Regarding health more specifically,a common agenda was developed by WHO,UNFPA and UNICEF (WHO 1997a;1999a)regarding actions for the health of adolescents,with the focus on improving knowledge,skills,access to counselling and health services,and safety and support of the environment (see Chapter 4).In'Health21:The Health for all Policy Framework for the WHO European Region,as revised in 1998,one of the two main aims is to promote and protect people's health throughout their lives,the other one being to reduce the incidence of the main diseases and injuries,and to alleviate the suffering they cause.Health as a fundamental human right,equity in health and solidarity in action,and participation and accountability for continued health development are the basic values(Health21 1998). PAHO has a Program of Adolescent Health(Division of Health Protection and Promotion)which seeks to promote the health and development of adolescents and youth between the ages of 10 and 24 in the Region,and which encompasses policy and advocacy,networking,evaluation of services and operational research. Blum(1998)has identified the key roles of the health sector for adolescent health in the USA,recognizing a more prominent role for public health than for personal health care-strategies and noting the relative scarcity of prevention programmes. It is noteworthy that in spite of a growing concern for adolescent health worldwide,adolescence has not been considered a high priority lifecycle stage for nutrition needs and intervention,with the exception of adolescent pregnancy.In the USA,however,nutrition was already outlined in 1990 as one of the key intervention areas in the'Healthier Youth by the Year 2000 Project'of the American Medical Association. It should be recalled that in the UN Convention on the Rights of the Child,which also applies to adolescents the need to "combat disease and malnutrition [through the provision of nutritious foods" in order to fulfil the right to the highest attainable standard of health is explicit in article 24. 1.3 Objectives and content of the paper Based on a literature search pertaining to developed and developing countries,the purpose of this discussion paper is to lay down the basis for WHO's recommendations on the prevention of nutritional disorders in adolescents and on their early detection/diagnosis and appropriate management.The specific objectives are: 1) to identify the key nutritional problems that affect adolescents,the main risk factors and their interaction with other health problems and life events; 2) to identify and discuss existing recommendations,strategies and programmes on prevention and control of these conditions;and 3) to propose additional recommendations when deemed relevant. The focus is on adolescents of developing countries,which means also addressing nutritional problems that are common to high-,middle-,and low-income groups,as well as those that are spreading throughout the world as a result of globalization.Much research on various factors of nutritional risk in adolescents has been carried out in high-income countries,with many findings also of relevance to middle-and low-income ones.Therefore,the discussion paper deals with adolescent nutritional issues and programmes within their own setting.An important caveat is that because of very wide differences that may exist between and even within countries,generalizing problems or solutions is irrelevant,and the paper may be perceived as being over-simplistic in this regard because of the need to synthesize.Although developed and developing country categories are used for the sake of simplicity,it is reaffirmed here that this distinction is becoming more and more irrelevant with respect to nutritional problems or other issues. Web site:www.paho.org/hpp/hppabout.htm,16/04/994/ 6 Web site: www.paho.org/hpp/hppabout.htm, 16/04/99 Regarding health more specifically, a common agenda was developed by WHO, UNFPA and UNICEF (WHO 1997a; 1999a) regarding actions for the health of adolescents, with the focus on improving knowledge, skills, access to counselling and health services, and safety and support of the environment (see Chapter 4). In ‘Health21: The Health for all Policy Framework for the WHO European Region’, as revised in 1998, one of the two main aims is to promote and protect people’s health throughout their lives, the other one being to reduce the incidence of the main diseases and injuries, and to alleviate the suffering they cause. Health as a fundamental human right, equity in health and solidarity in action, and participation and accountability for continued health development are the basic values (Health21 1998). PAHO has a Program of Adolescent Health (Division of Health Protection and Promotion) which seeks to promote the health and development of adolescents and youth between the ages of 10 and 24 in the Region6 , and which encompasses policy and advocacy, networking, evaluation of services and operational research. Blum (1998) has identified the key roles of the health sector for adolescent health in the USA, recognizing a more prominent role for public health than for personal health care-strategies and noting the relative scarcity of prevention programmes. It is noteworthy that in spite of a growing concern for adolescent health worldwide, adolescence has not been considered a high priority lifecycle stage for nutrition needs and intervention, with the exception of adolescent pregnancy. In the USA, however, nutrition was already outlined in 1990 as one of the key intervention areas in the ‘Healthier Youth by the Year 2000 Project’ of the American Medical Association. It should be recalled that in the UN Convention on the Rights of the Child, which also applies to adolescents the need to “combat disease and malnutrition [....] through the provision of nutritious foods” in order to fulfil the right to the highest attainable standard of health is explicit in article 24. 1.3 Objectives and content of the paper Based on a literature search pertaining to developed and developing countries, the purpose of this discussion paper is to lay down the basis for WHO’s recommendations on the prevention of nutritional disorders in adolescents and on their early detection/diagnosis and appropriate management. The specific objectives are: 1) to identify the key nutritional problems that affect adolescents, the main risk factors and their interaction with other health problems and life events; 2) to identify and discuss existing recommendations, strategies and programmes on prevention and control of these conditions; and 3) to propose additional recommendations when deemed relevant. The focus is on adolescents of developing countries, which means also addressing nutritional problems that are common to high-, middle-, and low-income groups, as well as those that are spreading throughout the world as a result of globalization. Much research on various factors of nutritional risk in adolescents has been carried out in high-income countries, with many findings also of relevance to middle- and low-income ones. Therefore, the discussion paper deals with adolescent nutritional issues and programmes within their own setting. An important caveat is that because of very wide differences that may exist between and even within countries, generalizing problems or solutions is irrelevant, and the paper may be perceived as being over-simplistic in this regard because of the need to synthesize. Although developed and developing country categories are used for the sake of simplicity, it is reaffirmed here that this distinction is becoming more and more irrelevant with respect to nutritional problems or other issues