The guidelines were issued by the General Office of the National Health Commission on February 7, 2024. In order to implement the Healthy China Action (2019-2030) and the National Nutrition Plan (2017-2030), develop traditional food and nutrition services, and prevent and control the occurrence and development of chronic diseases in China, the National Health Commission organized the compilation of the "Dietary Guidelines for Children and Adolescents with Obesity (2024 Edition)".
The Dietary Guidelines aim to give full play to the advantages of modern nutrition and the combination of traditional Chinese and Western medicine, integrate food and medicinal substances and new food raw materials into a reasonable diet, provide recipe examples and nutritional health suggestions for different seasons, different regions and different groups of people, and improve the applicability and operability of dietary guidance. We can refer to the guidelines to guide the application to assist in the prevention and improvement of chronic diseases. Residents are encouraged to refer to the recommended content of the guide, combine their own circumstances, reasonably mix daily meals, and develop good eating habits.
Foreword Obesity is a chronic metabolic disease. In recent years, the obesity rate among children and adolescents in China has risen rapidly, which has become one of the important public health problems. According to the Report on the Status of Nutrition and Chronic Diseases in China (2020), the obesity rate among children under 6 years old is 36% and 6 17-year-olds have a prevalence of obesity of 79%；In 1982, the obesity rate of 7 17-year-old children and adolescents in China was only 02%。The obesity rate among children and adolescents in urban areas is relatively high, while the obesity rate among children and adolescents in rural areas is increasing rapidly. Obesity is an important risk factor for a variety of diseases, which not only affects the motor ability, musculoskeletal and muscular development and cognitive development of children and adolescents, but also has adverse effects on their mental health, cardiovascular system, endocrine system, respiratory system, digestive system, etc. At the same time, childhood and adolescent obesity can persist into adulthood, increasing the risk of multiple chronic diseases and increasing the medical and socio-economic burden.
Primary obesity is the main cause of obesity in children and adolescents, which is mainly related to dietary nutrition, physical activity, genetics and other factors, among which dietary nutrition is the key factor. Unreasonable dietary structure, unhealthy eating behavior, and improper feeding of infants and adolescents are important causes of obesity. According to the theory of traditional Chinese medicine, children and adolescents are weak, have poor diet, congenital endowment, lack of exercise, and emotional injury, resulting in phlegm and dampness, which can lead to poor operation of qi, blood stasis, sputum stasis, and inability to retain, resulting in obesity in children and adolescents. In order to curb the epidemic of obesity among children and adolescents, cultivate healthy eating habits among children and adolescents, and promote healthy growth, this guideline is formulated in accordance with the relevant requirements of the Healthy China Action (2019-2030) and the National Nutrition Plan (2017-2030).
Definition of obesity
Obesity is a chronic metabolic disease in which the body accumulates too much fat to the point of endangering health, and it is a state of excessive weight gain due to energy intake exceeding energy expenditure or changes in the body's metabolism. Among them, primary obesity (or simple obesity) refers to the exclusion of obesity secondary to hypothalamic-pituitary-adrenal axis lesions, tumors, trauma, hypercortisolism, hereditary diseases and other causes, mainly due to unhealthy lifestyles, such as high energy intake, insufficient physical activity and other factors.
Obesity in children and adolescents is judged according to the Growth Standards for Children Under 7 Years of Age (WS T423) and the Screening of Overweight and Obesity in School-age Children and Adolescents (WS T 586), which are detailed in the appendix. 6 Central obesity in children and adolescents aged 17 years is judged by waist circumference or waist-circumference-to-height ratio. Waist circumference was screened based on the "Cut-off Value for High Waist Circumference Screening in Children and Adolescents Aged 7 and 18 Years" (WS T 611). 6 17-year-old boys and 6 9-year-old girls have a waist-to-height ratio greater than 048,10 17-year-old girls have a waist-to-height ratio greater than 046 It is recommended to determine central obesity. Central obesity is mainly due to excessive fat accumulation in the abdominal cavity and abdominal wall, which is more closely related to hypertension, hyperlipidemia, diabetes and other diseases.
Food choices for obese children and adolescents
According to the growth and development characteristics of children and adolescents and the principle of balanced diet, children and adolescents should choose a variety of foods, and pay attention to the combination of meat and vegetables, thickness and color. Prioritize foods that are lower in energy, higher in micronutrient density and lower in glycemic index, while ensuring intake of fish, poultry, eggs, lean meats, milk and dairy products, soy and dairy products, whole grains and vegetables. The main points are as follows: 1. Appropriateness: The daily intake of food should be moderate, and appropriate adjustments should be made according to the growth and development of children and adolescents and the level of physical activity. The recommended daily intake of various foods and the energy requirements for moderate-intensity physical activity levels in children and adolescents of normal weight of different ages are shown in Table 11。2. Accessibility: Ensure that ingredients are fresh and easily accessible. Among similar foods, preference is given to fresher and more economical foods. 3. Suitability: Choose foods with low energy, high micronutrient density and low glycemic index, and eat less foods with high oil, high salt and sugar and high energy density, see Table 12