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Many teenage girls are not getting the nutrients they need to ensure healthy development, putting them at risk for weight-related problems and cardiovascular disease. Female adolescence is an important time for setting up adult health, as nutritional needs change because of increased growth and the beginning of menstruation, said Andy Bellatti, who runs the popular nutrition blog Small Bites. But studies have shown that on average, teenage girls are not getting enough fiber, calcium, iron, zinc, magnesium or vitamins A, E and B in their diets, and are eating too much saturated fat and sodium, said Bellatti, who is also a graduate student in New York University’s Department of Nutrition, Food Studies and Public Health. “There’s a lot of work that needs to be done,” he said. In American adolescents aged 12 to 19, the obesity rate has more than tripled from 5 percent to 17 percent over the last three decades, according to the Institute of Medicine. Research suggests that these children are likely to remain overweight into adulthood. One study showed that about 80 percent of kids who were overweight from ages 10 to 15 will be overweight as adults, and another found that 25 percent of obese adults were overweight kids. These children are at risk for weight-related health problems in the future and overweight kids are more likely than their slimmer counterparts to show risk factors associated with cardiovascular disease like type 2 diabetes or high blood pressure. As childhood obesity rises, adolescents are more often turning to unhealthy methods to control their weight. A University of Minnesota study found that nearly 20 percent of girls and women had used diet pills by the time they turned 20. The incidence of use in high schoolers nearly doubled over the five years of the study, from 7.5 percent to 14.2 percent. The study revealed that more than 60 percent of teenage girls had resorted to diet pills, laxatives, vomiting or skipping meals to control their weight, and girls who employ these extreme diet methods are also more likely to be overweight. "A lot of girls believe that the way to lose weight is to cut calories,” Bellatti said. Ironically, a pattern of crash dieting or extreme calorie restriction will eventually affect metabolism and could lead to weight gain in the future. Teenage girls between the ages of 14 to 18 should eat between 2,200 and 2,400 calories a day, Bellatti said, something that a lot of popular diets don’t provide. "If you are overweight as a teenager, it's one thing to cut your calories,” he said. “But to be at a healthy weight at this age, it's really important to get all the nutrients you need. If you're eating 1,200 or 1,400 calories a day, that's really hard to do." The U.S. Department of Health and Human Services developed a program called BodyWorks, aimed at overweight or obese girls aged nine to 13. It aims to teach tweens about healthy eating and lifestyle choices as a way to control weight. The program gets many things right, Bellatti said, but also misses on a few clear areas. While he applauds the focus BodyWorks places on eating from a variety of food groups, Bellatti said that some of the advice may play into the fat-phobic or carb-phobic attitudes that many girls develop in their teenage years. The message to limit fats doesn't distinguish between types of fats, he pointed out. It lumps heart-unhealthy saturated fat and cholesterol in with essential fatty acids like omega 3s, which are lacking in many people's diets. All diets require some fat – about one-third of calories for teenagers -- but general advice to limit fats could lead people to avoid foods like salmon or avocado, he said, even if the fats they contain are healthy. "We're living in a time when people are just not eating enough omega 3s, and we just say to everybody 'limit your fat',” Bellatti said. “What that really means is to limit your saturated or trans fat." The BodyWorks pamphlet discusses the importance of whole grains in the diet, Bellatti said, but doesn’t make it clear how many grains are needed each day. The included sample meal plan is based on the U.S. Department of Agriculture food pyramid’s recommended 2,000 calories a day, which should include six one-ounce servings of grains. But while the pamphlet advises that girls eat three servings of whole grains daily, Bellatti points out that it neglects to mention any other grain intake, leading to an unnecessary low-carb message that is already popular among young women. It’s important to promote healthy food and exercise choices in teenagers without placing an undue emphasis on diet, or making them feel like unhealthy choices are bad or lazy, Bellatti said. "A lot of times people are doing things based on wrong information," he pointed out. They may be intending to make healthy decisions and not aware that they’re doing the opposite. "Let them know, first of all, that they have choices." When Bellatti talks to teens, he puts a focus on making healthy choices now so they can enjoy their adulthood without worrying about complications during pregnancy, osteoporosis or checking their blood sugar every couple hours. "Those usually are the things that stick with them."