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Adolescence is a transition period during which young people face many changes. Their desire to assert and differentiate themselves is reflected even in their food choices. These choices may have impacts until their adult lives. Moreover the media affect them in contradictory ways from images of extreme thinnesses to enticing advertisements of calorie food. A lack of self-esteem may appear, and in case of fertile ground may cause either diet, either addiction, or eating disorder. A comforting family as well as empathetic physicians have a main role in the medical care.

As main current topics in pediatric nutrition we have considered the results of the continuing research on the long term consequences of fetal malnutrition and intra-uterine growth retardation with the concept of metabolic imprinting leading to chronic disease in adulthood, the progresses of knowledge in the fields of iron metabolism and regulatory mechanisms of satiety, hunger and energetic balance, a better determination of recommended docosahexanoic and arachidonic acids intake in the first months of life for premature and term infants, and the studies on probiotics and prebiotics utilization for preventive and curative purposes. The concerns about vitamin D insufficiency in France have markedly decreased with the generalization ten years ago of cholecalciferol supplementation of infant formula, and more recently the authorization of dairy products supplementation. On the contrary the problem of iron deficiency in young children remains, as well as two major nutritional concerns: the very low percentage of breast-fed infants and the dramatic increase of childhood obesity which affects presently 14% of 10 year old children versus 5% in 1980.

The nutritional care of children and adolescents who practice sports more than 10 h/weeks is an important task. Advices must be adapted to the child according to his sport, his age, his gender, his weight and to the intensity of his physical activity; they intend to provide him, in addition to his basal requirements, those due to the extra expenses of water, energy, minerals and vitamins. The aim of the physician is to allow these children an adequate growth and the normal development of puberty, to prevent deficiencies and to concur with other specialists to the prevention of muscle, joint and bone wounds who can affect a growing organism. This ambitious program relies on a thorough knowledge in pediatrics, nutrition and sport in order to adapt the advice to the specific way of life of the child, taking into account the schedules of school time, training and competition. Such an approach needs that every child undergoes a medical examination 3-4 times/year, a biological check up at least once a year, a careful follow up of growth and pubertal maturation. Every time it is possible parents and coaches are encouraged to attend the visit when everything is OK and even more when difficulties occur, whether they are due to somatic or psychological trouble or in case of poor performance induced discouragement. A balanced nutrition, an adequate counseling and an adapted follow up are essential for the success of athletes; they do not make champions from them but decrease the hazard of wounds, underperformances and make easier blossoming for children.

Hundreds of studies carried out in the past 20 years have worked on youth and adolescent health indicators linked to general morbidity and mortality and to specific pathologies. The majority of research has focused on evaluating the impact of risk behaviours such as tobacco, alcohol and drug use, non-protected sexual intercourse, and unbalanced nutrition on the health of youth. The usefulness of medical care and health education programmes has thus traditionally been evaluated on the basis of their impact on mortality and morbidity. However, these measures have proven insufficient and the necessity to pay more attention to quality, and not only length of life is now apparent. This article focuses on the question of whether the tool for measuring quality of life linked to health, adapted from what now exists for "sick" adolescents, can constitute a new indicator allowing for evaluation of the unknown realm of adolescent health needs. The authors address the concept of measuring the quality of life by providing several of its definitions, noting the difficulties and insufficiencies of their measurement. The authors also wonder why the multiple professionals preoccupied with adolescent health have not yet imagined using a participative approach to developing these measures, i.e. an approach including the adolescents themselves, has not been used. The authors propose that to include adolescents in the development of evaluation tools would ensure that the adolescent's needs for expression and to be heard are fulfilled. The authors also maintain that education, both health and general, should enable individuals to understand what is positive within themselves, and thus develop these aspects to their fullest. It should not force models of behaviour onto individuals or groups. If this approach is taken in developing quality of life indicators for young people, a positive health promotion approach to enabling adolescents can be developed.

Bad dental hygiene in adults is usually the result of bad care during childhood. Within the framework of Health for All, WHO and the International Dental Federation defined global objectives for dental health which allow for monitoring progress in different countries. The most common dental problems, such as dental cavities, can be prevented by simple and inexpensive methods. Dental health is based on dental hygiene, nutrition, fluoride intake and dental service utilisation. Dental health promotion aims to create an environment favourable to the adoption of these healthy behaviours. The principle recommended dental health measures are through fluoridation of water, salt, and milk, a low consumption of sweets, and modification of the amount of sugar in the diet; implementation of monitored dental hygiene activities in schools; the organisation of regular dental services in schools/workplaces; and adopting legislative texts or laws requiring certain measures of prevention. In the past several years, certain African countries have set up national dental health programmes (there were 12 in 1993), However, the implementation of dental health promotion generally doesn't result from a national initiative, but from a regional or local scale. This is largely due to the lack of integration of dental health in activities of education and health promotion in general. Programmes planned at a national level and then implemented at a local level on a multisectoral base have had more success. This article presents examples of dental health promotion activities in several African countries, mainly focusing on programmes aimed at 12-13 year olds in primary school. Programmes from Morocco, Kenya, Madagascar, Côte d'Ivoire, Benin, and Tanzania are briefly presented and show that in Africa, dental health promotion has mostly consisted of the implementation of health education actions and that there are no consistent policies, unlike in other developing countries, for fluoridation of water, salt, and milk. In terms of dental health promotion, WHO recommends the promotion of traditional methods of dental hygiene (such as plants or sticks for cleaning), especially among adolescents living in rural and low income communities. In turn, the identification and promotion of the positive aspects of hygiene and traditional care will allow for the implementation of more culturally acceptable approaches.

Background: Physical and psychological disorders in adolescence may lead to specific food behaviours. The aim of this work was to make a group of adolescents full actors of the conception and realization of a study on their food consumption and attitudes., Population and Methods: Seventeen self-selected adolescents (age: 12 to 18 years) were enrolled in the study. They interviewed 186 peers (24% of the adolescents of the district) during March 1994., Results: 5.9% of adolescents never had breakfast; only 57.7% had the three main meals every day during the last week, but 14% had these three main meals and three snacks the preceding day. During a week, 22% (12-14 years old) and 32% (15-18 years old) had had at least one lunch outside their home or school canteen. Fast-food attraction was very strong, mainly among the youngest, the boys and the foreign students. However, family meals were appreciated by 87% of them., Conclusion: Even though absence of representation of the sample gave doubts on the most marginal forms of food behavior, the interest manifested by adolescents for this research program and the results favor a food educational program that should be planned with them.

Young high-level athletes are frequently exposed to deficiencies, the most frequent origin of which is dietary. Supervision must be clinical, biological and dietary. Recommendations should be made individually, based on the nature and intensity of the exercise, and are calculated from the recommended supplements for the paediatric population. Protein, glucid and lipid supplements must represent approximately 12, 60 and 28% of the daily energetic intake respectively, the glucid ratio reaching 70% under certain conditions of prolonged exercise. Liquids must be controlled when exercise takes place in a warm atmosphere because young athletes are rapidly exposed to dehydration, the osmolarity of the selected drink being below 250 mosm/l. Mineral and vitamin supplementations are recommended. For minerals, perspiration losses may be associated with dietary deficiency. Possible vitamin deficiencies concern B1, B2, B6, B9, B12, C and D vitamins. The daily mineral supplements are estimated at 10 mg for iron, 5 mg for zinc and 1 mg for copper, and have to be prescribed in regular treatment after biological control.