Why some children get fatter than others

'My son eats half as much as the neighbor's and yet he has a tendency to gain weight'. This phrase or a similar one is heard a lot in the pediatrician's office. The truth is that it is a real challenge to provide a coherent, scientifically based explanation that avoids costly and painful analytics, or that helps to resolve conflictive situations within the same family. For example, when one of the brothers is overweight and the other maintains a normal weight for his height and age despite eating more food, or, what is more disconcerting, despite eating 'worse', that is, eating more chips and more pastries than brother ... Why is this happening?

1. The child 'pecks more'. On some occasions, the appreciation of the quantity and quality of the food that one and the other eat is wrong. It is not true that the overweight child eats less or the same as another of the same age and height. The family may not count well those 'extras' that are often included.

2. The child 'eats secretly'. And it may even happen that the child ingests secretly and between meals (it is quite common to visit the cookie cupboard before going to sleep or at snack time) snacks or unhealthy food with high energy density.

3. Genetic issues. On other occasions, and this is more frequent, it is very evident that there are children (and also adults) who, eating the same quantity and quality of food as others who remain without overweight for years, find it easier to conserve energy in the form of fat. Genetics has studied (and continues to do so) these types of situations and we get to know better every day, the genes that have lasted for centuries of evolution to favor the accumulation of energy in the form of fatty tissue, as the usual in our long and millennial history as human beings it was spending a lot of energy to look for food and to survive because there were no supermarkets or orchards full of appetizing vegetables and fruit trees.

4. The actual society. In any case, even if your child has the so-called thrifty genes, the interaction with our current society will be responsible in 95-97% of cases for excess weight. The phrase is already classic: the genes load the gun, but the environment and our way of life pull the trigger.

For all these reasons, we must know well how the metabolism of our children works, and whether or not they are 'energy savers', it is highly advisable that match the quantity (and quality) of calories ingested with your genetics and activity levels, since physical activity is the most variable component within total energy expenditure (1).

Variations in Energy Expenditure at Rest (the energy that a child spends while resting) are related to:

- The weight

- Lean body mass (muscles, bones and organs)

- Sex (boys spend more than girls)

- Age (in adolescence there are increased needs)

- Genetic factors (individual but the weight of family members also 'matters')

- The race, Y multiple environmental factors (For example: the cold outside temperature forces us to spend more to keep our interior temperature stable).

- Finally, it also influences the nervious system (sympathetic or parasympathetic predominance) and our previous nutritional and clinical situation.

Really, then, there is no problem if a child has been thrifty (with a tendency to gain weight). On the contrary, he thinks that it is the result of genetics that are resistant to famines, ice ages and extremely long periods of droughts ... Of course, these children should eat healthy and less caloric foods. And it is no use saying that even if you eat badly, you will burn it with exercise: it is not worth eating badly, NEVER!

(1) Human Energy Requirements. Report of a Joint FAO / WHO / UNO Expert Consultation. Rome 17-24 October 2001.

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