Kushaikwa kwezvokudya zvinovaka muviri uye zvirwere zvevana: kufutisa uye kuwandisa muvana ndiwo matambudziko makuru ehutano munyika yedu uye njodzi kuhutano hwemangwana hwevana.

Kushaikwa kwezvokudya zvinovaka muviri, sezvinotsanangurwa neWorld Health Organization, kusaenzana pakati pehuwandu hwezvokudya uye zvokudya zvinovaka muviri zvinodiwa nemuviri pakukura nekuchengetedza mabasa ayo chaiwo uye huwandu hwezvokudya zvinodyiwa chaizvo.

Zvose hyponutrition kana kushaya zvokudya zvinovaka muviri nekuremara (uremu huremu) uye hypernutrition kana kushaya zvokudya zvinovaka muviri nekudarika (huremu hwakawandisa) zvinowira muboka rekushaya zvokudya zvinovaka muviri.

Italy neUnited States dzine makumi emakore dziine huwandu hwepamusoro hwevana vane huremu hwakawandisa, kunyange mumakore achangopfuura tsika dzave dzichidzikira zvishoma muItaly kune mamwe mapoka ezera: takabva pa23.2% yevana vakafuta muna 2008-2009 kusvika 21.3% muna 2016, nepo vana vakafutisa vabva pa12% muna 2008-2009 kusvika 9.3% muna 2016.

Zvisinei, chinetso chacho chinoramba chiri pakati pechinonyanya kunetsa kuvana vanhasi uye vakuru vamangwana.

HUPENYU HWEMWANA: DZIDZA ZVAKAWANDA PAMUSORO PENYAYA DZEVANHU NOKUSHANYIRA BHUKU PAMUSANGANO WEMAZANZVIRA

Kushaikwa kwezvokudya zvinovaka muviri nekuwanda: mune inopfuura 95% yezviitiko kufutisa ndiko kwekutanga kana kwakakosha, kureva kwete kukonzerwa nechirwere.

Essential obesity kunobva pane akati wandei.

Iyo inogara iri mhedzisiro yekusaenzana pakati pechikamu chesimba rinomedzwa uye iro rinopedzwa nemuviri, asi genetic (predisposition inoverengera kupfuura 50%) uye zvakatipoteredza zvinogona kuitawo pazviri, senge:

• Kudya kwaamai panguva yekuzvitakura;
• Kuberekwa uremu;
• Rudzi rwekuyamwisa;
• Kukurumidza kukura mugore rokutanga rehupenyu;
• Kudya;
• Chiyero chekugara kana kupikisa kusimba kwekuita kwemuviri.

Pakati pevana vane uremu hwakawandisa, chikamu chidiki chete (chisingasviki 5%) chine zvirwere zvemajini kana endocrine izvo zvinokonzeresa kufutisa, kana kuti vakafutisa nekuda kwemishonga yavanofanira kutora.

Ibasa raana chiremba kuona mafomu aya nekukurumidza zvichienderana nezviratidzo uye kuunganidza kwakangwarira kwenhoroondo yemwana:

• Zera rinoratidza kufutisa;
• Iko kushamwaridzana kunokwanisika nekuderera kana kuderedzwa kukura mukukura;
• Iyo neuro-psychomotor kukura;
• Kuvapo kwekuremara, kusanganisira kuremara kwechiso (dysmorphisms);
• Kushandiswa kwezvinodhaka (corticosteroids, sodium valproate, risperidone, phenothiazines, cyproheptadine, nezvimwewo).
• Zvichienderana nekufungira, chiremba wevana anogona kukumbira kuongororwa kwakananga kuti aongororewo endocrine-based uye genetic-based obesity.

Kufutisa chirwere chekiriniki chinoratidzwa nekuwanda kwemafuta akawanda anoderedza tarisiro yehupenyu uye hutano

Kutaura zvazviri, hapana kubvumirana kubvumirana pakati pevatsvakurudzi pamusoro penzira dzakakodzera dzekuona muganhu pakati pehuremu hwemazuva ose, kuwandisa uye kufutisa muhuduku.

Huremu hwakawandisa hunotanga muhudiki, chero zvakadaro, hunoramba huchienderera mberi kusvika pakukura (70-80% yevachiri kuyaruka vakafutisa vanowanzova vanhu vakuru vakafutisa), saka kukurumidza kuongororwa kwekushaya zvokudya zvinovaka muviri nekuwanda uye kupindira kwekurapa kwekutanga kwakaenzana kwakakosha.

Kushaikwa kwezvokudya zvinovaka muviri nekuwanda uye zviyero zveanthropometric (BMI)

Sezvo mukushaya zvokudya zvinovaka muviri nekusavapo, mukushaya zvokudya zvinovaka muviri nekuwanda kweanthropometric zviyero (uremu, kureba / kureba, uremu / kureba reshiyo uye kuverenga kwemuviri misa index kana BMI) zvinokwana kutsanangura kuwandisa kana kufutisa uye zvakare kufungidzira njodzi iri nyore yekurema.

Kana vari vana vari pasi pemakore maviri, huremu/hurefu hwakakosha, kureva kuti hapana huremu hwakakwana, asi zvakakosha kuti uremu hwemwana huenderane neurefu hwake, asi kana ari vana. pamusoro pemakore maviri ezera, iyo inonzi body mass index (BMI kana Quetelet index) inofungidzirwa, inoverengwa nekuparadzanisa uremu, inoratidzwa mu kg, ne square yehurefu, inoratidzwa mumamita.

Iyi data muchiitiko chemwana inofanira kugara ichifananidzwa neyakajairwa kukura macurves ezera uye inofanirwa kutariswa nekufamba kwenguva kuti iongorore maitiro.

Zvakakosha pakuwongorora mwana ane huremu hwakanyanya kana kufutisa kufungawo nezvekuvapo kwezvimwe zvirwere zvakadai se:

• Hypertension;
• Pre-diabetes uye chirwere cheshuga mellitus;
• Dyslipidemia;
• Non-doro hepatic steatosis;
• Gastroesophageal reflux;
• Polycystic ovary syndrome;
• Kurara-kutadza kufema;
• Orthopedic matambudziko;
• Idiopathic endocranial hypertension;
• Matambudziko epfungwa;
• Kusadzora kudya kusagadzikana.

Mamiriro ese aya anoratidza mamiriro ekunyanya kushomeka kwekudya nekuwedzeredza, izvo zvingada multidisciplinary manejimendi munzvimbo dzechipiri-nechitatu-nhanho nyanzvi.

Zvinangwa zvekurapa kwekushaya zvokudya zvinovaka muviri zvakanyanya zvakasiyana zvichienderana nekuoma kwehuremu hwakawandisa (kana kuwandisa) uye zera remwana.

Kunyanya muvana vakafuta vane makore ari pasi pemakore mashanu, kuderera kwehuremu kunofanira kuwanikwa, uye muvana vakafuta "huremu hwakasimba" hunofanira kuwanikwa.

Muvana vane makore ari pakati pe5 ne11 ekuberekwa, 'huremu hwakasimba' hunofanira kuwanikwa muvana vakafuta, uye muvana vakafuta, kuderedza uremu isingapfuuri hafu yekirogiramu pavhiki kunofanira kunangwa.

Pakupedzisira, muvana vane makore anopfuura gumi nerimwe, chinangwa chehuremu hwakanyanya 'huremu hwakasimba' asi mukufutisa munhu anenge achivavarira kuderedza uremu zvisingadarike 11 kg pasvondo.

Zvinangwa izvi zvinogona kuzadzikiswa nekudya uye maitiro ekurapa

Nhungamiro inorayira pamusoro pekushandiswa kwezvokudya zvakaderera-calorie kunze kwezviitiko zvakasarudzwa zvachose.

Kurapa kwekufutisa mukushaya chikafu chinovaka muviri kunofanirwa kuvimbiswa nerutsigiro rwakasiyana-siyana runosanganisira mabasa akati wandei pamatanho akasiyana ekuomarara: chiremba wevana vemhuri haagone kudzora kufutisa kwakaoma ari ega (mumamiriro ezvinhu akadaro anofanirwa kutsvaga rubatsiro kubva kune yechipiri- uye yechitatu-nhanho nyanzvi zvimiro) .

Uyezve, zvakakosha kuti hutungamiri hwekufutisa hutarisirwe kwete chete nenyanzvi dzehutano asi neaya mabasa anoshanda nevana, saka mitemo yezvehutano inofanirwa kuvimbisa kusimudzirwa kwehutano hwakakwana uye kuve nechokwadi chekuti nzvimbo dzese dzinoshanyirwa nevana (kwete zvikoro chete. !), shandai pamwe chete kuvimbisa mararamiro akanaka.

Kurapa kwechipiri-mutsara senge pharmacotherapy uye kuvhiyiwa kwebariatric kune zviratidzo zvishoma nekuti kushanda kwavo kunogumira kumakesi anofanirwa kunyatsosarudzwa.

Muvana vane makore gumi nemaviri kana kupfuura avo kupindira kwehupenyu kuderedza uremu kwakundikana, chiratidzo che pharmacotherapy chinogona kutariswa.

Chiratidzo chekuvhiyiwa kwebariatric chinogamuchirwa muvarwere vakatogadzirwa zera (pubertal nhanho 4-5 maererano naTanner uye kusvika kana kusvika padanho rechimiro) ne

• BMI yakakura kudarika kana yakaenzana ne 40 kg / m2 uye zvirwere zvinosanganiswa zvisiri zvakakomba zvakadai sepnea inodzivirira kurara (apnea / hypopnoea index kana AHI yakakura kupfuura 5), ​​hypertension, dyslipidaemia, kukanganisa glucose kushivirira;
• BMI yakakura kudarika kana yakaenzana ne35 kg/m2 uye chirwere chimwechete chakakomba chakabatana chakadai serudzi rwechipiri chirwere cheshuga, moderate-to-severe obstructive sleep apnea (AHI inopfuura 2), benign endocranial hypertension, non-alcoholic steatohepatitis ine inokosha fibrosis. .

Psychotherapy inofanirwa kukurudzirwa muzviitiko zvese zvingada rubatsiro rwepfungwa.

Kudzivirirwa kwekufutisa uye kushaya chikafu chinovaka muviri nekuda kwekuwandisa kunofanirwa kutanga kubva panguva yekuzvara nekudzivirira huremu hwekuzvarwa hwakaderera kana hwakanyanya, prematurity uye mamwe matambudziko.

Mune mushure mekuberekwa, kune rumwe rutivi, zvakakosha kutevera mamwe mitemo yekuzvibata: kudzivisa zvinwiwa zvine shuga mumakore maviri ekutanga ehupenyu, uye usawedzera mapuroteni quota kupfuura mazinga akakurudzirwa ekutora.

Sangano reItalian Society of Paediatrics neItalian Society of Pediatric Endocrinology uye Diabetology vakagadzira decalogue inobatsira yekudzivirira kushaya chikafu nekuda kwekuwedzeredza:

• Tarisa uremu hwako uye kureba nguva nenguva (inenge mwedzi mitanhatu yega yega);
• Iva nekudya kashanu pazuva, kudzivisa 'kunze kwekudya';
• Idya zvimedu zvishanu zvemichero kana miriwo pazuva;
• Inwa mvura yakawanda, kuderedza zvinwiwa zvine shuga;
• Deredza mafuta patafura, kunyanya nyama inotonhora, zvokudya zvakakangwa, condiments, sweets;
• Rega kushandisa chikafu se'mubairo';
• Ipa zvaunofarira kutamba kunze, kana zvichibvira ingangoita awa imwe pazuva;
• Famba pazviitiko zvakawanda sezvinobvira;
• Tamba mutambo nguva dzose. Hazvina kukosha kuve shasha pane zvese zvinodhura, asi kurovedza muviri nekunakidzwa;
• Deredza 'vhidhiyo kupindwa muropa' panguva yekuzorora: yakawanda maawa maviri pazuva.

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Source:

Mwana Jesu