Nutrition and Nutritional Diseases in Children

The core of children's nutrition is by no means "the more expensive you eat and the more supplements you take, the better", but a dynamic dietary balance that matches the digestive capacity and growth needs of different age groups. Currently, more than 70% of the nutritional diseases that are highly prevalent among children in China are "diseases of affluence" caused by structural imbalance, and less than 30% are due to actual insufficient intake of nutrients. Whether it is supplement abuse or extreme dietary structure, they are the core causes of disease.

Last week, I met a 4-year-old girl at a community child care free clinic. Her chubby face looked particularly cute. Her parents said that the child has been crying recently because she is tired, gasps for breath after running two steps, and likes to bite her nails. A blood test showed that her hemoglobin was only 98g/L, which is typical of iron deficiency anemia. The grandmother standing next to her looked in disbelief: "Our family has meat every day, and last week we bought two boxes of cordyceps for the baby to stew. How could it be lacking in nutrients? ”After asking, I found out that the child rarely eats green leafy vegetables, and rarely even rice. He relies on braised pork and fried chicken legs for every meal. The iron intake seems to be high, but it is heme iron. He lacks vitamin C to help with absorption. No matter how much he takes, it is useless.

Many people's impression of nutritional diseases is still stuck in the "rickets" and "night blindness" of the last century. They think they are diseases of the poor. Now that life has improved, why do we still have this problem? Not really. Today's children's nutritional problems have long since changed: on the one hand, many children in remote areas have insufficient intake of vitamin A, zinc, and essential fatty acids; on the other hand, the overweight and obesity rate among children in cities has been rising. In 2020, the physical fitness of national students Health surveys show that the overweight and obesity rate among children and adolescents aged 6-17 is close to 20%, and the accompanying cases of fatty liver, high uric acid, and precocious puberty in children have more than tripled compared to 10 years ago. Many 5- and 6-year-old children have even been diagnosed with dyslipidemia.

When it comes to whether to supplement nutrients for children, doctors from different directions have different opinions. Traditional pediatricians generally believe that as long as children can eat a balanced diet, except for vitamin D, which needs to be supplemented regularly until puberty, there is no need to supplement other nutrients. After all, nutrients in natural foods are the most easily absorbed by the body. If you supplement too much, there is a risk of overdose. However, colleagues working in functional medicine will put forward different views: Many children nowadays are very picky eaters, and many have chronic food allergies and intestinal flora imbalance. Even if they eat enough, their absorption may not be good. In this case, targeted serum nutrient testing and targeted supplements are more efficient. In fact, these two views do not conflict at all. If your child is not picky about his food, his growth curve has always been within the WHO standard range of 25%-75%, and he rarely gets sick throughout the year, then there is no need to buy supplements blindly. ； If the baby's growth curve has not moved for six months, has repeatedly suffered from respiratory infections, and is picky about food and only eats plain rice, then you can really check one layer more to find out whether there is an absorption problem.

I have been in clinical practice for almost 9 years, and I have seen too many parents step into the trap. They either give their children this supplement or that supplement, which will lead to precocious puberty, or they dare not give any supplement, and they still carry on despite the fact that they are deficient in iron, which ultimately affects the cognitive development of their children. In fact, there is a very simple way to judge. Just look at the child's growth curve. As long as the curve is moving upward smoothly and there is no sudden drop or surge, there is no need to be too anxious. Normally, cooking doesn’t need to be so complicated. Divide the dinner plate into four pieces, with half filled with dark-colored vegetables such as spinach, broccoli, and carrots, one quarter filled with whole grains such as sweet potatoes, corn, and oats, and the remaining quarter filled with high-quality proteins such as fish, shrimp, eggs, and lean meat. Drink enough milk for your age every day, and drink less milk tea, cola, and milk drinks. Most nutritional problems can be avoided.

Oh, by the way, don’t always think that children don’t like to eat because they are zinc deficient. I have met many parents who gave their children zinc tablets for half a year. After asking, they found out that their children had just eaten a large piece of cake half an hour before the meal. Of course, they didn’t want to eat when their stomachs were full. Children who are truly diagnosed with zinc deficiency account for less than 10% of the picky eaters. Indiscriminate supplementation will affect the metabolism of copper, and the gain outweighs the loss.

In fact, there is really no need to worry about nutrition when raising a baby. If you buy cherries worth hundreds of dollars per catty or DHA worth several thousand dollars per box for your child, why not make a more comfortable meal every time and take your child out to run around and bask in the sun more often than any other supplement. If you are really unsure about something, go to the pediatrics or nutrition department of a regular hospital and ask. Don’t listen to the sales in maternal and child stores, and don’t just believe in the “nutritional remedies” on the Internet. Take it easy, and most children will grow up healthy.