Youth health topics

It has never been a single issue of "nutrition and more exercise", but a mess of three dimensions: physical, psychological, and social support. There is no one-size-fits-all solution, and all intervention methods that try to be one-size-fits-all will eventually rebound.

Last week, I met a boy in the third grade of junior high school at the community youth free clinic. He was 1.83 meters tall and weighed almost 200 pounds. His systolic blood pressure was measured to be 140mmHg. The scale screening also showed mild anxiety. The first sentence his mother asked while holding the report sheet was "Doctor, do you want to give the child some DHA?" My recent mock test results dropped by five points. Is it because my brain can't keep up? ”I watched the child lower his head and pick at the zipper of his school uniform, and I didn't say anything for a long time.

This is actually a typical misunderstanding that many families have about adolescent health: they always equate "health" with "good grades, eating and growing up". As long as they don't have a fever or cold and are hospitalized, they assume that there is nothing wrong with their children. But the numbers in the "2023 Report on the Nutrition and Chronic Disease Status of Chinese Residents" are here: the overweight and obesity rate among children and adolescents aged 7-18 has reached 19.0%, the myopia rate exceeds 53.6%, and the detection rate of depressive symptoms among adolescents aged 14-18 is close to 18% - these problems are all accumulated quietly, and by the time parents discover something is wrong, it has often been delayed for less than half a year.

There is a lot of debate in the academic community about the direction of intervention in adolescent health, and there is no unified conclusion. Most experts in the field of public health advocate hard policy constraints, such as increasing the proportion of physical education classes in compulsory education to more than 10% of the total class time, and mandating one hour of outdoor activity time every day. Many pilot schools in Shenzhen and Shanghai have already implemented this. I went to a junior high school in Nanshan, Shenzhen for research. Not only did they have a physical education class every day, but they also changed the 10 minutes between classes to mandatory outdoor activities that "no stay in the classroom". After one semester of the pilot, the new myopia rate among students dropped by 7 percentage points. But the opposition is also very real: I know a grade director of a provincial key middle school who tried to change the self-study class before evening self-study to a 30-minute group run last time. The average grade score for the monthly exam that month dropped by 2.1 points. The parents were in trouble for three days, and finally had to change it back. "If you tell your parents about the risks of myopia and obesity, they will only tell you, 'You can't get into a good university. What's the use of being in good health.'"

Researchers in the field of psychology prefer to start from the bottom-up of emotions. They believe that most of the current physiological problems are essentially the externalization of emotional problems: staying up late to check the mobile phone is not due to poor self-control, but because only the hour before going to bed is completely your own time.； Overeating is not about being greedy, it is about eating when you are stressed and only eating can bring you certain happiness. I previously interviewed a girl who was a sophomore in high school. She suffered from nervous vomiting for almost half a year. After a full physical examination, she found no organic problems. After talking to her three times, I found out that her mother would watch her take supplements every time she failed in the exam. "I feel sick when I see those bird's nests and protein powder, but it makes me feel better to spit it out." Of course, many elders do not agree with this statement. They always feel that "we didn't have so many psychological problems when we were young, because today's children are too squeamish." This view is not entirely wrong, but it ignores one of the core variables: the intensity of competition and the pressure of comparison on social networks that today's teenagers have to face are things that children twenty years ago never experienced.

To be honest, I have been doing youth health intervention for five years, but I have not found any universal solution. I have conducted a small-scale pilot program for several classes in the second grade of junior high school before. They were not asked to run in circles and check in. They were only asked to remember one small thing every day that "does not need to consider right or wrong, as long as they are happy." Of course, there are also mistakes: There was a little boy who gained three pounds by eating ice cream for a month. His mother came to complain about my "bad idea."

You see, this is such a contradiction. Just like you can't ask a child who attends four cram schools every day to solve his health problems by "going to bed early and getting up early", you can't ask a school where the pressure for further studies hangs over your head to change all self-study classes into physical education classes. No one is completely wrong, but all the pressure will eventually fall on the child.

I talked to several high school students who love to play basketball before. They said that the happiest thing is not the formal physical education classes arranged by the school, but the happiness of occasionally skipping late night self-study and secretly going to the playground to play basketball for 20 minutes and chatting in the evening breeze. It is more effective than ten psychological counseling classes. Of course, I am not encouraging everyone to skip late night self-study. I just feel that health should not be a KPI based on a table. Don't always think about arranging the "correct" diet, "correct" exercise time, and "correct" routine for your children. Leaving a little space for them to run wild is better than anything else.

After all, the essence that can keep people healthy is that you feel "living is interesting" from the bottom of your heart, right?