For weight loss, parents may need to adopt more strategies and follow them more strictly. This is a period of significant growth and brain development in children. Brain growth requires a diet high in fat.
The American Academy of Pediatricians recommends breast milk or full fat formula in the first year of life, and whole milk for children 12 over 12 months of age. Children in this age group are sometimes overweight when parents allow them to have "junk" food such as chips, cookies, cakes, doughnuts, etc. In these cases, parents need to be educated about appropriate foods for their children. Often, eliminating the "junk" foods solves the problems.
Children who are overweight despite being fed appropriate foods require individual evaluation. New guidelines from the American Academy of Pediatrics state that overweight children who are 12 months and older may be given reduced fat milk. However, these changes should be undertaken only after consultation with a physician or dietitian. In general, reduced calorie diets are not commonly prescribed for children this age.
For children who have BMIs at or above the 95th percentile and health risks associated with being overweight high blood pressure, high lipid levels, etc. The "Preventing Further Weight Gain" strategies listed above can be used for weight loss. Specific strategies are also listed in the "Actions Steps for Weight Loss".
But before beginning a weight loss diet, all children should follow the guidelines listed below. All the data that has been collected on this topic applies to adults; however, it seems logical to assume that what adults do to keep the weight off should also work for children and adolescents. Adolescence covers a lot of ground, beginning at age 10 - 13 and ending at age Although nutrition needs for growth and development vary greatly during this period, growth and development do continue during this entire phase. Therefore, it is very important that nutrient needs continue to be met, especially during weight loss.
Adolescents should consult a dietitian or physician to determine whether weight loss is appropriate, how much weight should be lost and which methods would be most appropriate for each individual. Are any adult weight loss products or methods appropriate for adolescents? What about some of the currently popular diets, such as low carbohydrate diets, low glycemic diet, etc? The following section answers these questions. Being overweight can cause problems during childhood, adolescence or early adulthood.
Some of these problems include:. Because they have lower metabolic rates than other people, children and adolescents and adults with Down syndrome require fewer calories than other people and easily become overweight. Once excess weight is gained, it can be difficult to lose. Therefore, it is important to teach good eating habits to children and adolescents with this syndrome in order to prevent undesirable weight gain.
Exercise should be a regular routine for individuals with Down syndrome whenever possible. Children may be motivated to exercise regularly if they can do so with friends or family members. Exercise and physical activities that require coordination, balance and agility are good choices. Aerobic activities are also important in keeping weight down. Team sports such as basketball, softball soccer and volleyball may also be good choices as long as they are played with other children who are not overly aggressive.
Overweight children and adolescents may require unusually low calorie intakes in order to promote weight loss. Vitamins and minerals may have to be added back into the diet separately.
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Parents should consult a dietitian for appropriate weight loss diets and suggestions. The risk of excess weight gain is especially high in non-ambulatory children with this diagnosis. Because these children cannot exercise to burn calories, their only other option is to go on a reduced calorie diet. Calories may have to be reduced significantly before weight loss is seen, which can make weight loss a difficult process.
In individuals with Prader-Willi syndrome, the satiety center of the brain is not working properly. Consequently, children with this syndrome never feel full. They are always hungry and always trying to eat. The satiety problem is not present at birth; it develops after age three or four. But once it develops, it is there for life. Strict diets and exercise are likely to be necessary.
Locking the kitchen cabinets and refrigerator may also be necessary. Behavioral therapy may help individuals learn appropriate eating patterns, but unfortunately, they will still have a lifelong struggle with food. Prader-Willi syndrome predisposes children to have low muscle tone. By late childhood, however, regular exercise should be a part of each child's routine. Exercises and activities should be chosen based on each child's cognitive abilities. Most children with PW syndrome can participate in school physical education classes.
They should avoid jumping, twisting and other high impact activities but can participate in exercise that improves posture, strength and bilateral hand use. Aerobic exercise is also very important in keeping the weight down. Children and adolescents with any of these syndromes will be unusually large and heavy for age.
Being larger does not always mean being overweight. However, when children and adolescents are overweight, they can follow the same weight loss strategies as other children and adolescents. The best approach for individuals with these syndromes is to limit excess weight by limiting calories and encouraging physical activity when possible. Any child or adolescent taking corticosteroids for more than a few weeks is likely to gain weight. Steroids cause extra fluid and fat retention in the body.
It is difficult if not impossible to lose weight while steroid use continues. However, careful calorie restriction and regular exercise may limit the amount of weight that is gained. Weight loss can be accomplished if steroid use is discontinued. Corticosteroids cause bone thinning over time; therefore, extra calcium and vitamin D may be needed, and weight bearing exercise which stimulates and strengthens the bones is important. Many common activities provide weight bearing exercise such as walking, jogging, dancing, swimming, yoga, martial arts, gymnastics, weight lifting, bowling and team sports.
One important exception is bicycling, which is a good aerobic exercise but is not a weight bearing exercise. Therefore, biking should not be a frequent for of exercise for this population. Children and adolescents should be medically cleared for exercise by their physicians before beginning exercise programs.
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Other medications besides corticosteroids can cause weight gain, increased appetite, or both in some individuals. It is a good idea for parents to be forewarned about this side effect so they can prevent undesirable weight gain when children start taking these medications.
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Zyprexa, Risperdal, Depakote and Paxil are a few of the commonly used medications in the special needs population that can cause undesirable weight gain. All thickeners, whether homemade or commercially made, contain calories and add extra calories to the diet.
Weight gain is likely to result unless other parts of the diet are reduced. Sometimes overall diet quality suffers when reductions are made, and vitamin supplements may be needed to compensate. Children and adolescents who can exercise should do so, to keep undesirable weight gain to a minimum. New amputees and new wheelchair users often require fewer calories than they required previously. Parents should be made aware of this so they can help children reduce their calorie intake and prevent undesirable weight gain.
All children and adolescents should be encouraged to be active. Where safety is not a problem, children and adolescents should be sent outside after school to engage in age-appropriate activities. Extracurricular school activities should include some activities that require movement. Sedentary television, computer and video game time should be limited to two hours or less each day. Children and adolescents who have medical problems or conditions should be cleared by their physicians for exercise and referred to physical therapists who can design appropriate exercise plans for them.