Lifestyle Diseases in Adolescents: Addressing Physical, Emotional, and Behavioral Issues

Introduction to Adolescent Health and Lifestyle-Related Diseases

Aditi Singh¹, *, Abhishek Nandy¹

¹ Amity Institute of Biotechnology, Amity University Uttar Pradesh, Lucknow Campus, Lucknow-226028, India

Abstract

Adolescence is a crucial developmental stage that has long-term effects on a person's health and well-being as well as the welfare of society at large. Children learn how to understand abstract concepts, form moral beliefs, and create and sustain fulfilling relationships during adolescence. During adolescence, young people go through a variety of transformations as they become physically adults. Changes in the youth begin with the appearance of secondary sexual traits. Dynamic brain development that is distinguished by interaction with social circumstances throughout adolescence impacts the talents that a person carries into adulthood. In girls, there is the onset of the menstrual cycle, which leaves a big impact on their body. Adolescents across the globe have a lifestyle risk index comprising risky drug and alcohol consumption, unprotected sex, sleep duration, and smoking, which is a fair to good indicator of medical conditions connected to lethal (performing suicide and self-harm) and non-fatal (major depressive disorders and severe psychological distress) diseases. According to the findings of this study, the lifestyle risk index is a valuable summary indicator in the context of teenage health promotion and noncommunicable disease prevention. Adolescent lifestyle risk variables were discovered to cluster, giving additional backing for the deployment of numerous health behavior modification interventions rather than those having a single behavior emphasis.

Keywords: Adolescent, Lifestyle related disorders, Menstrual Cycle, Physical Development.

* Corresponding author Aditi Singh: Amity Institute of Biotechnology, Amity University Uttar Pradesh, Lucknow Campus, Lucknow-226028, India, Tel: +91 8303981347; E-mail: asingh3@lko.amity.edu

1. INTRODUCTION

Over 18 billion adolescents, or 27% of the global population, were under the age of 24 in 2008. This was the biggest cohort ever (UN, World Population Prospects, 2008). The number of people in this population and their health condition are the predictors of future population health (The World Bank, 2007) (WHO, Women and Health, 2009). Most people believe that adolescence is a period of excellent

health with a low disease burden (WHO, Global Health Risks, 2009). Risk elements and lifestyle choices that adolescents choose may not have a significant impact on their health at this time, but they could have a significant impact later in life and may have an impact on the health of generations to come (Patton et al., 2010). With an estimated population exceeding 1/8 billion, or roughly one-fourth of the world's population, the generation of persons aged 10 to 24 now is the greatest in history (United Nations, 2015). Nearly 90% of the world's population resides in low- and middle-income nations, where they make up a significantly larger percentage of the population than in high-income nations due to higher birth rates. A complex web of influences from family, peers, the community, society, and culture affects young people's health and well-being both now and in the future as they mature into adults (Viner et al., 2012).

2. ONSET OF PUBERTY

Similar to early infancy, adolescence is a delicate time when both healthy and unhealthy practices influence future course. This sensitivity has elements related to the physiologic changes occurring prior to, throughout, and after adolescence, as well as the social anchoring of health hazards. Hundred years ago, the general consensus was that puberty was simply a stage of physical development that thrust people into various social circumstances that had an impact on their health (Granville, 2016). We now recognize that adolescence is a highly programmed, physiologically influenced process that has a complicated impact on behavior, mental well-being, and health (Hall GS, 1905). For instance, the rise in behaviors associated with health or mental health states throughout adolescence is more closely connected to the date of puberty than to chronological age. These behavioral and mental health changes may be partially explained by alterations in oxytocin and vasopressin regulation that begin around puberty and have been connected to social connection, pair bonding, and parental behavior in other animals (Insel, 1997). Pubertal timing is also influenced by familial and societal variables, including parental health, marital conflict, and the existence of a stepfather, however, the underlying mechanisms are still unclear (Sandra et al. 2020) (Ellis & Garber, 2000).

3. PHYSICAL DEVELOPMENT

3.1. 10 to 14 Years of Age

These are often the first years of puberty. Early puberty is a time of fast growth for girls. The first menstrual cycle (menarche), which typically occurs between the ages of 11 and 14, causes development to halt (It can occur as young as at 9 years of age or as old as at 15 years of age). The height increase in males happens after the onset of other puberty symptoms. Despite being shorter than girls in early adolescence, guys eventually grow to be taller than girls. This occurs because guys develop more quickly and for a greater amount of time after growth begins.

Due to improved nutrition and health, there has been an ongoing tendency towards early puberty and greater development. The onset of puberty also appears to be influenced by race. Girls of African origin and Hispanic descent, for instance, may grow their breasts earlier than girls of Caucasian heritage (Physical Development., 2021).

Both boys and females frequently experience increased sex drive as a result of the puberty-related hormone surge. Members of both sexes frequently engage in private masturbation. Hormones may also be the cause of episodes of confrontational behavior toward parents and other authoritative figures (Reynolds and Wines., 1951).

The development of one bodily component might not follow the course of another. For instance, the development of the nose, arms, and legs may occur more quickly than that of other body parts. Other bodily changes that often occur throughout puberty include:

Bone development, which lengthens child's skeleton. Thickening of the skull's bones. The jaw moves forward, and the top of the head becomes more pronounced.

Gaining weight. In adolescence, a teenager's weight almost doubles.

Changes in the composition of body fat. Boys have more body fat than girls. Additionally, girls' current body fat migrates to the upper back, breasts, and pelvis.

Increase in organ size. The size of the lungs grows, and the weight of the heart doubles.

Boy's facial hair growth. Typically, hair grows from the top lip to the cheeks, then to the chin region.

Many males have gynecomastia, or the growth of breast tissue, between early and middle puberty. Usually, it disappears between six months to two years (van Sluijs et al., 2021).

3.2. 15 to 18 Years of Age

Teens develop at their own rates, and each adolescent experiences healthy growth in a unique way.

Most females experience their first period by the age of 15, after the occurrence of the puberty-related fast growth spurt. Teenage females grow an average of 4 to 7.5 cm (1.5 to 3 inches) after their first period. The development of pubic hair and breasts are two additional early signs of puberty. An average of four years following breast buds signify the start of puberty; in late teenage, typically, female breasts are fully developed (Reynolds EL., 1948).

Boys' growth spurts typically peak between early and middle adolescence. Despite being shorter than girls in their early adolescence, boys often catch up to girls in height by the age of 18. Boys develop more quickly and for an extended period of time after growth begins. Additionally, during the late adolescent years, facial hair, penis and testicles, and pubic hair continue to grow in boys (Blyth DA., 2023).

Individual differences in these and other bodily changes are significant. Some people bloom early, while others mature and develop later.

3.3. 19 to 21 Years of Age

The majority of young people's physical growth takes place when they are younger. However, those who go through puberty later in adolescence can still have physical changes. (Sawyer et al., 2012) Male facial hair may thicken at this point, and many young people may still have pimples and acne (Fig. 1 & Table 1).

Table 1 Physical and emotional development in males and females of different age group.

Fig. (1))

Physical development between the age of 12-18 in males and females.

4. Emotional Development

4.1. 10 to 14 Years of Age

Between childhood and maturity, years 11 through 14 represent a transitional period. Adolescents naturally experience the psychological need to distance themselves from their relatives. This can occasionally be observed in an obsessive interest in friendships and teen interests. Strong, same-sex friendships often develop in the early adolescent years. Teenagers frequently get disinterested in family issues. They might prefer to be alone themselves at home, dancing to loud music in their rooms (Sacks et al., 2003). Parents may find it upsetting when their children act sullenly and distantly at times. But given the age, that is normal. Teenagers want to feel like adults, but when they are with their guardians, they are constantly reminded of the fact they are still children, even if their elders are not treating them that way (Thijssen, Sandra et al., 2020). The more parents want to maintain their children's innocence, the more freedom teenagers often demand (Ellis and Garber., 2000). Many teenagers engage with friends and work to be independent of their families in order to develop their individuality. As a source of support and guidance, the peer group frequently takes the position of parents, at least in part. Teenagers who have a positive sense of self may be less susceptible to peer pressure. They are most able to draw on principles instilled in them at home when they are presented with challenging situations (Thijssen et al., 2020).

4.2. 15 to 18 Years of Age

Teenagers become better at thinking about and comprehending abstract concepts like morality as they get older. Additionally, they start to comprehend others more fully. They frequently have a strong conviction that their own beliefs are the most accurate while having some empathy and the ability to comprehend that others may have different opinions. Finding one's place in the world plays a large part in the emotional and social development of adolescents. Therefore, it is expected that their moods may fluctuate from day to day (Harris et al., 2005).

Even after puberty, boys continue to grow stronger and more agile. Usually, girls level out. Boys and girls who exercise frequently have stronger muscles and better coordination. Teenagers frequently experiment with or focus heavily on their appearance, hair, jewelry, tattoos, piercings, political beliefs, and speech (Johnson et al., 2011). While parents frequently question whether their kids are self-centered, this conduct is really a means for them to practice, evaluate, and help define who they are. Typically, as teenagers mature, they outgrow it.

In the later adolescent years, teens become more at ease with their own identities and their peers become less significant. Teenagers start to hang out in mixed-gender groups and on one-on-one dating. They could develop close relationships with older children or adult mentors. These partnerships let teenagers discover more about themselves.

4.3. 19 to 21 Years of Age

Each young person has unique challenges with their adjustment to major familial and societal duties, as well as with basic development in both their bodies and minds. These physiological and social procedures, in addition to their onset and organization, have been impacted by wider factors of history and culture (Shanahan MJ., 2003). As a result, the returns on higher education—the amount someone earns throughout their career after acquiring their undergraduate or master's degree—have reached record levels, particularly in special subjects that support rapidly expanding economic sectors. Moreover, staying in school for a longer period of time can help develop skills . High school graduation as a middle-class entrant is no longer as conducive to flexibility as it once was (Granville S., 2016).

5. MENSTRUAL CYCLE

The menstrual cycle lasts from the first day of bleeding to the first day of the subsequent period. A cycle typically lasts 28 days. However, having a cycle that is either shorter or longer is common. A teen's periods can be lengthy (up to 45 days), eventually getting shorter as they age (Fig. 2).

Fig. (2))

A complete menstrual cycle of a healthy young teenager. Image Credit: How Does the Menstrual Cycle Impact Exercise & Nutrition? PureGym. PureGym; 2023.

Hormonal changes set off each of the three phases of your menstrual cycle.

Menstrual Phase: It may last between four and six days. The endometrium, the uterus' thicker lining, begins to shed on the first day of your cycle.

Follicular stage: The egg follicle inside an ovary prepares for the release of an egg (ovulation) during the follicular phase.

Premenstrual (Luteal) phase: When the egg is expelled from the ovary's egg follicle on ovulation day, this phase begins. It can occur at any moment during a typical menstrual cycle, from day 7 to day 22.

You might have red spotting or lower pelvic pain or discomfort (mittelschmerz) for less than a day during ovulation. These ovulation symptoms are typical.

A pregnancy starts when the egg implants in (attaches to) the endometrium after being fertilized by sperm (This pregnancy is tracked starting on the first day of this cycle).

The endometrium begins to deteriorate if the egg does not get fertilized or if the fertilized egg does not implant.

To stop bleeding, tampons, pads, or menstrual cups are used. When swimming or engaging in other strenuous activities, tampons and menstrual cups should be worn since they are inserted into your vagina. A pad's adhesive strips make it easier for it to adhere to your pants. Tampons and pads need to be changed often. Girls may still engage in all of their regular activities when they are on a period. No one will know when you are having one.

5.1. Menarche

The term menarche refers to the first menstrual cycle, which often begins at the age of 12. However, it can begin sooner or later. The menstrual cycle includes your menstruation. The human body goes through a variety of changes throughout this cycle to get ready for a potential baby. Menarche also indicates that sperm can fertilize an egg through intercourse in order to become pregnant. Menarche and the menstrual cycle only occur in adolescent females (Singh et al., 2019).

One can feel anxious or emotional in the days leading up to the onset of your cycle of menstruation. One can feel bloated and gain water weight. Legs, back, or abdominal cramps that continue for several hours or more are possible. Some might develop acne and have sore breasts.

Girls will see a spot of blood on the cloth or in the bathroom when their period first starts. The blood flow from your vagina normally starts out mild and then gradually gets heavier over the course of a couple of days before slowing off. The blood may first be brownish in hue before becoming a brighter crimson. Each month, your period typically lasts 3 to 7 days.

Regular exercise, a heating pad, a warm bath, and non-steroidal anti-inflammatory medicines (NSAIDs) like ibuprofen or naproxen may be helpful if one experiences cramps during your period. Medications must be used with caution (Singh, Jerome Amir et al., 2019).

Menstrual symptoms may be alleviated by engaging in regular exercise, consuming a range of healthy foods, and lowering stress. Limiting foods and beverages like alcohol or caffeine that aggravate the symptoms may also be beneficial. Keeping a record of the day your period begins each month is a good practice. The calendar can assist you in determining when your next period will arrive if the cycle is regular. Recording the symptoms of self can be helpful to find out the pattern of premenstrual symptoms.

5.2. Premenstrual Syndrome

Premenstrual syndrome, also known as PMS, is a collection of bodily or emotional symptoms that appear before your monthly menstruation. The symptoms start one to two weeks before the start of menstruation and disappear in the first couple of days. A few days before your period, it is typical to have bloating, achy muscles, and sore breasts. These premenstrual symptoms are typical. However, PMS symptoms are those that affect your daily life. The hormonal changes that take place throughout the menstrual cycle are linked to PMS. It is still a mystery to doctors why some women experience premenstrual symptoms more severely than others.

Bloating, swollen and sore breasts, poor energy, headaches, cramps, and lower back pain are typical physical symptoms of PMS. It is also typical to experience sadness, rage, irritability, or anxiety. One to two weeks before the onset of your menstruation, symptoms may appear. Within the first several days of your period, these symptoms disappear. No one therapy is effective for everyone. Adapting your way of life might be beneficial. Healthy food, frequent exercise, and reducing alcohol and caffeine use are a few examples of these adjustments. After a few monthly cycles, if these adjustments do not help inreducing your symptoms, your doctor may recommend medication for bloating or severe PMS symptoms.

6. LIFESTYLE-RELATED DISEASES

The term lifestyle diseases refers to conditions whose development is mostly dependent on a person's daily routine and results from an unsuitable interaction between that person and their surroundings (Akseer et al., 2020). People are susceptible to a number of ailments that depend on their way of life and professional habits. Making nutritional and behavioral changes, and changing the environment can help minimize them. Lifestyle diseases are those whose occurrence is mostly influenced by people's daily activities and results from an inappropriate relationship that exists between humans and their surroundings (Nguyen et al., 2015).

These chronic illnesses creep up on you, take years to emerge, and are challenging to cure once they do. Poor food behaviors, inactivity, bad physique, and generally circadian clock are the primary root causes of lifestyle ailments. Studies show that individuals who emigrate from one nation to another often become prone to cancer, suggesting the role of environment. The main reasons for the variance in cancer rates among nations are not hereditary factors. The dietary habits of various groups may have an impact on the incidence of cancer (Age limits and adolescents., 2003).

Today, diseases associated with lifestyles are a major global public health concern. The World Health Organisation (WHO) estimated that in 2005, lifestyle-related illnesses caused 35 million deaths, or 61 percent of all fatalities, and 49 percent of the global disease burden. By 2030, it is anticipated that 56 percent of the world's population will have a medical condition and that diseases associated with lifestyles will be responsible for seventy percent of all fatalities. The largest increase is anticipated in Africa and the Eastern Mediterranean (United Nations Youth., 2015).

The adult population has been the center of the conversation about attempts to combat lifestyle-related illnesses thus far, with teenagers receiving little attention. The young population is typically seen as being in good health, and since lifestyle-related disorders are sometimes referred to as chronic illnesses, limited attempts have been made to evaluate their health, disease prevention, and lifestyle modification. But teens bear a disproportionately large burden of the world's lifestyle-related ailments (King et al., 2009; Sharma et al., 2009).

Youth worldwide are at significant risk of lifestyle-related illnesses, the most prevalent of which are conduct disorders and mental health conditions, including depression in both sexes. Our findings indicate that these modifiable factors that begin in youth are responsible for a significant amount of the economic burden of lifestyle-associated disorders in adults (Amy et al., 2012). The prevalence of illness among teens is significantly influenced by nearby behavioral and lifestyle risk factors. The primary causes of lifestyle illnesses in adults are poor diets, smoking, excessive alcohol consumption, drug use, and symptoms of metabolic conditions (high cardiovascular disease, elevated cholesterol level, and diabetes), and the risks of each of these frequently begin in adolescence (Lichtenstein et al., 2000).

By gender and geography, there are significant differences in the risk and protective factors for lifestyle illnesses among teenagers, including alcohol consumption, smoking, being stationary and jobless, and being overweight. These findings are in line with past empirical research on young populations' susceptibility to disease, indicators of risk, and beneficial behaviors (Supplement NZ-WMW., 1990). It also draws attention to the necessity of reducing the current burden of lifestyle illnesses among youth and preventing substantial adult morbidity and death associated with chronic illnesses acquired early in life. The discrepancies and trends highlight the need for policies and programs to be developed at the regional and national levels that particularly address the main causes of the financial strain due to chronic illnesses.

Additional significant intermediate variables that significantly contribute to lifestyle-related diseases among teenagers include infrastructure like urbanization and access to power, resources like health spending and personnel for wellness, equality by gender, and empowering young people. The relevance of underlying macro-level determinants is highlighted by these findings, which throw doubt on the generally accepted belief that individual risk factors and livelihood safeguards are the primary causes of lifestyle-related disorders (Patton et al., 2016). Additionally, several research studies have shown associations between mortality, morbidity, risk factors, and protective variables among adolescents and larger economic and social variables of health.

CONCLUSION

Teenagers are not