Did you know? Kaimen┋Children’s obesity: affecting height is just the tip of the iceberg

Written by: Li Yue, attending physician of the Department of Clinical Nutrition, First Affiliated Hospital of Xinjiang Medical University, registered dietitian in China

Reviewer: Li Li, President of Xinjiang Nutrition Society, Director of the Clinical Nutrition Department of the First Affiliated Hospital of Xinjiang Medical University, Chief Scientific Communication Expert of the Autonomous Region, Health Science Popularization Expert of the Autonomous Region Health Commission

The "Report on the Nutrition and Chronic Disease Status of Chinese Residents (2020)" shows that the overweight and obesity rate among children and adolescents aged 6 to 17 is close to 20%, and is expected to reach 28% in 2030. Weight problems are troubling more and more children and parents.

Parents all know that obesity affects their children's height, but this is only one of the many problems caused by obesity. Obesity can also affect bones and joints, sexual development, mental health, chronic diseases, academic performance and many other aspects.

Children's obesity is a health hazard warning! As parents, we must do something.

1. Come and calculate whether your child is overweight/obese?

Childhood obesity refers to excessive accumulation of body fat in children, resulting in a weight that exceeds the normal range for children of the same age. The commonly used measurement standard is the body mass index (BMI), which is calculated based on the child's age, gender and height.

Step 1: Calculate your child's BMI

Step 2: Substitute into the overweight and obesity screening cutoff table

For example, a 13-year-old boy is 1.50 meters tall and weighs 65 kilograms, so his BMI = 65 / (1.50 × 1.50) = 28.89. Substituting this into the BMI cutoff table, the boy's BMI is greater than 25.2, which means he is obese.

Second, we must first understand what type of obesity the child has?

Childhood obesity is divided into two types: primary obesity and secondary obesity.

Primary obesity is also called simple obesity, and 95% of childhood obesity is simple obesity. Simple obesity is caused by unhealthy lifestyles, excluding organic diseases, such as unreasonable diet, lack of exercise, too much video time, excessive mental stress, too much or too little sleep, etc.

Secondary obesity, also known as pathological obesity, accounts for only 5% of all obesity cases. It is usually caused by diseases or abnormalities in chromosomes, genes, endocrine system, central nervous system, etc., such as hypothyroidism, hypercortisolism, growth hormone deficiency, etc.

Therefore, before helping your child lose weight, you must first go to the hospital for a specialist examination to rule out secondary obesity, and then carry out symptomatic weight loss.

3. How harmful is obesity to children?

The impact of obesity on children is not just external changes in body shape and height, but is also accompanied by adverse effects on brain development, bone development, endocrine system, cardiovascular system, digestive system, sexual characteristics development, psychological behavior, etc.

It causes a variety of complications including diabetes and insulin resistance, dyslipidemia, hypertension, hyperuricemia, non-alcoholic fatty liver disease, precocious puberty in girls, abnormal external genital development in boys, polycystic ovary syndrome, asthma and obstructive sleep apnea, and leads to mental health problems in children such as inattention, decreased self-esteem, depression, and anxiety.

Moreover, childhood obesity can lead to an increase in the number of fat cells in the body, making it difficult to lose weight in adulthood. Studies have found that 88% of obese children may continue to be obese in adulthood.

4. What should I do if I have a fat child at home?

For children with simple obesity, lifestyle intervention is the preferred first-line treatment.

6 things your child needs to do

1. Eat a nutritious breakfast every day

Including three or more of the following categories: whole grains and potatoes, meat and eggs, milk and beans, fruits and vegetables.

2. Eat enough vegetables and fruits every day

The amount of vegetables (cooked) should be at least the size of two child's fists, and the amount of fruit should also be the size of two fists.

3. Slow down your eating speed and adjust the order of eating

Each meal should last 20-30 minutes.

When eating, it is recommended to eat vegetables first, then fish, poultry, meat, eggs and beans, and finally cereals and potatoes.

4. Avoid or limit sugary drinks

Including carbonated drinks, sports drinks, lactic acid drinks and fruit juices.

5. Limit the amount of time you watch videos each day

Encourage and support children and adolescents to limit screen time for non-learning purposes to one hour per day, and reduce other sedentary behaviors such as playing games.

Also, avoid watching TV or watching electronic products while eating.

6. Exercise for at least 1 hour every day

It is recommended to perform moderate to high intensity, whole-body aerobic exercise for 30-60 minutes every day (such as jogging, skating, swimming, etc.), ≥4 days a week, and duration ≥150 minutes; perform resistance training 3-4 times a week (such as pull-ups, sit-ups, high leg raises, etc.), and it is recommended to do it every other day.

5 things parents need to do

1. Try to avoid bringing unhealthy food home

For example, candy, chocolate, potato chips, biscuits, pastries, fried foods, etc. Avoid excessive intake of high-sugar, high-fat foods. You can use fruits, nuts, seaweed, low-sugar cheese, sugar-free yogurt, etc. as snacks.

2. Mobilize the whole family and adjust the eating and exercise habits of the whole family

Reduce your consumption of fast food, dining out and takeout.

Cook in portions, either a little or a lot, and avoid buying large packaged foods.

Parents should provide more opportunities for outdoor activities and actively participate in their children's sports.

Try not to eat after 10pm.

Parents who have obesity problems should set a good example and accompany their children to lose weight together.

3. Ensure your child gets enough sleep

It is recommended that school-age children aged 6-12 have 9-12 hours of sleep per day and teenagers aged 13-18 have 8-10 hours of sleep at night.

4. Monitor your weight every week and record it

A weighing scale is a must-have in your home, and it is best placed in front of a mirror.

Weigh yourself every week at the same time in the morning after emptying your stomach and recording your weight in a special notebook.

5. If losing weight makes your child feel difficult or anxious, he or she needs to seek help from professionals (nutritionists, psychologists, pediatricians)

Professionals will help children to relieve their psychological stress and develop their own diet and exercise plans.

Prefer low-calorie foods

【Meat】such as chicken breast, fish, shrimp, lean beef and mutton, etc.

[Vegetables] Such as cucumbers, tomatoes, bell peppers, mung bean sprouts, celery, cabbage, eggplant, etc.

【Fruits】Such as apples, kiwis, grapefruits, watermelons, strawberries, melons, mangoes, oranges, pears, etc.

[Coarse grains] such as corn, purple sweet potato, yam, buckwheat, oats, brown rice, barley, whole wheat, rye, etc.

I hope every child can overcome obesity and have a healthy and bright future.

References

[1] Freedman, DS et al., (2018). Tracking and Variability in Childhood Levels of BMI: The Bogalusa Heart Study. Obesity (Silver Spring, Md.), 26(7), 1197–1202.

[2] Expert Group on the Guidelines for the Assessment, Treatment and Prevention of Childhood Obesity in China, etc. "Guidelines for the Assessment, Treatment and Prevention of Childhood Obesity in China." Chinese Journal of Maternal and Child Health Research 32.12(2021):7.

[3] General Office of the National Health Commission. Dietary Guidelines for Children and Adolescents with Obesity (2024 Edition).