When it comes to adolescent obesity, parents will have all kinds of "little chubby dun" figures in their minds.
According to the Report on the Status of Nutrition and Chronic Diseases in China (2020), the obesity rate of children under 6 years old is 3.6%, and the obesity rate of children and adolescents aged 6~17 years old is 7.9%, while in 1982, the obesity rate of children and adolescents aged 7~17 years in mainland China was only 0.2%. The obesity rate among children and adolescents in urban areas is relatively high, while the obesity rate among children and adolescents in rural areas is increasing rapidly.
This year, the National Health Commission has formulated the "Dietary Guidelines for Children and Adolescents with Obesity (2024 Edition)", and we use a case to share some details that need to be paid attention to in the daily diet of overweight or obese children.
The children in the family are too fat, what should I do?
The big one is in the fourth grade, the younger one is 145, and the other is 122, but both of them are too fat, the small one is more than 70 pounds, and the big one is almost 100 pounds. I didn't think they were too fat until today
I sent them to my grandmother's house to play today, and I just wanted to put on a show for my grandmother, and then I turned out the pantyhose they bought in kindergarten. When the small one is worn, it feels very tight, and then the small one is split and the socks burst violently......
After seeing it, I didn't say that the quality of the socks was a problem, and I had to wear the surviving one to continue the performance, so I said I still don't wear it. I didn't listen and continued to wear it, but I just put it on and lifted my legs and exploded.
Now I can basically grow more than ten pounds a year. Do you still want to control their weight?
Whether children and adolescents in mainland China are obese refers to the "Classification Standards for Body Mass Index of Chinese School-age Children and Adolescents for Overweight and Obesity Screening"
This is the body mass index commonly used in the world, and it is calculated as BMI = weight (kg) / height ² (m²).
Calculate that Dabao's age is about 10 or 11 years old, with a height of 145cm, a weight of 50kg, and a BMI of 23.78, which is already considered obese.
Erbao is about 6 or 7 years old, 122cm tall, 35kg in weight, and 23.5 in BMI, which is also in the obesity range.
Another reference indicator is "body fat content", which refers to the percentage of adipose tissue in the human body as a percentage of body weight, which is a more intuitive indicator for judging obesity. However, there are many ways to measure body fat content, and it may not be accurate to operate it yourself at home, so if you want to get an accurate value, I am afraid you still need to go to a professional institution.
In general, if you want to judge whether a child is overweight, it is basically enough to use the BMI index plus the above screening criteria.
We have also noticed that in the last two years, our early students are facing the children entering adolescence, so we also pay more attention to the weight management of children and adolescents.
When parents feel that their children are too fat and need to lose weight, the first thing that comes to mind for parents is what we often hear, "keep your mouth shut and open your legs". For adults whose physical development has been stereotyped, "keeping your mouth shut" is indeed effective, but parents are reminded to pay attention to the fact that children, adolescents and adults are in different stages of growth and development, and children and adolescents cannot control their weight simply and crudely by restricting their diet.
According to the recommendations of the Guidelines for the Prevention and Control of Overweight and Obesity among School-age Children and Adolescents in China, the process of screening and processing overweight and obesity is as follows:
Therefore, it is recommended that parents take their children to the hospital for a comprehensive physical examination to determine whether the child is primary obesity or secondary obesity. Most children are obese due to primary obesity related to genetics, diet, and physical activity level, and a small number of obesity is caused by a clear cause, such as endocrine diseases, hypothyroidism, chromosomal abnormalities, inflammation of the hypothalamus, pituitary gland, etc.
The long-term consequence of childhood and adolescent obesity is that obesity and its associated health risks may persist into adulthood. Common health hazards include psycho-behavioral problems, hypertension, dyslipidemia, impaired glucose tolerance, type 2 diabetes, early atherosclerosis, obstructive sleep apnea, nonalcoholic fatty liver disease, microalbuminuria, polycystic ovary syndrome, acanthosis nigricans, and many more.
It is highly recommended to take the child for a comprehensive physical examination to rule out the above possible early health problems caused by obesity, and to intervene and recover early.
The "Dietary Guidelines for Children and Adolescents with Obesity (2024 Edition)" just released this year can be referred to
According to the characteristics of children and adolescents in mainland China, the dietary principles and suggestions for obese adolescents are formulated:
The principles are simple and straightforward, and you can basically get the general idea at a glance. Let's focus on how to make dietary adjustments.
One of the things that impressed me a lot was when I was in high school, there was a female classmate in my class, who saw me eating snacks during recess and said enviously, "Your mother is so nice and lets you eat snacks." I was surprised and said, "Why, won't your mother let you eat?" and she said very depressedly, "My mother said I was too fat to eat." "I felt that there were still parents who really didn't let their children eat enough? My whole family always thought that I ate too little, let me eat more, and even if I occasionally told me that I was fat, it never restricted me from eating. The point is that I don't think that female classmate is fat at all, and it looks like she is fat and thin.
Most of the problems of children's weight loss that we come into contact with in our work are that parents let their children eat less, but they are worried that their children are growing up, and eating less will affect their health, and after limiting their children's appetite, they keep shouting that they are hungry and secretly use their pocket money to buy snacks to eat.
Another challenge is that parents are busy with work, their children eat simply in the morning, eat at the small dining table or school at noon, and only have time to prepare dinner for their children after work in the evening. At this time, parents often have a "guilty" psychology, and at the same time feel that their children did not eat breakfast and lunch well, and they should make a nutritious meal in the evening to "compensate" their children.
The last problem is that children attend interest classes or make-up classes, and sometimes they don't have time to arrange dinner, so they eat takeout or fast food instead. Or sometimes parents don't have time to make dinner, so they go to restaurants to dine-in or order takeout, and there are more times a week to eat out. Takeaway or fast food is generally high-salt and high-fat food, and children who often eat out can also cause health problems.
Parents should pay attention to the fact that the child is now in the period of growth and development, first of all, to ensure the normal growth and development of the child, and then through the quantitative adjustment of the diet, the dietary structure tends to be reasonable, and the intake of fat is reduced. It is also important to avoid blind dieting and reduce energy intake to achieve rapid weight loss. In particular, "starvation therapy" cannot be used to control weight.
Now both children of parents have different degrees of obesity, indicating that there must be unreasonable eating habits at home, or the home environment belongs to the "obesity-prone environment".
In the "Guidelines for the Prevention and Control of Overweight and Obesity in Chinese School-age Children and Adolescents", you can refer to the "obesity susceptibility factors" in your own home
Excessive energy intake:
Excessive dietary energy intake
Regularly consume energy-dense foods or meals
Unhealthy Eating Behaviors:
Eat fast
Eat before bedtime
Snack while watching TV
Skip breakfast
Eat out often
Eat fried foods regularly
Eat Western-style fast food regularly
Lack of physical activity:
Less physical activity
Excessive sedentary activity (watching TV, using a computer, playing video games, etc.)
Take the bus to and from school
Reduced physical recreational activities
Socio-economic and cultural factors:
Convenient transportation
Convenient for buying high-energy, high-fat foods
Increased opportunities to dine out
Fewer public sports venues
"Fat is blessed" traditional cultural concept
Advertisements for high-fat, high-energy foods
Commercial promotion
mass media
It is recommended that parents can record their children's diet for 7 consecutive days, what they eat every day, how much they eat, what you do for three meals a day, how well their children eat when they eat, how much each dish and staple food they eat, etc. Through this data, we can roughly see the eating habits of the family.
Then compare the 6~10-year-old school-age children's balanced diet pagoda and the 11~13-year-old school-age children's balanced diet pagoda below
Compare these two recommended standards for healthy eating to see what problems exist in the current daily diet structure of the family.
Some adjustments can be made according to the recommendations of the "Dietary Guidelines for Children and Adolescents with Obesity (2024 Edition)".
In the process of weight loss in obese children and adolescents, it is recommended that dietary energy should be reduced by about 20% on the basis of the needs of normal weight children and adolescents. At the same time, the dietary structure should be conducive to reducing hunger, increasing satiety, and appropriately increasing foods with high micronutrient density.
Children and adolescents should not be picky eaters, overeaters, and chew slowly. When the meal is over, leave the table immediately. Three meals a day should be eaten at regular intervals and at an appropriate length, about 20 minutes for breakfast and 30 minutes for lunch or dinner, and the total energy intake of each meal should be controlled, and no food should be eaten after 9 p.m. as much as possible. Children and adolescents should arrange three meals reasonably, emphasizing eating a good breakfast, and the energy provided by breakfast, lunch, and dinner should account for 25%~30%, 35%~40%, and 30%~35% of the total amount of the whole day, respectively. Obese children and adolescents are advised to eat vegetables first, then fish, poultry, eggs, beans, and finally cereals and potatoes.
When choosing snacks, children and adolescents should give preference to clean and hygienic foods with high micronutrient density, such as milk and dairy products, fresh vegetables and fruits, and plain nuts; combine nutrition labels to eat less overly processed foods that are high in oil, salt, and sugar, and provide no more than 10% of the total daily energy. Do not drink sugary drinks, drink plenty of clean and hygienic plain water, in small amounts and often. Try to eat at home, eat out and pay attention to a variety of foods, ensure the appropriate intake of fresh vegetables, whole grains and mixed beans, and control the intake of animal foods, fried foods, sweets and beverages.
Highlights:
1. In the process of weight loss in obese children and adolescents, it is recommended that dietary energy should be reduced by about 20% on the basis of the needs of normal weight children and adolescents.
The following is the recommended intake and energy requirement of various foods for children and adolescents of normal weight aged 2~17 years, and the energy can be appropriately reduced on this basis according to the situation
Of course, considering the actual situation of the child, for example, the original meal of 50 grams of meat, now suddenly changed to only 50 grams of meat a day, the child must not be very happy, including us adults suddenly from eating without scruples to eating to control the diet, it is difficult to get used to it all at once. Therefore, parents should study more, learn more about nutrition, pay attention to the diversification of food choices in the daily preparation of three meals, pay attention to the combination of meat and vegetables, thickness and color, and ensure the intake of fish, poultry, eggs, lean meat, milk and dairy products, soybeans and their products, whole grains and vegetables, while giving priority to foods with lower energy, higher micronutrient density and lower glycemic index. Eat less foods that are high in oil, salt and sugar and high in energy density.
You can refer to the table above to gradually replace restricted foods and unsuitable foods with preferred foods.
2. Three meals a day should be regular and quantitative, and the meal duration should be appropriate, about 20 minutes for breakfast, and about 30 minutes for lunch or dinner;
Normally, as long as the parents make a reasonable combination of three meals, we do not recommend that parents ration the food. However, children and adolescents have reached the level of obesity, and it is necessary to control the amount of food at each meal.
As long as the mix is reasonable, you can eat foods with a strong sense of satiety and low calories. At this point, parents should have a correct understanding, and do not immediately think of letting their children starve when they hear about controlling the amount of food, which is not the case.
Pay attention to the reasonable arrangement of three meals, and eat a good breakfast.
Why the emphasis on eating a good breakfast?
From the families of elementary school students we meet in our work, it is basically a good dinner and a simple breakfast. Breakfast is mostly porridge, soup or soy milk that can be reserved with a rice cooker or can be quickly cooked with pasta, fruits, and eggs
In primary school, morning time is often tight, parents don't want to get up early to cook, or don't cook well, such a breakfast combination is the most common. However, most children will choose to drink the soup first (they need to rehydrate after a night's sleep), eat the fruit (sweet and sour, delicious and watery), and then eat eggs and pasta. But at this time, the soup porridge and fruits have already been eaten, and they are not very hungry, and they feel full after not eating much pasta that provides energy. But because of the low energy density of this meal, children will quickly feel hungry in the morning and will not be able to meet the needs of learning and activities in the morning.
In addition, a hearty dinner or eating before going to bed, and not having too much exercise consumption at night, will also affect the appetite of the next morning, which is manifested as the child cannot eat at breakfast and does not feel hungry.
Therefore, it is very important to have a balanced breakfast and a reasonable combination. Breakfast supplements some nutrients, and also reduces the "guilt" psychology of parents when making dinner.
Below is a breakfast that our students made for their first and second grade elementary school students
Breakfast, lunch, and dinner should provide 25%~30%, 35%~40%, and 30%~35% of the total amount of the day, respectively.
3. Control the total energy intake of each meal, and try not to eat after 9 p.m.
It's easy to see why it's necessary to control total energy intake if you're going to lose weight. Try not to eat until you go to bed at night. This also reminds parents from the side to pay attention to the child's sleep time not too late. Sometimes when we feel hungry at night, it is not necessarily that we have not eaten enough dinner, but that we should have fallen asleep, and after falling asleep, the consumption of our body gradually decreases, and we do not feel hungry. But because of going to bed late, for example, when children write their homework late, their brains consume a lot of energy, and they may feel hungry and want to eat.
If you want to control the problem of eating at night, you can provide low-calorie foods such as milk and fruits between your child's homework, or brush your teeth in advance.
Finally, parents are reminded to pay attention to the impact that puberty may have on weight.
The onset of puberty is marked by a rapid increase in androgen in boys and estrogen in girls due to changes in the pituitary gland axis, which is characterized by a rapid increase in height and weight, as well as the appearance of secondary sex characteristics.
Normal-weight children and adolescents mature relatively late, and even if the level of energy and protein intake is high during puberty, it is more reflected in the development of lean body mass and high level of physical activity such as bones and muscles, and the possibility of obesity is very small. However, the disorder of neuroendocrine regulatory mechanisms in obese children and adolescents leads to early sexual maturity in puberty, which is now the "precocious puberty" that many parents are worried about. Increased levels of sex hormones during sexual maturity during puberty can exacerbate obesity. "Precocious puberty" is closely related to the early occurrence of metabolic syndrome.
Therefore, it is also recommended that parents go to the child growth and development department of the hospital to do some examinations in this area to rule out possible risks.
All in all, if parents want to help their children lose weight, they must first change their concepts, take action, and arrange three meals a day for their children.
I am Wan Dad, a nutritionist and nursery, I like to share the knowledge of baby food production and feeding, and the baby food for different ages has been filmed into videos and graphics, which are included in my public account "Wan Dad Parenting", including staple food, soup, baking, food therapy and a meal matching, etc., pay attention to me, no longer worry about what the baby eats!