Don’t let obesity steal your child’s health

During the summer vacation, weight-loss summer camps for children and teenagers are very popular, and "little fat guys" gather together to lose weight. Studies have shown that overweight and obesity have become an "epidemic" worldwide. Among them, overweight and obesity among children and adolescents are global public health problems that cannot be ignored.

What are the dangers of being overweight and obese? How to help children manage a healthy weight? Our reporter interviewed Li Qian, the attending physician at Shunyi Women's and Children's Hospital of Beijing Children's Hospital.

Obesity is more harmful than imagined

"Doctor, how come my child is so young and has fatty liver and diabetes?"

Not long ago, Li Qian met a parent who brought his child to the clinic for treatment. The child's name was Liangliang (pseudonym), 13 years old. According to parents, Liangliang has been obese since she was a child. After entering puberty, her weight increased more significantly and she became less active. She often took time off from physical education classes, which made her parents very worried.

Li Qian's examination revealed that Liangliang's body mass index was very high, and she also had symptoms such as acanthosis nigricans and purple striae, indicating she was already obese. Further examination revealed that Liangliang also had symptoms of fatty liver and obese type 2 diabetes.

"We worked together with the nutrition clinic and the weight loss clinic to develop a personalized weight loss plan for Liangliang with dietary adjustments and exercise intervention. Liangliang's parents realized the seriousness of the problem and were very cooperative." Li Qian said that she returned to the clinic a month later. At that time, Liangliang had lost 2 kilograms in weight. “My blood sugar is well controlled. Although the fatty liver is still there, my liver function has basically returned to normal.”

"Many parents know that obesity in children is not good for their health, such as getting tired easily and making it difficult to participate in normal sports activities. In fact, obesity causes more health problems than we imagined." Li Qian said that multiple surveys and studies It shows that there are more than 200 co-existing diseases related to obesity; obesity in children and adolescents will not only affect physical development and increase the risk of advanced bone age and precocious puberty, but also increase the risk of premature chronic diseases such as obesity, cardiovascular and cerebrovascular diseases in adulthood; Obesity can cause various complications including diabetes and prediabetes, dyslipidemia, hypertension, non-alcoholic fatty liver disease, polycystic ovary syndrome, obstructive sleep apnea, etc. Overweight and obese children are more likely to suffer from low self-esteem and depression. , anxiety and other mental health issues.

"Some parents think that it is okay for children to be fat and they will lose weight when they grow up, but this is not the case. Management of healthy weight should start from early on." Li Qian said that women preparing for pregnancy should adjust their pre-pregnancy weight, increase their weight to an appropriate level during pregnancy, and prevent Fetal weight growth is too rapid to reduce the occurrence of macrosomia; after the child is born, breastfeeding is encouraged and complementary foods are added appropriately; during childhood, attention should be paid to a balanced diet, appropriate exercise, adequate sleep, regular physical examinations, assessment of overweight or obesity, and early detection of growth Deviate and intervene early.

How to tell if a child is obese? Li Qian introduced that it is recommended that infants and young children under 2 years old use the "length-by-weight" evaluation method as the judgment standard, that is, compared with other normal children of the same age, same gender, and same height, a child's weight is more than 85% higher than other normal children of the same height. Overweight, more than 97% are obese. For children over 2 years old, body mass index can be used as a criterion.

Body mass index (BMI) = weight/(height × height) (unit: kg/m2)

Li Qian introduced that children aged 2 to 5 years old can refer to the BMI reference cutoff points for overweight and obesity for Chinese children aged 2 to 5 years old formulated in the "Growth Curve of Body Mass Index for Children and Adolescents Aged 0 to 18 Years in China"; Children can refer to the "Screening of Overweight and Obesity in School-aged Children and Adolescents" for the gender and age-specific BMI reference cutoff points for screening overweight and obesity in school-age children aged 6-18 years; at the age of 18, the BMI of both men and women is 24kg/m2 and 28kg. /m2 is the cut-off point for overweight and obesity, which is in line with the Chinese adult overweight and obesity screening standards.

Cultivate children to be the first person responsible for their own health from an early age

"Children's routine health examinations are generally conducted at least four times during infancy, at 3, 6, 8, and 12 months of age; children aged 1 to 2 years old are examined at least once every six months, and children 3 years old and above are examined at least once a year." Li Qian said that parents can appropriately increase the frequency of health examinations based on their children's health status and family circumstances. "It is recommended that parents learn how to calculate BMI and use growth monitoring charts (tables) to monitor the growth trends of children's height, weight and BMI, especially for excessive weight growth." For children who are overweight or obese, a combination of home monitoring and institutional monitoring can be used, with weight and length (height) monitored every 1 to 3 months."

"Children's obesity intervention focuses on early prevention, starting from the formation of a healthy lifestyle, and training children to be the first person responsible for their own health from an early age." In Li Qian's view, children's obesity is ultimately related to "eating more and exercising more." It is related to the unhealthy lifestyle of "getting less". Overweight and obese children need to "keep their mouths open and open their legs" like adults to lose weight.

Children and adolescents are still in the growth and development period. How can they eat to ensure balanced nutrition, not affect their growth, and effectively control their weight?

"Diet control must be scientific, and you cannot blindly use starvation methods to lose weight. Three meals a day should achieve a balanced intake of protein, fat, and carbohydrates: protein accounts for 15% to 20% of the total calories throughout the day, and fat accounts for 25% to 20%. 30%, and carbohydrates account for 50% to 55% to ensure the growth and development of children and adolescents." Li Qian suggested that children who need to lose weight need to change their eating habits and slow down their eating speed; eat on time and regularly, avoid Skip breakfast and keep snacking during the day. In the daily diet, pay attention to the combination of thickness and thickness of staple food. Whole grains can account for 1/3 of the staple food intake; the combination of meat and vegetables, try to choose high-quality and high-protein meat; eat more vegetables with each meal to increase dietary fiber intake; try not to Eat foods high in oil, sugar and calories, reduce the intake of sugary foods and avoid sugary drinks, and do not drink alcohol; reduce the intake of high-fat, high-sodium processed foods; reduce the consumption of fast food, eating out and ordering takeaways; Pay attention to the cooking method of food, avoid eating fried food as much as possible, and choose steaming, boiling or stewing.

In terms of "spreading the legs", Li Qian suggested that children under 6 years old should engage in at least 180 minutes of physical activity every day, and encourage more outdoor activities (such as outdoor walking, playing, running, jumping, etc.), preferably distributed throughout the day, and more It is better), every static behavior time (such as operating mobile phones, computers, tablets, reading books, newspapers, TV, etc.) or restricted time (such as in strollers/strollers, high chairs, tied to the caregiver's back) above) no more than 1 hour. For children and adolescents aged 6 years and above, it is recommended to accumulate at least 60 minutes of moderate to high-intensity physical activity (such as brisk walking, cycling, running, playing ball, skipping rope, swimming, dancing, etc.) every day, and arrange at least 3 days a week to enhance muscle strength and Activities that strengthen bone health, each static behavior lasts no more than 1 hour, and the total screen time per day is less than 2 hours.

"It is recommended that children and adolescents do more stretching and bouncing exercises, such as playing basketball, skipping rope, swimming, jogging, squatting and jumping, etc., and appropriately carry out some strength exercises, which can promote the metabolism of epiphyseal cartilage throughout the body to be relatively strong. state, so that the whole body can grow and develop evenly." Li Qian said that children and adolescents should also ensure adequate sleep. Insufficient sleep may affect hormone secretion and aggravate obesity.

Don’t be too hasty to help your child lose weight.

"Generally speaking, the main causes of childhood obesity are excessive energy intake and lack of exercise, but genetic factors, cultural customs, living habits and environmental factors also have a certain impact on the occurrence of obesity." Li Qian said, for example, parents If you are overweight or obese, the probability of your children being obese will be greatly increased; the traditional concept is that being "fat" is a blessing, and some elderly people like to "feed their children"; with the improvement of living standards, a variety of snacks, sugary drinks, etc. Children have laid one "sweet trap" after another; some parents are worried that their children will not eat well at school and feed large amounts of food at dinner, causing their children to develop the bad habit of eating at night; some parents do not pay much attention to the nutritional matching of food. , causing children to have unbalanced nutrition; due to factors such as heavy academic burden and the popularity of electronic products, the phenomenon of insufficient physical activity among children and adolescents is widespread... These can easily lead to overweight and obesity in children and adolescents.

Data from the "Report on Nutrition and Chronic Disease Status of Chinese Residents (2020)" show that the overweight and obesity rate among domestic children and adolescents aged 6 to 17 years old reaches 19%, and the overweight and obesity rate among children under 6 years old is 10.4%. "This means that about 1 in 5 children and adolescents aged 6 to 17 are overweight or obese." Li Qian said, "Parents are the first person responsible for the prevention and control of childhood obesity, and the process of helping their children lose weight can be very good. It reflects the educational philosophy of parents.”

Many parents are worried after discovering that their children are overweight. Some will use Internet celebrity weight loss methods such as light fasting to try to make their children lose weight quickly, but the results often backfire. "Take Liangliang for example. At first, because he didn't have enough to eat or couldn't eat delicious food, Liangliang would quarrel with his parents in protest, which made the family restless." Li Qian said, later Liangliang's parents realized that losing weight It is not a matter for the child alone, but requires the mobilization of the whole family, so the whole family actively participates in it - what Liangliang eats is what the family eats, and the whole family also participates in Liangliang's exercise. "After persisting in this way for a while, not only Liangliang has achieved good results in losing weight, and her family has become thinner and healthier.”

"Scientific weight loss cannot be achieved overnight. Parents should not be impatient when helping their children lose weight, and should not let their children go on extreme diets or take weight-loss drugs." Li Qian reminded that extreme dietary restrictions can cause psychological depression in children, and sometimes It can also cause children's resistance to weight loss. "Teach children that pursuing a healthy weight is a long-term process. Reasonably adjust their diet, cooperate with scientific exercise, and persist a little bit every day, and the effect will slowly appear. This will not only help children lose weight, but also It helps children develop good habits and exercise their will.”