Do you know? Open the door┋Even if your growth is slow, there are ways to continue to grow taller, so that you don’t have to worry about why they are taller than me?

Contributing expert: Li Caihong, Urumqi First People's Hospital, Chief Technician (Nutrition), Member of Chinese Nutrition Society, Member of Xinjiang Nutrition Society

Review expert: Zhang Yi, executive director of Xinjiang Nutrition Society, editor-in-chief of Xinjiang Center for Disease Control and Prevention, health science expert of Xinjiang Health Commission

Proper diet, food is good medicine - Growth retardation

Why is his child taller than mine? Growth retardation?

Whenever parents see their children are much shorter than their classmates, they can't help but wonder: "Why is my child short? How can I make him taller?" This is probably the thought of most of our parents.

Affected by factors such as genetics, diet, exercise, and sleep, each child's growth rate is different, but there is also a corresponding range of limits.

Growing slowly does not necessarily mean growth retardation, but if the height is below the corresponding threshold range, it is considered growth retardation. The determination of growth retardation in children and adolescents of different age groups is different. Parents can make a preliminary judgment on whether their children have growth retardation based on the following reference standards (Table 1).

There are many factors that contribute to the onset of growth retardation in children. Growth retardation reflects the long-term lack of protein or energy, vitamins, and minerals in the diet, and is a long-term malnutrition. This will in turn affect the physical and intellectual development of children and adolescents, resulting in decreased physical fitness and poor academic performance. In severe cases, they are more likely to suffer from diseases such as diarrhea and pneumonia, and increase the incidence and mortality of infectious diseases. In addition, it may also affect their height in adulthood, increase the risk of chronic diseases such as obesity, cardiovascular disease, and diabetes, and reduce labor productivity.

Is it possible to restore a child to normal height if he/she has growth retardation? Yes! Growth retardation is a disease that must be treated early. Comprehensive intervention can be made in terms of diet, exercise, sleep, etc. The earlier the intervention, the better the effect. Because a reasonable diet is a good medicine, to pay attention to children's health, we must start with the most basic and healthiest diet.

Therefore, don’t be afraid even if your growth is slow. It is important to do the following three points.

1. Scientific diet helps children grow up healthily

In order to promote the improvement of nutritional status of children and adolescents, further reduce the rate of stunting, and help children and adolescents develop healthy eating habits, the "Dietary Guidelines for Growth Stunting in Children and Adolescents (2023 Edition)" issued by the National Health Commission was officially released in early 2023.

The guidelines emphasize that the food choices of children and adolescents with growth retardation should be comprehensive, balanced, and diverse, ensuring three meals a day, regular meals, and regular diets. Diversified foods can better meet the needs of growth and development. It is recommended to consume an average of more than 12 kinds of food per day and more than 25 kinds of food per week. Therefore, on the basis of a balanced diet, you can appropriately increase the intake of foods rich in high-quality protein such as red lean meat, aquatic products, poultry, eggs, and soybeans, consume calcium-rich foods such as milk and dairy products every day, eat enough fresh vegetables and fruits, and increase iron-rich foods (such as animal liver, but no more than once a week, and no more than 50g at a time).

Recommended intake of various foods for children and adolescents aged 2-17 (see Table 2). For children aged 2-5, three meals and two snacks should be ensured every day: such as milk, fruits, eggs and nuts, with a small amount of soft pastries, 350-500ml of milk and 600-800ml of water per day. Children and adolescents aged 6-17 should arrange three meals reasonably, eat a good breakfast, and consume more than 300ml of liquid milk or equivalent amount of dairy products every day.

Examples of dietary supplements

Children are full of vitality and grow and develop rapidly. Once they fall ill, their positive energy is easily deficient and their negative energy is easily excessive. Under the advice of doctors or nutrition counselors, you can choose food and medicine substances that have the effects of strengthening the spleen, appetizing, eliminating stagnation, and benefiting the kidneys according to the specific conditions of children and adolescents. The dosage for children and adolescents in different regions and of different ages is not completely consistent. The severity of symptoms and the degree of growth and development will affect the dosage and frequency of the food and medicine prescription, and it should be adjusted according to the actual situation. (The following food and medicine prescription is taken as an example for 8-year-old school-age children with growth retardation - excerpted from the "Food and Medicine Guide for Children and Adolescents with Growth Retardation (2023 Edition)").

1. Hawthorn and malt digestion soup

Main ingredients: 5g hawthorn, 15g malt, 15g dried yam, 2g orange peel, 100g lean pork (or other lean meat such as beef and mutton).

Preparation method: Wash hawthorn, malt, dried yam and orange peel to remove dust and soak for 30 minutes. Wash the lean pork and cut into pieces. Put all the ingredients into the pot, add appropriate amount of water, boil over high heat, then change to medium-low heat and cook for another 30 minutes. Season and serve.

Dosage and Administration: Drink a small bowl of soup 30-60 minutes before meals, 2-3 times a week.

2. Lotus Seed and Coix Seed Porridge

Main ingredients: 15g dried lotus seeds, 15g dried water chestnuts, 15g coix seeds, and 25g japonica rice.

Preparation method: Remove the core of the dried lotus seeds and set aside. You can stir-fry the coix seeds slightly or directly buy stir-fried coix seeds. Soak the dried lotus seeds, dried coix seeds and stir-fried coix seeds for 30 minutes. Wash the polished rice, put all the ingredients into a pot, add appropriate amount of water, cook until done and then serve.

Dosage and Administration: Can replace part of staple food, 2-4 times a week.

(III) Walnut and Longan Porridge

Main ingredients: 5 walnut kernels, 5g dried longan, 5g alpinia oxyphylla kernel, 50g polished rice.

Preparation method: Shell the walnuts and keep the walnut kernels for later use. Rinse the dried longan and yizhi kernels, wash the polished rice, add appropriate amount of water, put all the ingredients in, cook until done and serve.

Dosage and Administration: Can replace part of staple food, 2-3 times a week.

Appropriate physical activity helps to increase height

Children and adolescents are the second peak period of growth and development for everyone. Reasonable and efficient exercise can bring many benefits to physical growth. Maintaining appropriate physical activity can enhance appetite, promote gastrointestinal motility, and improve digestive function; especially for children and adolescents in the critical period of growth and development, it can promote the growth and development of bones and muscles and help increase height.

Research conclusion: The peak period of height velocity is in the stage of children and adolescents aged 6-18 years old. Regular exercise during this period can effectively promote height growth. It is recommended that children and adolescents with growth retardation should do more moderate-intensity exercise, such as skipping, basketball, swimming and other sports. Combined with traditional fitness exercises such as Ba Duan Jin, Wu Qin Xi, and martial arts. The total physical activity time of children aged 2 to 5 years old should reach 3 hours a day, outdoor activities should be at least 2 hours, and the cumulative moderate-intensity activity time should be no less than 1 hour. Children and adolescents aged 6 to 17 years old should perform medium-to-high intensity physical activities for no less than 1 hour a day. For children and adolescents with growth retardation, there should be 3 days of exercise per week to strengthen muscle strength and/or bone health (such as tug-of-war, long jump, etc.). With the increase of age, the daily physical activity time can be appropriately extended. During school, you can also actively participate in collective sports organized by the school, such as skipping, playing with balls, jumping rubber bands, and various ball games.

The World Health Organization's scientific research report shows that children grow fastest from March to May each year, with an average height increase of 7.3 mm. Therefore, parents and school teachers should seize the "golden period" of children's growth during these three months each year and encourage children to participate in more physical exercise, keep their body and mind healthy, and promote their growth. At the same time, they should cultivate good sports habits.

On weekdays, we should reduce the time of sitting still. Children aged 2 to 5 should watch videos (TV, mobile phones and other electronic screens) for no more than 1 hour a day, and children and adolescents aged 6 to 17 should watch no more than 2 hours. The less the better. At the same time, we should advocate the combination of regular exercise and diet to promote the physical development of children and adolescents.

Sufficient sleep is beneficial to the secretion of growth hormone

Adequate sleep is an important guarantee for the growth and development of children and adolescents. Children and adolescents should develop good sleeping habits and ensure adequate sleep time.

It is generally not recommended to eat 3-4 hours before going to bed. Under normal circumstances, it takes about 3-4 hours for food to be completely decomposed and absorbed after entering the human digestive tract. Eating before going to bed will increase the burden on gastrointestinal function. "If the stomach is not in harmony, you will not be able to sleep well." Poor digestive function will affect sleep, which in turn affects the secretion of growth hormone and causes short stature. Therefore, it is not advisable to eat too much before going to bed, and try to finish dinner before 19:00-20:00.

Human growth hormone is secreted in pulses within 24 hours, and the peak time of secretion is at night, and the peak time is one hour after falling asleep. Because of this characteristic, we need to ensure enough sleep time when we need to grow taller! So encourage children to fall asleep after 21:00-22:00 in the evening. Because the two stages with the most growth hormone secretion are 21:00-01:00 and 5:00-7:00, so it is important to go to bed early and have a deep sleep.

Children aged 2 to 5 years old should sleep 10 to 13 hours a day, including a 1 to 2 hour nap; children aged 6 to 12 years old should sleep 9 to 12 hours a day, and children and adolescents aged 13 to 17 years old should sleep 8 to 10 hours a day.

References [1] General Office of the National Health Commission. Dietary Guidelines for Growth Retardation in Children and Adolescents (2023) [EB/OL]. (2023-02-01).

http://www.nhc.gov.cn/sps/s7887k/202301/0e55a01df50c47d9a4a43db026e3afc3.shtml.

[2] Mu Bingyan. Analysis of growth and development of 1 500 children and related influencing factors[D]. Changchun University of Chinese Medicine, 2022.

[3] Shi Chunfang, Chen Chao. Research progress on the effect of exercise on the height of children and adolescents [C] Chinese Society of Sports Science, Abstracts of the 12th National Sports Science Conference - Special Report (School Sports Branch), 2022: 812-814.

[4] Ma Ruizhe, Li Chengwu, Zhang Meng, Huang Ruohua. Research on the effects of spring sports on children's height growth[J]. Jilin Education, 2017(16):162-163.