To counteract child overweight, should children be put on a diet?

Doctors are also wrong, and some have done it for years when it comes to overweight children. His mistake has been to disseminate to the parents the idea that they should not give too much importance to the overweight of their children, that the normal thing is that the small ones lose in adolescence. But now it's known that the lug doesn't solve the problem. What is more, scientific studies have shown that child overweight causes insidious health consequences, effects that tend to go unnoticed until the young become older.

"Childhood-initiated obesity is associated with increased risk in the development of metabolic syndrome in adulthood, a group of conditions that involve insulin resistance, arterial hypertension, and alteration of lipid metabolism, which It increases the risk of cardiovascular disease and type 2 diabetes, explains the pediatrician at the Hospital Universitario del Henares María Alegre. But complications go well beyond this syndrome, which is now beginning to be detected even in children.

Children with excess weight also suffer respiratory disturbances such as sleep apnea, have asthma, digestive, cardiac, neurological, endocrinological and dermatological problems. and face psychological problems such as anxiety and depression. An obese child has the 80% chance of being able to remain so when it reaches 35 years, and a teenager are overweight or obese, even if it thins in the future, increases their risk of mortality for any cause with respect to another of normal weight, Especially for cardiovascular triggers.

According to the World Health Organization, Spanish children are among the most obese in Europe: from 6 to 9 years, 18.1% suffers this disease and another 23.2% is overweight, as the study Aladdin, the Spanish Agency of Consumer Safety Food and Nutrition (Aecosan). The solution of the epidemic of the kilos of more seems clear, but it is not at all: to put a diet to the children is a sensitive subject that it is advisable to assess carefully. It is not always good to do so and, when necessary, you have to know very well what is the concept of diet among the child population, which differs greatly from that of adults. Children should not starve, they need to receive a given calorie intake each day, depending on their age, sex and type of activity. That's why slimming down on the basis of cutting calories is not the solution to child overweight.

Three tricks: Eat slowly, chew well and satiate with water

Even in cases of childhood obesity, which are the most delicate, pediatric endocrine Hospital 12 de Octubre Maria del Mar Martínez explains that "low calorie diets, as they are usually recommended in the adult patient, are not indicated. they should only be done in cases of severe obesity or refractory-those in which, despite having introduced routines on the table that should lower the extra kilos, the child does not get to lose weight. The dietitian-nutritionist of the Hospital Ramón y Cajal Maria Garriga adds that, "rather than putting on a strict diet we should try to give healthy eating tips to redirect the food guidelines at risk. It is essential to make difficult decisions easy, and to make healthy food accessible. " And it brings another important fact: "Not only is it worrying that the child has obesity, it is also that it has gained a lot of weight in a short time."

It is not the amount of energy that needs to be monitored but the quality of the nutrients. "An overweight child should always eat the calorie intake that is right for his or her age, but in the form of healthy foods. You will be advised to limit the intake of simple fats and carbohydrates and to increase less caloric foods such as vegetables and fruits, as well as increased fiber and water, "says Alegre. I mean, goodbye to trinkets, biscuits, industrial pastries, sausages, canned juices and carbonated beverages; Hello to the 4 pieces of fruits and vegetables a day. And if it doesn't work... "The primary goal of intervention in an overweight child is family and patient education. However, in situations of major obesity should be assessed in a personalized way and with the help of a nutritionist the possible restriction of the caloric intake in the form of fats and carbohydrates, "explains Alegre.

And what happens to the quantities? Is it necessary to take the scale to prepare the portions? According to Martínez, the endocrine of October 12, "It is not necessary to weigh the food, but it is recommended that the food is ingested slowly and with adequate chewing, drinking water to facilitate the feeling of satiety and avoid ingestion Compulsive. Also that the dinners are light, since the last part of the day is in which less energy is consumed. "

' One day is a day ', the phrase that is never fulfilled

The time when the doctor tells parents that your child is overweight and that you have to do something about it tends to be delicate. "How come he won't eat a sweet once in a while, if he's a child!", they say. That or an equivalent phrase. The Gastroenteróloga pediatrician at the Ramón y Cajal Hospital in Madrid Saioa Vicente recounts his experience when faced with situations in which families are reluctant to put their child on a diet. his arguments are often based on the idea that the child is too small to deprive him of a trinket or a piece of cake on a birthday, but they are usually wrong.

"Many parents don't understand that day-to-day is loaded with those ' every now and then nothing happens ', and that what happens at the end is that your child is consuming food not recommended more often than they think. My job is to face reality and show you the amount of unhealthy food your child is ingesting, more often than you think. It is what makes the end aware that they have to introduce healthy changes in the food of the whole family and never offer the child the food as a reward, " says Vicente.

"Yes, in general the word diet frightens," corroborates the pediatrician of the University of Navarra Cristina Azcona San Julián, who assures that she has also noticed that, when pronounced, it generates some anxiety in the parents. That's why she doesn't usually use it, but avoiding the parents ' scare is not the only reason. "It creates the wrong impression that by doing a diet for a few months everything is fixed, and it is not true. The important thing is to instill healthy eating habits, knowing which are the healthiest foods to eat every day and which can be taken from time to time, and in smaller amounts. "

On the other hand, it is important to note that one of the most important factors in the development of childhood obesity is family obesity, which is inherited from parents. In fact, most of the visits to the specialist are motivated by the experience of the parents with the overweight. But in any case, how do you know if a child is overweight?

So the weight is monitored and the bad habits are rectified

The Spanish Association of Pediatrics has tables that indicate what to weigh and measure a child, approximately, in each age, which serve to guide pediatricians. Parents can also use them to get clues as to whether their children's growth and development are evolving normally. For example, a child should fatten between 2 and 2.5 kilos annually when it is between 1 and 3 years of life. Between 4 and 6 years, the increase is usually 2.5 and 3.5 kilos; From 7 to 12, about 2 kilos a year, and from 4 to 4.5 kilos when the child is approaching puberty, an age in which increases calorie expenditure because the practice of sport is more intense.

There are several reference patterns to define obesity, although the body mass index (BMI), which is calculated by dividing the weight between the square of the height of a person and that is recommended by the American Association of Pediatrics, is the most common. But this index deceives. That is why some specialists, such as the pediatrician at the University of Navarra Azcona San Julián Clinic, use the percentage of body fat as a reference instead. "Obesity is defined as excess body fat rather than by weight or body mass index, if the percentage of fat is more than 25% in boys and 30% in girls, we will be talking about obesity," he explains.

If that time comes, the diet will be unavoidable... But the pediatric style. Among the usual recommendations are to avoid eating at an hour, encourage the consumption of healthy foods and eliminate industrialists, do not use meals as rewards, avoid sodas and sweetened beverages, as well as pecking, As long as it's not with a fruit or yogurt. It is also a priority to eat slowly and with family, without screens, to remove from the shopping cart the processed sausages, salted snacks, industrial pastries and precooked, and not forget to exercise.

Put the fair portions, cook with olive oil and limit the quantities, that the bread is preferably integral and that the way of cooking is steamed, baked, grilled or poached are customs that are worth acquiring and, although it may not seem important , it is advisable to sleep at least 7 hours a day. It is also to choose lean meats, and not to consume more than 2 or 3 times a week, to include the fish that same number of days and, the times you put on the table pasta or rice, legume or potato, that is a unique dish. There are many things to consider, but very few when it comes to the health of children.