Adolescent Nutrition

Narrative

Adolescents face unique challenges to healthy eating as they become more independent from their families. Improving diet quality among this population is a key public health concern, as approximately one out of every five adolescents aged 12–19 years was obese in 2011–2012.1 Inadequate consumption of essential nutrients can have a negative impact on adult health. Adequate calcium intake in adolescence is essential to attainment of peak bone mass.4 In addition, poor diet quality can increase the risk of chronic diseases such as cardiovascular disease, cancer, and type 2 diabetes.2

The Healthy Eating Index-2010 (HEI-2010) is designed to measure dietary quality3 and can be used to assess how well a population eats on average compared to the recommendations outlined in the 2010 Dietary Guidelines for Americans. Nine of the 12 HEI-2010 components address dietary adequacy of healthy foods. The remaining three components assess intake of foods that should be consumed in moderation: refined grains, sodium, and empty calories. In the table below, the HEI-2010 total and component scores are averages across all children, based on a 24-hour dietary recall.

In 2009–2010, the overall composite score for the HEI-2010 among adolescents aged 12–19 years was 46 out of 100 possible points, where 100 points indicates a diet that aligns with the 2010 Dietary Guidelines for Americans. With regard to the nine components of dietary adequacy, adolescents received 96 percent of the possible points for protein intake and 63 percent of the possible points for whole fruit intake. Adolescents were least likely to consume adequate amounts of greens and beans and whole grains, with 17 and 14 percent, respectively, of possible points obtained (Table 1).

diet quality among adolescents by poverty status

Table 1 Source

HEI-2010 scores for individual components varied with sex. Female adolescents consumed 50 percent of the possible points for vegetables compared to 43 percent for males. Female adolescents were also more likely to consume recommended levels of sodium than were male adolescents, with 42 and 38 percent, respectively, consuming moderate levels. Non-Hispanic White adolescents were closer to meeting recommended levels of dairy consumption (78 percent) than non-Hispanic Black and Hispanic adolescents (59 and 64 percent, respectively). Overconsumption of refined grains, sodium, and empty calories was prevalent across all racial and ethnic groups.

Overall composite scores for diet quality did not vary by household poverty level; however, these scores mask differences in consumption of individual components (table 1). With regard to seafood and plant proteins, adolescents in households with incomes of 200 percent or more of poverty consumed about 57 percent of possible points compared to 36 percent among those in households with incomes of less than 100 percent of poverty. Conversely, adolescents living in households with incomes of 200 percent or more of poverty had lower scores for optimal consumption of sodium compared to adolescents in households with incomes less than 100 percent of poverty (35 versus 43 percent, respectively).

Data Sources

Table 1. Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey, 2009–2010. Data analyzed by the Maternal and Child Health Epidemiology and Statistics Program.

Endnotes

1 Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. Journal of the American Medical Association. 2014;311(8):806–814.

2 U.S. Department of Agriculture; U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 7th edition. Washington, DC: Government Printing Office; 2010 Accessed September 30, 2014.

3 Guenther PM, Casavale KO, Reedy J, et al. Update of the Healthy Eating Index: HEI-2010. Journal of the Academy of Nutrition and Dietetics. April 2013;113(4):569–580.

4 American Academy of Pediatrics. Calcium requirements of infants, children, and adolescents. Pediatrics. 1999;104(5):1152–1157.

Data

Statistical Significance Test

Calculate the difference between two estimates:

Calculated Z-Test Result 0.9567433 Not statistically significant

We follow statistical conventions in defining a significant difference by a p-value less than 0.05 where there is a less than 5% probability of observing a difference of that magnitude or greater by chance alone if there were really no difference between estimates. The 95% confidence interval includes a plausible range of values for the observed difference; 95% of random samples would include the true difference with fewer than 5% of random samples failing to capture the true difference.

This website allows comparisons between two estimates using the independent z-test for differences in rates or proportions. This test is appropriate for comparing independent populations across years (e.g., 2011 versus 2012) or subgroups (e.g., Male versus Female) on corresponding measures. To the extent possible, the functionality of this application has limited estimate comparisons based on appropriate use of the independent z-test. However, some tables present subgroup categories within broader categories that will allow comparisons between non-independent populations (e.g., low birth weight and very low birth weight). Users should exercise caution when interpreting these test results, which will frequently overstate statistical significance.

For some tables, the website does not allow for comparisons between two estimates, even though the data represent independent populations. Generally, this is because the standard errors were not publicly available at the time this website was created.

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