends vary by country and have stalled in some. (LLM, conf=0.90)

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    Premisecitation

    Studies in adolescent sheep show that excess calories given during pregnancy will be allocated to the mother's growth over the growth of the fetus; the degree to which this is true in humans has not been adequately studied.

    “Studies in ado-lescent sheep show that excess calories given during pregnancy will be allocated to the mother's growth over the growth of the fetus; 41 the degree to which this is true in humans has not been adequately studied.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [41] 41. Reiches, M.W., S.E. Moore, A.M. Prentice, et al. 2013. The adolescent transition under energetic stress: body compo- sition tradeoffs among adolescent women in The Gambia. Evol. Med. Public Health 2013: 75-85. source

      The Conclusions and Implications section says that earlier findings suggest growing pregnant women allocate a higher proportion of energy to maternal than fetal tissue. It does not describe adolescent sheep studies or show that excess calories given during pregnancy are allocated preferentially to maternal growth. The study itself excluded pregnant participants. (LLM, conf=0.82)

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    Premisecitation

    Boys' height velocity begins 1-2 years after girls, and as a result boys' growth in height occurs for a longer period than girls, and final adult height is usually achieved by 17 years of age.

    “Boys' height velocity begins 1-2 years after girls, and, as a result, boys' growth in height occurs for a longer period than girls, and final adult height is usually achieved by 17 years of age.28,30”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [28] 28. Parent, A.S., G. Teilmann, A. Juul, et al. 2003. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr. Rev. 24: 668-693. source

      In “Age references in well-off conditions” (p. 5), the paper says girls classically precede boys by an average of 0.8 years in pubertal onset, while noting that some recent studies found no difference. That partly supports later maturation in boys, but it does not establish that boys’ height velocity begins 1–2 years later, that they grow for longer, or that adult height is usually reached by age 17. The discussion of final height (p. 11) explicitly sets aside pubertal growth and final-height patterns. (LLM, conf=0.79)

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    • cites [30] 30. Fellmeth, G.L., C. Heffernan, J. Nurse, et al. 2013. Educa- tional and skills-based interventions for preventing relation- ship and dating violence in adolescents and young adults. Cochrane Database Syst. Rev. 6: CD004534. source

      The Background discusses adolescent dating violence, while the Results discuss participants’ ages and gender; neither addresses physical growth. Searches for height velocity, boys’ growth, and adult height at 17 found no relevant passage in our copy. (LLM, conf=0.78)

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    Premisecitation

    Several studies have shown that adolescent women are able to grow during pregnancy if their nutrition is adequate, while others have shown that pregnancy may limit maternal growth.

    “Several studies have shown that adolescent women are able to grow during pregnancy if their nutrition is adequate, 38,39 while others have shown that pregnancy may limit maternal growth.40”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [38] 38. Scholl, T.O., M.L. Hediger & I.G. Ances. 1990. Maternal growth during pregnancy and decreased infant birth weight. Am. J. Clin. Nutr. 51: 790-793. source
    • cites [39] 39. Rah, J.H., P. Christian, A.A. Shamim, et al. 2008. Preg- nancy and lactation hinder growth and nutritional status of adolescent girls in rural Bangladesh. J. Nutr. 138: 1505- 1511. source
    • cites [40] 40. Wallace, J.M., R.P. Aitken, J.S. Milne & W.W. Hay Jr. 2004. Nutritionally mediated placental growth restriction in the growing adolescent: consequences for the fetus. Biol. Reprod. 71: 1055-1062. source

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    Premisecitation

    Existing data suggest that, when energy is constrained, the physiology of younger adolescents invests in growth, while that of older adolescent females privileges reproductively valuable adipose tissue.

    “Existing data suggest that, when energy is constrained, the physiology of younger adolescents invests in growth, while that of older adolescent females privileges reproductively valuable adipose tissue.42”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [42] 42. Gigante, D.P., K.M. Rasmussen & C.G. Victora. 2005. Preg- nancy increases BMI in adolescents of a population-based birth cohort. J. Nutr. 135: 74-80. source

      The Abstract reports that adolescents can continue growing during pregnancy and that growth is associated with increased weight gain and fat storage. The Discussion also reports nutrient competition during adolescent pregnancy. Neither passage establishes that energy-constrained younger adolescents prioritize growth while older adolescents prioritize adipose tissue. (LLM, conf=0.78)

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    Premisecitation

    Dietary recommendations suggest that 50% or more of total daily calories should come from carbohydrates, with no more than 10-25% of calories derived from sugars, such as sucrose and high fructose corn syrup.

    “Dietary recommendations suggest that 50% or more of total daily calories should come from carbohydrates, with no more than 10-25% of calories derived from sugars, such as sucrose and high fructose corn syrup.36”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [36] 36. Salam, R.A., M. Hooda, J.K. Das, et al. 2016. Interventions to improve adolescent nutrition: a systematic review and meta-analysis. J. Adolesc. Health 59: S29-S39. source

      The Results section on promoting healthy nutrition and preventing obesity discusses dietary-control interventions and BMI, but gives no recommended calorie shares. Searches for the carbohydrate and sugar percentages, sucrose, and high-fructose corn syrup found no passage in our copy addressing the claimed recommendations; page numbers were not provided. (LLM, conf=0.76)

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    Premisecitation

    Because at-risk groups of adolescent girls more often have LBW babies and babies born prematurely or suffering neonatal death, survivors will have elevated risks for chronic conditions, including hypertension over the life span, early-onset renal disease, type 2 diabetes, mental disorders, and many other chronic conditions.

    “Because at-risk groups of adolescent girls more often have LBW babies and babies born prematurely or suffering neonatal death, 53,54 survivors will have elevated risks for chronic conditions, including hypertension over the life span, 55 early-onset renal disease, 56 type 2 diabetes, 57 mental disorders, 58 and many other chronic conditions.59”
    Quote in the paperNot a substantial claim2 of 4 sources checked
    • cites [53] 53. Mombo-Ngoma, G., J.R. Mackanga, R. Gonzalez, et al. 2016. Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multi- country study. BMJ Open 6: e011783. source

      The Abstract Results and Discussion report that very young mothers in this sub-Saharan African cohort were more likely to have low-birthweight infants or deliver prematurely. The paper calls these outcomes markers of infant mortality, but does not show that their babies more often died as neonates. The chronic-condition risks have separate citations in the citing sentence and are not attributed to this source. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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    • cites [54] 54. Barker, D.J. & C. Osmond. 1988. Low birth weight and hypertension. BMJ 297: 134-135. source
    • cites [55] 55. Lackland, D.T., H.E. Bendall, C. Osmond, et al. 2000. Low birth weights contribute to high rates of early-onset chronic renal failure in the Southeastern United States. Arch. Intern. Med. 160: 1472-1476. source
    • cites [56] 56. Barker, D.J., C.N. Hales, C.H. Fall, et al. 1993. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia 36: 62-67. source

      Split into 2 atoms — 1 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

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    Premisecitation

    Adolescent girls are two to five times more likely to die from pregnancy-related causes than women aged 20-29 years.

    “Adolescent girls are two to five times more likely to die from pregnancy-related causes than women aged 20-29 years.47”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [47] 47. Ward, D., A. Drahota, D. Gal, et al. 2008. Care home versus hospital and own home environments for rehabilitation of older people. Cochrane Database Syst. Rev. 4: CD003164. doi: 10.1002/14651858.CD003164.pub2. source

      The Types of participants section concerns rehabilitation for people aged 60 or older. Searches for adolescent pregnancy-related mortality and the comparison with women aged 20–29 returned no passage addressing either point; the retrieved material concerns older-person rehabilitation. (LLM, conf=0.79)

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  • May combine two claims.

    Premisecitation

    In boys, peak weight velocity occurs at about the same time as peak height velocity and averages 9 kg/year.

    “In boys, peak weight velocity occurs at about the same time as peak height velocity and averages 9 kg/year.31”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [31] 31. Holliday, M. 1971. Metabolic rate and organ size during growth from infancy to maturity and during late gestation and early infancy. Pediatrics 47: 169-179. source

      The Background and Results passages address adolescent dating violence, not physical growth. Searches for peak weight velocity, peak height velocity, and 9 kg/year found no passage in our copy addressing the claim. (LLM, conf=0.78)

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    Premisecitation

    LMICs now bear a double burden of undernutrition and overnutrition.

    “More recently, there has been an epidemiological transition in LMICs, since these countries now bear a double burden of undernutrition and overnutrition.77,78”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [77] 77. Wang, H., M. Naghavi, C. Allen, et al. 2016. Global, regional, and national life expectancy, all-cause mortality, and cause- specific mortality for 249 causes of death, 1980-2015: a sys- tematic analysis for the Global Burden of Disease Study 2015. Lancet 388: 1459-1544. source

      The Results (page unavailable in our copy) identify high BMI as a major stroke risk factor in low- and middle-income countries, which supports the overnutrition side of the claim. The paper does not establish that these countries also bear a burden of undernutrition or describe the claimed double burden; its findings concern stroke risks rather than nutrition status generally. (LLM, conf=0.78)

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    • cites [78] 78. Popkin, B.M., L.S. Adair & S.W. Ng. 2012. Global nutri- tion transition and the pandemic of obesity in developing countries. Nutr. Rev. 70: 3-21. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In some countries as many as half of all adolescents are stunted, reflecting persistent and cumulative effects of growth retardation from an early age.

    “Though data on the burden of stunting among adolescent females are limited, it has been estimated that in some countries as many as half of all adolescents are stunted, reflecting persistent and cumulative effects of growth retardation from an early age.18”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] 18. UNICEF. 2013. Improving child nutrition: the achievable imperative for global progress. New York. UNICEF.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In 2011, an estimated 43 million (7%) children younger than 5 years were overweight globally, a 54% increase from an estimated 28 million in 1990, and most of these overweight children (32 million) lived in LMICs.

    “In 2011, an estimated 43 million (7%) children younger than 5 years were overweight globally, marking a 54% increase from an estimated 28 million in 1990, 2 and most of these overweight children (32 million) lived in LMICs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] 2. Black, R.E., C.G. Victora, S.P. Walker, et al. 2013. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382: 427-451. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Protein-energy malnutrition is among the top 10 causes of death among children and adolescents, accounting for 225,906 deaths in 2013.

    “Recent findings from the global burden of diseases and injuries among children and adolescents suggest that protein-energy malnutrition is among the top 10 causes of death among children and adolescents, accounting for 225,906 deaths in 2013.15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] 15. Thomas, R.E., M. Russell & D. Lorenzetti. 2010. Interven- tions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst. Rev. 9: CD005188. doi: 10.1002/14651858.CD005188.pub2. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Childhood overweight is associated with multiple immediate and long-term risks, including raised cholesterol, triglycerides, and glucose; type 2 diabetes; high blood pressure; and an elevated risk of developing adult obesity and its associated consequences.

    “Childhood overweight is associated with multiple immediate and long-term risks, including raised cholesterol, triglycerides, and glucose; type 2 diabetes; high blood pressure; and an elevated risk of developing adult obesity and its associated”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [9] 9. Lloyd, L.J., S.C. Langley-Evans & S. McMullen. 2012. Child- hood obesity and risk of the adult metabolic syndrome: a systematic review. Int. J. Obes. 36: 1-11.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] 10. Lobstein, T., L. Baur & R. Uauy. 2004. Obesity in children and young people: a crisis in public health. Obes. Rev. 5: 4-85. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Current evidence suggests adolescents grow in distinct spurts that occur only rarely (about 5% of the time), as established for infants and young children.

    “Current evidence suggests that adolescents grow in distinct spurts that occur only rarely (about 5% of the time), as has been established for infants and young children.23”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] 23. Lampl, M. & M.L. Johnson. 2011. Infant growth in length follows prolonged sleep and increased naps. Sleep 34: 641- 650. source

  • May combine two claims.

    Premisecitation

    The prevalence of underweight among adolescent females aged 13-17 years across five world regions and about 60 countries is generally less than 5%, but in some LMICs in Africa and Asia almost 10% or more of younger adolescent girls (13-15 years) are too thin for their age and height.

    “The prevalence of underweight among adolescent females aged 13-17 years across the five regions of the world and about 60 countries is generally less than 5%; however, in some LMICs in Africa and Asia, almost 10% or more of younger adolescent girls (13-15 years) are too thin for their age and height.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] 17. Khara, T. & E. Mates. 2015. Adolescent nutrition: policy and programming in SUN+ countries. Save the Children, London. Accessed March 10, 2017. https://www.save thechildren.org.uk/sites/default/files/images/Adolescent_ Nutrition.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Overweight and obesity affect one in every three adolescents worldwide.

    “Global nutrition trends in adolescents have been discussed in detail in a companion paper, 16 but, briefly, overweight and obesity affect one in every three adolescents worldwide.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] 17. Khara, T. & E. Mates. 2015. Adolescent nutrition: policy and programming in SUN+ countries. Save the Children, London. Accessed March 10, 2017. https://www.save thechildren.org.uk/sites/default/files/images/Adolescent_ Nutrition.pdf.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    In girls, menarche occurs mostly at Tanner stage B4 but can extend into B5 about 2-3 years after the onset of breast development.

    “Menarche occurs mostly at stage B4 but can extend into B5 about 2-3 years after the onset of breast development.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] 29. Eckert, K.L., V.A. Loffredo & K. O'Connor. 2009. Adolescent physiology. In Behavioral Approaches to Chronic Disease in Adolescence: A Guide to Integrative Care. W.T. O'Donohue, Ed.: 29-45. New York, NY: Springer. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many LMICs bear a double burden of malnutrition, with increasing overweight and obesity along with an existing high burden of undernutrition.

    “Many LMICs now bear a double burden of malnutrition, 11,12 with the increasing burden of overweight and obesity along with existing high burden of undernutriton.13,14”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [11] 11. Popkin, B.M. & P. Gordon-Larsen. 2004. The nutrition tran- sition: worldwide obesity dynamics and their determinants. Int. J. Obes. 28: S2-S9. source
    • cites [12] 12. Nichols, M.S., A.M. de Silva-Sanigorski, J.E. Cleary, et al. 2011. Decreasing trends in overweight and obesity among an Australian population of preschool children. Int. J. Obes. 35: 916-924. source
    • cites [13] 13. Rokholm, B., J.L. Baker & T.I. Sørensen. 2010. The levelling off of the obesity epidemic since the year 1999-a review of evidence and perspectives. Obes. Rev. 11: 835-846. source
    • cites [14] 14. Collaboration GBoDP. 2016. Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013. JAMA Pediatr. 170: 267-287.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    The high rate of growth during puberty is second to infancy but greater in duration, and therefore total nutritional requirements during puberty may be greater than during any other period in life.

    “The high rate of growth during puberty is second to that in infancy, but is greater in duration, and therefore total nutritional requirements during puberty may be greater than during any other period in life.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The growth spurt in adolescence requires rapid tissue expansion with special nutrient requirements, including amino acids for growth of striated muscle, as well as calcium and vitamin D to accommodate bone growth.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Iron-deficiency anemia is the leading cause of years lived with disability among children and adolescents, affecting an estimated 619 million in 2013.

    “Iron-deficiency anemia is the leading cause of years lived with disability among children and adolescents, affecting an estimated 619 (95% confidence interval (CI), 618-621) million in 2013.8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] 8. Koplan, J.P., C.T. Liverman & V.I. Kraak. 2005. Preventing childhood obesity: health in the balance: executive summary. J. Am. Diet. Assoc. 105: 131-138. source

  • May combine two claims.

    Premisecitation

    Adequate nutrition is crucial for adolescents to achieve full growth potential, and failure to achieve optimal nutrition may lead to delayed and stunted linear growth and impaired organ remodeling.

    “Since it is a period of rapid growth, adequate nutrition is crucial for achieving full growth potential, and failure to achieve optimal nutrition may lead to delayed and stunted linear growth and impaired organ remodeling.7”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] 7. Patton, G.C., C. Coffey, S.M. Sawyer, et al. 2009. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet 374: 881-892. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The largest contributors to micronutrient deficiency burden among female youth globally are iron deficiency and iron deficiency-related anemia, responsible for about 700-1200 disability-adjusted life years per 100,000 girls aged 10-14, 300-900 in 15-19-year-olds, and 300-1100 among 20-24-year-old females.

    “The largest contributors to micronutrient deficiency burden among female youth globally are iron deficiency and iron deficiency-related anemia, which are responsible for about 700-1200 disabilityadjusted life years per 100,000 girls in the 10-14 years age group, 300-900 in 15-to 19-year-olds, and 300-1100 among 20-to 24-year-old females.8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] 8. Koplan, J.P., C.T. Liverman & V.I. Kraak. 2005. Preventing childhood obesity: health in the balance: executive summary. J. Am. Diet. Assoc. 105: 131-138. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Globally, around 34 deaths per 100,000 children and adolescents are attributed to malnutrition, varying between developing countries (38.5 per 100,000) and developed countries (0.2 per 100,000).

    “Globally, around 34 deaths per 100,000 children and adolescents are attributed to malnutrition, and this number significantly varies between developing (38.5 per 100,000) and developed countries (0.2 per 100,000).15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] 15. Thomas, R.E., M. Russell & D. Lorenzetti. 2010. Interven- tions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst. Rev. 9: CD005188. doi: 10.1002/14651858.CD005188.pub2. source

  • May combine two claims.

    Premisecitation

    During normal puberty, height and body weight increase (50% of adult body weight is gained during adolescence), bone mass and muscle mass increase, blood volume expands, and the heart, brain, lungs, liver, and kidney all increase in size.

    “During normal puberty, height and body weight increase (50% of adult body weight is gained during adolescence), bone mass and muscle mass increase, blood volume expands, and the heart, brain, lungs, liver, and kidney all increase in size.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] 22. Lampl, M., J.D. Veldhuis & M.L. Johnson. 1992. Saltation and stasis: a model of human growth. Science 258: 801-803. source

  • May combine two claims.

    Premisecitation

    Nutrition surveys show that many adolescents have inadequate intakes of vitamins and minerals, which is more pronounced in females than in males.

    “Nutrition surveys show that many adolescents have inadequate intakes of vitamins and minerals, which is more pronounced in females than in males.63”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] 63. Henkel, D. 2011. Unemployment and substance use: a review of the literature (1990-2010). Curr. Drug Abuse Rev. 4: 4-27. source

  • May combine two claims.

    Premisecitation

    There appears to be an increasing prevalence of obesity among adolescents worldwide, explained by widespread nutrition transitions to lipid-rich diets and a decrease in physical activity, especially among urban adolescents.

    “There appears to be an increasing prevalence of obesity among adolescents worldwide, explained by widespread nutrition transitions to lipid-rich diets and a decrease in physical activity, especially among urban adolescents.62,63”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [62] 62. Schneider, D. 2000. International trends in adolescent nutri- tion. Soc. Sci. Med. 51: 955-967. source
    • cites [63] 63. Henkel, D. 2011. Unemployment and substance use: a review of the literature (1990-2010). Curr. Drug Abuse Rev. 4: 4-27. source

  • May combine two claims.

    Premisecitation

    Basal metabolism is the energy required for cellular and tissue maintenance; it increases rapidly to 2 years of age and levels off throughout adolescence.

    “Basal metabolism is the energy required for cellular and tissue maintenance--it increases rapidly to 2 years of age and levels off throughout adolescence 32”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] 32. Norgan, N.G., B. Bogin & N. Cameron. 2012. Nutrition and growth. In Human Growth and Development. 2nd ed. source

  • May combine two claims.

    Interpretationreasoning

    Excessive total energy intake may lead to overweight and obesity; if decreased total energy intake falls below BMR, then ECG and AEE will be compromised and can lead to growth stunting, pubertal delay, menstrual abnormalities in girls, and interference with bone mass accumulation.

    “Excessive total energy intake may lead to overweight and obesity; however, if a decreased total energy intake falls below BMR, then ECG and AEE will be compromised and can lead to growth stunting, pubertal delay, menstrual abnormalities in girls, and interference with bone mass accumulation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Teens as a group tend to snack and graze, miss meals, eat away from home, consume fast foods, and diet (especially females) more frequently than younger children.

    “Teens as a group tend to snack and graze, miss meals, eat away from home, consume fast foods, and diet (especially females) more frequently than younger children.60,62”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [60] 60. Moreno, L.A., G. Rodriguez, J. Fleta, et al. 2010. Trends of dietary habits in adolescents. Crit. Rev. Food Sci. Nutr. 50: 106-112. source
    • cites [62] 62. Schneider, D. 2000. International trends in adolescent nutri- tion. Soc. Sci. Med. 51: 955-967. source

  • May combine two claims.

    Premisecitation

    In a systematic review, Bellamy estimated that the relative risk for a mother who suffered preeclampsia at any age to acquire hypertension within 14 years was 3.7 (95% CI: 2.70-5.05), ischemic heart disease and stroke within 10 years was 2.16 (95% CI: 1.86-2.52) and 1.81 (95% CI: 1.45-2.27), respectively, and thromboembolic venous disease within 5 years was 1.79 (95% CI: 1.37-2.33).

    “In a systematic review, Bellamy estimated that the relative risk for a mother who suffered preeclampsia at any age to acquire hypertension within 14 years was 3.7 (95% CI: 2.70-5.05), to acquire ischemic heart disease and stroke within 10 years was 2.16 (95% CI: 1.86-2.52)and 1.81 (95% CI: 1.45-2.27),respectively, and to acquire thromboembolic venous disease within 5 years was 1.79 (95% CI: 1.37-2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bellamy

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Most of the large-scale initiatives exist in Brazil, Mexico, and Chile.

    “and most of the large-scale initiatives exist in Brazil, Mexico, and Chile, where there have been efforts to systematically address obesity.79”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [79] 79. Ruel, M.T., H. Alderman & Maternal and Child Nutrition Study Group. 2013. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382: 536- 551. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Brazil, Mexico, and Chile, there have been efforts to systematically address obesity.

    “and most of the large-scale initiatives exist in Brazil, Mexico, and Chile, where there have been efforts to systematically address obesity.79”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [79] 79. Ruel, M.T., H. Alderman & Maternal and Child Nutrition Study Group. 2013. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382: 536- 551. source

  • May combine two claims.

    Premisecitation

    Today's adolescents are more exposed to nutritional risks, harmful alcohol consumption, sexually transmitted diseases, and other risks than in the past.

    “It has become increasingly important to target this vulnerable group, as today's adolescents are more exposed to nutritional risks, harmful alcohol consumption, sexually transmitted diseases, and other risks than in the past and face other new challenges, such as social media.[84][85][86]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [84][85][86]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

34 of 34

  • The paper relies on this without support.

    The timing and duration of body composition changes are linked directly to sexual maturation, and nutritional requirements depend more on sexual maturity than on chronological age.

    “The timing and duration of body composition changes are linked directly to sexual maturation; thus, nutritional requirements depend more on sexual maturity than on chronological age.”

  • The paper relies on this without support.

    Adolescent bodies are not physically ready for pregnancy.

    “Nutrition in pregnant teens is crucial, since their bodies are not physically ready for pregnancy and they tend to give low priority to nutrition despite having enhanced needs for nutrients owing to their pregnant state.”

  • The paper relies on this without support.

    Adolescent fertility is three times higher in LMICs owing to contextual factors including traditional marriage practices, poverty, lack of education and employment, restricted access to care, weak health systems, abuse, unplanned or unwanted pregnancies, and absence of autonomy or support.

    “Adolescent fertility is three times higher in LMICs owing to various contextual factors, including traditional marriage practices, poverty, lack of education and employment, restricted access to care, weak health systems, abuse, unplanned or unwanted pregnancies, and the absence of autonomy or support in their social arrangements.”

  • The paper relies on this without support.

    Appetite increases during adolescence.

    “Appetite increases during adolescence, and sedentary individuals are more likely to accumulate fat if they have access to high-energy food.”

  • The paper relies on this without support.

    The growth spurt in adolescence requires rapid tissue expansion with special nutrient requirements, including amino acids for growth of striated muscle, as well as calcium and vitamin D to accommodate bone growth.

    “The growth spurt in adolescence requires rapid tissue expansion with special nutrient require-ments, including amino acids for growth of striated muscle, as well as calcium and vitamin D to accommodate bone growth.”

  • The paper relies on this without support.

    Protein requirements per unit of height are highest for females in the 11-to 14-year age range and for males in the 15-to 18-year age range, corresponding to the usual timing of peak height velocity.

    “Protein requirements per unit of height are highest for females in the 11-to 14-year age range and for males in the 15-to 18-year age range, corresponding to the usual timing of peak height velocity.”

  • The paper relies on this without support.

    Adult health can be affected by nutrition during adolescence.

    “Adolescents are vulnerable and deserve special attention in nutrition because adult health can be affected by nutrition during adolescence.”

  • The paper relies on this without support.

    Adolescents are vulnerable.

    “Adolescents are vulnerable and deserve special attention in nutrition because adult health can be affected by nutrition during adolescence.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Height and weight are affected by the quantity and quality of nutrition, energy expenditure, and some infections.

    “Height and weight are affected by the quantity and quality of nutrition, energy expenditure, and some infections.19,20”

    From Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults (2024) · cites this paper as [20]

    The Background and Current trends in adolescent nutrition sections link inadequate nutrition to stunted growth and describe undernutrition and overnutrition as affecting body size. Metabolism and Nutritional requirements during adolescence also connect energy intake, activity, and nutrient needs to growth and weight. The passages found do not say that infections affect height or weight, so that part of the attributed claim is unsupported. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Unhealthy eating contributes to obesity and associated health issues among adolescents such as growth retardation, impaired organ development, micronutrient deficiencies, and later in life can lead to non-communicable diseases (NCDs) including cardiovascular diseases, diabetes mellitus, and hypertension.

    “Unhealthy eating contributes to obesity and associated health issues among adolescents such as growth retardation, impaired organ development, micronutrient deficiencies, and later in life can lead to non-communicable diseases (NCDs) including cardiovascular diseases, diabetes mellitus, and hypertension [3–7].”

    From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [5]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Early adolescence has two age ranges

    Minor

    The paper defines early adolescence as ages 10-14, but Box 1 calls ages 12-15 early adolescence. The latter also overlaps the paper's definition of late adolescence at age 15.

1 of 1

Cited works that were retracted

Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.

  • Cites a retracted work: 10.1186/1758-5996-5-49

    Major

    The cited work was retracted on 2014-05-20 (notice 10.1186/1758-5996-6-60), before this paper was published (2017-04). Its authors could have known.

    Cited work 10.1186/1758-5996-5-49 · retracted 2014-05-20 · notice 10.1186/1758-5996-6-60 · this paper published 2017-04

1 of 1

Cites

1 retracted

Flagged first, then by citations

Research works printed but not linked: 7

  1. Hellerstedt W.L., 2005, Guidelines for Adolescent Nutrition Services
  2. Story M., 1992, Nutritional requirements during adolescence, Textbook of Adolescent Medicine, 75
  3. UNICEF, 2013, Improving child nutrition: the achievable imperative for global progress
  4. 10.1007/978-0-387-87687-0_4 · DOI · Paper page
  5. Hellerstedt W.L., 2005, Guidelines for Adolescent Nutrition Services, 1
  6. 10.1093/jn/138.8.1505 · DOI · Paper page
  7. Story M., 2005, Guidelines for Adolescent Nutrition Services, 9

Cited by

Sorted by citations

Related

Authors
Das, J. K., Salam, R. A., Thornburg, K. L., Prentice, A. M., Campisi, S., Lassi, Z. S., Koletzko, B., & Bhutta, Z. A.
Affiliations
  • Aga Khan University (PK)
  • Oregon Health & Science University (US)
  • London School of Hygiene & Tropical Medicine (GB)
  • Hospital for Sick Children (CA)
  • The University of Adelaide (AU)
  • Ludwig-Maximilians-Universität München (DE)
Corresponding author
Bhutta, Zulfiqar A.
ORCID
Venue
Annals of the New York Academy of Sciences
Publisher
Wiley
Published
2017-04
Volume
1393
Issue
1
Pages
21-33
ISSN
  • 0077-8923 (ISSN-L)
  • 1749-6632
DOI
10.1111/nyas.13330
OpenAlex
W2608466962
Cited by
597
References
83
Citations by year
2026: 58 · 2025: 72 · 2024: 88 · 2023: 98 · 2022: 101 · 2021: 72 · 2020: 56 · 2019: 33 · 2018: 16 · 2017: 3
FWCI
3.05
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 23 d)
Locations
  • Annals of the New York Academy of Sciences (publishedVersion)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Health Professions › General Health Professions › Adolescent Health and Behaviors
Keywords
adolescent nutrition, adolescent growth, puberty, nutrient requirements, dietary habits, pregnant adolescents, adolescent transition, nutrition interventions, body image, food preferences
MeSH terms
Adolescent, Adolescent Behavior, Child, Energy Metabolism, Feeding Behavior, Female, Humans, Male, Nutritional Requirements, Nutritional Status, Pregnancy, Adolescent Nutritional Physiological Phenomena, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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