After two years of growth parameters are mapped with gWachstumsgrafiken from the CDC (1).
In adolescence (usually from the age of 10 until the late teenage or early 20s), boys and girls reach the height and weight of adults and live through puberty. For boys, see Sexual differentiation Adrenarche and puberty; for girls see puberty. The timing and speed at which these changes occur vary and are influenced by both genetic as well as environmental factors. After two years of growth parameters are mapped with gWachstumsgrafiken from the CDC (1). Note 1. Grummer-Strawn LM, Reinold C, cancer NF, Centers for Disease Control and Prevention (CDC): Use of World Health Organization and CDC growth charts for children aged 0-59 months in the United States. MMWR RECOMM Rep RR information and additional information. MMWR RECOMM Rep 59 (36): 1184, 2010. Physical growth in boys occurs at the age of 12-17 years to a growth spurt, typically with a peak between the ages of 13 to 15 years; an increase in size of> 10 cm can be expected in the year of the highest growth rate. In girls, a growth spurt occurs at some point between the ages of 9 ½ and 14 ½ years, with a peak aged between 11 and 13 ½ years; an increase in size of 9 cm can be expected in the highest growth rate. In a delayed puberty, enables growth to slow considerably. If the delay has no pathological causes, the typical growth spurt occurs later, so that the size and growth caught up again and the percentiles are to reach the genetically determined size cut up. From the age of 18 years boys grow still averaged 2.54 cm, girls whose growth is completed at 99%, slightly less. In girls with a real precocious puberty (before the age of 8 years), there is the young age at an early growth spurt and an early menarche, but in the end they remain because of the premature closure of the growth plates small. Although precocious puberty is defined as development starting before the age of 8 years, some girls that develop before the age of 8 years, be normal. All organ systems and the body as a whole to grow significantly during adolescence; the most obvious changes are the development of breasts in girls and genital and the change of body hair in both sexes. Although this process is normal, mental changes are inevitable. If the timing of the development is atypical, v. a. if delayed physical development in a boy or occurs early in a girl to be reckoned with an additional psychological stress. Most boys who grow slowly, have a constitutional growth delay and bring the deficit to sooner or later. but a clarification is needed to exclude pathologic causes and to reassure the family. All adolescents should be advised on diet, physical fitness and lifestyle, and especially the role of sports activities, artistic activities, social engagement and volunteer activities in the social environment of young people should be addressed. The relative need for protein and energy (g or kcal / kg body weight) increases from the end of infancy to adulthood, more and more (see table reference values ??for the supply * of some macronutrients, “Food and Nutrition Board, Institute of Medicine of the National Academies “), with the absolute demand naturally increases. Protein requirements for boys aged 15 and 18 years is 0.9 g / kg / day and for girls the same age at 0.8 g / kg / day; the mean relative energy requirements for boys aged 15 and 18 years is 45.5 kcal / kg and for girls the same age 40 kcal / kg. Maturity The sexual maturation follows fixed procedures in both sexes. The age of onset and rate of sexual development vary and depend on genetic and environmental factors. The sexual maturation begins today ahead of what is attributed to the improvement of nutrition, general health and living conditions a century ago. Thus, the average age of menarche is now three years earlier than a century ago. The physiological changes that are of sexual maturation based are discussed in Reproductive Endocrinology Reproductive Endocrinology of the man and the woman. For the boys, the changes with the growth of the scrotum and testicles start, followed by a growth in length of the penis and the growth of the seminal vesicles and prostate. After that, the pubic hair is visible, two years later, followed by underarm and facial hair. The growth spurt usually begins about a year after the start of testicular enlargement (puberty – development of female sexual characteristics.). The mean age for the first ejaculation (in the US between 12½ and 14 years) depends on psychological, cultural and biological factors and is about one year after the penis growth. Gynecomastia, usually in the form of breast buds, is common in young adolescent boys and disappears usually after a few years. Puberty when male sexual characteristics develop. For most girls, the breast buds are the first visible signs of sexual maturation, closely followed by the beginning of the growth spurt. Shortly thereafter, the shame and the underarm hair appears. Menarche is usually expected about two years after the start of breast development and after the peak of the size growth. The timing of menarche varies widely, and it is used in most girls of 12 or 13 years for the first period (puberty – development of female sexual characteristics.). Breast development (Schematic view of the maturation of the human breast (stages I-V Tanner)) and pubic hair (Schematic representation of the stages I-V Tanner for the development of pubic hair in girls.) Can be divided using the Tanner stages and assessed , If the order of sexual development is disrupted, the growth may be impaired; the physician should consider pathological causes into consideration. Puberty – development of female sexual characteristics. The bars indicate the normal distributions. Schematic representation of the maturation of the human breast (stages I-V Tanner) from Marshall WA, Tanner JM: Variations in patterns of pubertal changes in girls. Archives of Disease in Childhood 44: 291-303, 1969; approved imprint. Schematic representation of the stages I-V Tanner for the development of pubic hair in girls. From Marshall WA, Tanner JM: Variations in patterns of pubertal changes in girls. Archives of Disease in Childhood 44: 291-303, 1969; approved imprint.