Adolescence

Adolescent Health Promotion

Adolescence is a stage in life between childhood and adulthood, from ages 10 to 19. It is a particular stage of human development and an important time for laying the foundations of good health.

Healthy eating

Adolescents grow at a quick rate that is surpassed only by the staggering growth rate of a newborn. Good nutrition plays an important role in the adolescent stage of life. Adolescents are increasing in height, muscle and bone mass, while nearly every system and organ in the body matures. For adolescent girls, menarche (onset of menstruation) also increases nutritional needs for iron and other micronutrients related to growing bone and muscle mass, including calcium, zinc and vitamin D.
Good nutrition can support optimal physical and mental growth, giving adolescents the strength and focus to study, work, prevent illness and disease, and fully participate in their daily lives.
Developing healthy eating habits in adolescence will benefit adolescent health in adulthood. Reducing the intake of foods high in saturated fats, trans-fatty acids, free sugars, or salt as well as sugar sweetened beverages, caffeinated drinks such as energy drinks which are popular amongst adolescents whilst providing access to healthy foods are important for all, but especially for children and adolescents. For further information on healthy eating in adolescents please access the link below:
https://deputyprimeminister.gov.mt/en/health-promotion/Documents/library/publications/EN%20healthy%20guide%20inside%20HI.pdf

Overweight and Obesity rates among adolescents
The number of adolescents who are overweight or obese is increasing in low-, middle- and high-income countries.
Globally, in 2016, over 1 in 6 adolescents aged 10–19 years was overweight.
A national report on the HBSC data (2017/2018) indicates that 44% of boys and 34% of girls among 11-year-olds were overweight/obese. Among 13-year-olds, the corresponding figures were 38% for boys and 35% for girls, and among 15-year-olds, 41% for boys and 30% for girls who were overweight or obese.

Physical activity and sports 
Physical activity provides major health benefits for adolescents, including:
•    improved cardiorespiratory and muscular fitness, 
•    bone health, 
•    mental health (reduced signs of depression), 
•    maintenance of a healthy body weight, and 
•    psychosocial benefits. 

WHO recommends that adolescents (Carlos please link to PA leaflet children to adolescence in new webite) 
•    should perform at least an average of 60 minutes per day of moderate-to-vigorous intensity, mostly aerobic, physical activity, across the week.
•    should incorporate vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone, at least 3 days a week.
•    should limit the amount of time spent being sedentary, particularly the amount of recreational screen time.

Mental health

Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated.
Depression is one of the leading causes of illness and disability among adolescents, and suicide is the second leading cause of death in people aged 15–19 years. Mental health conditions account for 16% of the global burden of disease and injury in people aged 10–19 years. 
Many factors have an impact on the well-being and mental health of adolescents. Violence, poverty, stigma, exclusion, and living in indecent settings can increase the risk of developing mental health problems. The consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults.
Building socioemotional skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote good mental health. Programmes to help strengthen the ties between adolescents and their families and improve quality of home environments are also important. If problems arise, they should be detected and timely managed by competent and caring health workers.
For further information about adolescent mental health kindly access here

Alcohol and drug use 
Early onset of substance use is associated with higher risks of developing dependence and other problems during adult life, and people of younger ages are immensely affected by substance use compared with people of older ages.
Drinking alcohol among adolescents is a major concern in many countries. It can reduce self-control and increase risky behaviours, such as unsafe sex or dangerous driving. It is an underlying cause of injuries (including those due to road traffic accidents), violence and premature deaths. It can also lead to health problems later on in life and affects life expectancy. Worldwide, more than a quarter of all people aged 15–19 years are current drinkers, amounting to 155 million adolescents. Prevalence of heavy episodic drinking among adolescents aged 15¬–19 years was 13.6% in 2016, with males most at risk. Read more

Cannabis is the most widely used psychoactive drug among young people with about 4.7% of people aged 15–16 years using it at least once in 2018. Alcohol and drug use in children and adolescents is associated with neurocognitive alterations which can lead to behavioural, emotional, social and academic problems in later life.
Prevention of alcohol and drug use are important areas of public health actions and may include population-based strategies and interventions, activities in school, community, family and on the individual level. Setting a minimum age for buying and consuming alcohol and eliminate marketing and advertising to minors are among the key strategies for reducing drinking among adolescents. 

Tobacco use 
The vast majority of people using tobacco start in the adolescent years. Prohibiting the sale of tobacco products to minors (under 18 years) and increasing the price of tobacco products through higher taxes, banning tobacco advertising and ensuring smoke-free environments are essential. Globally, at least 1 in 10 adolescents aged 13–15 years uses tobacco, although there are areas where this figure is much higher. Outreaches on campus during Fresher’s weeks are organised by HPDP whereby adolescents are made aware of the harm tobacco smoke causes and they are encouraged not to start smoking as nicotine is an addictive substance and is detrimental to their health. Read more

Some facts about the risks of e-cigarettes and young adults (CDC)
•    The use of e-cigarettes is unsafe for kids, teens, and young adults.
•    Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.1
•    E-cigarettes can contain other harmful substances besides nicotine.
•    Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

Digital wellbeing 
We live in a digital world. Everything we do has a digital element to it, especially in more recent years. For adolescents, screen time can include things like researching a school project, creating music or art, or interacting with friends via social media. But it also can include less productive activities, like watching inappropriate TV shows, visiting unsafe websites, or playing violent video games. Too much screen time can interfere with activities like being physically active, doing homework, playing with friends, and spending time with family. The latter can contribute to obesity, attention problems, sleep disorders, and problems at school. Some studies show that teens spend almost 9 hours daily online, on the phone, watching TV, or playing games. Parents should continue to set limits on screen time and stay aware of what their teens are doing online.
For more information on the warning signs of excessive device use, how can we practice digital wellness and tips on useful Smartphone Applications that can help you practice digital wellbeing can be found here.
 

Vaccinations
Many vaccines are recommended to protect adolescents against serious infectious diseases. The recommended vaccinations for adolescents as per National immunistaion services Malta are as per table
For information regarding vaccinations related to the prevention of the human papilloma virus one can access  https://sexualhealth.gov.mt

Sexual health
Adolescence is a critical period in the development of sexual behaviours that may lead to acquiring sexually transmitted diseases (STDs), such as human papilloma virus (HPV) that may lead to cervical cancer in females and genital warts, human immunodeficiency virus (HIV), and to unintended pregnancy. Young people partake in riskier sexual behaviors with higher rates of sexual partner change and poor levels of contraception, including condom use.
For further information on sexual health in adolescents kindly access our sexual health website.