LOVELY PROFESSIONAL UNIVERSITY

Term paper of Adoloscent

Course Code- EDU 887
Topic- An individual's pattern of growth and development is
conditioned by various factors like physical, social, and emotional.
Discuss this statement with specific examples.

Submitted by: Submitted to:

Name- Pridhi Bedi Miss Kamalpreet Kaur

Section- SE 142
Reg no. -10804540
Roll no. – 45
ACKNOWLEDGEMENT

It is not until you undertake the project like this one that you realize how massive the effort it
really is, or how much you must rely upon the Selfless efforts and goodwill of others. There are
many who helped us with this project, and we want to thank them all from the core of our
Hearts.

We owe special words of thanks to our Teachers Mrs. Kamal preet kaur for her vision,
thoughtful counseling and encouragement at every step of the project. We are also thankful to
the teachers of the Department for giving us the best of knowledge and guidance throughout the
project.

And last but not the least, we find no words to acknowledge the financial assistance & moral
support rendered by our parents in making the effort a success. All this has become reality
because of their blessings and above all by the grace of god.
Contents:
 General Introduction to Adoloscent
 characterstics of adolescent period
 Adolescent growth and development
 Growth
a) Linear growth
b) Growth velocity
 Stages of growth
a) Prenatal
b) Postnatal
1) Infancy
2) Childhood
3) Adolescence
 Hormonal basis of adolescence
a) Physiological changes
b) Maturity
1) Skeleton
2) Dental
3) Shape age
 Senescence
 Ageing
 Theories of ageing
 Development
 Normal physical growth and development
 Changes in Weight and Body Composition
 Normal physchosocial and cognitive development
 Factors affecting growth and development
Introduction to Adolescent: Adoloscent derived from the Latin word ‘adolescere’ means
‘to grow’ or ‘to mature’. Adolescence (ages 11 to 21), the transition between childhood and
adulthood, is one of the most dynamic periods of human development. Adolescence is
characterized by dramatic physical, cognitive, social, and emotional changes. These changes
along with adolescents growing independence, search for identity, concern with appearance,
need for peer acceptance, and active lifestyle, can significantly affect their physical activity
behaviors.
Adolescence period runs between childhood and adulthood and is also called the
period of teenage. The child experiences a number of changes in this transitional period.

Puberty: Process by which a person attains sexual maturity and the ability to reproduce.
GENERAL CHARACTERISTICS OF ADOLESCENCE PERIOD:

• Combination of opposites- behaves like a child in many ways and on the other hand he likes to
be treated as an adult.

• Know-it –all attitude

• Feeling of more grown-up

• Intensely emotional – fluctuates between two extremes.

• Self-seeker- seeking his own place in the life around him.

Adolescent growth and development:

Growth = Growth is a dominant biological activity during the first two decades or so of human
life, including, of course nine months of prenatal life. While growing the individual also matures.
Growth is an increase in the size of the body as a whole or the size attained by specific parts of
the body. It can be measured in terms of centimeters and kilograms or metabolic balance i. e.
retention of hydrogen and calcium in the body. It is a fundamental characteristic of all living
organisms. Growth is a form of motion.
Growth means the increase in the size of the various parts and organs
of the body by multiplication of cells and intercellular components during the period
commencing from fertilization to physical maturity. Changes in size are outcomes of three
underlying cellular processes: (a) an increase in cell number or hyperplasia; (b) an increase in
cell size or hypertrophy; (c) an increase intercellular substances or accretion. Hyperplasia,
hypertrophy and accretion all occur during growth, but the predominance of one or another
process varies with age and the tissue involved. The increase in number is a function of cell
division (mitosis), which involves the replication of DNA and the subsequent migration of the
replicated chromosomes into functional and identical cells. The increase in cell size involves an
increase in functional units within the cell, particularly protein and substrates, as is especially
evident in the muscular hypertrophy that occurs with regular resistance exercise.
Linear or Distance growth: It is overall growth at some point of time. Gradually, with
time, there occurs increase in height and weight of a child which can be revealed by measuring at
some point of time.

Growth Velocity or Rate of Growth:

It is increment in growth in a unit of time. The comparison of child’s height and weight with the
growth-chart helps to determine if the particular child is within the expected normal range for his
sex and socio-economic stratum. It does not show whether the child’s growth was normal in the
recent past. Measurement of velocity of growth is more fruitful. It helps in early assessment of
retarding factors of growth as well as prediction of ultimate growth.

STAGES OF GROWTH: The stages or phases of growth have been classified in different
manners by different researchers.
1)Prenatal Period: The prenatal period comprises, on the average, about 10 lunar months
(there are 28 days in a lunar month), 9 calendar months, or 40 weeks. A fertilized egg of a
multicellular animal is transformed into an embryo by cell division, growth and differentiation.
This growth into the embryo is called prenatal growth. In the prenatal period (before birth) the
embryo is formed with rudiments of all organs and systems. Prenatal growth has three distinct
stages: the fertilized ovum (egg), or zygote (first 2 weeks); the embryo (from 2 to 8 weeks) and
the foetus (from 2 to 10 lunar months). The human ovum at conception is about 0.1 mm in
diameter. During the first part of this period (ovum), it is like a homogeneous mass. During the
embryonic stage, though the rate of growth is slow, yet during this time the differentiation
process in the mass to form various regions which later on give rise to different parts, like head,
arm, leg and others starts. By the eighth week the embryo becomes child-like in appearance.
During foetus stage the rate of growth in length as well as weight is considerably high.

2)Postnatal Period: Postnatal growth is commonly divided into the following age periods.

a)Infancy: Infancy comprises the first year of life. This is a period of rapid growth in most
bodily systems and dimensions and rapid development of the neuromuscular system. After birth,
he growth is oriented towards functional state of life. Growth is mainly by addition of more cells
or increase in the protoplasm. It can be said that anabolic processes exceed catabolic processes
and there is increase in size, shape and weight. This characterizes the infant stage. Immediately
after birth the rate of growth increases. In case weight the peak velocity is reached at two months
after birth. The cells become larger in size. The cervical and lumber curvatures of the spinal
column appear as the baby begins to straighten the head and tries to sit up and to stand. During
infancy growth is very rapid. More than 50 percent of birth length and 200 percent of birth
weight take place during the first year of life.

b)Childhood: Childhood ordinarily spans from the end of infancy (the first birthday) to the start
of adolescence. The infant attains childhood before reaching adolescence. It is often divided into
early childhood and middle childhood. The early childhood is the period of eruption of milk
teeth. The middle childhood (7 to 10 years) is the period of eruption of permanent teeth, though
not all erupt. The late childhood starts from the prepubertal period and continues up to the time
of puberty. Childhood is period of relatively steady progress in growth and maturation and rapid
progress in neuromuscular or motor development.

c)Adolescence: After childhood comes adolescence period. The adolescence period extends
from the time of puberty upto around 20 years. In this period of life, the hormonal influences
play a leading role in order to attain sexual maturity. During this period there is a marked
acceleration of growth which is known as adolescence growth spurt. The adolescence spurt is a
constant phenomenon and occurs in all children, though it varies in intensity and duration from
one child to another. In boys it takes place, on the average from age 12 to 15. In girls the spurt
begins about two years earlier than in boys. Differentiation in primary and secondary sexual
characteristics marks the adolescence period. There are changes in the reproductive organs, in
body size and shape, in the relative proportions of muscle, fat and bone and in a variety of
physiological functions.
At adolescence sex differences in physical increase greatly, due chiefly to the
differential action of hormones, gonadal and other. Men become considerably larger, acquire
broader shoulders, a deeper larynx; women enlarge their pelvic diameter and deposit fat in
various strategic places, including the breast.

Hormonal Basis of Adolescence: Adolescence is intimately linked to the secretion of sex

hormones in boys and girls. The male sex hormone is testosterone secreted by the gonad, testes.
The female sex hormone is oestrogen secreted by ovary. The gonads, ovary and testes are
stimulated by pituitary hormones, called Follicle stimulating hormone (FSH) and Luteinizing
hormone (LH). Together, these are called gonadotrophins. The pituitary hormones, FSH and LH,
in turn are controlled by hormones of specialized region of brain, called hypothalamus.
Hypothalamus secrets gonadotrophin releasing hormone (GnRH). Under appropriate internal and
external signals, GnRH is released from hypothalamus that has effect on pituitary causing release
of gonadotrophins. Gonadotrophins act on gonads and effect release of testosterone and
oestrogen in males and females respectively.

1)Physiological Changes: Changes in physiological function occur during adolescent spurt.

They are much more marked in boys than girls and serve to confer on the male his greater
strength and physical endurance. Before adolescence boys are on average a little stronger than
girls. After adolescence boys are much stronger, chiefly by virtue of having larger muscles. Boys
have larger hearts and lungs relative to their size, a greater capacity for carrying oxygen in the
blood, and a greater power for neutralizing the chemical products of muscular exercise. In short,
the male becomes at adolescence more adapted for the tasks of hunting, fighting and
manipulating all sorts of heavy objects, as is necessary in some forms of food gathering. There
occurs in the boys an increase in the number of red blood cells at puberty and consequently in the
amount of hemoglobin in the blood. No sex difference exists before adolescence. The systolic
blood pressure rises throughout childhood, but this process accelerates in boys at adolescence;
the heart rate falls. The alveolar carbon dioxide tension increases in boys and not in girls, giving
rise to a sex difference in the partial pressure of carbon dioxide in arterial blood. Coincidentally,
the alkali reserve rises in boys. Thus, the blood of an adult man can absorb during muscular
exercise, without change of pH, greater quantities of lactic acid and other substances produced
by the muscles than that of a woman – a necessity in view of greater relative development of
muscular bulk in the male. As a direct result of these anatomical and physiological changes the
athletic ability of boys increases greatly at adolescence.

2)Maturity: In the adolescent period of life, the hormonal influences play a leading role in
order to attain sexual maturity. The endocrine glands under the direction of pituitary hormones
prepare the body for adulthood. An important sign of maturity is reproductive maturity. During
adolescence reproductive maturity begins but not completed. The active reproductive period
extends upto 40 or 45 years of age in the human beings. The cessation of growth of height is also
regarded as a sign of maturity.
There have been found biological criteria for maturity. There are three such criteria.
a. Skeletal Maturity
b. Dental Maturity
c. The shape age.

a. The Skeletal Maturity: Bones show gradual development in its histologic structure.
There appears first a main ossification center and gradually, with time, there appear many
subsidiary centers that fuse with the main ossification centre. Such centres are easily diagnosed
in X-rays because ossification centres, because of its high calcium content, make it opaque. The
bone-age is calculated by the number of ossification centres as well as stage of its development.
The X-rays of hand bones is matched with the atlas specifying the changes with increasing age
and found out to which of the sample in the atlas the radiograph matches. In recent times, there
can be found developmental age of each bone. Hence each bone is matched separately and given
a score. The total scores thus gained is matched with therange of score of the standard group.

b. Dental Maturity :
It is calculated on the basis of stages of calcification as seen in the jaw X-rays in just the same
way the skeletal maturity assessment through radiograph.

c. Shape Age: Shape age is difficult to derive and is a research problem. Mere calculating
height or weight or 1Q do not give any indication of age. In shape age, a combination of body
measurements are taken into account, all of which change with ages but independent of final size
and shape. It should not concern us here because, as already stated, it is a research problem.
Individuals are characterized by several maturational characteristic.

Senescence : The term senescence is used when talking about the changes which occur during
the period of obvious functional decline in the later year of life-span. Some people use the term
ageing for the same processes and period. Others use it in a much general way, with ageing
meaning simply growing older, and ageing changes being any changes related to age, regardless
of when in the life span they occur. Thus, the onset of puberty might be described as an ageing
change, but not as a senescent change.
After the active phase in the span of life, there is a declining process
resulting in old age or senescence. During this period many molecular and cellular changes
occur. There are also organismic changes. These changes are measurable and can be explained,
but these do not exhibit any specific pattern or well-defined sequence. It seems that a multi-
causal mechanism is involved in this process. In some individuals the changes are fast; in others
slow. Individuals are characterised by several senescent characteristics such as graying of hair,
loss of strength, reduction in sensory capabilities, poor homeostatic mechanisms, reduced
resistance of body against the diseases, cardiovascular irregularity and several other criteria. Like
maturity characteristics, the senescent characteristics also appear at different chronological ages.
A person at 35 years of age may suffer from graying of his or her hair, loss of homeostatic
mechanisms and a cardiovascular irregularity. In such cases, chronological age of the person is
low, but his or her biological age is much advanced. For late maturers, however, biological age is
generally lower than chronological age.

It is evident from definitions that senescence has at least three cardinal

characteristics. Firstly, the changes that occur during ageing are deleterious; they increase the
chances that an animal will die. Ageing, therefore, involves a decrease in the ability of an animal
to cope with its environment. Secondly, the deleterious age-related changes are cumulative.
Death, the ultimate result of ageing, is sudden, but the process of ageing involves a progressive
increase in the probability of dying. A third characteristic of ageing and senescence, which is
implicit in most of the definitions which have been given, is that the processes involved are
common to all members of a species and are inescapable consequence of getting older. That is to
say, ageing and senescence are fundamental intrinsic properties of living organisms.

AGEING: Ageing is a process involving many changes in the body. There are molecular,
cellular and organismic changes. These changes are measurable and can be explained. After the
active phase in the span of life, there is a declining process resulting in old age or senescence. It
seems that a multi-causal mechanism is involved in this process. Some of the changes are –
1. Decline in metabolic efficiency.
2. Decrease in the power of replacing worn out old cells repairing the damaged tissues, organs
and organ systems. A few organs responsible for vital functions may become functionally
inefficient.
Manifestation of these changes, as the individual grows older is known as ageing. Thus, ageing
may be defined as the deterioration in the structure and function of body cells, tissues and organs
of the individual.

Theories of ageing : Several theories have been put forward to explain the process of ageing.
1. Ageing is due to interaction of the genetic material and the environment, a product nature and
nurture combination.
2. Ageing is caused by accumulation of some harmful products of metabolism in the cells and in
intercellular spaces. In other words the internal environment of cells undergoes adverse changes
resulting in ageing.
3. Ageing is due to intrinsic property of the genetic material ( gene = DNA ) i. e. the programme
is already there in the body and it is undergone as predetermined activity.
4. Wear and tear theory suggests that the tissues of the body become wornout because of
continuous and constant usage and are not replenished that fast.
5. Very high rate of metabolic activity during life advances old age, and slow rate enhances the
lifespan.
Because of ageing the tissues do not renew and as a result cells show senile
involution. The memory declines. Aged persons need more time to learn and to react. Systolic
blood pressure increases. The speed of conduction in motor nerves shows a decline. The range of
accommodation of the eye lens declines. Peripherial resistance and circulation time in the
cardiovascular system show an increase. There is reduction of density of long bones and
vertebrae, and therefore, height and sitting height show decrease. Vital capacity and muscle tone
declines. Arm span circumference of forearm ad that of calf diminishes.
Visible changes due to ageing are morphological and physiological. A
dry skin shriveled and stooping body with wrinkled skin is often quite visible in old persons.
With age the heart’s efficiency to pump blood diminishes. Brain and kidneys receive smaller
quantities of blood. The quantity of blood passing through the lungs is reduced consequently
affecting intake of oxygen. With age the number of taste buds in the tongue and the number of
kidney tubules (nephrons) get reduced. Bone marrow does not produce as many new cells as they
were producing when the body was young. Cells do not retain water and therefore dry skin, less
volume of blood and less urine is formed. Muscles become weak and bones get brittle.
All these changes are mainly due to physical and physiological changes within
the cells and intercellular spaces in the tissues. Cellular changes include chromosomal
abnormalities and mutations in the genetic material. Inactivation of certain enzymes, productions
of defective proteins are all due to increased defects of the DNA structure. Some cells of the
brain accumulate worn out cell organelles or pigments. In other words, cells in different parts of
the body lose their efficiency. The intercellular proteins especially collagens undergo a marked
change in their constitution. These proteins which are permeable, flexible and easily soluble in
young persons, become less permeable, rigid and insoluble as age advances. These property
changes affect gaseous exchanges and expulsion of nitrogenous wastes.

Development = A gradual change in abilities, emotions , change in character and skills as

people get older. Development refers to the increase of functional capacity in perfect form
resulting from production of specialised tissues from unspecialised ones
Biological, psychosocial and cognitive changes that
begin during puberty and continue through out adolescence directly affect nutritional status and
nutrient needs. Adolescents experience dramaticphysical growth and development during
puberty, which in turn appreciably increases their requirements for energy, protein, and many
vitamins and minerals. Adolescents also experience significant changes in their ability to assess
and comprehend complex situations and information and in their desire to become independent,
unique individuals. The increased need for energy and nutrients among adolescents, combined
with increasing financial independence, increasing need for autonomy when making food
choices, and immature cognitive abilities, places adolescents at nutritional risk. Therefore, it is
vital that health care providers who provide nutrition education and counseling have a thorough
understanding of adolescent physical and psychosocial growth and development.

NORMAL PHYSICAL GROWTH AND DEVELOPMENT:

The beginning of biological growth and development during adolescence is signified by the
onset of puberty, which is often defined as the physical transformation of a child into an adult. A
myriad of biological changes occur during puberty including sexual maturation, increases in
height and weight, completion of skeletal growth accompanied by a marked increase in skeletal
mass, and changes in body composition. The succession of these events during puberty is
consistent among adolescents, however, there may be a great deal of deviation in the age of
onset, duration, and tempo of these events between and within individuals. For this reason,
adolescents of the same chronological age can vary greatly in physical appearance. This has
direct relevance for the nutrition requirements of adolescents. A 13-year-old male who has nearly
completed the linear growth spurt associated with puberty and has experienced significant
muscular development will have remarkably different energy and nutrient needs than those of a
13-year-old male who has not yet experienced puberty. Consequently, sexual maturation should
be used to assess the extent of biological growth and development and the individual nutritional
needs of adolescents in place of chronological age.
Sexual Maturation Rating (SMR), also known as Tanner Staging, is
based upon a scale of secondary sexual characteristics that permits health professionals to gauge
the degree of pubertal maturation that has occurred among adolescents, regardless of
chronological age. SMR is based on the appearance of pubic hair, the development of breasts,
and the occurrence of menarche among females; and on the degree of testicular and penile
development and the appearance of pubic hair among males. SMR stage 1 corresponds with
prepubertal growth and development, while stages 2-5 indicate the progression of puberty. By
SMR stage 5, sexual maturation has been completed. Sexual maturation correlates remarkably
well with linear growth, changes in weight and body composition, and hormonal changes.
Figure 1 depicts the occurrence of the linear growth spurt and the onset of menarche relative to
the occurrence of secondary sexual characteristics among females during puberty. The first signs
of puberty among females are the development of breast buds and sparse pubic hair, which
occurs between ages 8-13 on average (SMR stage 2). The onset of menstruation occurs 2-4 years
after the initial appearance of breast buds and pubic hair, usually during SMR stage 4. The
average age of menarche is 12.4 years for females in the United States, but the age at which it
occurs is highly variable; menarche can occur as early as 9 or 10 years of age or as late as 17
years of age. The onset of menstruation may be delayed in females who restrict their caloric
intake and body weight or who are competitive athletes.

There appear to be ethnic and racial differences in the initiation of sexual maturation among US
females. Research indicates that African American girls may enter puberty earlier than their
white peers. Among females in a large study, 48% of African American girls had reached SMR
stage 2 by age 8, compared to 15% of their white peers.2 Among African American girls in that
study, the average age of initial breast development was 8.8 years, while it was 9.9 years for
white females. Pubic hair growth began at age 8.7 years in African American females, occurring
almost 2 years earlier than their white peers. Menarche, however, occurred at approximately the
same time in both groups– 12.2 years for African American and 12.8 for white females. The
findings of that study suggest that, on average, puberty may begin earlier and last longer among
African American females than among white females.
The linear growth spurt begins most commonly during SMR
stage 2 in females, between 9.5 and 14.5 years of age. Peak velocity of linear growth takes place
at the end of SMR stage 2 and during SMR stage 3, approximately 6 to 12 months prior to
menarche. It is estimated that 15 to 25% of final adult height is gained during the growth spurt of
puberty.3 The average increase in height is estimated at 8.24 in (20.5 cm), with a range of 2-10
in (5-25 cm) seen in most females. During the peak of the linear growth spurt, females gain
roughly 3.5 in (8 - 9 cm) per year. The linear growth spurt lasts 24 to 26 months, ceasing by 16.5
years of age in most females. Some adolescent females experience small increments of growth
past age 19 years, however. Linear growth may be delayed or slowed among females who
severely restrict their caloric intake.

Testicular enlargement and change in scrotal coloring are the

first signs of puberty among males, usually occurring between 10.5 and 14.5 years of age (11.6
on average) during SMR stage 2 (Figure 2). The development of pubic hair is also observed
during SMR stage 2. Testicular enlargement starts between 9.5 and 13.5 years of age in most
males (SMR 2 to 3), concluding between the ages of 12.7 and 17 (SMR stage 5). Spermarche, or
the onset of sperm production,occurs at approximately age 14 among males. The onset of
puberty among males is highly variable, thus nutritional needs of male adolescents of the same
chronological age are also highly variable.
Peak velocity of linear growth occurs later in puberty among males than
among females, most often during SMR stage 4, at 14.4 years of age on average. The greatest
rates of linear growth among males coincide with or closely follow testicular development and
the growth of facial hair. Adolescent males experience increases in height of 4-12 in (10-30 cm)
during puberty, with an average of 2.8 - 4.8 in (7 - 12 cm) attained each year.3,4 Linear growth
continues throughout adolescence, at an increasingly slower rate, ceasing between 18 and 21
years of age.
Changes in Weight and Body Composition:
Approximately half of adult ideal body weight is gained during adolescence. Peak weight gain
follows the linear growth spurt by 3 to 6 months in females and by approximately 3 months in
males. Girls will gain approximately 18.3 lb (8.3 kg) per year during peak rates of weight gain,
(12.5 years of age on average). Average weight gains during puberty among females are between
15-55 lb (7-25 kg), with a mean gain of 38.5 lb (17.5 kg). Weight gain slows around the time of
menarche, but will continue into late adolescence. Adolescent females may gain as much as 14 lb
(6.3 kg) during the latter half of adolescence.

Adolescent males gain an average of 20 lb (9 kg) per year during puberty. Overall,
male teens gain 15-65 lb (7-30 kg) during puberty, with a mean gain of 52.2 lb (23.7 kg). Body
fat levels decrease among males during adolescence, dropping to an average of 12% body fat by
the end of puberty. Body composition changes more significantly among females during puberty.
The average lean body mass of teen females falls from 80%-74% while average body fat levels
increase from 16%-27% by the end of adolescence. Females experience a 120% increase in body
fat during puberty. On average, teen females acquire approximately 2.5 lb (1.14 kg) of body fat
mass each year during puberty. While the accretion of body fat mass is a normal, physiologically
essential process, adolescent females often view it with negativity. Weight dissatisfaction is
widespread among teenage females, leading to an increased risk of health-compromising
behaviors such as excessive caloric restriction, frequent dieting, use of diet pills or laxatives,
severe body image distortions and eating disorders.

NORMAL PSYCHOSOCIAL AND COGNITIVE DEVELOPMENT:

During adolescence teens develop a stronger recognition of their own personal identity,
including recognition of a set of personal moral and ethical values, and greater perception of
feelings of self esteem or self worth. Psychosocial and cognitive development is best understood
when divided into three periods: early adolescence (11-14 years), middle adolescence (15-17
years), and late adolescence (18-21 years). Each of these distinct periods of development is
marked by the mastery of new emotional, cognitive and social skills (Table 2).
Psychosocial Development:
Adolescents experience dramatic biological changes related to puberty; these biological changes
can significantly affect psychosocial development. An increased awareness of sexuality and a
heightened preoccupation with body image are fundamental psychosocial tasks during
adolescence. Dramatic changes in body shape and size can cause a great deal of ambivalence
among adolescents, especially among females, leading to the development of poor body image
and eating disturbances or disorders if not addressed by family or health care professionals.
Similarly, a perceived delay in sexual maturation and biological development, especially among
males, may lead to the development of poor body image and lowered self-esteem. It is
imperative that health professionals who work with adolescents have a clear understanding of
how normal psychosocial and cognitive development relate to biological growth and
development, and are able to appreciate how these processes affect nutritional intake and status.
Peer influence is a dominant psychosocial issue during
adolescence, especially during the early stages. Young teens are highly cognizant of their
physical appearance and social behaviors, seeking acceptance within a peer group. The desire to
conform can influence food intakes among teens. Focus groups comprised of adolescent females
have revealed that food is divided into two classification groups: junk foods and healthy foods.8
Eating junk foods, according to these focus groups, was associated with being with friends,
having fun, gaining weight, and guilt, whereas eating healthy foods was associated with family,
family meals, and home life. Obviously, teens adopt or develop food preferences and make food
choices based on associations with feelings of being accepted and having fun with peers and may
use food as a way to exert independence from families and parents.
The broad chronological age range during which biological
growth and development begins and advances can become a significant source of personal
dissatisfaction for many adolescents as they struggle to conform to their peers. Males who enter
puberty at a later age may consider themselves to be late bloomers, and may feel physically
inferior to their peers who mature earlier. This sense of dissatisfaction may lead to the use of
anabolic steroids and other supplements in an effort to increase linear growth and muscle
development and to gain weight. Such dissatisfaction can also lead to markedly reduced self-
esteem. For females, however, it is often early maturation that is associated with poor body
image, poor self-esteem, frequent dieting, and, possibly, disturbed or disordered eating
behaviors. Early maturing female teens are also at increased risk for engaging in other unhealthy
behaviors such as smoking, alcohol consumption, and early sexual intercourse. 9-11 Young
adolescents should be educated on normal variations in initiation and progression of biological
growth and development in an effort to facilitate the development of a positive self-image and
body image and to reduce the likelihood of early initiation of health compromising behaviors.

Cognitive Development:
The early stage of adolescence is a time of great cognitive development. At the beginning of
adolescence, cognitive abilities are dominated by concrete thinking, egocentrism, and impulsive
behavior. The ability to engage in abstract reasoning is not highly developed in most young
teens, limiting their capacity to comprehend nutrition and health relationships. Young
adolescents also lack the skills necessary to problem solve in an effort to overcome barriers to
behavior change and the ability to appreciate how current behaviors can affect future health
status. Middle adolescence is characterized by growth in emotional autonomy and increasing
detachment from family. The bulk of physical growth and development is completed during this
stage, however body image concerns may continue to be a source of trepidation, especially
among males who are late to mature and females who have experienced great changes in body
composition and size. Conflicts over personal choice, including food choices, become
increasingly common during this stage of adolescence. Peer groups become more important than
family and their influence with regard to making food choices peaks. Coinciding with the
increased importance of peer acceptance, the initiation of health compromising behaviors such as
smoking, alcohol consumption, using street drugs, and engaging in sexual activities often occurs
during middle adolescence. Teens may consider themselves invincible and often still display
impulsive behaviors.
Abstract reasoning skills begin to emerge among most teens during middle
adolescence, however,these skills may not be highly developed. Adolescents will often regress to
concrete thinking skills when faced with overwhelming emotions or stressful situations. Teens
start to comprehend the relationship between existing health behaviors and future health status
but their desire to fit in with peers may make it difficult for adolescents to make health related
choices based upon knowledge rather than peer pressure.
The late stage of adolescence is characterized by the development of a
strong personal identity. Biological growth and development has concluded among most teens
and body image issues are less common. Older adolescents are able to manage increasingly
sophisticated social situations, are able to suppress impulsive behaviors, and are less affected by
peer pressure. Economic and emotional dependence upon family is markedly decreased and
conflict over personal issues, such as food choices, also decreases. Relationships with a single
individual become more influential than those with a group of peers as a stronger sense of
personal identity emerges.
The expansion of abstract reasoning skills continues to occur during late
adolescence, which assists teens in developing an ability to comprehend how current health
behaviors affect long-term health status. This is an especially important skill for adolescent
females who plan to have children or who become pregnant during late adolescence. Older teens
are now capable of learning problem solving skills that can assist them in overcoming barriers to
behavior change.

FACTORS AFFECTING GROWTH AND DEVELOPMENT:

The integrated nature of growth and maturation is largely maintained by a constant interaction of
genes, hormones, nutrients and other factors. These factors also influence physical performance.
Some are hereditary in origin. Others, such as season, dietary restriction, severe psychological
stress, originate in the environment and simply affect the rate of growth at the time they are
acting. Others again, such as socio-economic class, reflect a complicated mixture of hereditary
and environmental influences and probably act throughout the whole period of growth.

1)Genetic control: The height, weight or body-build of a child or an adult always represents the
resultant of both the genetical and environmental forces, together with their interaction. It is a
long way from the possession of certain genes to the acquisition of a height of 2m. gene depends
for its expression firstly on the internal environment created by all the other genes, and secondly
on the external environment. The control of body size is certainly a complicated affair involving
many genes, yet a disturbance in a single gene or group of genes may produce a widespread and
drastic effect, as in the condition of achondroplasia, which is inherited as a simple dominant. On
the other hand, the effects may be quite restricted and specific. The genetic control of dental
maturation and eruption appears to be separate from that of skeletal maturation, and there is even
evidence that the genes controlling the growth of different segments of the limbs are independent
of each other. It is now believed that dental development and the sequence of ossification are
primarily genetically controlled; the timing of ossification is partly influenced by genetic factors
and partly by environmental ones. Maturation as a whole is even more affected by environment,
but genetic influences are still detectable. It seems that the genetic materials operate throughout
entire period of growth. Heredity influenced the rate of growth of early maturers or late maturers.
Parent – offspring correlation in regard to height from birth to maturity for each are and sex has
been reported. Chromosomal abnormalities suggest genetical control on growth. Genetic factors
probably play the leading part in the difference between male and female patterns of growth.

2)Environmental : There is a well-marked seasonal effect on velocity of growth visible in

most human growth data. Growth in height is on average fastest in spring and growth in weight
fastest in autumn. This is true at all ages, including adolescence. The mechanism of the seasonal
effect is not known; probably variations in hormone secretion are involved. Climate seems to
have a very minor effect on overall rate of growth in man. It has been suggested that each major
race of mankind varies in stature according to the climates in which they live. Seasonal variation
in growth has also been observed in many studies. Longitudinal studies have shown that only
about 30% of the children have cycles of increase and decrease in growth velocity which are
strictly seasonal. The remaining children show accelerations and decelerations of growth which
can not be clearly related with seasons.

3)Endocrine regulation: Endocrine glands are commonly referred to as ductless glands, or

glands of internalsecretion. They secrete chemical substances, hormones directly into the
bloodstream. Human growth is affected by biochemical products such as hormones. Hormones
are regarded as growth promoting substance. Probably all the endocrine glands influence growth.
Most of the hormones are secreted by the endocrine glands and play a significant role in
regulating the pattern of growth and development as per instructions of the genes. The most
important hormone controlling growth from birth up to adolescence is growth hormone or
somatotrophin. This is infact a polypeptide secreted by the pituitary. It helps growth of bones
and thereby increases the height of persons. Growth hormone controls the rate at which growth
takes place upto the time of steroid - induced adolescent spurt.
Its administration causes the amino acids to be incorporated into
tissues to form new protein. It also causes an over all growth rate of most of tissues including
brain. Thyroid hormone plays a vital role throughout the whole of growth. The activity of the
thyroid, judged by the basal metabolic rate, decreases gradually from birth to adolescence. In
hypothyroidism growth is delayed, skeletal maturity, dental maturity and growth of the brain are
all affected. During adolescence a new phase of growth occurs under the control of steroid
hormones secreted by the adrenals and gonads. The gonads of both sexes secrete estrogens in
small quantities from the time of birth onwards. At puberty the estrogen level rise, sharply in
girls and to a much more limited extent in boys; the sex differences is possibly due to an
inhibitory hormone secreted by the seminiferous tubules of the testicle. Testosterone, produced
by the testicle, is important in stimulating growth and it is responsible for the greater growth of
muscle. Gonadotrophins are responsible for the growth of the ovaries and testis, and later on the
secretion of the amounts of estrogens and testosterone responsible for the growth and
development of secondary sex characters.
4)Nutritional: Growth is closely related with nutrition. A sufficiency of food is essential for
normal growth. An adequate supply of calories is naturally essential for the normal growth of
humans and the need varies with the phase of development. Nine different amino acids have
been claimed to be essential for growth and absence of any one will result in disordered or
stunted growth. Other factors are also essential for growth. For example, zinc plays a part in
protein synthesis and is a constituent of certain enzymes; a deficiency of zinc causes stunting,
interference with sexual development and falling out of hair. Iodine is needed for the
manufacture of the thyroid hormones. Bone will not grow properly without an adequate supply
of calcium, phosphorus and other inorganic constituents such as magnesium and manganese. Iron
is required for the production of haemoglobin. Vitamins play an important part in growth.
Vitamin A is thought to be control the activities of osteoblasts. In vitamin C deficiency the
intercellular substance of bone is inadequately formed. Vitamin D deficiency is the cause of
rickets. Malnutrition during childhood delays growth, and malnutrition in the years proceeding
adolescence delays the appearance of the adolescent spurt. Growth studies have demonstrated
that malnutrition may cause serious impairment of growth. The term malnutrition generally
refers to the effects of an inadequate intake of calories or other major dietary components such as
proteins. Malnutrition may also result from diseases which decrease the appetite or interfere with
digestion and assimilation. A majority of malnourished children fail to achieve their full genetic
potential of body growth (both linear and ponderal) and are thus stunted or wasted or both.

5)Cultural: The physical growth of human beings is definitely affected by cultural factors.
Culture differs from ethnic group to ethnic group. The body growth differences correlate with
varied cultural groups. The physical growth of the body follows some adaptations in different
geographical areas of distribution of the groups.

6)Socio economic: Socioeconomic influence on human growth is also a well known factor.
Children from different socioeconomic levels differ in average body size at all ages that have
been investigated. The upper groups being always more advanced along the course to maturity.
The cause of this socio - economic differential are
probably multiple. Nutrition is almost certainly one, and with it all the habits of regular meals,
sleep, exercise and general organization that distinguish, from the point of view, a good home
from a bad one. Growth differences are more closely related to the home conditions than to the
strictly economic status of the families and home conditions reflect the intelligence and
personality of the parents.
Size of family exerts an indirect influence on the rate of growth. In a large
family with limited income the children do not get proper nutrition. As a result the growth is
affected. The number of children in the family exerts an effect on the children’s rate of growth.
Children in large families have been shown to be usually smaller and lighter than children in
small families. Possibly this is because in large families children tend to get less individual care
and attention.