As providers we are often questioned about healthy habits, working out, and diets, but in the pediatric population, what works for adults may be very harmful to the growing body. Many of the food products that are advertised as "healthy" are nowhere close to healthy.

With childhood obesity on the rise, many parents and teens are looking for ways to lose weight or maintain a healthy lifestyle to avoid obesity. But, many resort to restricted diets that lack important nutrients for proper growth.

Adolescents also are notorious for skipping meals, snacking, and late night eating. Teens in particular resort to starvation to lose weight quickly. This is usually ineffective because most will binge on unhealthy food when they become hungry, negating the effects of the decreased intake (J. Pediatr. Nurs. 2005;20:258-67). In terms of skipping breakfast in particular, a study of schools that participated in a breakfast program showed that there was an increase in math grades and physical performance in children who ate breakfast. Generally, teens who consistently ate breakfast had better nutrition than those who did not.

The use of diet aids and stimulants is another quick weight loss trick that has detrimental side effects. Hydroxycut, diuretics, and amphetamines are just a few of the many substances used. Hydroxycut use has been linked to elevated liver enzymes, jaundice, and seizures. The Food and Drug Administration has urged consumers to stop using this product. Improper use of diuretics can cause electrolyte imbalances, and improper use of some stimulants has been indicated as a cause of sudden death.

Fad diets come out weekly and usually include low-carbohydrate/low-fat or meatless diets. Vegetarian diets also are becoming more popular. The problem with any diet in the adolescent age group is that their bodies are growing, and they actually have a higher demand for certain nutrients, in particular iron, zinc, and calcium.

A typical adolescent diet is low in iron, calcium, folic acid, fiber, and zinc. Low iron intake has been shown to impair cognitive function and physical performance. Low calcium intake increases the risk of fractures and osteoporosis later in life.

Vegetarian diets, depending on how restricted they are, can leave children with significant deficiencies. Children with rapid growth have increased iron needs. Iron from meat sources are more readily absorbed than from plant sources, and iron absorption from plant sources is greatly affected by dietary components. Therefore, there is less absorption of iron if consumed with legumes, nuts, and soy protein. Supplementing the diet with consumption of vitamin C during a meal significantly increases the absorption of iron (Hum. Nutr. Appl. Nutr. 1986;40:97-113). Careful consideration of what food is eliminated in a diet and ensuring its replacement by food substitution or vitamin supplements can prevent deficiencies.

Exercise and weight training are another avenue for weight loss but unfortunately are not used as often because they require discipline and time. But exercising and weight lifting aren’t without risk either. The growing adolescent has open growth plates. Therefore, with intense resistance exercises, there is a risk of injuring the growth plate, which could negatively impact the growth of the affected bone. Encouraging teens to train with supervision and to get accurate instructions are crucial to avoiding injury.

The use of protein shakes is popular among male teens, who are often looking to bulk up. Whey protein is commonly used and is safe when taken in proper amounts and with good hydration. The average teen needs approximately 50 g of protein per day. Excessive protein has been thought to cause kidney disease, but the research does not support this claim. Although lowering protein intake can be beneficial for a person with kidney disease, that does not extrapolate to excessive protein leading to kidney disease. But adequate hydration should be encouraged.

It is always prudent to monitor for eating disorders and the use of illicit drugs to improve physique. In adolescents who seem to be overly competitive or overly obsessed with their appearance, addressing concerns directly, informing parents of your observations, and making the appropriate referrals can prevent significant injury and health consequences.

Here are some general recommendations to help you guide your patients:

• Visit choosemyplate.gov, a comprehensive site that reviews dietary guidelines and individualizes the guidelines based on age, sex, and activity level.

• Educate families on reading food labels so they can make good choices.

• Warn against following restricted diets that could lead to nutritional deficiencies resulting in illness.

• Educate about the danger of weight loss drugs and their risks.

• Advise families that strength training can be effective but only when well designed and supervised to avoid injury.

Dr. Pearce is a pediatrician in Frankfort, Ill. E-mail her at pdnews@frontlinemedcom.com. Scan this QR code to view similar columns.

Keeping ‘good health’ healthy