22.1 Nutrition for Adolescents and Adults: Growth Spurt, Risk Factors, and NCD Prevention

The life cycle competency area asks examinees to describe growth, nutrient needs, meal patterns, risk factors, and nutrition services for each age group, including adolescents and adults.

Adolescence (about 10-19 years)

Growth spurt: girls usually begin earlier (around 10-13 years) and boys later (around 12-15 years). During peak growth, adolescents gain about 20% of adult height and a large share of adult bone mass. Boys gain more muscle and blood volume; girls gain more body fat and begin menstruation.

PDRI 2015 energy and protein:

Nutrients of concern:

• Iron: girls lose iron through menstruation; boys need it for expanding muscle and blood volume. Anemia lowers school performance.
• Calcium and vitamin D: bone mineral accrual peaks; milk, small fish with bones, tofu, and green leafy vegetables.
• Folate: important for adolescent girls before any pregnancy.
• Iodine and zinc: growth and sexual maturation.

Common nutrition problems and risk behaviors:

• Skipping breakfast and irregular meals
• Frequent fast food, instant noodles, and sugar-sweetened beverages
• Overweight and obesity, linked to screen time and low activity
• Dieting, body image concerns, and eating disorders
• Adolescent pregnancy, which adds the needs of the fetus to those of a growing mother
• Smoking, vaping, and alcohol use
• Iron deficiency anemia

Counseling adolescents:

• Ensure privacy and confidentiality within legal limits.
• Use a psychosocial screen such as HEEADSSS (home, education, eating, activities, drugs, sexuality, suicide and depression, safety).
• Respect independence; give choices rather than rules.
• Focus on immediate benefits (energy, appearance, sports performance) more than long-term disease risk.
• Involve peers, schools, and social media positively.

Sample school day for a 15-year-old girl (about 2,170 kcal):

• Breakfast: rice, scrambled egg with tomatoes, a banana, and a glass of milk
• Recess: boiled corn or a peanut butter sandwich, with water
• Lunch (baon): rice, adobong manok, ginisang sitaw and kalabasa, and a mango
• Afternoon snack: taho or a glass of fresh buko water instead of soft drinks
• Dinner: rice, grilled galunggong, pinakbet, and watermelon

This pattern supplies iron from egg, chicken, fish, and green vegetables, calcium from milk and taho, and vitamin C from fruit to aid iron absorption.

Adulthood (19-59 years)

PDRI 2015 energy: 2,530 kcal (men) and 1,930 kcal (women) at 19-29 years; 2,420 and 1,870 kcal at 30-59 years. Protein is 71 g for men and 62 g for women.

Major risk factors for noncommunicable diseases (NCDs):

Meal pattern for adults (Pinggang Pinoy): half the plate vegetables and fruits (vegetables more than fruits), about a third rice or other go foods, and a smaller portion of fish, meat, egg, or legumes, with water as the main drink.

Special adult concerns:

• Women of reproductive age: iron and folate status before pregnancy.
• Menopause: declining estrogen accelerates bone loss; PDRI calcium rises to 800 mg/day for women 50-59 years, with weight-bearing exercise and vitamin D. Weight and abdominal fat tend to increase.
• Shift workers and office workers: irregular meals, sedentary work, and reliance on fast food.
• Men: higher rates of smoking, alcohol use, and early heart disease.
• Adults with existing NCDs: need individualized medical nutrition therapy, regular follow-up, and support for medication adherence alongside diet changes.

Nutrition Services for Adolescents and Adults

• School-based programs: nutrition education, healthy canteens, weekly iron-folic acid for female learners.
• Adolescent-friendly health services.
• Workplace wellness programs and canteen menus.
• NCD risk screening and lifestyle counseling at primary care facilities.
• Community physical activity and healthy cooking programs.

Example: adult NCD screening. A 42-year-old man is 165 cm tall, weighs 75 kg, and has a waist of 96 cm. His BMI is 75 ÷ (1.65 × 1.65) = 27.5 kg/m², which is overweight by the WHO cutoffs (25-29.9), and his waist is above 90 cm, showing abdominal obesity. He needs blood pressure, glucose, and lipid screening and lifestyle counseling.