Excess weight in children: causes, consequences, methods of correction. Is your child overweight? Change your lifestyle

Our expert is the leading researcher of the laboratory for the study of the structure and planning of nutrition of the population of the State Research Institute of Nutrition of the Russian Academy of Medical Sciences, Doctor of Medical Sciences, Professor of the Department of Nutrition for Children and Adolescents of the RMAPE Arseniy Martinchik.

Step one:

Assess reality

First of all, it is necessary to understand whether the child is overweight and how much he needs to lose weight. For this, pediatricians use special tables.

These are average indicators of height and weight for boys, the weight of girls may differ by 0.5-1 kg down from the lower limit, height - by 1.5-2 cm down.

Weight is considered overweight if it is 5-10% above the norm. If it is higher than 20%, it is already obese.

Action plan

If it turns out that the child is overweight, you will have to change your lifestyle. And not only the child, but also their own, since children are guided by their parents, copy their habits, addictions, including gastronomic ones.

Step two:

Let's look in the fridge

Overweight children are prescribed a “soft” diet with a gradual decrease in the calorie content of foods. First of all, by reducing animal and vegetable fats. In the daily diet of a child, meat or fish, cottage cheese, seafood, and eggs must be present. Meat, poultry and fish should be lean and cooked boiled or baked. Carbohydrates and carbohydrate-fatty foods: sugar, cakes, soda, glazed curds, chips, fried potatoes, rich and puff buns - will have to be severely limited, but it is better to completely exclude for a while. Cereals, pasta durum and bread should be reduced to a minimum. And it is better to eat grain or bran bread without seeds and nuts.

Fat intake can also be reduced by choosing low-fat dairy products: 1% milk, 0-1.5% cottage cheese and yogurt, 10-15% sour cream, hard cheeses. A lot of fat is found in canned food, sausages, sausages, sausages and meatballs - so these products should be excluded from the children's diet.

Action plan

1. Keep a "Food Diary", where you will enter everything that your child, you and your family members eat during the day. Include in this list and light snacks, and tea with sweets, and a glass of milk at night - absolutely everything.

2. Visit a pediatric dietitian who will monitor the child's weight and health.

3. Teach your child (and yourself) to eat 4 small meals a day at fixed times. Take your time, eat more slowly - then the feeling of satiety will come earlier.

4. Breakfast and lunch should be more plentiful than dinner. A hearty breakfast is very important for a baby - he will be calm, cheerful, will not ask for sweets. Offer fruit for dessert.

5. Never force a child to eat if he does not want to. In no case do not punish for half-eaten soup.

6. Remove the TV from the dining room or kitchen and do not allow family meals while watching a movie or reading a book - in such a situation, a person is distracted from eating and, as a result, does not notice that he is overeating.

7. When buying products, read the labels carefully. And do not take your child to the store if he is hungry.

8. Start a tradition of drinking a glass of water before meals, and start your meal with a light soup or vegetable salad.

Step three:

Life on the move

“The educational program provides for two compulsory physical education lessons per week. But two hours a week is nothing! The child must run for an hour every day,” says Dr. Martinczyk. But even from these two lessons, the guys are in a hurry to evade: either they bring a certificate of release, or they simply shirk. Yes, and what fun - jump through the "goat" or wind circles around the school. Last year, the federal target program "Development of physical culture and sports in the Russian Federation for 2006-2015" began to operate, which should radically change the content of physical education lessons. It is planned to create several different sports clubs and sections in each school so that students can choose an activity to their liking. Well, instead of boring races, it was decided to teach aerobics to girls, and martial arts to boys. But so far, in most Russian schools, physical education lessons are conducted in the old fashioned way.

Action plan

1. Try to free up at least an hour in your schedule for a walk together. Walk from home to school and teach your child. If the baby wants to run and jump, you don’t need to pull him up, like some mothers who require the child to “behave decently”, meaning by this measured walking.

2. Find out which sports clubs are located in your area and enroll your child there. Swimming is considered the most useful for weight loss. By the way, the whole family can go to the pool.

3. At home, install a children's ladder with a horizontal bar so that the child can climb and pull himself up in the morning. If the apartment has a free corner, do not be stingy and buy an exercise bike - so the child can arrange bike rides even in bad weather.

4. Try to spend your holidays with your children and actively - in sports and health resorts, hiking, horseback riding, kayaking or cycling.

Step four:

We do not look at the "box"

Experts urge to limit TV viewing for children to two hours a day. This is maximum. And only for older children. And for babies under 2 years old, the American Academy of Pediatrics does not recommend watching TV at all. “Children who from an early age are accustomed to spending a lot of time at the “blue screen” are often overweight. The child's element is movement. You can't make a 4 year old lie on the couch for an hour. But a child can sit in front of the TV all day, thereby causing enormous damage to his health, ”says Dr. Martinczyk.

Action plan

First you need to remove the TV and computer from the nursery. Put all the necessary equipment in your room - it will be easier to control the child. Then set a time limit beyond which the son or daughter must not go. If you are afraid that in your absence the child will watch not the best films, program the TV to show only certain channels.

In the modern world, the problem of excess weight in children is not uncommon. Many parents ask themselves: how to lose weight for a child of 10 years old? After all, the fight against extra pounds in boys and girls must be taken seriously so as not to harm the growing body.

Causes of childhood obesity

To help your child lose weight, it is important to understand what caused the weight gain. The most common are:

• lack of physical activity;
• incorrectly composed diet;
• the predominance of fat-containing foods in the daily menu;
• hormonal disorders in the body.

Modern technology allows our children to lead a sedentary lifestyle. This is especially noticeable in the cold season, when a 10-year-old child spends his evenings not on the street, but sitting at a computer or watching TV. Such a pastime, of course, will not benefit a growing body, therefore it is the main problem that prevents you from losing weight.

In second place, you can put the addiction of children to fast food, carbonated drinks, all kinds of chips, crackers and fast food. In order for the child to lose weight, it is important to ensure that he and the dishes are cooked at home. In two or three weeks, he himself will give preference to healthy food.

Before choosing a method that will help you lose weight, you need to seek help from a specialist. Only a competent nutritionist will tell you how to lose weight at the age of 10 without harm to health, since being overweight can be a sign of some kind of disease that only a doctor can identify.

How to quickly lose weight without harm to health

Before compiling a diet, you need to figure out how to quickly lose weight for a 10-year-old child without harm to health. Rigid diets at this age are strictly prohibited. Therefore, you should choose a balanced and healthy menu and age-appropriate physical exercises. In order to lose weight, the child must be moving.

A child's body that is not accustomed to physical activity will quickly get tired. For this reason, it is best to choose dancing, cycling or swimming. The training regimen must be developed with a professional trainer.

It is impossible to reduce the number of meals on the menu of boys and girls. Therefore, nutritionists recommend reducing the amount of servings. If you follow the advice of doctors, then the daily norm of products will be distributed as follows:

• breakfast - 25%;
• afternoon snack - 10%;
• lunch - 45%
• dinner - 20%

Each meal should be complete and balanced, otherwise by the end of the day the child will want to eat more food than necessary.

How to lose weight in 10 years for boys and girls without dieting

Regardless of the gender of the child, it is not worth subjecting him to a strict restriction in foods and diets. The best solution to the question of how to lose weight without harm at 10 years old is to change the lifestyle of the whole family. To do this, you will need to review:

• diet;
• physical activity of all family members;
• psychological home environment.

A growing 10-year-old child's body must necessarily receive the necessary norm, nutrients, minerals, vitamins. For this reason, various diets are not suitable, it is worth giving preference to proper nutrition.

Food should be steamed or stewed. Fried foods should be completely excluded from the diet, replacing them with baked ones, since they have a much lower level of fat. In order for the child to lose weight, you need to include fresh vegetable salads, fruits and greens in his diet.

Best for breakfast:

• egg white;
• bread;
• milk;
• cottage cheese;
• vegetables.

A child who is losing weight needs to put a snack in a school backpack. It can be various fruits or a cheese sandwich. Sauces, ketchups and mayonnaises will have to be excluded from the children's menu, replacing them with homemade dressings made from natural yogurt or low-fat sour cream. The same rule applies to sausages. If the family adheres to the proposed nutrition system, in two months the question of how to lose weight safely for a 10-year-old child will not bother parents.

In addition to diet, it is important to set aside time for exercise. A 10-year-old boy can be given in, and dancing, aerobics or Pilates are perfect for a girl.

The support of family and friends is very important for the child at this time.

It is possible that he will not show much interest in losing weight, but parents do not need to despair and give up everything halfway.

If you make the necessary efforts, setting the child in the right mood, then the first results will become noticeable in two to three weeks. It is worth drawing the attention of the child to the fact that losing weight has a positive effect on his appearance. This will motivate you to move on.

Be sure to be an example for your child and try to lose weight with him. If possible, exercise together. This will definitely have a positive impact not only on the appearance, but also on the relationship between parents and children.

In addition, you need to keep a diary of food and weight control. Every day, write down with your child everything that was eaten during the day. Once every two weeks, data on weight and volumes are entered into the diary. Recorded progress will inspire further weight loss.

Girls are more sensitive to the problem of excess weight. At the age of 10, the child's body goes through puberty, which leads to the growth of the hormone estrogen, which contributes to the accumulation of fatty tissues. Losing weight at this time is quite difficult. To resolve the issue, it is best to contact a specialist. He will develop the optimal menu and give the necessary recommendations.

Parents should provide maximum psychological support. It is worth explaining to your child that the figure will acquire its final shape only by the age of 20. You can’t point out to a girl that she’s overweight, put her on a diet, and especially set an example for other teenagers who have bypassed this problem. This will harm the unstable children's psyche, and will not at all become an incentive that will encourage you to lose weight. The girl may develop feelings of inferiority and self-loathing.

What Not to Do

Some parents, helping their child to lose weight quickly, resort to methods that are not able to help get rid of excess weight. Radical measures can only harm a growing organism. These include:

1. Exhausting workouts. Of course, it is necessary to try to increase the physical activity of the child, but you should not get too carried away with sports activities. Excessive loads have a negative impact on the physical and mental state of the child, and do not help to lose weight. A child's body exhausted by sports does not give a 10-year-old teenager the opportunity to fully engage in mental work, which affects academic performance.
2. Strict diets and fasting. An actively growing body of a child at the age of 10 needs a sufficient amount of nutrients. Deficiency of trace elements, vitamins and other necessary components of the diet can cause a delay in the physical and mental development of the child.
3. Preparations for weight loss. Any formulations that help to lose weight can cause irreparable harm to the health of the child. Even herbal teas to cleanse the body disrupt the gastrointestinal tract, leading to dysbacteriosis.

When choosing the best and safest ways to help boys and girls of 10 years old lose weight, it is important to understand that it is often enough to increase physical activity in the fight against overweight. In addition, the right homemade food will help you quickly get rid of excess weight.

In order to understand how urgent the problem of childhood obesity is today, it is enough just to go out into the street, walk through playgrounds or parks. Surely you have noticed that almost half of the children have one or another degree of completeness.

Note the increase in overweight children and pediatricians. But parents, unfortunately, do not always pay attention to this aspect of the development of their child. What is the reason for such negligence?

There are several reasons, as always. These are chubby babies in advertising and films, and the eternal certainty that if a child eats well, then he is healthy. Do not forget about such a phenomenon as natural children's fullness. This condition is typical for children aged about 9 months. At this time, the fatty layer begins to actively form.

However, this does not mean that you can ignore the overweight of your child during this period. In addition, you should not mentally stretch the period of natural childhood fullness. If after the child begins to actively walk, the extra weight does not disappear, then it's time to sound the alarm.

To begin with, it is worth understanding what are the causes of excess weight in children. As always, it is impossible to single out one thing. Every child has their own problems and their own solutions.

Usually, in children, as in adults, obesity develops due to chronic overeating . The law of conservation of energy also applies here: if you eat more than is consumed per day, you will inevitably encounter excess weight.

In second place, of course, low mobility . Typically, both of these factors are present. Today, fatty foods, fast food, and various sweets have gained immense popularity. All this can be purchased literally at every step. Even the parents themselves sometimes, saving time, feed the child junk food. At the same time, modern children are more and more resting in front of a TV or computer. Naturally, an imbalance occurs in the body, which instantly affects the weight of the child.

Here it can also be noted social factor . Children copy their parents in everything, and if adults eat high-calorie foods, children are likely to prefer the same foods. Often a child is devoutly fed, believing that he should eat exactly as much and not a crumb less. Usually grandmothers are prone to such behavior, especially if their childhood was not the post-war years.

Such a feeding system violates one of the most important precepts of a healthy diet - to eat exactly as much as you need to saturate. It is better to leave part of the serving on the plate and eat it later than to choke and eat everything, just to leave nothing.

However, one cannot discount the hereditary factors . If one of the parents of the child is obese, then in half the cases the child himself is faced with this problem. If obesity is observed in both parents, the risk increases even more. In the case of hereditary obesity, more attention should be paid to prevention, rather than waiting for the problem to occur.

Strange as it may sound to many, but psychological aspects can affect the child's overweight. Children, like their parents, can “eat” some of their sorrows, worries and stresses.

In some cases, although quite rarely, the cause of obesity is various diseases . Despite the fact that this is far from the most common cause of extra pounds, you should not forget about it.

What is the danger of obesity in children?

It is important to understand that being overweight in children is much more dangerous than the same problem in an adult. After all, the child's body grows, changes, forms. Many systems in it are not yet fully functional, but are only learning to perform their tasks.

The first to suffer, as it is not difficult to understand, spine. It is on him that the overtime load suddenly falls. But at preschool age, the rapid formation of the skeleton is still going on, the bones are actively growing, and the child is also growing. It is at this stage that posture is formed, and excess weight, coupled with low mobility, can disrupt it even at this stage, which is fraught with various diseases of the spine.

The load on the circulatory system also increases, in connection with this, in children who have been overweight since infancy, by adolescence such traditionally occur age-related diseases like hypertension, heart failure, ischemia, increases the risk of heart attack.

The pancreas also cannot cope with excess nutrients, which causes a violation of glucose metabolism, and this can lead to the development of diabetes.

should not be overlooked and psychological problems. Overweight children are often teased by their peers, which is why they develop complexes, they become insecure. And these complexes accompany such children for the rest of their lives, even if the child's overweight problems can be solved.

Is there any reason for concern?

However, after reading all this, you should not immediately put the child on a diet. Firstly, "adult" diets in the case of a child, especially an infant, are not only ineffective, but also dangerous to health. Secondly, the development of a child is a very individual concept, and before taking any measures, you need to make sure that the problem really exists.

If you think that your child is overweight, you should first try to determine whether this is so on your own. In particular, special tables of weight norms depending on age and height can help with this. Please note that you need to evaluate the situation on all three parameters.

So, if the child weighs too much for his age, do not forget to pay attention to his height. If the growth is also above the norm, then everything is in order. You just encountered a particular version of the norm.

The parameters in infants vary especially greatly. First of all, because they have a different start and a large, in comparison with the total weight, the initial difference in height and weight. Some children weigh less than 3 kg, others more than 4. During this period, not the weight itself is much more important, but the weight gain per month. This information can also be seen in the table:

It is important to keep in mind that formula-fed babies almost always gain weight faster than their breastfed peers. Assessing the weight of your child, this point must also be taken into account.

Another way to determine if a child is overweight is to calculate the body mass index. Please note that this calculation makes sense only after the age of two. This is done quite simply: BMI is equal to body weight in kg divided by cm squared. The resulting value should be compared with the table. It shows the values ​​for overweight and for obesity.

If the resulting number is less than the BMI with overweight, then everything is in order in your case, if it is equal or more, then the problem is there. If the BMI value has reached the obesity mark, then the problem in the child is very serious.

Regardless of which method you used, if there is a suspicion that your child is overweight, you do not need to immediately rush to solve the problem, limit the child in food and drive to classes. First you need to contact the pediatrician. He will confirm or refute your fears, and also determine the cause of overweight.

Only then will it be possible to find an adequate solution to the problem. So, if the cause of excess weight in children is a particular disease, food restrictions and any physical activity may be ineffective, and in some cases even dangerous. In this case, you must first identify and cure the disease - the cause.

If everything is more prosaic, and the reason lies in overeating, then you can start the fight against excess weight.

How to deal with overweight in infants?

Excess weight in a breastfed baby is extremely rare. When the baby feeds on mother's milk, he, together with the parent's body, regulates the amount of milk he drinks. This makes overeating almost impossible.

But with artificial feeding, everything is somewhat more complicated. Determining when a child is full at this age is still difficult. It is necessary to draw up a clear feeding schedule, strictly follow the recommendations for the amount of mixture and the volume of water.

Sometimes you can hear the opinion that it is better for artificers to introduce complementary foods as early as possible. In fact, it's not necessary at all. But if you decide to introduce complementary foods to a formula-fed child, then keep in mind that you need to start with vegetable purees. They are the least caloric, and will not contribute to weight gain.

Often vegetable purees are made on the basis of potatoes. Pay attention to this, potatoes should be no more than 50% of the serving. Ideally, make your own puree at home, so you can definitely be sure of the purity of the products and their ratio.

The next item in complementary foods will be cereals with skim milk. Give preference to buckwheat or oatmeal, but it is better to refuse semolina. In addition, porridge can be given only once a day, preferably in the morning. If there is a need to sweeten porridge, it is better to do this with berries and fruits, without adding sugar.

How to deal with excess weight in a preschooler?

With older children, the situation is somewhat more complicated. When a child moves to a common table with his parents, it becomes more difficult to control his diet. The child sees what his parents eat and tries to eat the same.

Another aspect that often interferes with the process of losing weight is food in the kindergarten. There, parents cannot control the child's menu. First of all, you need to talk to the staff and find out what they feed the children in general. Then ask the teachers to cut portions, if necessary, do not give supplements, remove especially high-calorie foods, of course, if possible.

However, the main difficulties still await you at home. The fact is that the whole family will have to rebuild their diet, get used to a healthy diet. It is impossible to explain to a child why everyone will eat dumplings with sour cream or a sweet cake, and he will eat steamed vegetables. He will perceive this as a punishment, as a manifestation of some kind of injustice.

Therefore, everyone will have to come to terms with changes in the menu. However, this is not at all bad, because such a diet is healthy and suitable for people of any age. The nutrition of your family should be balanced, proteins, fats and carbohydrates should be present in the right proportions. As a rule, this ratio is called: 1:1:4, where the last digit refers to carbohydrates - the main source of energy and fiber. The main thing to remember is that these should be complex carbohydrates, not sweets and starchy foods.

Abundance on your menu vegetables and cereals it is also necessary because fiber helps to restore impaired metabolism, and also, like a real brush, cleans the intestines and helps to remove toxins accumulated in it. All this normalizes the functioning of the gastrointestinal tract, relieves various digestive problems, including constipation, which are not at all rare in overweight children.

However, meat fish, dairy products and fats should also be present. The child's body needs proteins without fail, as it is constantly growing, and it needs building material for cells.

However, it is better to give preference to dietary meat, not fatty. It can be poultry, veal, lean beef. As for cooking methods, it is better to abandon frying and smoking completely, and stop at boiled meat and steamed meat.

By the way, the same applies to vegetable dishes. There is also no need to saturate them with oil during frying, this significantly increases the calorie content of dishes, and apparently, no visible harmful substances in heated oil.

Concerning dairy products, then you should give preference to skim milk, kefir and sour cream. Also, do not get carried away with various yoghurts with additives. It is better to use natural products, without preservatives. Kefir and yogurt can be made at home based on a special starter culture. Buying it today is not a problem. You should not refuse cheese, but it must be served in limited quantities.

Fats should be predominantly vegetable, and the child will receive a sufficient amount of animals from milk. Sunflower or olive oil can be seasoned with vegetable salads.

Another little tip: buy for a child separate dishes, smaller than yours. In a small plate, even a truncated portion will seem quite sufficient, and a small spoon will have to scoop food from the plate more often. A large number of movements will help to deceive the body, and the feeling of fullness will come earlier.

For this, it is necessary to organize a calm atmosphere for the child during meals. It is better to turn off the TV, radio, you should not occupy the baby with conversations. Yes, and at this time it is better to be silent. This will allow him to fully focus on food and his feelings.

An integral part of the weight loss process should be physical exercise. The child can be given to the sports section, start walking with him in the evenings, sign up for the pool. But here it must also be borne in mind that if you continue to spend time sitting, your child is unlikely to be inflamed with a desire to make any effort.

What can not be done?

When parents are faced with the problem of obesity in a child, there is a great temptation to start blaming someone, arrange terror or concentrate all their energies on achieving a result. However, it is very important to understand what can and cannot be done. So, in itself, the search for the guilty will not lead to anything. No need to blame a kindergarten with an unbalanced diet, a grandmother with her pies, a child with his immoderate appetite, or yourself. The most important thing in this situation is to recognize the problem and the cause and deal with them without undue reproach.

As mentioned above, simply forbidding a child to eat certain foods will not work. At preschool age, such measures are perceived very painfully. You should not make goodies a coveted prize received for some kind of achievement. In this case, the child can make a cult out of food, and this is unlikely to have a positive effect on the process.

Separate conversation - physical activity. You can't solve anything by force either. It is better to try to make morning exercises a fun game, and practice with your baby. This will not only help instill a good habit in him, but will also give you the opportunity to communicate more and better with your child.

As for the choice of sections ... Again, there is a great temptation to choose those where the greatest loads go, but you need to give the child a choice. Classes should not be held under pressure. Let it be a calmer and less energy-intensive sport, but the child will like it, and, as a result, he himself will give all the best in the classroom.

As you know, a specific goal in front of your eyes is the best motivation. However, the goal must be achievable. There is no need to demand everything from the child at once. Start small. First, accustom him to daily exercises, only then proceed to the selection of the section. In food, follow the same principle.

And one more thing: do not concentrate on the problem yourself and focus the attention of the child on it. He should not feel flawed, this adversely affects both the process and the child's psyche. Let it be a game, fun and relaxed.

Prevention of childhood obesity

Of course, prevention is always better than a hasty solution to a problem that has already arisen. Actually, for the purpose of prevention, you can and should do about the same thing that is required for weight loss. That is, morning exercises, sports, mobility, proper nutrition.

Of course, if there is no excess weight yet, prohibitions and restrictions can be much less strict. In any case, the child does not have to be strictly controlled, for example, at the festive table. One piece of cake or a serving of salad with mayonnaise is unlikely to hurt him.

The advantage of prevention is not only that it allows you not to face the problem of excess weight in children, but also that the child will get used to a healthy lifestyle from childhood, which means he will avoid many other problems.

Overweight child. School of Dr. Komarovsky (video)

Nutrition for an overweight child (video)

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The age range from 7 years to 12 (14.5 years) is such an indefinite period, this is prepuberty (the time before puberty). Minimum age of onset of puberty 8 (8.5 years), latest onset 14.5 years
(more often in boys). It is during this period that gender differences appear in the dynamics of weight gain.

Girls gain weight faster and more than boys, which is associated with an earlier onset of puberty. In general, it is during this period that parents mark the debut of obesity, more often the age is called - 8 years. Apparently, it was during this period that the “wrong eating habits” laid down earlier begin to be clearly realized, “stimulated” by the beginning of the synthesis of sex hormones and the increased pubertal concentration of insulin, a hormone that helps to absorb glucose.

There is a lot of insulin, both as a result of the "sexual surge" and as a result of overfeeding. It turns out a vicious circle: more insulin - more glucose is absorbed, more glucose - more insulin is produced. It is clear how to break this cycle - reduce your intake of "light" carbohydrates. In all other respects, this age period is intermediate and nothing more remarkable.

An important point about obesity during this period: if an obese girl enters puberty, obesity will cause her to disrupt the formation of the hormonal system, if a boy enters puberty, obesity (unless it is grade 4 obesity) will not lead to a significant disruption of puberty .

Testosterone, in this case, is the magic hormone. It, together with growth hormone (and in boys during puberty it is produced much more than in girls), create a good metabolism for “melting fats”. For girls, the opposite is true. The female hormone - estradiol several times faster promotes the assimilation of the chain of fatty acids and their deposition in fat depots.

During this period, it is important to start accustoming the child to regular sports! to discipline, to self-discipline. It is always important if before the eyes of the child there is an example of an adult. It is important for girls to learn plasticity - dancing, gymnastics. Boys are just discipline, so the sport is not important. The main thing is movement, 3-5 times a week, at least 30 minutes a day.

Now about nutrition. I give an example of a CK1 diet for a given age and a set of allowed foods. It is not difficult to see that this diet "resonates" with the Pevsner 8 diet in adults.

It is necessary to exclude: rich broths, smoked meats, spicy and salty snacks, fatty meats and fish, sausages, sausages, fruit juices, soda, chips, crackers, coffee, daily use of sweets, products with xylitol, sorbitol, cakes, pastries, nuts, seeds, mayonnaise , ketchup and other sauces.

Restrict: butter up to 2 tsp, olive and vegetable oil up to 1 tbsp, soups in 2 broths (do not fry vegetables in soup), potatoes, rice, pasta, potatoes (boiled / mashed) up to 6-7 tbsp. l. in boiled form - these are foods that are eaten only for lunch, eggs in 2-3 days in the form of an omelet, bread 2-3 pieces a day (not bourget, not whole grain, mostly rye), legumes 2 times a week, fruits up to 3 pieces per day (bananas after 2-3 days, grapes are limited), refined sugar 1 piece in tea, 2-3 times a day, marmalade on natural juice - 1 piece or marshmallows 1 piece, (as an exception), cookies 2 PCS. type "Maria", jam and jam no more than 1-2 tsp.

Allowed: vegetables, vegetable soups, low-fat meat and fish (in the form of meatballs, cutlets), stewed, mainly rabbit, beef, turkey, perch, cod (cutlets), cottage cheese up to 5% fat content (in the morning - natural, in the evening - casserole or cheesecakes ), low-fat cheese, cereals up to 6 tbsp. boiled (except for semolina, rarely wheat), milk, kefir, yogurt up to 2-3 glasses a day.

Eating fractionally up to 5-6 times a day.

Sample menu for a child at this age:
Morning: any milk porridge 6-7 tablespoons, boiled meat (or cutlet), bread, slightly sweet tea 200 ml.

2 breakfast: yogurt 200 ml.

Lunch: vegetable salad 100-150 gr, soup or cabbage soup 200 ml, boiled chicken 100 gr, boiled potatoes 100 gr, dried fruit compote 200 ml, rye bread 60 gr.

Snack: cottage cheese 150 gr, dry rye bread 1 pc., compote, or tea, or vegetable juice 200 ml.

Dinner: steam meat cutlet, boiled cauliflower 200 gr, wheat bread 1 slice, tea 200 ml.

At night: kefir 150 ml.

Naturally, with different degrees of obesity, the caloric content of the diet is recalculated individually, at this age there are still no gender differences.

During this period, with obesity of 3-4 degrees, you can put into practice fasting days- the child's body is already ready for this. The bottom line is to reduce the caloric content of the diet to 1000 kcal per day 1 time per week. They usually start with “protein” fasting days - cottage cheese, meat or dairy, then switch to fruit or vegetable fasting days, it is good to use double fasting days: 1 day - protein, 2 days - carbohydrate. Water is not limited these days.

One of the main factors in the treatment of obesity is appetite suppression through the consumption of large volume, but low-calorie, predominantly protein monotonous food!

After the completion of the subcalorie diet stage, when the required weight is reached, there is a transition to maintenance diet with the gradual introduction of "forbidden foods", you can continue the practice of fasting days.

From the age of 9 years, to lose weight in a child with a high degree of obesity, pathological hyperinsulinism, medications can be administered. But this issue is decided only by a doctor or a council of doctors!

In the age periods of 0-1, 1-7, 7-14.5, we are not talking about weight loss, and it is important to understand this, but about the suspension of its set (growth continues, the weight is “worth”), but in the fourth age period - puberty Let's talk about weight loss.

WHAT NOT TO DO WITH OBESITY IN CHILDREN(psychological motivation):

Do not tell your child that he is "greedy" or "lazy". Tell him that you understand how difficult it is to make good ("healthy") food choices.
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Don't make your child feel guilty about his eating habits. Praise him when you see that he is eating right.
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Do not tell your child that he is not helping himself. Ask your child how you can help him eat well.
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Do not scare your child with weight loss. Tell him what will be good when he is less heavy.
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Don't complain about your weight or how "boring" dieting is. Set a good example and do everything you expect your child to do.
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Do not give a negative assessment to other people (friends, relatives, celebrities) who are overweight. Notice all the beauty in your child: his eyes, his hair, his good deeds, choice of clothes, etc.
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It is not necessary to make it clear to the child that he will be happy only at a normal weight. Talk to your child about the positive effects of working on your weight.
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Don't tell your child that being overweight is their fault. Explain that some people find it more difficult to control their weight than others - life can be unfair, but maybe they are lucky in other things!

I also want to talk about such an interesting topic as scales. Tanita with fat analyzers, water in the body. If they are at least somehow adapted to adults, then they “do not work” for children, because the WHO (World Health Organization) has not yet fully developed the permissible levels of fat / water content in the body of children of different ages. Therefore, it will not be possible to independently control these parameters, no matter how sad it is.

To be continued…… in the next part I will talk about being overweight already by separating the obesity of girls and obesity of boys at puberty.

Doctors never tire of repeating that obesity is a real war, where there is only one enemy, but at the same time countless victims. This problem of modernity is exacerbated by the fact that children are on the “battlefield”.

According to statistics, in the United States, every second child is overweight, and one in five is obese. In Western European countries, these figures are smaller, but they are steadily growing. The disease is already beyond the scope of hereditary predisposition. Increasingly, physical inactivity and the abuse of fast foods and trans fats are among the main reasons.

The reasons

Like adults, obesity in children is difficult to treat. In order for the therapy to be successful, it is first necessary to find out the causes of the disease. To do this, doctors collect an anamnesis and conduct all kinds of laboratory tests.

The most common causes of overweight include:

• excess intake of calories;
• hypodynamia;
• hereditary predisposition;
• metabolic disease;
• tumor of the hypothalamus, hemoblastosis, skull trauma;
• neuroendocrine diseases: hypercortisolism, hypothyroidism;
• lack of sleep;
• lack of daily routine;
• long-term use of glucocorticoids, antidepressants;
• gene mutations;
• chromosomal and other genetic syndromes: Prader-Willi, Ahlstrom, Cohen, fragile X-chromosome, Down, pseudohypoparathyroidism.

All these risk factors need to be identified in a timely manner in order to begin the necessary treatment. Unfortunately, parents often delay until the last degree, until obesity of the first degree turns into the third with all the complications and consequences for life and health.

Symptoms

The clinical picture of the disease is closely related to the age characteristics of the child. So at certain stages of his life, the symptoms may be different. As a rule, the signs of obesity develop progressively, i.e., they appear brighter with each stage.

Preschool age:

• overweight;
• severe allergic reactions;
• dysbacteriosis;
• constipation.

Junior school age:

• overweight;
• excessive sweating;
• shortness of breath when walking and physical exertion;
• deformation of the figure due to the appearance of fat folds in the abdomen, hips, buttocks, arms and shoulders;
• high blood pressure.

Adolescence:

• pronounced symptoms described above;
• fast fatiguability;
• violation of the menstrual cycle in girls;
• dizziness, frequent and severe headaches;
• swelling of the limbs;
• aching pain in the joints;
• depressive, depressed state;
• conscious isolation from peers.

In adolescence, the disease reaches a new level, covering not only the physiology, but also the psychological state of the child. Being overweight does not allow him to fully communicate with his peers. Often this leads to maladaptation, antisocial behavior and even autism.

Diagnostics

Having noticed the first signs of the disease in your child, one should not hope that this is temporary, this happens to everyone, all this is age-related and will soon pass. You need to contact an endocrinologist as soon as possible, who will make the correct diagnosis and give appropriate recommendations.

Collection of anamnesis:

• birth weight;
• age of onset of obesity;
• growth dynamics;
• the presence of type II diabetes mellitus and cardiovascular diseases;
• neurological complaints: headaches, vision problems;
• psychomotor development;
• height and weight of parents.

Objective data:

• androgen-dependent dermopathy: hirsutism, oily seborrhea, acne;
• arterial pressure;
• waist circumference;
• distribution of fatty tissue in parts of the body;
• growth;
• stage of sexual development.

Laboratory diagnostics:

• blood chemistry;
• lipidogram;
• Ultrasound of the liver to determine its enzymes;
• glucose tolerance test to determine insulin resistance;
• these are the hormones that will need to be tested for analysis: thyroid, cortisol, ACTH, leptin, parathyroid hormone, proinsulin, prolactin, LH, FSH, SSSH, testosterone, anti-Mullerian hormone, growth hormone;
• 24-hour blood pressure monitoring.

Instrumental research:

• bioimpedancemetry;
• MRI of the brain;
• ophthalmological examination;
• polysomnography;
• Ultrasound of the abdominal cavity;
• ECG, ECHO-KG.

Molecular genetic research:

• determination of the karyotype;
• search for gene mutations.

Expert advice:

• physical therapy doctor;
• gastroenterologist;
• geneticist;
• gynecologist;
• nutritionist;
• cardiologist;
• neuropathologist;
• otolaryngologist;
• psychologist;
• endocrinologist.

There is no need to be afraid that if a poor child is suspected of being obese, they will be driven through all these studies and analyzes. After collecting an anamnesis, the doctor will make assumptions about what factors caused the disease and prescribe only those diagnostic methods that are necessary to confirm the diagnosis.

Age features

Due to the fact that adipose tissue in the body is formed with different intensity, there are stages of childhood obesity associated with age-related characteristics:

• in children under one year old, the first buildup of adipose tissue occurs and obesity is not diagnosed;
• 1-3 years - a critical period when parents and relatives overfeed the baby with sweets - this is the first stage when symptoms of the disease may appear;
• 3-5 years - fat growth stabilizes, weight problems are rarely observed;
• 5-7 years - the second critical stage, characterized by the growth of body fat;
• 8-9 years old - school-age children in the primary grades rarely have problems with weight, since active life, physical education, lessons allow them to spend a sufficient amount of calories;
• 10-11 years is also a relatively calm stage, but here it is very important for parents to prepare a teenager for the upcoming puberty and instill healthy eating habits in him;
• 12-13 years old - it is at this age that serious hormonal changes occur in the teenage body due to puberty, which often becomes an impetus for gaining extra pounds.

Knowing the critical periods in a child's life, parents can be more attentive to the problem of overweight at these stages. This will allow everything to be corrected in the initial stages, when the disease has not yet started.

Classification

Doctors have more than one classification of childhood obesity: by etiology, consequences, degrees, etc. In order for parents not to wander into them, it is enough to have minimal information.

First, the disease can be:

• primary - due to heredity and congenital pathologies;
• secondary - acquired as a result of malnutrition and physical inactivity.

Secondly, there is a special table that will help determine obesity in a child by body mass index (BMI), which is calculated by the formula:

I (BMI) \u003d M (weight in kilograms) / H 2 (height in meters).

• I degree

A little overweight in a child does not cause anxiety in parents. They even rejoice at his excellent appetite and plump cheeks. The diagnoses of pediatricians are not taken seriously, always appealing to the good health of their child. In fact, obesity of the 1st degree is easy to cure with sports and proper nutrition. But because of this behavior of adults, this happens extremely rarely.

• II degree

The disease gradually progresses, which leads to obesity of the 2nd degree. At this stage, shortness of breath and increased sweating appear. Children move little and are often in a bad mood. Problems begin with physical education at school and social adaptation in the classroom.

• III degree

At this stage, the disease is already manifesting itself with might and main, so it is difficult not to notice it. The joints of the legs begin to hurt, the pressure rises, the level of sugar in the blood fluctuates. The child becomes unbalanced, irritable, falls into depression.

So parents themselves can determine the degree of obesity at home. This will allow you to seek medical help in a timely manner.

Norm and pathology

In addition to degrees, a table by age will allow you to identify overweight, where, according to WHO data, pathological values ​​of body weight are collected. For boys and girls, the parameters will be different. In addition, they still need to be adjusted depending on growth.

Weight of girls 1-17 years old, according to WHO

Weight of boys 1-17 years old, according to WHO

If the child is very tall, it is allowed to slightly increase the parameters given in the table.

Treatment

Parents and the child himself will have to go through the Obesity School without fail. So doctors call a set of measures for the correction of eating behavior and adequate physical activity. This motivational training is considered the foundation of therapy. It is there that clinical recommendations for the treatment of pathology are set out in detail.

Food

First of all, in case of childhood obesity, diet therapy is prescribed, compiled according to Pevzner's table No. 8. Without it, it is impossible to treat this disease.

The Pevzner Special Diet for Children with Obesity recommends including the following foods in their diet in the following amounts:

• bread (coarse grinding or bran) - up to 170 grams per day;
• fermented milk products up to 1.5% fat - 200 gr;
• (minimum potatoes) - 220 gr;
• chicken, turkey, lean meat and fish - 180 gr;
• , buckwheat and barley porridge - 200 gr;
• vegetables in unlimited quantities, cooked in any way;
• unsweetened fruits - 400 gr;
• tea, uzvar, freshly squeezed juices - in any quantity.

Sample menu for obesity 2 degrees

At the first degree, the diet can be varied with honey, more fatty dairy products, sweet fruits, fried foods. At grade 3, vegetable oil and any indulgence in food are excluded.

• reduction in portion sizes;
• fractional 5 meals a day;
• dinner - 3 hours before bedtime;
• abundant use of ordinary water;
• complete exclusion of fast food, chips, snacks, soda.

Children's diet meals:

• curd-banana dessert;
• beet-carrot casserole;
• dried fruit pastille;
• lazy soup with meatballs;
• meat soufflé;
• cottage cheese pancakes;
• chicken cutlets in a double boiler and others.

Recipes

• Steam meatballs

150 g of lean beef, cleaned of tendons and film, scroll 2-3 times through a meat grinder. Cook a tablespoon of rice, cool, stir into minced meat. Pass through the meat grinder again, add a quarter of a boiled egg and 5 g of butter. Beat the whole mass with a blender. Roll up small meatballs, put them in a frying pan, thinly oiled, pour cold water, boil for 10 minutes.

• Vegetable soup

Chop 2 small and 2 celery stalks. Chop the onion. Mix chopped vegetables, add 100 g of white beans, cut into halves 4 cherry tomatoes. Pour 500 ml of vegetable or chicken broth. Boil after boiling for half an hour. Season to taste with sea salt. Before serving, add a little low-fat sour cream.

• cupcakes

Grind 1 medium-sized banana and a handful of almonds in a blender. Mix them with grated carrots. Add 200 g of oatmeal, 10 ml of honey, 20 ml of lemon juice. Fill the molds with the resulting mass, put in the freezer. After 2 hours, move them to the refrigerator for an hour. Serve with tea.

Physical exercise

The treatment of obesity in children is not complete without adequate physical activity. She suggests:

• daily sports for at least 1 hour (if more - only welcome);
• it is better to devote most of these activities;
• games;
• competitions;
• travel;
• recreational activities;
• various complexes.

Medical treatment

Due to age-related contraindications of most drugs, drug treatment of the disease is limited.

In certain cases, according to the testimony of specialists, the following medications may be prescribed to the child:

• Orlistat - allowed from the age of 12, helps fats be absorbed in the small intestine;
• - is prescribed from the age of 10 with type II diabetes mellitus.

The use of drugs such as Octreotide, Leptin, Sibutramine, Growth Hormone is limited to clinical and scientific studies and is not recommended for the treatment of childhood obesity.

According to studies, dietetics, physical education and drug therapy are not very effective. In this regard, in some countries, childhood obesity is treated with surgical methods. However, clinical trials have shown that the use of bariatrics in children and adolescents (when compared with adults) is accompanied by numerous postoperative complications, low compliance, and frequent relapses in weight gain. In the Russian Federation, such operations for the treatment of obesity in those under 18 are prohibited.

Prevention

Parents should know what is the prevention of childhood obesity:

• full awareness of proper nutrition;
• breastfeeding up to 6 months;
• physical activity;
• sports;
• constant monitoring of BMI, timely detection of babies with this indicator over 10 at the age of 2-9 years;
• instilling healthy eating habits;
• walks in the open air.

If all this is implemented from a very early age, children and adolescents will never be diagnosed with obesity.

Complications

The most terrible thing in all this is what this pathology threatens. Unfortunately, parents do not always represent the full danger of the disease. Meanwhile, the consequences can be the most serious - up to death (at 3 degrees).

Among the most common complications:

• apnea;
• arterial hypertension;
• gynecomastia;
• hyperandrogenism;
• dyslipidemia;
• cholelithiasis;
• delay or acceleration of sexual development;
• pathologies of the musculoskeletal system: osteoarthritis, Blount's disease, spondylolisthesis;
• carbohydrate metabolism disorders: insulin resistance, impaired glucose tolerance, fasting glycemia;
• fatty liver: hepatosis and steatohepatitis are the most common conditions in children;
• relative androgen deficiency;
• diabetes mellitus type II;
• diseases of the gastrointestinal tract: inflammation of the pancreas, gastritis, hemorrhoids, constipation;
• liver failure;
• mental illness, psychosocial disorders;
• decrease in male reproductive function, female infertility in the future.

Parents should understand that obese children are unhappy. Therefore, their main task is to prevent such a development of events, and if this has already happened, to do everything to cure the child. The sooner adults realize it, the more chances for recovery and a prosperous life he will have in the future.