The status of young adolescent health & well-being: Nutrition

The last decade has witnessed unprecedented attention to a comprehensive agenda for adolescent health, an agenda that takes a holistic and multidimensional approach to promoting and addressing the health and well-being of adolescents [1Global strategy for Women's, children's and adolescents' health (2016–2030). Every Woman Every Child, N Y2015Google Scholar, 2Patton G.C. Sawyer S.M. Santelli J.S. et al.Our future: A Lancet commission on adolescent health and wellbeing.Lancet. 2016; 387: 2423-2478Abstract Full Text Full Text PDF PubMed Google Scholar, 3World Health OrganizationAccelerated action for the health of adolescents (AA-HA!): Guidance for country implementation.2nd ed. World Health Organization, Geneva2017Google Scholar, 4Bundy D.A.P. Silva N. Horton S. et al.Child and adolescent health and development: Realizing neglected potential.in: Bundy D.A.P. Silva N.D. Horton S. Jamison D.T. Patton G.C. Adolescent Health and Development. 3rd ed. The International Bank for Reconstruction and Development, The World Bank, Washington (DC)2017Crossref Google Scholar, 5Adolescents: The missing population in universal health coverage. World Health Organization, Geneva2019https://plan-uk.org/file/plan-adolescent-health-reportpdf/download?token=VVsY-cTpDate accessed: May 6, 2023Google Scholar, 6Political declaration of the high-level meeting on universal health coverage "universal health coverage: Moving together to build a healthier world". United Nations, New York2019https://www.un.org/pga/73/wp-content/uploads/sites/53/2019/07/FINAL-draft-UHC-Political-Declaration.pdfDate accessed: May 6, 2023Google Scholar, 7Clark H. Coll-Seck A.M. Banerjee A. et al.A future for the world's children? A WHO–UNICEF–Lancet commission.Lancet. 2020; 395: 605-658Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar, 8Ross D.A. Hinton R. Melles-Brewer M. et al.Adolescent well-being: A definition and conceptual framework.J Adolesc Health. 2020; 67: 472Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar, 9Making every school a health-promoting school: Global standards and indicators. World Health Organization and the United Nations Educational, Scientific and Cultural Organization, Geneva and Paris2021https://apps.who.int/iris/handle/10665/341907Date accessed: May 6, 2023Google Scholar]. At the global level, building on successes in advancing sexual and reproductive health, adolescent health and well-being have been gradually reframed toward a more comprehensive approach including HIV and other infectious diseases, unintentional injuries, violence, communicable and noncommunicable diseases, mental health, and key risk factors, such as alcohol and drug use, tobacco use, sedentary behaviors, and poor nutrition, as well as protective factors such as education and connectedness (Table 1) [1Global strategy for Women's, children's and adolescents' health (2016–2030). Every Woman Every Child, N Y2015Google Scholar,2Patton G.C. Sawyer S.M. Santelli J.S. et al.Our future: A Lancet commission on adolescent health and wellbeing.Lancet. 2016; 387: 2423-2478Abstract Full Text Full Text PDF PubMed Google Scholar]. Crucial for this reframing was generating strong data showing the breadth of public health concerns for adolescent health and well-being.Table 1Selected milestones in advancing the comprehensive agenda for adolescent health and well-beingEventThe role in promoting a comprehensive agenda for adolescent health and well-being2015 – Global Strategy for Women's, Children's, and Adolescents' Health (2016–2030)Includes adolescent health as a new strategic area and provides a roadmap that is comprehensive not only across health priorities but also across SGDs and political, social, economic, and environmental determinants of health and sustainable development [1Global strategy for Women's, children's and adolescents' health (2016–2030). Every Woman Every Child, N Y2015Google Scholar].2016 – Our future: a Lancet commission on adolescent health and well-beingShows great variations in adolescent health profiles between countries and within nation states, and calls for reframing adolescent health and well-being to include a broader vision of adolescent health inclusive of issues beyond sexual and reproductive health [2Patton G.C. Sawyer S.M. Santelli J.S. et al.Our future: A Lancet commission on adolescent health and wellbeing.Lancet. 2016; 387: 2423-2478Abstract Full Text Full Text PDF PubMed Google Scholar].2017 – Accelerated Action for the Health of Adolescents: guidance for country implementationIn support of the implementation of the Global Strategy for Women's, Children's, and Adolescents' Health, calls for investing in comprehensive adolescent health programmes informed by national priorities. Following its publication and support by WHO and other UN partners, many countries have used the guidance to develop or update comprehensive strategies and plans for adolescent health and well-being [3World Health OrganizationAccelerated action for the health of adolescents (AA-HA!): Guidance for country implementation.2nd ed. World Health Organization, Geneva2017Google Scholar].2017 – The investment case in a comprehensive package of services in adolescence in the 3rd edition of the Child and Adolescent Health and DevelopmentBrings new insights into the benefits of investing in a comprehensive package of services for adolescent health and well-being, with a strong focus on return on investment from school health interventions [4Bundy D.A.P. Silva N. Horton S. et al.Child and adolescent health and development: Realizing neglected potential.in: Bundy D.A.P. Silva N.D. Horton S. Jamison D.T. Patton G.C. Adolescent Health and Development. 3rd ed. The International Bank for Reconstruction and Development, The World Bank, Washington (DC)2017Crossref Google Scholar].2019 – Political declaration on Universal Health CoverageAdolescents took the spotlight in the lead-up to the United Nations High-level Meeting on Universal Health Coverage in 2019 [5Adolescents: The missing population in universal health coverage. World Health Organization, Geneva2019https://plan-uk.org/file/plan-adolescent-health-reportpdf/download?token=VVsY-cTpDate accessed: May 6, 2023Google Scholar]. The resulting political declaration stressed the need comprehensively address a broad range of health problems and their social, economic, and environmental and other determinants of health by working across all sectors [6Political declaration of the high-level meeting on universal health coverage "universal health coverage: Moving together to build a healthier world". United Nations, New York2019https://www.un.org/pga/73/wp-content/uploads/sites/53/2019/07/FINAL-draft-UHC-Political-Declaration.pdfDate accessed: May 6, 2023Google Scholar].2020 – The COVID-19 pandemicBrought to the spotlight the need to have a holistic response to the pandemic that considers the totality of adolescents needs such as access to services related to physical activity, nutrition, mental health, sexual and reproductive health, child protection, water, sanitation and hygiene, and other services [12World Health OrganizationAccelerated action for the health of adolescents (AA-HA!): Guidance for country implementation.2nd ed. World Health Organization, Geneva2023https://iris.who.int/bitstream/handle/10665/373300/9789240081765-eng.pdf?sequence=1Date accessed: January 2, 2024Google Scholar].2020 – A future for the world's children? A WHO–UNICEF–Lancet CommissionCalls for a comprehensive narrative that places children's and adolescent's health and well-being at the center of the sustainable development goals and the notion of sustainability, and recommends reconfiguring the global, national, and subnational governance to provide strong multisectoral solutions [7Clark H. Coll-Seck A.M. Banerjee A. et al.A future for the world's children? A WHO–UNICEF–Lancet commission.Lancet. 2020; 395: 605-658Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar].2020 – UN H6+ agencies' Adolescent Well-being InitiativeProposes a consensus conceptual framework for adolescent well-being that consists of five interrelated domains 1) good health and optimal nutrition; 2) connectedness, positive values, and contribution to society; 3) safety and a supportive environment; 4) learning, competence, education, skills, and employability; and 5) agency and resilience [8Ross D.A. Hinton R. Melles-Brewer M. et al.Adolescent well-being: A definition and conceptual framework.J Adolesc Health. 2020; 67: 472Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar].2021 – WHO, UNESCO, and UNICEF initiative Making Every School a Health Promoting SchoolCalls to put learners' health and well-being at the core of the education agenda by investing in health-promoting education systems, and publishes global guidance to inform a new generation of comprehensive school health programmes [9Making every school a health-promoting school: Global standards and indicators. World Health Organization and the United Nations Educational, Scientific and Cultural Organization, Geneva and Paris2021https://apps.who.int/iris/handle/10665/341907Date accessed: May 6, 2023Google Scholar,10Making every school a health-promoting school: implementation guidance. World Health Organization, Geneva2021https://apps.who.int/iris/handle/10665/341908Date accessed: May 6, 2023Google Scholar].2022 – The Lancet Series Optimising Child and Adolescent Health and DevelopmentProvides evidence of the effectiveness of a comprehensive intervention package for adolescents across a range of priorities and delivery platforms, and provides evidence that school health programmes are particularly well placed to promote, prevent, and address issues related to nutritional problems, anemia, vision and dental problems, mental health (including anxiety and depression), and learning disabilities [11Vaivada T. Lassi Z.S. Irfan O. et al.What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years.Lancet. 2022; 399: 1810-1829Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar].2023 – The second edition of the Accelerated Action for the Health of Adolescents: guidance for country implementationThe case for investing in comprehensive adolescent health programmes informed by national priorities is made stronger by articulating how a more holistic understanding of adolescent well-being, based on the adolescent well-being framework, can inform a new generation of programmes [12World Health OrganizationAccelerated action for the health of adolescents (AA-HA!): Guidance for country implementation.2nd ed. World Health Organization, Geneva2023https://iris.who.int/bitstream/handle/10665/373300/9789240081765-eng.pdf?sequence=1Date accessed: January 2, 2024Google Scholar]. Open table in a new tab Countries' response has followed. In 2023, 96 countries reported having an adolescent health programme. By the end of 2022, most countries in the WHO African region, the Americas region, the South-East Asia region, and selected countries in the Eastern Mediterranean and Western Pacific regions have used the Accelerated Action for the Health of Adolescents (AA-HA)! guidance to develop or update comprehensive adolescent health strategies and plans [12World Health OrganizationAccelerated action for the health of adolescents (AA-HA!): Guidance for country implementation.2nd ed. World Health Organization, Geneva2023https://iris.who.int/bitstream/handle/10665/373300/9789240081765-eng.pdf?sequence=1Date accessed: January 2, 2024Google Scholar]. Informed by the AA-HA! guidance, regional initiatives and political commitments were made, such as the Adolescent Health Flagship Programme for Africa, the Plan of Action for Women's, Children's, and Adolescents' Health 2018–2030 of the Pan American Health Organization, the Regional Framework of Joint Strategic Actions for Young People of the Eastern Mediterranean Region, and the European Region adaptation of AA-HA! [12World Health OrganizationAccelerated action for the health of adolescents (AA-HA!): Guidance for country implementation.2nd ed. World Health Organization, Geneva2023https://iris.who.int/bitstream/handle/10665/373300/9789240081765-eng.pdf?sequence=1Date accessed: January 2, 2024Google Scholar]. However, much more needs to be done to close the gap in providing effective coverage with critical interventions for adolescent health and well-being [2Patton G.C. Sawyer S.M. Santelli J.S. et al.Our future: A Lancet commission on adolescent health and wellbeing.Lancet. 2016; 387: 2423-2478Abstract Full Text Full Text PDF PubMed Google Scholar]. Moving forward requires the ongoing monitoring of progress and accountability to implement this comprehensive agenda. In this context, the consensus list of priority indicators for adolescent health measurement recommended by the Global Action for the Measurement of Adolescent Health Advisory Group comes at the right time. The list redefines how to measure and learn about adolescent health and makes an important contribution to the WHO' and partners' vision for adolescent-responsive health and social systems, and health-promoting education systems, through comprehensive approaches. First, the indicators recommend that adolescent health be measured in a comprehensive way—acknowledging not only all the important causes of adolescent ill health but also their social and other determinants. Although similar attempts were made earlier for global monitoring [2Patton G.C. Sawyer S.M. Santelli J.S. et al.Our future: A Lancet commission on adolescent health and wellbeing.Lancet. 2016; 387: 2423-2478Abstract Full Text Full Text PDF PubMed Google Scholar], a study of 16 global and regional initiatives including adolescent health indicators found that some areas such as interpersonal violence, HIV/AIDS, and adolescent sexual and reproductive health were commonly addressed, while others such as anxiety disorders were commonly neglected [14Newby H. Marsh A.D. Moller A.B. et al.A scoping review of adolescent health indicators.J Adolesc Health. 2021; 69: 365-374Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar]. Second, the list includes measures of systems' performance. It fills an important gap where measurement of policies and systems has long lagged behind health outcomes and conditions or even health behaviors and risks [13World health Organization. Maternal, Newborn, Child and adolescent health and ageing data portal.https://platform.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-explorer-new/MCA/national-adolescent-health-programmeDate accessed: June 30, 2023Google Scholar]. Such accountability is essential to redress the current situation when the quality of services for adolescents is substandard across both health and social systems [15Kruk M.E. Lewis T.P. Arsenault C. et al.Improving health and social systems for all children in LMICs: Structural innovations to deliver high-quality services.Lancet. 2022; 399: 1830-1844Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar]. Third, the list extends the accountability for adolescent health beyond the health sector. With the unprecedented attention that school health has recently received [9Making every school a health-promoting school: Global standards and indicators. World Health Organization and the United Nations Educational, Scientific and Cultural Organization, Geneva and Paris2021https://apps.who.int/iris/handle/10665/341907Date accessed: May 6, 2023Google Scholar,16Baltag V. Sidaner E. Bundy D. et al.Realising the potential of schools to improve adolescent nutrition.BMJ. 2022; 379e067678PubMed Google Scholar], underpinned by an increased understanding of the need to embed healthy development and nutrition within education systems, measuring the proportion of schools that offer comprehensive school health services and life skills-based HIV and sexuality education will provide valuable data to accelerate the WHO/UNESCO/UNICEF vision Make Every School a Health Promoting School. Finally, the recommended approach embraces measures of well-being related to education, connectedness, agency, and a safe and supportive environment, and ongoing work by WHO and partners will further this work in the next years to a more granular way of understanding and measuring adolescent well-being [17Newby H. Hagell A. Marsh A.D. Guthold R. UN H6+ Adolescent Wellbeing Measurement Writing GroupOpportunities to advance measurement of adolescent wellbeing: Building on a new conceptual framework.BMJ. 2022; 379e068955PubMed Google Scholar]. The time is right. The second edition of the AA-HA! guidance that integrates the work by the Global Action for the Measurement of Adolescent Health group is being published in 2023, the year when the largest-ever gathering for adolescent well-being, the Global Forum for Adolescents, is taking place. This is a unique opportunity to celebrate success and inspire adolescents and the global community to advocate society's support for a successful transition from adolescence to adulthood. At the same time, it is important to ensure continued momentum, beyond the Global Forum for Adolescents '23, to sustain commitments to resource mobilization and joint efforts by all stakeholders to increase political and financial investments in adolescent health and well-being. The United Nations partners involved in advancing the vision for adolescent-responsive health and social systems, and health-promoting education systems through comprehensive approaches, stand ready to support sustained attention to adolescent health and well-being in national and global policies and to provide technical assistance as countries act to accelerate action for the new generation of adolescent health and well-being programmes. © World Health Organization [year]. Licensee JAH. This is an open access article distributed under the terms of the Creative Commons Attribution N-Noncommercial IGO License (https://creativecommons.org/licenses/by/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. The authors wish to thank Andrew Marsh for his suggestions in reviewing this manuscript.

Applying latent growth curve analysis to a sample of 310 adolescents, this study demonstrates that level of and changes in observed parental behavior are liked to the level of and changes in adolescent physical health status, respectively, through adolescent perception of parental support. In addition, the level of observed parental behavior had a significant direct effect on subsequent changes in adolescent health status. The results provide evidence for the influence of parental support on adolescent physical health, both directly and indirectly through the adolescent's perception of that support. Confidence in the findings is strengthened by (1) employing a prospective, longitudinal research design, (2) analyzing intraindividual changes in support and health, and (3) reducing potential method variance confounds by using multi-informant reports of parental behavior.

This study aims to estimate the prevalence of depressive symptoms among adolescents seen in hospital emergency departments and to investigate the concordance between self-reported adolescent depression and parental perceptions of their adolescents' health status. A multicentre cross-sectional survey in three emergency departments receiving adolescents in Ile-de-France took place in 2010. All adolescents completed a questionnaire including the Adolescent Depression Rating Scale (ADRS) and a series of questions concerning somatisation and risk behaviours. Parents simultaneously completed a questionnaire collecting their perceptions of their adolescent's health status. The study included 346 adolescents, and of them, 320 were fully analysed. ADRS scores were in the normal range for 70.6 % of the sample (score of <3) (n=226); 19.4 % (n=62) showed moderate depressive symptoms (3 ≤ score<6), and 10.0 %, severe depressive symptoms (score of ≥ 6) (n=32). We observed a wide discrepancy between adolescent depression, determined by a score on a self-administered scale, and parental perceptions of it. Routine use of a self-administered questionnaire in emergency units could enable identification of adolescents with moderate or severe depressive symptoms. The present study confirms the importance of increasing parental awareness of their adolescent children's depressive symptoms.

Few validated health status measures have been assessed in children with chronic kidney disease (CKD). The objective was to assess the validity of a generic health status measure, the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), in adolescents with CKD. A case-control study was performed (1) to assess scores on the CHIP-AE in adolescents with CKD compared with two control groups of age-, socioeconomic-, and gender-matched peers and (2) to compare health of patients who had chronic renal insufficiency (CRI), were on dialysis, and were posttransplantation. Seven pediatric nephrology centers recruited 113 patients (mean age, 14 yr; 39 CRI, 21 dialysis, 53 posttransplantation). Compared with 226 control subjects, patients with CKD had lower overall satisfaction with health and more restriction in activity. Positively, patients with CKD had more family involvement, better home safety and health practices, and better social problem-solving skills and were less likely to participate in risky social behaviors or socialize with peers who engaged in risky behavior. Patients who received dialysis were less physically active and experienced more physical discomfort and limitations in activities than did transplant or CRI patients. It is concluded that patients with CKD have poorer functional health status than age-matched peers. Among CKD patients, dialysis patients have the poorest functional health status. These results suggest that the CHIP-AE can be used to measure functional health status in adolescent patients with CKD.

The aim of this study was to characterize the association between clinical and psychosocial factors as they related to perceptions by parents and adolescents to the adolescent's oral health status and treatment need. Additionally, the degree to which adolescent's and parent's perceptions of oral health and treatment need were related was examined. Data from the Pennsylvania oral health needs assessment for 530 parent-adolescent pairs were used to address the objectives of this study. Comparisons between clinical oral health measures, psychosocial factors, and the parent- and adolescent-reported perceptions of the adolescent's oral health status were made using descriptive and inferential statistics, including exploratory factor analysis and path analysis. Parents and adolescents exhibited only modest concordance on ratings of the adolescent's oral health status and need for dental treatment. Furthermore, parents tended to rate their adolescent's oral health status as better than did the adolescent. The results of the path analysis showed that adolescents based their ratings of oral health status more on oral symptoms, while parents rated their adolescent's oral health more on esthetic or psychosocial factors. Adolescents and parents based their perceptions of oral health status and treatment need on different underlying factors. Additionally, adolescents' perceptions of their oral health status and treatment needs did not appear to be communicated to their parents.

The COVID-19 pandemic provided an extraordinary and naturalistic context to observe young people’s psychosocial profiles and to study how a condition of environmental deprivation and lack of direct social contact, affects the well-being and health status of adolescents. The study explored whether the COVID-19 outbreak changes, in the short term, the acute well-being perception in adolescents, as measured by a Personalized Well-Being Index (PWBI) and the four components affecting health (i.e., lifestyle habits, social context, emotional status, mental skills), in a sample of early adolescent students. Data from 10 schools were collected on 1019 adolescents (males 48.3%, mean age 12.53 ± 1.25 y). Measurements were obtained at two time points, in September/October 2019, (baseline condition, BC) as part of the “A new purpose for promotion and eVAluation of healTh and well-being Among healthy teenageRs” (AVATAR) project and during the Italian Lockdown Phase (mid–late April 2020, LP), with the same students using an online questionnaire. During COVID-19 quarantine, adolescents showed a lower PWBI (p < 0.001) as compared to the BC. Considering the four health-related well-being components, lifestyle habits (p < 0.001), social context (p < 0.001), and emotional status (p < 0.001), showed significantly lower values during LP than BC. However, mental skills, in LP, displayed a significant increase as compared to BC (p < 0.001). In this study, we have provided data on the personalized well-being index and the different components affecting health in adolescents during the COVID-19 lockdown, showing a general decrease in well-being perception, expressed in lifestyle habits, social, and emotional components, demonstrating detrimental effects in the first phase of quarantine on adolescents’ psychosocial profiles. Our results shed new light on adolescence as a crucial period of risk behavior, especially when social support is lacking.

We examined the association between county-level estimates of children's health status and school district performance in California. We used 3 data sources: the California Health Interview Survey, district archives from the California Department of Education, and census-based estimates of county demographic characteristics. We used logistic regression to estimate whether a school district's failure to meet adequate yearly progress goals in 2004 to 2005 was a function of child and adolescent's health status. Models included district- and county-level fixed effects and were adjusted for the clustering of districts within counties. County-level changes in children's and adolescent's health status decreased the likelihood that a school district would fail to meet adequate yearly progress goals during the investigation period. Health status did not moderate the relatively poor performance of predominantly minority districts. We found empirical support that area variation in children's and adolescent's health status exerts a contextual effect on school district performance. Future research should explore the specific mechanisms through which area-level child health influences school and district achievement.

BackgroundInsufficient evidence exists regarding the relationship between diabetes risk reduction diet (DRRD) and metabolic health status in adolescents. The current study aimed to investigate the relationship between DRRD and metabolic health status in Iranian adolescents with overweight/obesity.MethodsIn this cross-sectional study, a multistage cluster random sampling method was used to select 203 overweight/obese adolescents. Dietary intakes were evaluated using a validated 147-item food frequency questionnaire. The following parameters were measured: blood pressure, anthropometric indices, fasting glucose, insulin, and lipid profiles. Participants were classified to metabolically healthy overweight/obese (MHO) or metabolically unhealthy overweight/obese (MUO), based on 2 methods: International Diabetes Federation (IDF) criteria and a combination of IDF and Homeostasis Model Assessment Insulin Resistance (HOMA-IR).ResultsBased on IDF criteria, highest vs. lowest adherence to DRRD was associated with a lower odds of having an MUO phenotype in both crude (OR = 0.05; 95%CI: 0.02–0.12) and fully adjusted model (OR = 0.06; 95%CI: 0.02–0.20). Based on IDF/HOMA-IR criteria, similar findings were obtained. This relationship was significant in both genders and was especially significant among adolescents with obesity. In both crude and fully adjusted model, adherence to DRRD was significantly lower the likelihood of having high fasting blood glucose, triglycerides, and HOMA-IR.ConclusionAdolescents who adhered more strictly to DRRD were less likely to be MUO, and have high fasting blood glucose, triglycerides, and HOMA-IR. Additional large-scale prospective studies are necessary to affirm these results.

The purpose of this study was to examine the relationship between the perceived physical health status of Korean adolescents, adults, and elderly adults and their frequency, intensity, time, and duration of exercise. In 2012, 1,144 adolescents (under 18 years old), 6,474 adults (19–64 years old), and 1,382 elderly adults (over 65 years old) participated in the Korean Survey on Citizens’ Sports Participation Project (N = 9,000). The association between self-reported health status and exercise was assessed using multivariate logistic regression analyses, controlling for sex and age. The study found that the health status of adolescents showed little or no association with the frequency, intensity, time, or duration of exercise. However, the health status of adults and elderly Koreans was associated with the frequency, intensity, time, and duration of exercise. The physical condition and health status of adolescents was better than that of adults and the elderly, many of whom had declining health. Our findings show the need for exercise-promotion programs customized for particular age groups. The limitations and strengths of the study are discussed, as well as the implications for future research and managerial applications for promoting exercise in each age group.

The association of plant-based diets with health status is underestimated in pediatrics. We aimed to examine the relation between plant-based diets (including overall plant-based index (PDI), healthy plant-based (hPDI) and unhealthy plant-based (uPDI)) and metabolic health status in Iranian adolescents with overweight/obesity. We conducted a cross-sectional study on 203 adolescents with overweight/obesity (12–18 years old) selected by a multistage cluster random-sampling method. Usual dietary intakes were assessed through a validated 147-item food frequency questionnaire (FFQ). Anthropometric indices and blood pressure values were measured and fasting blood samples were drawn. For classification of participants into metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO) groups, two methods of International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR) were applied. No significant association was observed between higher adherence to PDI and odds of MUO status defined by both IDF and IDF/HOMA-IR strategies. After adjustments for all potential confounders, adolescents in the highest tertile of hPDI, compared with those in the lowest tertile, had 85% (95% CI 0.05–0.43) and 84% (95% CI 0.05, 0.52) lower odds of being MUO based on IDF and IDF/HOMA-IR criteria, respectively. Greater adherence to uPDI was associated with odd of 3.95 (95% CI 1.41, 11.12) and 4.06 (95% CI 1.31, 12.57) of being MUO based on IDF and IDF/HOMA-IR definitions, after considering all potential confounders. Stratified analysis revealed that these associations were stronger in girls and overweight subjects. Adherence to healthy plant-based foods was inversely associated with odds of MUO status in Iranian adolescents. In contrast, unhealthy plant-based diets was directly associated with MUO in pediatrics. Further studies with prospective nature, are required to affirm these results.

Sleeping patterns and association with health and school-related outcomes and behaviors among adolescents

This study tracked the longstanding effect of childhood adversities on health status over the course of a life. This study used the data from China Health and Retirement Longitudinal Study which was a nationally representative survey and documented the generation who had arrived in the middle- and old-age phase and experienced the difficult time in the early founding of PR China in their childhood. Results shown the significant associations between multiple forms of children adversities (economic distress, child neglect, child abuse, lack of friends, parental mental health problems) and health status in adolescence (from 0.068 to 0.102, p<0.01), and health status in mid and late adulthood, including self-rated general health problems (from 0.039 to 0.061, p<0.01), chronic conditions (from 0.014 to 0.120, p<0.01 except for lack of friends), body aches (from 0.016 to 0.062, p<0.01 except for child neglect), and depression (from 0.047 to 0.112, p<0.01). Meanwhile, results also shown an underlying pathway (i.e., health status in adolescence) linking childhood adversities and health status in mid and late adulthood. Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.

The status of young adolescent health & well-being: Bullying

Guidelines for Adolescent Health Research*1, *2A position paper of the Society for Adolescent Medicine

Factors influencing health and well-being of children and adolescents are related to their morphological characteristics and health status. Anthropometric and morphological parameters correlate with children’s health, well-being, physical activity, and self-esteem. Therefore, the aim of this study was to analyze the factors with the most significant impact on the body composition and health status and to evaluate overweight and obesity levels of girls and adolescents between the ages of 8 and 19 by using WHO references. This study included 202 girls with a mean age of 12.1 ± 3.5 years, mean height of 150.1 ± 15.0 cm, and mean BMI of 18.8 ± 4.0 kg/m2. All of the participants were assessed by using the InBody120 body composition analyzer. Principal component factor analysis, using body height as a selection variable, was used in order to determine the main factors related to health status of children and adolescents. The factor analysis identified three main factors: (1) anthropometric parameters of obesity; (2) morphological characteristics; (3) age and metabolism. In conclusion, the anthropometric parameters of obesity had the most significant impact on the analyses of the body composition and health status in children and adolescents.