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Adolescence
World Health Organisation (WHO) defines adolescence both in
terms of age (spanning the ages between 10 and 19 years) and in terms
of a phase of life marked by special attributes. These attributes
include:
- Rapid physical growth and development
- Physical, social and psychological maturity but not all at the same
time
- Sexual maturity and the sexual activity
- Experimentation
- Development of adult mental processes and adult identity
- Transition from total socio-economic dependence to relative
independence
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Puberty, which usually begins between
the age of 10 and 16, is the gradual process of changing from a child
to an adult. Each person starts to change at a different time. Changes
in the body, behaviour and lifestyle are some of them. The changes that
occur during the process are
- Hands, feet, arms, legs, hips and chest will become
larger. The body will produce hormones which are special chemical
messengers that tell the body how to grow and change.
- The private parts of the body will get bigger and begin
producing fluids.
- The skin may become more oily
- Presence of hair in armpits, legs and
arms
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There are few simple and basic things required to take good
care of the body.
- As one reaches puberty, perspiration increases more.
Bathing will keep clean and smelling nice.
- Clean the teeth at least twice a day to avoid tooth decay
(cavities) and to have nice breath.
- As the oil glands produce much sebum (an oily
substance), pimples may develop. Pimples are a normal part of
adolescence, and there is no way to avoid them altogether.
Keeping the skin clean is the best solution.
- A nutritious diet is a must. Avoid eating too many sweets
fried foods.
- Think positive as a sound mind is also required
for good health
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Adolescence is time when many young people and their parents have
trouble getting along. Some points that the young should remember
to do are
- Appreciate one's family.
- Be understanding of the parent’s beliefs and values.
- Remember that parents want the best for their
children
- Be honest and open with parents.
- Care for parents and be respectful
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India is the second most populous
country in the world with total population of over 1081 million.
Adolescents (10-19 years) form a large section of population – about
22.5 percent, that is, about 225 million. They are living in diverse
circumstances and have diverse health needs. The total population of
young people (10 – 24 Years) is approximately 331 million comprising
nearly 30 percent of the total population of India (Census 2001).
Adolescents are full of energy, have
significant drive and new ideas. They are a positive force for a Nation
and are responsible for its future productivity provided they develop
in a healthy manner. Since mortality in this age group is relatively
low the adolescents are considered to be healthy. However, Mortality is
a misleading measure of adolescent health. In fact, the adolescents do
have a range of health problems that cause a lot of morbidity as well
as definite mortality.
Complementary actions are needed to promote healthy
development in adolescents; to prevent health problems or problem
behaviours, and to respond to them if and when they arise. They need
interventions to decrease and to mitigate their vulnerability. These
include: information and skills; a safe and supportive environment; and
appropriate and accessible health and counseling services.
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Many mental health problems emerge in
late childhood and early adolescence. Enhancing social skills,
problem-solving skills and self confidence can help prevent mental
health problems such as conduct disorders, anxiety, depression and
eating disorders as well as other risk behaviours including those that
relate to sexual behaviour, substance use, and violent behaviour.
Health workers need to have the competencies to relate to young people,
to detect mental health problems early, and to provide treatments which
include counselling, cognitive-behavioural therapy and, where
appropriate, psychotropic medication.
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In addition to laws that limit the
availability of illicit substances, tobacco and alcohol, interventions
to reduce demand for these substances improve the conditions for
healthy development. Increasing their awareness of the dangers of
substance use, building their competence to resist peer pressure and to
manage stress in a healthy manner is effective in reducing adolescents'
motivation for substance use.
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Approaches for reducing road traffic
crashes, and the occurrence of serious injuries if and when crashes
occur, are important for safeguarding adolescent health. These include:
enforcing speed limits; many mental health problems emerge in late
childhood and early adolescence.
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Life skills and social development
programmes for children and adolescents are important for reducing
violent behaviour. Supporting teachers and parents to build skills in
problem solving and non-violent disciplining is also effective in
reducing violence. If and when violence does occur, actions to make
health systems more responsive, and to build the empathy and competence
of health workers, can help ensure that adolescents who experience
violence, including sexual violence, get effective and sensitive care
and treatment. Ongoing psychological and social support can help
adolescents deal with the long term psychological effects of violence,
and to reduce the likelihood of their becoming perpetuators of vio
- Combining education with laws to promote seat belt (and helmet) use
and to prevent driving under the influence of alcohol or other
psychoactive substances
- Providing alternatives to driving by increasing the availability of
safe and inexpensive public transport
- Actions to make the environment safer and to educate children and
adolescents on how to avoid drowning, burns and falls can help reduce
the likelihood of their occurrence. When someone is injured, prompt
access to effective trauma care can be life saving.
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Chronic malnutrition in earlier years
is responsible for widespread stunting and to adverse health and social
consequences throughout the life span. This is best prevented in
childhood but actions to improve access to food could benefit
adolescents as well. Anaemia is one of the key nutritional problems in
adolescent girls. Preventing too-early pregnancy and improving the
nutritional status of girls before they enter pregnancy could reduce
maternal and infant mortality, and contribute to breaking the cycle of
intergenerational malnutrition. This will involve improving access to
nutritious food, to micronutrient supplementation and in many places to
preventing infections as well. Adolescence is a timely period to shape
healthy eating and exercise habits which can contribute to physical and
psychological benefits during the adolescent period and to reducing the
likelihood of nutrition-related chronic diseases in adulthood.
Promoting healthy lifestyles is also crucial to halting the rapidly
progressing obesity epidemic.
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Programmes that aim to educate
adolescents about sexual and reproductive health need to be combined
with programmes aimed at motivating them to apply what they have learnt
in their lives. They should also be combined with efforts to make it
easier for adolescents to obtain any preventive or curative health
services they might need from competent and empathetic health workers.
Sexual coercion in adolescence needs to be fought at different levels.
Laws requiring severe punishment for this crime should be passed and
energetically enforced, and public opinion should be mobilized to
become fiercely intolerant of it. Girls and women should be protected
from sexual harassment and coercion in educational institutions, work
places and in other community settings.
Preventing too early pregnancy may
require the enactment and enforcement of laws that specify a minimum
age for marriage, as well as actions to mobilize families and
communities to give their daughters the additional time they need to
grow and develop from girlhood into womanhood before becoming wives and
mothers.
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Young people’s risk of HIV infection is
closely correlated with age of sexual debut. Abstinence from sexual
intercourse and delayed initiation of sexual behaviour are among the
central aims of HIV prevention efforts for young people. Decreasing the
number of sexual partners and increasing access to, and utilization of
comprehensive prevention services, including prevention education and
provision of condoms, are essential for young people who are sexually
active. Programmes should also focus on prevention and early
intervention in other health risk behaviours, such as substance use.
Young people need HIV testing services that are accessible and
appropriate. Young people living with HIV need treatment, care, support
and positive prevention services. All HIV services for young people
should involve young people living with HIV in their planning and
provision.
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Bones are so important that it is vital
to keep our bones healthy throughout our lives. Healthy bones provide a
strong foundation, allowing mobility and protection from injury. They
also serve as a bank for important minerals, such as calcium, that help
support numerous organs in our body.
Bones are alive and constantly
changing, with new bones being made and old bone lost throughout lives?
In adults, the entire skeleton is completely replaced every 7–10
years.
Taking care of bones by proper
nourishment and exercise when you are still young will help you to
attain good bones helping you to live the life that you love. Here at
bone health, you can learn and understand the basics of bone health. We
also provide you with realistic and achievable self-management steps
like dietary management and exercises to build strong which is the best
defense against osteoporosis, a bone disorder that is high in
women.
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Bones are the living tissues that form
the major portion of your skeleton. There are 206 bones in an adult’s
body whereas infants have around 300 bones in their body. Bones help
you in mobility and protect your internal organs.
Bone structure
Bone is made up of proteins and other
minerals like calcium,  phosphate and magnesium.
Collagen (a protein), which is a cementing substance, forms the
structure and framework of bones.
The basic structural components of a bone are
Periosteum: This is a thin membrane
that covers the outer surface of your bone. It consists of nerves and
blood vessels.
 Compact bone: This
forms the outer layer of all your bones and is very dense. When you
look at a skeleton, the compact bone is what you see.
Cancellous bone: This looks like a
sponge and is not as hard as the compact bone. It covers the bone
marrow which is the innermost part of your bone.
Bone growth
Bones continuously keep undergoing a
vigorous process of resorption (removal of old bone) and deposition
(formation of new bone) known as bone metabolism.
There are two major Cells involved in
the resorption and deposition of your bones. They are:
- Osteoblasts: These are Cells that are responsible for the formation
of new bones
- Osteoclasts: These are Cells that are responsible for the breaking
down of bones
It is with the cooperation of these
Cells that your body maintains proper balance of minerals required for
your body’s physiological functions. The process of resorption and
deposition goes on throughout life.
Diet and bone
health
Intake of adequate calcium is necessary
to maintain healthy bones since your bone contains 99% of the calcium
present in your body. Other important nutrients include phosphorus,
magnesium, fluoride and vitamin K. Foods that are rich in calcium are
milk and dairy products.
 Vitamin D is required for proper absorption
of calcium from food. Sunlight provides your body with enough vitamin D
which is absorbed by your skin.
It can also be obtained through dietary
sources such as fortified milk, vitamin D-fortified foods and fatty
fish.
Factors affecting bone
health
There are various factors that affect bone health.
- Genetics: Bone disorders can run in the family. If your parents
 or siblings have had bone problems, you are
more likely to get it. Certain ethnic groups have comparatively
stronger bones than other ethnic groups
- Diet: Adequate calcium and vitamin D is required for healthy bones.
Cigarette smoking and consuming alcohol increase the risk of bone
loss
- Physical activity: Regular exercises and physical activity
strengthen your bones
- Age: The strength of your bones decreases with age. You are more
likely to develop bone problems as you reach Menopause
- Body size: Thin and underweight women tend to have weaker
bones
One can maintain healthy bones with a
calcium rich diet and physical exercise. Bone disorders can affect the
quality of life.
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Osteoporosis occurs when there is a
loss of mineral content from bone mainly in the form of calcium.
Osteoporosis mainly affects women, although it also affects men, but in
a smaller percentage.
Osteoporosis shows no symptoms and is
usually part of the normal aging process. However some women develop
the disease early in life due to other co-existing disease factors.
Women also run the risk of developing it post Menopause. Since it
displays no symptoms it is only when you get a fracture or recurrent
fractures, that your doctor will suspect osteoporosis.
Your doctor will evaluate the loss of
mineral from your bones through tests which will determine your Bone
Mineral Density (BMD).
Preventing osteoporosis
The development of strong bones begins
early in life. Staying healthy throughout life is an excellent way to
keep your bones healthy. The factors essential for healthy bones
are:
Hormones: The production of the Hormone
Estrogen is vital in adolescent females and young women so as to
maintain bone mass. A shortage of Estrogen occurs in the following
conditions, affecting bone mass and could lead to osteoporosis:
- Absence of periods
- Infrequent menstrual cycles
- Delay in the onset of the first period
- Early menopause
Lifestyle: Smoking
affects bone health and results in a substantial loss of bone mass
(bone mineral density) in women. Besides osteoporotic women who
continue to smoke while on medication for osteoporosis, fail to achieve
the full benefits of treatment. Women who consume
excessive alcohols are also at risk for osteoporosis.
Other lifestyle factors that can lead to osteoporosis are:
- Insufficient calcium intake,
- very minimal physical activity,
- excessive caffeine intake,
- excessive alcohol intake and
Nutrition
Calcium: Calcium is
one of the most essential nutrients necessary for you to reach the
highest level of bone strength. To prevent osteoporosis you should eat
a well balanced diet with adequate amounts of dairy products, which are
the primary source of foods rich in calcium.
Vitamin D: Vitamin D
serves many important functions in relation to calcium metabolism. It
helps increase your calcium absorption from the gastrointestinal system
and kidney and thereby makes it available to your body tissues and
blood. It also functions to help with the deposition of calcium to your
bones.
Recommended daily calcium
intake
| Category |
Age(yrs) |
Calcium(mg) |
| Children |
1-3 |
500 |
| 4-8 |
700 |
| Girls |
9-11 |
1000 |
| 12-18 |
1300 |
| Women |
19-50 |
1000 |
| >50 |
1300 |
| Pregnancy/Lactation |
14-18 |
1300 |
| 19-30 |
1000 |
| 31-50 |
1000 |
Average calcium content of
various foods
| Dairy |
| Food Source |
Serve Size |
Calcium |
| Regular milk |
1 cup (250 ml) |
285 |
| Skim milk |
1 cup (250 ml) |
310 |
| Natural yogurt |
1 tub (200 g) |
340 |
| Low fat yogurt |
1 tub (200 g) |
420 |
| Cheddar cheese |
40 g cube |
310 |
| Low fat cottage cheese |
100 g |
80 |
| Non-Diary |
| White bread |
1 slice |
15 |
| Cooked spinach |
1 cup (340 g) |
170 |
| Canned salmon (+ bones) |
½ cup |
230 |
| Canned sardines (+bones) |
50 g |
190 |
| Almonds |
15 Almonds |
50 |
Bones go through a constant state of
bone loss and re-growth. As you age, more bone loss than bone growth
can occur which is a normal and natural process. To increase your
chances of staying healthy, exercise every day and get enough calcium
and vitamin D. Seek your doctor’s advice about ways to prevent
osteoporosis or the treatment options available.
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As you age, body goes through many
changes. Some of the major changes that occur in your body as you get
older are:
- Bone mass and density decrease
- Muscle size and strength decrease
- Tendons and Ligaments become less elastic
- Cartilage degeneration and joint inflammation occur
The above bodily changes put you at an
increased risk of fractures, various injuries, osteoporosis and
arthritis. Exercising everyday can help prevent the above complications
and provide a lot of relief in some chronic conditions such as
osteoarthritis and osteoporosis. Regular exercise can also help prevent
bone loss and allows you to maintain muscle strength, coordination, and
balance, which in turn help to prevent falls and related fractures.
Before you begin an exercise program,
consult your doctor. Perform only the exercises advised by your doctor.
Do not follow an exercise regimen of your own, because your doctor may
recommend certain restrictions based on your individual health
status.
Source: Indianwomenshealth
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