Youth health management

Adolescent health management is by no means a standardized task of "supplementing nutrition, controlling weight, and forcing exercise". It is a dynamic adjustment process that takes the rhythm of individual growth and development as the core and takes into account physical health, psychological state, and social adaptability. There is no unified template that is universally applicable.

Let me tell you something I just encountered at the community child care clinic last week and you will understand. Here is a 14-year-old boy named Haohao, who is in the second grade of junior high school. He is 1.78 meters tall and already weighs 182 pounds. His mother clutched a thick stack of health plans and said that in order to help him lose weight and gain height, he was forced to drink 1L of full-fat high-calcium milk every day and run 3 kilometers around the playground after school. I was able to go home and do my homework, and I also scheduled two interest classes for swimming and fencing on the weekends. As a result, I was diagnosed with hyperuricemia during a physical examination last month. My child secretly tugged on my sleeve and said that now I feel sick when I see milk. My legs feel weak when I walk to the playground after school. I dropped 15 places in the final exam this semester.

In fact, the industry's current views on adolescent health management are not completely unified. Most researchers in the field of public health in colleges and universities prefer standardized management. According to the hard indicator card of the "Health Guidelines for Chinese Adolescents Aged 7 to 18 Years Old": Accumulate more than 1 hour of moderate to high-intensity exercise every day, ensure 7 to 10 hours of sleep in descending order according to age, and maintain BMI in the 10% to 90% range of the percentile for the same age and gender. This set of standards is indeed effective in large-sample group intervention, but when it comes to Individuals are often not accustomed to the environment - I once met a 10-year-old girl who was born with little sleep. She only slept 7 hours a day but never felt sleepy in class. Her grades were always in the top 5 of her grade. Her mother used to force her to lie down for 9 hours a day, which caused the child to suffer from insomnia for half a year. Later, she removed the sleep time requirement and only asked her not to touch electronic products 1 hour before going to bed, but she slowly recovered.

Most of us who are doing children's health intervention on the front line prefer the idea of ​​​​"flexible adaptation". To be honest, there is really no need to be stuck: If your child would rather play basketball with his classmates for half an hour than follow you on a 5-kilometer hike, then choose basketball. The effect of moving is 10 times better than walking with a sad face. ； If your child really wants to drink a cup of bubble milk tea this week, then use all the added sugar quota for the day on this cup of milk tea. You don’t have to completely ban it, but you won’t let him save up his pocket money to secretly buy three-no snacks. When I was doing health management for my nephew, I never made any strict daily plan for him. I would sit down and chat with him for 10 minutes every week, list the "junk food" he wanted to eat, the sports he wanted to play, and calculate the caloric gap. Now he is 12 years old, and his height is 3 cm taller than the average for his age. He also won second place in the 100-meter dash at the last school sports meeting.

By the way, there is another pitfall that many parents have stepped on, which is to supplement nutrition indiscriminately. The 2023 youth nutrition screening data in our jurisdiction shows that less than 8% of urban children are calcium deficient, but more than 62% are vitamin D deficient. Many parents rush to buy calcium tablets, DHA, and protein powder for their children, but forget the most basic vitamin D supplement. Excessive supplementation will increase the metabolic burden on the kidneys, and in severe cases can induce kidney stones.

After talking about eating and exercise, there is another issue hidden under the water that many people have not noticed: emotions have a much greater impact on health than you think. Survey data from the National Health Commission in 2023 show that the depression detection rate among adolescents in our country has reached 17.5%. Among them, nearly 30% of children have depression trigger points related to parents’ over-control of their health. They are not allowed to eat their favorite snacks, not allowed to go out to play with classmates, and forced to do exercises they don’t like. Even if you give him a good nutritious meal, he will be scolded while eating, and the efficiency of nutrient absorption will be at least half. There was a fifth-grade girl who came to us for treatment of anorexia. After checking, nothing was wrong. After chatting for a long time, we found out that her mother always told her that she was "too thin and eat more" every time she ate, which made her suffer from physical nausea as soon as she sat down at the table. Later, we asked her mother not to mention anything related to eating when eating. After less than two months, the child's appetite increased on its own.

Of course, this does not mean that standardized guidelines are completely useless. If a child has clear health problems such as moderate to severe obesity, true myopia, or high blood pressure, he or she must still intervene strictly according to the standards in the early stage, wait for the condition to return to the normal range, and then slowly switch to a flexible and individualized plan. There is no conflict between the two views, but the applicable scenarios are different.

I have been doing children's health intervention for 6 years, and my biggest feeling is that adolescent health management is never about "indicators", but about "people". No matter how nice the numbers you see on the scale card look, if your child has to live a miserable life every day, that’s not healthy. After all, the healthy habits that will stay with him for a lifetime are never forced.