Teenagers and Their “Chronic Illnesses” Due to Poor Dietary, Sleep, and Lifestyle Habits

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Over the years, while I have focused on how the "Milk and Cookie Disease" (MCD), or excessive dairy and sugar, cause toddlers and preschoolers to have chronic snotty noses, congestion, snoring, and many ENT symptoms, I have also learned a great deal about teenagers and their common complaints. Poor diets, sleep, and lifestyle habits with little or no exercise impact teenagers as much as children of any age, so the ENT and upper airway symptoms described in A Healthier Wei and Acid Reflux in Children apply to everyone, including adults. The particular challenge with teenage patients is that most parents and physicians are not addressing the underlying issues that are causing how they “feel”, and may spend time and money ordering unnecessary tests, and misdiagnosing them with “medical” diseases when adolescents really need a serious “makeover” of their entire daily routine. 

For teenagers, the most complaintthat I encounter, yet was never formally “trained” to treat, are “chronic fatigue” or “always sick”, followed by what is up my alley which is “chronic sore throat”, “congestion”, and even “ear pain”. I want to share first about perhaps the most difficult diagnosis for any doctor who hears “chronic fatigue” in a teenager. Parents report they have a “mysterious illness” that doctors can’t figure out, they have been to the pediatrician, much “blood work” has been done, and doctors can’t find the problem. Most have had their “thyroid” checked and blood work shows a normal “thyroid hormone” level. I meet teenagers who are skinny, overweight, or obese with this complaint. As I try to patiently listen to the venting of parents of how we, doctors, and the medical system, have “failed” them by not providing an explanation and “cure”, and telling me how debilitating this has been, to the point of many no longer being able to go to school but are now home-schooled (very common in Florida), I always take extra time to do a detailed dietary, lifestyle, and sleep habit intake. 

Here is what parents and teenagers won’t volunteer and what these patients have in common: 

  1. They don’t eat breakfast. 
  2. Most will tell me they don’t pack a lunch, nor do they eat lunch at school because it’s “gross”.  
  3. The ones who eat lunch at school eat primarily pizza. 
  4. Most admit to drinking soda, not once a day or one can, but multiple servings and with dinner. 
  5. They are sugar-addicted, drinking not only just soda, but most often Powerade, Gatorade, and sweet tea (Arizona Green Tea or other commercial flavored sweet teas). 
  6. They come home “starving”, binge eat, and then often “nap” for hours. 
  7. Their bedtime is not set, they are always on the internet/devices/social media, and they eat anytime, all night long, up to bedtime. Foods include highly processed refined carbohydrate snacks, candy, and all other “junk food”. 
  8. They typically don’t exercise, don't have a routine, and are not in sports. 
  9. They may be depressed if you ask them for history of depression or the possibility of being “depressed”. 
  10. The more overweight or obese, the more likely they seem to be withdrawing and further enforce already unhealthy life habits. 
  11. They rarely drink water. 
  12. They don’t have a “sense of purpose” in life, or something that is meaningful to them, nor do they know what they want to do when they “grow up”. 
  13. Most don’t know how to prepare food, don’t go to the grocery store with their parents, do not know how to read nutrition fact labels, and have never been taught the impact of choices and dietary habits on health. 
  14. Some have played sports in the past, but stopped, and as they gain weight, they have “joint” problems and even need to see my orthopedic surgeon colleagues, especially those who are severely overweight and obese. 
  15. Some have frequent headaches, often as a result of not enough sleep. 

What has been really eye opening is that most parents or caretakers are quiet during these conversations, and are equally surprised as they had no idea that their teenager or preteen are not eating lunch, or not eating breakfast as many parents leave for work early and get home late. After all, when our children are away from us at school or anywhere but home, no one is “tracking” their diet and dietary habits. After the interrogation on sugary beverages, I spend as much time as it takes to go over their eating, or NOT EATING, habits! 

Here is what you can expect from an average high school student: 

  • Mothers will complain to me with disappointment that their kid does not eat breakfast, but state it as a matter of fact and as if there is nothing we can do about it. 
  • Yes, it’s true that our public school system may be feeding our students the same processed foods that we use to feed prisoners. (Watch Fed Up on Netflix if you want to learn more about why our public school lunch programs are the way they are.) 
  • If they do eat the school's lunch, usually it’s pizza from Pizza Hut, burgers and fries. Hey, fries belong to the vegetable group according to our government compliance definitions for school lunch programs. Most public schools allow vendors to bring in soda machines, and other vendors of fast foods, because it’s a revenue source for the school. Taco Bell, Pizza Hut, and many other food chains get access to your child’s lunch through some type of contract/sponsorship and well, money. 
  • For the many teenagers who skip breakfast and even lunch, they maintain their “energy” and alert level, while being hypoglycemic, with SUGAR! Yes, that’s right. Can’t stay awake through your classes unless there is Monster Energy Drink, Coca-Cola, and any other sugary beverages. Many teenagers will drink them daily during school. 
  • When teenagers get home, often when working parents are not there, and, after “starving” all day, they will eat whatever they please. 
  • Teenagers stay up LATE! Many parents can’t even tell me what time they go to bed, but you can be sure they eat/drink all the way up to bedtime. 
  • Teenagers will eat anything from a second dinner, to “pizza rolls,” anything processed that you can heat up in microwave/oven, and plenty of sugars in the form of cookies, ice cream, snacks, etc. 
  • Teenagers often drink soda and other sugary and caffeinated beverages throughout the evening. By the way, the most common “throat problem” teenagers complain of in my office, feels like something is “stuck” in their throat, which is “globus sensation” due to nightly acid reflux. Their stomach contents move back up to their throat because, during what little sleep they get, their stomach is full of sugar, which breaks down into acid. 

I have also met many teenagers with severe and scary “episodes” where they can’t “breathe”, even get close to fainting, and these kids have seen many specialists who tell them they have “vocal cord dysfunction”. I am convinced, after meeting them one by one, that most are healthy without risk factors or true asthma, but what they have in common is horrific unhealthy eating habits and drinking a ton of sugar every day. 

I am encouraged that we can make a difference, because during every one of these office visits, I explain to the teenager WHY it is so important they become very aware of the food and beverage choices they make. I tell them why they must be in charge and that their body is trying to tell them to stop treating it like crap, else he/she will feel like crap. 

Not every patient or every family is motivated or willing to make a change, but for the most part, I find many teenagers very interested in what I tell them because they want to feel better. 

We haven’t even addressed their school performance yet…that will have to be a separate blog. You better believe that these kids are generally not our valedictorians since poor nutrition/eating habits do not support high levels of academic performance. 

I am not a formally trained therapist, but I take these brief, likely single opportunity when meeting these patients and their families, to focus on speaking to the teenager. The most important message I can share during our interaction is to look them in the eyes, hold their hands, and tell them that “you matter”. You are important, you are special, and you matter. In order to create healthier habits, a routine for regular bedtime, instill awareness on why daily good choices and healthy dietary habits impact how they feel, and embrace the difficulty of sugar withdrawal in the short term on their way to drinking water, I tell them WHY they must make the change. Doctors can’t fix “life” and doctors are not accountable for your lack of health as a result of your lack of discipline and willingness to care about your own health. We are not going to prescribe a “pill” that makes you not tired. One will be “fatigued” by being completely sedentary, our evolution and biology mandates physical activity, even as simple as walking, which doesn’t cost anything.  

All I can do is to be a mirror for every preteen and teenager so they can see themselves, have awareness, then accountability, then take action for what’s really going on. I want them to believe that change is possible, that they need to be accountable and not their parents, for their own health and life, for the rest of their lives, one day at a time.

This blog is in no way saying that medical evaluations are not necessary, they may be for particular situations, or if the teenager is having issues despite eating regular meals, sleeping with routine, getting adequate sleep and exercise, drinking water and ingesting minimal sugar. Until then, work on these things instead of taking more pills. 

PLEASE, share this blog with any teenager in your life. Help them make a change to live "a healthier wei".

Acid Reflux Conversations Dietary Habits Lifestyle Obesity Sleep Well-Being

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