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"Child`s Health" (62) 2015. Тематический выпуск "Детская гастроэнтерология"

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Nutritional aspects of global strategh to end childhood obesity

Authors: Chaychenko T.V. — Kharkiv National Medical University

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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obesity, children, prevention, nutrition.

The publication provides an overview of materials concerning the nutritional aspects of the global strategy aimed at ending childhood obesity from leading international health care organizations. It is shown that the main feature of the obesity epidemic that the problem could be prevented. 
WHO Director-General announced the establishment of a high-level Commissionon EndingChildhood Obesityatthe World Health Assembly 2014. The evidence-based strategy presented at the interim report of it. 
Protecting, promoting and supporting breastfeeding, according to guidelines, using regulatory measures as needed protect child from overweight. Focus at the first 1000 days of life could be explained by the “window of opportunity” for the very early interventions. Epigenetic impact at body composition might explain variability in fat mass among genetically predisposed individuals. Thus, protein and carbohydrates load should be avoided at early childhood. It was established that high-protein formula intake is a causative factor for overweight in infancy. The same tendency is for the cows’ milk consumption. High carbohydrates level in diet is associated with postprandial hyperinsulinemia and further exhausting of beta-cell function. High lipid load isn’t linked obesity but related to carotid intima-media thickening and relevant vascular remodeling. 
The American Heart Association recommended some diet for infants, children and adolescents to promote cardiovascular health. It is recommended to eat only enough calories to maintain a healthy weight, eat foods low insaturated fat, trans fat, cholesterol, salt (sodium), and added sugars.Total fat intake should be between 30 to 35 percent of calories for children 2 to 3 years of age and between 25 to 35 percent of calories for children and adolescents 4 to 18 years of age. Variety of fruits and vegetables should be given weekly. Every meal should contain some vegetable or fruit. Half of all grains should be whole.The American Academy of Pediatrics recommends that low fator reduced fatmilk should not bestarted before 2 years of age.
Sugar-sweetened non-alcoholicbeverages, nutrient-poor food should be limited for prevention of excess weight gain.Dietary Guidelines address portion sizes, which are correct for the children. Many people confuse portion size with serving size, which is a standardized unit of measuring foods—for example, a cup or ounce—used in dietary guidance. That leads to the excessive consummation of food. Food labeling at shops and restaurants is an unique opportunity for consumerto know about his food. That’s why there is a strategy from FDA (food and drug administration) aimed for the education of population to read a labels, which typically lead to the prevention of excessive food intake. The necessity of correct food labeling and portion sizes restriction is demonstrated as well as importance of relevant education for children and their parents.
Sugar-sweetened non-alcoholic beverages intake is a main cause of overweight in low-income countries. Healthy hydration working group together with WHO recommend consuming the pure water for healthy hydration. It is recommended 100-190 ml/kg/d for 0-6 month, 800 – 1000 ml/kg/d for 6-12 month, 1100-1200 ml/kg/d for 1-2 y.o, 1300 ml/kg/d for 2-3 y.o., 1600 ml/kg/d for 4-8 y.o, 1900 ml/kg/d for 9-13 y.o girls and 2100 ml/kg/d for 9-13 y.o boys, 2000 ml/kg/d for 14 y.o girls and 2600 ml/kg/d for for 14 y.o boys.
The current strategy is aimed to improve an access to healthy foods and restrict that of unhealthy food around schools. Health care systems should provide family-based multicomponent strategy, in which health care system is a key, but not only participant. Thus, social, educational, political institutions and mediasectors must also be involved to the struggle for the prevention of childhood obesity epidemic.

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