Now is the time for evidence-based, specific dietary guidance to nourish adolescents

Adolescence is a critical time for nutritional health, given the rapid physical growth, hormonal changes, and neurodevelopmental shifts taking place. Yet diet quality is at its lowest during this pivotal life stage, which is compounded by unique physiological, social, and behavioral factors facing adolescents. In fact, public health guidance has noted that nutrient gaps among adolescents set the stage for a “constellation of potential nutritional risk factors.”¹ This public health challenge is exacerbated by the lack of scientific research and specific, evidence-based dietary guidance tailored to adolescents.

“Research has established that nutrient adequacy in adolescence impacts physical growth, development, and academic performance, as well as long-term health and chronic disease risk,” said Colin Kay, PhD, director of the Arkansas Children’s Nutrition Center, one of six USDA Agricultural Research Service national human nutrition research centers. “However, current dietary guidance do not sufficiently address adolescence as a distinct life stage with unique needs. This complex and transitional period should no longer be treated simply as an extension of childhood or adulthood, and more research is urgently needed to inform relevant recommendations that can reverse this persistent public health issue.”

To elevate awareness of this issue and identify research needs, the Arkansas Children’s Nutrition Center (ACNC) partnered with the National Cattlemen’s Beef Association, on behalf of the Beef Checkoff, to convene Nourish Now: A Science Dialogue on Improving Adolescent Health through Nutrition, including 50 leading nutrition scientists, previous Dietary Guidelines Advisory Committee members, physicians, registered dietitians, and public health experts. Two manuscripts from this convening have now been published in Critical Reviews in Food Science and Nutrition: Proceedings from Nourish Now: A science dialogue on improving adolescent health through nutrition; and Call to action: the future of evidence-based, adolescent-focused dietary guidance.

The workshop addressed four objectives:

• Demonstrate the need for balanced dietary patterns to address the unique nutritional needs and gaps of adolescents;
• Highlight the nutrition-related health challenges affecting adolescents, as well as the potential public health impact of these issues;
• Identify barriers and challenges for adolescents to consume nutritionally adequate diets; and
• Identify research needs and opportunities to better support evidence-based dietary guidance to effectively improve the health and wellbeing of adolescents.

Key considerations that the workshop attendees aligned on included:

• Rapid growth marked by increases in height, bone mass, muscle development, and, for girls, the onset of menstruation, intensify requirements for energy, protein, iron, zinc, calcium, vitamin B12, among other nutrients. Despite these increased needs, U.S. adolescents consistently have the poorest diet quality compared to other life stages.
  • NHANES analyses report that adolescents, on average, under-consume nutrient-dense foods such as fruits, vegetables, dairy, whole grains and high-quality protein foods, like beef.
  • In particular, adolescent girls show the propensity to fall short on their dietary intakes of protein, iron, folate, and vitamin B12, nutrients essential for growth, oxygen transport, energy metabolism, and brain health.
• The modern food environment makes it difficult for adolescents to meet their nutritional needs. Greater independence, busy schedules, social media influence, and easy access to more highly processed, highly palatable foods mean adolescents often prioritize convenience and taste over nutrient density and health.
• Low physical activity, inadequate sleep due to changing sleep cycles, and rising rates of anxiety and/or disordered eating can all further disrupt behavior, appetite regulation, food choices, and nutritional status during this developmental period.
• Nearly 25% of teens experience some degree of food insecurity, increasing their risk of nutrient inadequacies and developing poor health habits.
• Adolescents are at greater risk, compared to other age groups, of inadequate intake of key nutrients that can be obtained from fruits and vegetables; legumes; whole grains; and high-quality, animal-source foods.
• The importance of healthy dietary patterns and of meals eaten at home was stressed, noting that adolescent diet quality remains strongly linked to the meals and foods that are available and consumed within the household, even as teens gain independence.

The Nourish Now dialogue culminated with a public health call-to-action for increased investment in adolescent-tailored nutrition research, including more focused monitoring of nutrient status, well-designed intervention studies, and a clearer translation of science into practical, life stage-specific guidance. Attendees also stressed the need for an updated understanding of nutrient requirements during this stage of life.

“We know adolescence is a complex life stage, yet research and dietary guidance do not yet adequately reflect the various factors affecting low diet quality during this time,” said Elisabet Børsheim, PhD, associate director, Arkansas Children’s Nutrition Center. “For example, assessing protein intake and requirements during vulnerable life stages like adolescence is an emerging priority, with protein quality playing a role in optimal growth and development.”

1Dietary Guidelines Advisory Committee. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service; 2020. https://www.dietaryguidelines.gov/2020-advisory-committee-report