Children and adolescents

  Population considerations

  • Developmental Changes. Adolescence is a time of immense change- physical, mental and social.  Often, healthy eating is viewed as less of a priority compared to these other issues (Hoelscher, 2002). 
  • Food availability. Parents/guardians and schools are the major determinants of the types of foods available to children and adolescents. As a result, children and adolescents often have limited choices related to the foods they consume (Hoelscher, 2002).
  • Vending machines. Vending machines, as well as school stores, have played an increasing role in adolescents’ diets. Many of the choices available in vending machines or school stores are high in calories and low in nutritional value (Nielsen, 2002). 
  • Parental and peer modeling. The choices parents make at home regarding food have a strong influence on children’s eating patterns. Parents are role models for their children.  Parents are more likely to pass along their food habits to their children (Kratt, 2000; Cooke, 2004). As children get older, peers gradually play a more important role in food choice (Hill, 2002).
  • Media. More than half of television advertisements aimed towards children promote foods and drinks that are high in calories and fat and low in basic nutrients.  Young children may be particularly vulnerable due to their lack of ability to understand the difference between information and advertising (Institute of Medicine, 2005).
  • Independent choices. Adolescents seek independence in decision-making.  Unfortunately their food choices may be inadequate, as they are typically high in fat, sugar and salt, and low in fruits, vegetables, and whole grains (Hoelscher, 2002). 
  • Allowance for food. Adolescents who have access to money, through an allowance or job, spend the majority of their funds on snack items (Alhabeeb, 1996).
  • Meals outside of home.  As a trend, children and adolescents are eating less food from home and more food from fast food establishments and other convenient locations (Nielsen, 2002).  Children who eat fast food typically consume more calories and fat, sweetened beverages, and less fruits, vegetables, and milk (Institute of Medicine, 2005).
  • Social norms. Eating nutritious foods may go against social pressures to conform to certain behaviors. For some children this may mean eating foods high in fats and low in nutrients, such as fast foods. For others this may mean decreased caloric intake to lose weight and therefore fit in with some image of an idealized thin body size (Hill, 2002).

  Strategies to address these considerations

  • Tailor to age group. Nutrition interventions must be tailored to the different developmental and educational stages of children. No single intervention will work for all age groups. Identify social norms that nutrition messages will counteract, and focus messages on short term outcomes and benefits of healthy food choices as opposed to long term outcomes (Hoelscher, 2002). For example, children and early adolescents think in concrete terms whereas older adolescents have the ability to think abstractly.
  • Address food availability. Consider working with families, schools, and other social networks that provide food and nutrition education to children and adolescents. These groups can communicate benefits and model increased consumption of nutritious foods as well as enhance children and adolescents’ skills to choose and prepare nutritious foods. These groups may also improve access to healthy choices and decrease access to less nutritious choices (Nielsen, 2002).
  • School Environment. Work with schools to ensure foods available, including foods in vending machines, are consistent with current healthy eating guidelines.  Replacing high fat and high sugar snacks and drinks with healthier, low-fat snacks and drinks can increase the likelihood that children will select and consume healthier items.  Some schools have incorporated nutrition education into existing curricula. Evidence shows that at least 50 hours of nutrition education in schools is needed to produce dietary and behavior changes (Hoelscher, 2002). 
  • Family environment.  The structure of meals at home is important to children’s dietary health. Educating parents is one of the biggest factors influencing healthy eating in children, especially in terms of providing fruits, vegetables, and dairy foods in the home (Golan, 2004). Family meals can also have a positive impact on children’s dietary intake and meal patterns (Larson, 2007).
  • Make use of the power of media. Media has great potential to play a positive role on food and nutrition choices, habits, and social norms.  A multimedia campaign, focused on a particular issue, can provide ongoing messages to a large audience to help gain support of policy changes as well as provide needed information to youth and parents (Institute of Medicine, 2005).  Children and adolescents are familiar with technology and could easily adapt to nutrition education that incorporates various forms of media and technology (Hoelscher, 2002).
  • Empower children and adolescents. Interventions aimed at enhancing knowledge and skills can provide children and adolescents the background necessary to make healthier choices (Hill, 2002).  In addition, including children and adolescents in the decision-making process or on advisory committees can capitalize on their desire to be independent (Hoelscher, 2002).
  • Financial Incentives. Evidence shows that subsidizing the price of food can encourage the purchase and consumption of healthier foods while taxes may deter purchase and consumption of less healthy foods (Hoelscher, 2002).
  • Promote healthy eating when dining away from home. Providing general nutrition information about food selection and portion sizes can help children and parents make informed decisions. Point of purchase information can also help children and parents make informed decisions (Larson, 2009). Another option is to work with community members to create a demand for healthier food options so that local food establishments will find value in expanding their healthy food options (Institute of Medicine, 2005).
  • Addressing social norms. Incorporating peer-led activities or peer leadership programs can stimulate social norm changes (Holescher, 2002).  Families and communities can also support positive changes by reinforcing healthy food messages and providing these foods at social events (Cullen, 2000).

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