Underweight, like overweight, is a relative term, being based on the ideal weight for a given height, build and sex. A child can be regarded as moderately underweight if he or she weights 10 per cent below the ideal body weight and markedly so if 20 per cent below the ideal body weight.
Loss of weight is one of the major problems in children. While the adjult’s weight should be more or less stationary, the child’s weight should be increasing consequently, an actual loss of weight is always to be taken seriously in a child. It calls for thorough investigation unless the cause is clear.
Thinness in children due to an inadequate caloric intake is a serious condition. They often feel easily fatigued, have poor physical stamina and lowered resistance to infection. Diseases like tuberculosis, respiratory disorders, pneumonia, circulatory disorders like heart disorders, nephthritis, typhoid fever are quite common among them.
The commonest cause of thinness in children is infection, often acute but sometimes chronic. Not all loss of weight, however, is due to physical causes. Seperation from the mother and trouble at school are examples of emotional causes.
Other causes of thinness include inadequate nutrition or excessive physical activity or both. Bad habits such as skipped meals, small meals, and inadequate exercise also contribute to thinness. Inadequate digestion and absorption of food due to a wrong dietary pattern for a particular metabolism, metabolic disturbances such as an overactive thyroid and hereditary tendencies. Disorders such as chronic dyspepsia, chronic diarrhoea, presence of parasites like tapeworm in the ailmentary canal, liver disorders, diabetes mellitus and constipation are some of the other factors leading to thinness.
Diet plays an important role in building up health for gaining weight. Nutrients which help keep the nerves relaxed are of utmost importance as nervousness cause all the muscles to become tense and energy which goes into the tensing of nerves uses up a great deal of food.
Although all vitamins and minerals are required for relaxation, the most important ones are vitamin D and B6, calcium and magnesium. The richest sources of vitamin D are milk, Cod-liver oil and the rays of the sun. Calcium is also supplied by milk and yoghurt. Magnesium can be obtained from green leafy vegetables such as spinach, parsley, turnip, radish and beet tops. These vegetables should preferably be taken in salad form or should be lightly cooked.
Lack of appetite can result from an inadequate supply of vitamin B, which leads to low production of hydrochloric acid in the stomach. Hydrochloric acid is essential for the digestion of food, absorption of vitamins and minerals into the blood. It is, therefore necessary that the daily diet should be rich in vitamin B for normal appetite, proper digestion and absorption of foods and regular elimination . Foods rich in vitamin B are all whole grain cereals, blackstrap molasses, nuts, soyabean, eggs and butter. Vegetable oil is of special value to those wishing to gain weight as it is irch in vitamin E and essential fatty acids.
Underweight children should eat frequent small meals as they tend to feel full quickly. Meals may be divided into six small ones instead of three big ones. These may consist of three smaller meals and three substantial snacks between them.
All refined foods such as products containing white flour and sugar should be avoided, as they destroy health. Excessive intake of refined carbohydrate and fats may help the individual to put on weight but this will be detrimental to general health. The diet should be tilted towards alkaline forming foods such as fruit and vegetables. Alkaline foods should comprise 80 percent of the diet. The other 20 per cent should consist of acid forming foods such as cereals and lentils. Beverages containing caffine like soft drinks, coffee, and tea should be curtailed. Water should not be taken with meal but half an hour before or one hour after meals.
Figs ( anjeer) are an excellent food remedy for increasing weight in case of thinness. The high percentage of the rapidly assimilable sugar makes them a strengthening and fattening food. The child- patient can be given one to three dry figs daily according to his age.They should be soaked in water in the night after thorough cleaning and should be taken next morning alongwith water in which they are soaked.
Raisins (Manugga) are a good food for those who wish to gain in weight. They can be taken upto half a kg. depending on the age of the child. They should be taken after soaking them in water in the same way as figs.
Regular exercises like walking and dancing, yoga and massage are also important as they seve as relaxants, reduce stress and induce good sleep. Yogasanas which will be especially helpful are sarvangasana, halasana and matsyasana.