Youth health management content

The core of adolescent health management is by no means "unified indicator check-in", nor does it only focus on the three explicit standards of "not getting sick, growing tall enough, and having good eyesight", but dynamic personalized intervention covering the three core dimensions of physiological development adaptation, mental state adjustment, and behavioral habit correction. There is no universal plan that is suitable for all children. All intervention actions must match the individual's development rhythm, growth environment, and personality traits.

Not long ago, I was doing a free youth health clinic on the street, and I met a boy in the third grade of junior high school who was already 1.72 meters tall at the age of 15. His mother was very anxious while holding a height comparison table. She said that the average boy in the same class was 1.75 meters tall. A difference of 3 centimeters would affect his future entrance to the police academy. In order to pursue height, she forced her children to drink 3 cups of whole milk every day, jump 1,000 ropes, and not touch Coca-Cola. She stopped basketball classes on weekends and replaced them with nutritional supplements. As a result, the children secretly poured the milk into the sewer, hid in the corridors while skipping rope, and even started picking their hands until they bled due to stress. She dropped 27 places in the mock test. The parents thought it was an IQ problem at first, but they realized after talking for a long time that their health management had gone astray from the root.

To be honest, the current understanding of the health management of adolescents in the parent circle is basically polarized: one group is the "metrics-oriented" group. They have four or five different versions of height and weight comparison charts and vision standard charts on their mobile phones. If the BMI exceeds 0.1, they will start to cut off staple food for their children. If the bone age exceeds half a year old, they will ask around for growth hormones and inhibitory injections. Even the daily water intake must be clocked in milliliters. They want to fit all of their children's lives into a standard template.； The other school is the "let nature take its course", which believes that "children will be fine when they grow up" and wear glasses if they are short-sighted. Being fat is "cute and strong", and having a bad mood is "rebellious in adolescence, and you can get over it with just a few scoldings". Even children who have had insomnia for half a month and don't want to go to school think it is hypocritical, and do not take early abnormal signs seriously.

Both of these approaches actually go to extremes. I had a case last year of a 12-year-old girl named Duoduo. Her mother was a typical "indicator". The physical examination revealed that her bone age was over 8 months and her height was 2 centimeters shorter than the standard value. She cried on the spot and wanted to give the child growth hormone injections. I took my child and chatted alone for half an hour before I found out that she had to attend three cram schools every day after school, drink a cup of full-sugar milk tea every day before going to bed, hardly go out on weekends, and even took time off from school to make up for homework. Later, instead of taking the injection, we discussed with her parents that we cut one of the weekend cram schools and replaced it with a rock climbing class of her own choice. The milk tea was replaced with freshly squeezed corn juice without sugar. We left an extra 10 minutes every day before going to bed for her to draw at will. After half a year, we took the test again. Not only did her bone age not advance, but her height actually increased by 4 centimeters. Her mother no longer stares at the comparison chart every day and wipes tears from her eyes.

Many people think that health management means taking care of the body, but in fact it is not. What particularly impressed me was that a mother brought her 14-year-old son here last month. She said that the child complained of headaches every day. She went to three hospitals for CT scans and electroencephalograms, but no organic problems were found. She took a lot of medicines but it didn't work. Later, I left the parents alone to talk to the child, and I found out that he was the disciplinary committee member of the class. The teacher asked him to remember the names of the classmates who spoke in class. As a result, he was isolated by the classmates. No one even sat at the same table with him in the cafeteria. He did not dare to ask the teacher for a change of position, and was afraid that his parents would say he was useless. He suppressed it every day and suffered from neurological headaches. Later, we communicated with the teacher and offered him a job as a publicity committee member, and asked his parents to accompany him to play his favorite basketball game twice a week. Within a month, he no longer had the headache.

As for the question that parents are asking a lot now, "Can they let their children go to the gym to do strength training, or should they take protein powder?" In fact, there is no absolutely unified conclusion on this issue in the field of sports medicine: some experts believe that the epiphysis has not yet closed in adolescents, and high-intensity resistance training can easily damage the epiphyseal line and affect the final height.； Some experts also pointed out that as long as the movements are standardized and the weight is appropriate, appropriate strength training can increase bone density and improve the rounded shoulders and hunched posture, which will do more good than harm to development. Our current consensus in frontline intervention is that there is no need to force children to do sports they don’t like. If they don’t like running, don’t force them to run circles every day. If they like playing badminton, go play badminton. If they like climbing trees, go climbing. As long as you can ensure more than one hour of outdoor time every day, exercise is more effective than any standardized training. ； As for supplements, as long as you eat a balanced diet and consume enough meat, eggs, milk and vegetables, there is no need to take extra protein powder and multivitamins. Taking too much will increase the metabolic burden on the kidneys.

After six years of doing youth health intervention, my biggest feeling is that there is no template for a "perfect healthy teenager". Some children grow early, some grow late, and some children just like to be quiet and not active. As long as there are no organic abnormalities in the physical examination indicators, and they usually feel relaxed, eat well and sleep well, there is no need to worry about those standard values ​​every day. In the final analysis, health management is about helping children develop healthy habits that will benefit them for a lifetime, rather than putting layers upon layers of digital shackles on them.