Fat in Children's Diets: Friend or Foe?

This is the 5176th article of Da Yi Xiao Hu

With the popularity of fast food and snacks, obesity has become a "common occurrence" among children. "Is fat good or bad?" "Can fat children not eat anything oily?" "Will children gain weight easily after eating fatty foods?" These are questions that every parent of an obese child will ask. With these questions, let's first look at the dangers of childhood obesity. Data shows that in recent years, the incidence of childhood obesity has not only increased significantly but also shown a trend of younger age:

• In 2020, the increase in China's children's body mass index (BMI) has ranked among the highest in the world;
• According to the 2020 Chinese Residents’ Chronic Disease and Nutrition Report, the prevalence of obesity and overweight among children under 6 years old and aged 6-17 has increased to 10.4% and 19% respectively;
• As of 2019, the obesity rate among primary school students was as high as 23.6%, making them a key focus.

Childhood obesity can cause metabolic disorders, such as precocious puberty, non-alcoholic fatty liver disease, metabolic syndrome, hyperuricemia, diabetes and other metabolic disorders, and also increase the risk of metabolic diseases and cardiovascular and cerebrovascular events in adulthood. Dietary management has always been a key link in children's health management, among which fat is often regarded as the main culprit of childhood obesity. Today, let's talk about whether "fat" in children's diet is a friend or an enemy.

1. What are “good fats” and “bad fats”?

Fat is composed of 1 molecule of glycerol and 1 to 3 molecules of fatty acids.

Usually, we use the standards of "good fat" and "bad fat" to make judgments. "Good fat" refers to unsaturated fats such as olive oil, fish, peanuts, and melon seeds. These "good fats" are involved in human energy metabolism, cell signal transduction, etc., and play an important role in the intellectual development of infants and young children. "Bad fat" refers to saturated fat and trans fat, which are mainly found in fatty meat, animal oil, fried foods, desserts, etc. Among them, trans fat has almost no benefits and increases cardiovascular risks, obesity, and the development of diabetes.

2. What is the value of fat for children?

1. Fat is an important source of energy, and each gram of fat can provide about 9 kcal of energy. When the human body consumes too much fat and cannot be used, it will be stored; when the body needs it, the lipase in the fat cells will break down triglycerides into energy again.

2. Subcutaneous fat can also play a role in insulation and heat preservation, maintaining normal and constant body temperature, so thin people are more afraid of cold.

3. Dietary fat is an important source of fat-soluble vitamins (such as vitamins A, D, E, and K), which can be better absorbed in the intestines through fat.

4. Fat is also an important element in the formation of endocrine hormones and has a profound impact on the development of the nervous system and brain.

It can be seen that fat plays a vital role in the growth and development of children, especially preschoolers aged 1-3 years old. If they consume too little, it may affect the development of intelligence and sexual organs, and even cause a series of health problems, such as skin, nervous system and cardiovascular system. Therefore, we must not be afraid of "fat" and need to ensure a certain amount of fat intake every day.

3. How to manage children’s daily diet?

1. A balanced diet ensures the growth and development of children. The Dietary Guidelines for Chinese Residents (2022) recommends that each person consume more than 12 kinds of food per day and more than 25 kinds of food per week. When you are hungry between meals, give priority to foods with low energy density and strong satiety, such as dairy products, fresh fruits and vegetables.

2. Cultivate children's correct and reasonable eating habits, reduce fast food, dining out and ordering take-out; reduce high-fat, high-sodium, high-sugar or highly processed foods; do not eat too fast, it is recommended to control each meal to 20-30 minutes; avoid watching electronic products while eating.

3. Use cooking oil properly for cooking. It is not recommended to add cooking oil to babies under 6 months old; for babies aged 7-12 months, it is recommended that the daily intake of fat should not exceed 10g (about half a spoon to 1 spoon with a regular spoon), and for babies aged 13-23 months, it is recommended that the daily intake of fat should be 5-15g. The total amount of fat recommended for other age groups is shown in the table below.

4. Choose high-quality fat foods. Many foods in daily life may contain the fats and oils that children need for a day. For example, the minimum fat intake for babies aged 13-23 months is 5g. If you choose any of the foods in the picture below, you can meet the daily fat intake. If the complementary food for babies aged 7-9 months is mainly plant-based foods such as cereals, vegetables, and fruits, and the intake of meat and eggs is relatively small, an additional 5-10g of fat is needed. It is recommended to use vegetable oils rich in linolenic acid as the first choice, such as linseed oil, walnut oil, etc.

5. Control the intake of saturated fat and trans fat. For children and adolescents aged 4 to 18, the daily saturated fat intake should be controlled within 8% of the total energy, and trans fat should not exceed 2%. Take a 6-inch chiffon cake (sponge cake without cream) as an example. The ingredients require at least 30g of vegetable oil or butter, and up to 80g. Eating a 6-inch chiffon cake will far exceed the daily fat "quota".

6. Dietary management for children during the weight loss period requires an appropriate total amount of fat rather than excessive pursuit of low-fat or oil-free. It is necessary to reduce the intake of saturated fat and trans fat and increase the intake of unsaturated fat. The following picture is a red, yellow, and green light label for food choices for obese children for parents' reference.

7. Encourage children to engage in various forms of physical activities that are appropriate for their age and personal abilities. The intensity of physical activity is generally measured by metabolic equivalents. The method of defining metabolic equivalents is the ratio of the metabolic rate of a certain activity to the resting metabolic rate or basal metabolic rate, referred to as metabolic equivalents (Met). From sedentary behavior to high-intensity physical activity, we divide the intensity of physical activity into four levels based on the different metabolic equivalents of children. The "Guidelines for Physical Activity for Children and Adolescents in China" recommends that healthy children aged 6-17 years old should accumulate at least 60 minutes of moderate and high-intensity physical activity every day, mainly aerobic exercise, and that sedentary behavior should be limited to 2 hours per day.

4. Tips for managing children’s fat diet at home

Fat is an essential nutrient for the human body and one of the three major energy-producing nutrients. Parents and children are advised to remember the following tips for managing "fat" diet at home:

Children should eat the right amount of fat.

Don’t forget nuts and fish.

Eat less fried food.

Exercise and rest should be proper.

Author: Luo Wenyi, Chief Nurse of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine

Illustration: Yan Si-nian, a nursing graduate student at the School of Nursing, Shanghai Jiao Tong University