Diet and Children

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Importance of a Proper Diet

Preventive function of diet for children

A correct diet guarantees the young organism a balanced and healthy growth.
The risks of an improper diet in childhood are different:

• Tendency to overweight and obesity, both in childhood and in adulthood
• Tendency to be underweight in pediatric age
• Specific or generalized malnutrition, which can occur with both underweight and overweight (when only junk foods low in vitamins and minerals in fruits and vegetables are consumed).

Taking care of nutrition in this period of life is essential to avoid that being overweight or underweight brings with them problems for the physical and psychological health of the child and the future adolescent.
For parents it is therefore extremely important to monitor, and possibly correct, the eating habits of their children.
Overweight and obesity in childhood are mainly related to the simultaneous presence of two factors:

1. Incorrect diet, characterized by a high consumption of high-calorie foods, rich in fats and simple sugars
2. Sedentary lifestyle and reduction of time devoted to physical activity.

The first measures to be adopted will therefore be aimed at reducing excess weight, paying particular attention to the consumption of sugars (sweets, soft drinks and fruit juices) and encouraging the practice of regular physical exercise.

Underweight: how harmful can it be for the child and the future adult?

Being underweight can be bad for growing babies.
This is because it often indicates a slowdown or simply a slowness of development.

Although it is not always pathological or dangerous, in some cases the underweight hides a generalized or specific nutritional insufficiency. It is therefore necessary to consult a doctor to rule out malabsorption, even pathological, or any endocrine pathologies.
If significant lack of appetite is evident, it may be helpful to increase dialogue in the family, eat meals together or at least consult a psychologist specialized for childhood.

Overweight and Obesity

Importance of childhood overweight and obesity in your country

Please note: The weight and height of the growing subjects is estimated with the percentile method, not the body mass index (BMI or BMI), instead adopted for adults.

Childhood obesity is certainly the most common nutritional pediatric disease in your country and in other Western countries.
If on the one hand the growing organism makes use of a greater developmental / adaptive capacity than the adult one, on the other hand the child / adolescent can "drag along" behind various problems or diseases acquired during development. Obesity is one of them.
In fact, it is estimated that about 40% of children and 60% of obese adolescents will remain obese even in adulthood, with all the negative consequences of the case, affecting:

• The psycho-physical health of the subject
• The health costs of society.

Psychophysical health of overweight or obese children

Children with overweight or obesity are more likely to get sick, in adulthood or even in childhood, of:

• Metabolic disorders
• Type 2 diabetes mellitus
• Hypertriglyceridemia
• Hypercholesterolemia
• Hypertension
• Hyperuricemia and gouty attacks
• Atherosclerosis, thrombosis and cardio-cerebro-vascular events in general (especially in adulthood)
• Eating Disorders - DCA (especially from adolescence onwards)
• Bulimia nervosa
• Binge Eating Desorder
• Nervous anorexia
• Secondary or borderline

Social cost of obesity

The social cost of obesity is extremely high.
In some countries of the European Union it reaches 1% of GDP (gross domestic product) and constitutes 6% of direct health expenditure.

Childhood Obesity Statistics

Observing the recent official epidemiological surveys in 2016, it is observed that in the Bel Paese:

• 9,8% of children suffer from obesity
• 20,9% are overweight.

Notes: the areas most affected are in the center-south and in the Campania region a percentage of overweight equal to 50% is reached.

• Among elementary school children (6-10 years):
• 24% are overweight
• 12% show evident obesity

These figures get worse year after year.

Risk factors

Family

Let's start by pointing out that, for a child, the nutritional status of the parents is a very important factor.

• If one parent is obese, the child's risk of becoming an obese adult increases by 40%
• If both parents are obviously overweight, this risk increases by up to 80%.

Another extremely indicative element, which offers a concrete, albeit gruesome, image of the family educational trend, is given by the evaluation of the parents themselves towards the offspring.

• About 40% of mothers of children with overweight / obesity do NOT think their child is overweight.

Childhood Obesity Considerations

At the origin of this dizzying increase in overweight and childhood obesity, a genetic predisposition could insist; however, this occurrence corresponds (strictly speaking) to only 1% of cases.
The data in this regard suggest that the influence of bad habits (lifestyle understood as diet and sport) transmitted by parents and by the community to children and adolescents is even more important (99% of cases).
Let's look at some extremely important risk factors for the onset of childhood overweight and obesity

Diet

First of all, it must be borne in mind that:

• Excessive diet in the first two years of life causes

1. Enlargement of fat cells (hypertrophy)
2. Increase in the number of fat cells (hyperplasia) as adults and, as it will be possible to reduce the size of the cells but not eliminate them, consequent:

• Greater predisposition to obesity
• Difficulty losing weight or keeping it within limits.

Furthermore:

• 11% of children do not have breakfast
• 28% consume breakfast in an inadequate manner
• 82% have a snack at school that is not qualitatively correct
• 23-25% of parents declare that their children do NOT consume fruit and vegetables daily
• Only 2% of all children eat more than 4 servings of fruit and vegetables per day
• 41% drink sugary drinks daily
• 17% consume sugary drinks more than once a day

Physical Activity

• Only 10% of children have a recommended physical activity level for their age
• Only 18% practice sports for only one hour a week
• 50% spend more than 2 hours a day in front of a television or video games and have a television in their bedroom.

Diet plays an important role in the development of obesity: today more than ever, many children eat poorly, consume too much fat and prefer foods with a high calorie density

How to intervene?

Fundamental considerations

What do you need to know before "putting children on a diet"?

To best treat overweight and obesity in children it is necessary to take into account the most important elements (of various kinds).

• Elements of pregnancy
• They greatly affect the child's overweight attitude: malnutrition in pregnancy, especially in the first and second trimester, gestational diabetes or pre-existing type 2 diabetes mellitus increase the chances of childhood obesity.
• Familiar elements:
• As we said at the beginning of the article, overweight and obesity in young children can increase the risk of developing metabolic and cardio-cerebro-vascular diseases, both at a young age and in adulthood.
• These pathologies also have a genetic basis - hereditary and family, and tend to be transmitted with the generational handover.
• For this reason, pediatric obesity has a variable severity level, which increases if one or more grade I or II family members suffer from: obesity, type 2 diabetes mellitus, dyslipidemia, arterial hypertension and heart disease occurring before the age of 55.
• It is also necessary to look for related factors of different kinds, such as eating disorders (DCA) and thyroid diseases.
• It seems to have a negative effect, and therefore represents a factor to work on, the cultural level of the mother or grandmother who manage the meals.
• Furthermore, contrary to popular belief, childhood overweight and obesity are more prevalent in less well-off social situations and with limited economic resources. Unfortunately, this is an element that cannot be changed, but it will have a significant impact on the therapy.
• The room for improvement of children is strictly linked to the habits of life and the willingness of parents / grandparents / guardians to apply changes in diet and lifestyle.
• Physiological elements:
• The inadequate weight of the child at birth is of primary importance in the tendency to be overweight
• The same applies to the type of breastfeeding (breastfeeding is considered protective) and the practice of weaning (both early and late forms are inappropriate)
• The growth curve and pubertal development offer very useful data to understand the hormonal structure of the overweight subject, which can evolve more rapidly or slowly (in both cases, these are not positive aspects)
• Lifestyle elements:
• The situation worsens: the low aptitude for motor activity and the high predisposition to watch TV and play videogames.
• Unhealthy adolescent habits, such as smoking, alcohol, and drugs, are also not helpful
• Pathological elements:
• The treatment must also take into consideration the time of onset of excess weight, which is as serious as it is early, and any previous failed attempts to lose weight (especially related to clinical pictures of DCA).

Correct the diet of overweight children

Many children's diets are not only high in calories, but also unbalanced and full of junk foods that heavily impact their quality of life and future morbidity.
Correcting these poor eating habits is one of the best interventions to decrease the growth of obesity in our children and adolescents.
The dietary advice useful in pediatric age roughly reflects those proposed to the general population.
When addressing a child we should avoid the term "diet", which is often understood as a kind of punitive action.
If the child eats a lot and is of normal weight, it is important not to hinder food intake, as a growing organism actually needs high amounts of nutrients.
In particular:

• The increased need for some nutrients (calcium, iron, vitamin D and proteins) must be satisfied by consuming a wide range of foods; no integration is normally necessary. Many of these nutrients are contained mainly in foods of animal origin and depriving the child of these foods (vegan diet) means creating a nutritional deficit that could interfere with normal development. On the other hand, however, we must not forget the advantages of fruit and vegetables, often unwillingly consumed by the child. To make these foods more palatable it is possible to resort to centrifuged and smoothies prepared at home (only if raw or cooked vegetables are systematically refused). Instead, it is advisable to limit the consumption of juices and industrial fruit juices, as they are too rich in sugar and often poor in vitamins, fibers and mineral salts.
• If the child proves intolerant to milk and dairy products, it is important to ensure an adequate intake of calcium through the consumption of water rich in this mineral and foods that contain it in good quantities, such as green vegetables (broccoli, cabbage), legumes ( soy, chickpeas, red beans), nuts and seeds (sesame seeds, flax seeds). Cola-based sodas can negatively affect the calcium balance.

If the child has poor appetite and is of normal weight (not underweight), once the pathological causes have been excluded, it is advisable not to force him to eat more than he should.

In this way, in fact, the child's sense of disatiety would be altered, and once he grew up he could maintain the ability to eat more than necessary.

Useful Tips

Useful tips for the diet of the overweight child

• Clean the house of "junk" foods (especially snacks, sugary drinks and sweets)
• Keep the child away from foods with a very sweet or very salty taste for as long as possible, avoiding introducing them into the diet early
• Educate the child to eat slowly, as the first digestion takes place in the mouth
• Forcing the child to eat a large breakfast, according to the rules of the Mediterranean diet (cereals, milk or yogurt, fruit); his health, his mood and his academic achievement will benefit
• When preparing the backpack, also insert a bottle of water, both to accustom the child to drink frequently, and to avoid the risk of dehydration which in children is higher than in adults
• Do not use food as a means of pressure (eating everything on your plate), of reward or consolation (if you are good I will buy you ice cream)
• Avoid turning food into punishment or threat (going to bed without dinner)
• Turn off the TV during meals and consume them at set times and places (not where and when it happens)
• Spend more time preparing your child's meals and snacks, using products that are as natural as possible, not packaged; presenting foods with imagination to satisfy all the senses of the child
• Encourage the child to enjoy the meals provided by the school canteen; if your child does not accept the dish that is provided, at the end of the meal he will still be hungry and satisfied with snacks, brioches and various snacks.

Food Consumption Frequency

Frequency of consumption of foods in the diet against overweight