Nutritional and Lifestyle Guide for Improving Childhood Obesity
To Parents/Guardians
This guide provides practical information to support healthy weight management for children aged 6 to 18.
When addressing childhood obesity, it is important to gradually improve lifestyle habits while ensuring the necessary nutrients for growth, rather than aiming for rapid weight loss in a short period.
Extreme dietary restrictions and self-taught diets can lead to impacts on growth, nutritional deficiencies, rebound weight gain, and eating disorders.
Obesity is not solely determined by an individual's efforts. Various factors are involved, including body type, daily rhythm, sleep, exercise levels, stress, food and drink available at home, and screen time.
Making small environmental adjustments throughout your home will help you stick with it in the long run.
For detailed meal content and sample menus, please refer to our separate article, "Dietary Guide for Improving Childhood Obesity: Protein, Bulk-Up Ingredients, and Meal Planning Tips."
Basic Concept
It's important for the whole family to work together to improve a child's obesity.
When parents serve as good role models and gradually create a supportive home environment, children are more likely to naturally adopt healthy habits.
What's important is not aiming for perfection.
First, let's start by choosing one thing you can do and try it for one to two weeks.
Basic Dining Etiquette
🥤 1. Review of drinks
When trying to improve obesity, the first thing you should re-examine is sugary drinks like juice and sports drinks.
Sweet drinks are easy to drink, but they contain a lot of sugar and are not very filling. Even if you reduce your food intake a little, your weight will not improve much if you drink sweet drinks every day.
Drinks to avoid on a daily basis
Juice
Carbonated drinks
Sports drink
Lactic acid beverage
Café au lait with sugar
🔸Milk tea with sugar
Energy Drink
Tea/coffee with sugar
Recommended drinks
Water
Unsweetened tea
Barley tea
Sugar-free sparkling water
You can drink milk, but let's decide on a quantity so you don't drink too much.
Sports drinks are perceived as "good drinks for exercise," but they are not something to drink every day for daily hydration. They should only be used during strenuous exercise that causes a lot of sweating or when instructed by a doctor.
Goal
It's recommended to reduce your intake of sugary drinks as much as possible in your daily life. We suggest starting by "not keeping them stocked at home" and "switching to water or tea."
Broccoli 2. Things to eat
When it comes to eating, "improving the content" is more important than "not eating."
Things to increase
Vegetables
Mushroom
Seaweed
Fruits
Whole grains
Brown rice
Whole wheat bread
Oatmeal
Foods rich in dietary fiber
Lean protein
Chicken
Fish
Egg
Tofu
Natto
Soybean
Eat fruit as it is, rather than as juice.
Things I want to reduce
Fast food
Processed food
🔸Salty snacks
Sweet bread
Fried food
High-fat and high-sodium foods
🔸Foods high in sugar
Thinking of things as absolutely forbidden makes it harder to stick with it. Let's separate everyday foods from the ones we enjoy occasionally.
🍚 3. Rules for eating
Set a time
Eat breakfast, lunch, and dinner as regularly as possible.
Reduce mindless snacking after coming home from school or after dinner
Make time to have meals together as a family
control the amount
🔸Do not order a large portion from the start
Serve an appropriate amount on a plate.
Do not take food from the shared platter multiple times
Eat slowly
Eat vegetables and soups first
🔸For seconds, first choose vegetables or soup
Set up the environment
🔸Don't keep juice at home
🔸Do not stock up on sweets and snacks in large bags
🔸 Do not eat while watching TV or using your smartphone.
Decide on days to eat out or use convenience stores
🔸During meals, prioritize a fun eating atmosphere over talking about weight and body shape.
🌷 4. Mood and Meals
Your child might also be eating out of boredom, stress, loneliness, or fatigue.
In that case, simply trying not to eat might not work.
Let's explore ways to calm your mind without using food.
For example, the following methods can sometimes be helpful.
Take a walk
Listen to music
Take a bath
Talk with family
Playing your favorite game
Go to bed early
🚶♀️ Exercise and Activity
For children and adolescents, about 60 minutes of physical activity per day is recommended.
However, you don't necessarily have to exercise diligently every day right from the start.
Walking, using the stairs, riding a bicycle, helping around the house, and playing outside are also included in physical activity.
Recommended activities
Brisk walking
Bicycle
Swimming
Ball game
Dance
Jump rope
Use the stairs
Housework
Dog walking
🔸Stretching
For children who are overweight, running suddenly can put a strain on their knees and feet. In the beginning, it may be a good idea to start with activities that put less stress on the legs and lower back, such as walking, cycling, or swimming.
If your knees or feet hurt, please do not force yourself to run and consult us.
Start with about 20 minutes at first, and as you get used to it, let's gradually increase the time.
📱 Reduce sitting time
Spending too much time on TV, smartphones, video games, and videos decreases the time spent moving the body and easily disrupts daily rhythms during meals and before bedtime.
In particular, habits such as eating snacks while watching videos, looking at smartphones right before bed, and going to sleep late because of playing video games tend to affect weight management.
Rules we want to decide at home
🔸Do not look at your smartphone while eating
🔸Stop using smartphones and playing games 1 hour before going to bed
🔸Do not bring smartphones into the bedroom
Use only after finishing homework, taking a bath, and preparing for tomorrow.
🔸Set a time limit so you don't use it too much even on days off
🔸Do not eat snacks while watching videos
Time I want to be screen-free
🔸During meals
🔸1 hour before bed
🔸 During morning school preparation
🔸Studying
🔸Time for family conversation
Places where I want to be screen-free
Bedroom
Dining table
Study desk
Sleep
Getting enough sleep is also important for weight management.
Lack of sleep leads to increased appetite, late-night snacking, and reduced daytime physical activity. Going to bed later makes it harder to wake up in the morning, making it easier to skip breakfast and reducing the time spent moving the body during the day.
Recommended sleep duration by age
| Age | Recommended sleep duration |
|---|---|
| Ages 6 to 12 | 9 to 12 hours |
| 13-18 years old | 8 to 10 hours |
Tips for better sleep
🔸Do not significantly change your wake-up time even on days off
🔸Do not make a habit of eating midnight snacks
🔸 Do not drink sugary drinks right before going to bed
Basking in the morning sun
Eat breakfast
Try to go to sleep around the same time every day
Regarding the rules for smartphones and games, please also refer to the "Reduce sitting time" section.
Parents' Role
1. To set a good example
Eat healthy meals together
Let's exercise together
Choose water or tea
🔸 Reduce staying up late
2. Improve the home environment
Prepare healthy foods
🔸Reduce stockpiling of juice and snacks
Regulate eating and sleeping rhythms
Make time to cook meals with family
3. Support
Finding small successes
Focusing on healthy behaviors rather than weight or appearance
Acknowledge what has been continued
Care about whether there is bullying or teasing
Examples of what to say
🔸"Let's eat in a way that revitalizes our bodies"
🔸 Let's get ready for a good night's sleep
🔸Let's start by cutting back on juice.
🔸"Let's switch to tea or water as a family"
🔸 "Let's make some time to move our bodies."
4. Setting goals together
🔸Set achievable goals together with your child
🔸Start with one small change a week
Once achieved, move on to the next goal
🔢 Recommended daily calorie intake by age
The following is a general guideline. Required amounts vary greatly depending on age, gender, height, activity level, and developmental stage.
man
| Age | Estimated recommended calorie intake |
|---|---|
| Ages 6 to 8 | 1,400 to 2,000 kcal |
| Ages 9-13 | 1,600 to 2,600 kcal |
| Ages 14 to 18 | 2,000 to 3,200 kcal |
Woman
| Age | Estimated recommended calorie intake |
|---|---|
| Ages 6 to 8 | 1,200 to 1,800 kcal |
| Ages 9-13 | 1,400–2,200 kcal |
| Ages 14 to 18 | 1,800 to 2,400 kcal |
Attention
Even when adjusting meal portions to improve obesity, extreme calorie restriction is not recommended for growing children. If necessary, proceed in consultation with a doctor or dietitian.
🥗 Nutritional Balance Guide
For growing children, not only calories but also nutritional balance is important.
| nutrients | estimate |
|---|---|
| Protein | Eat at every meal to support growth, muscles, and bones. |
| Lipid | Be careful not to consume too much, and avoid eating fried or fatty foods every day. |
| Carbohydrates | Adjusting the quantity and quality without completely eliminating it |
| dietary fiber | get from vegetables, mushrooms, seaweed, legumes, and whole grains |
It is easier to sustain and safer to review sugary drinks, snacks, late-night meals, and fried foods than to completely cut out staple foods.
For detailed information on dietary content, how to consume protein, and creative menu ideas using shirataki, konjac, mushrooms, seaweed, and tofu, please refer to our other article.
⚠️ Things to avoid
Extreme calorie restriction
Trending diet
🔸 Meals with unbalanced nutrition
Skipping meals
Focusing only on weight and appearance
Depending on DIY supplements or meal replacement diets
🩺 When extra caution is needed
If you experience any of the following symptoms, it is necessary to check not only your weight, but also your sleep, blood pressure, blood test results, joint pain, and mental state.
Suddenly gained weight
🔸 Loud snoring
🔸Very sleepy during the day
High blood pressure
🔸Told I have abnormal liver function
🔸Told I have dyslipidemia
🔸Told I have abnormal blood sugar levels
Pain in the knees or feet
🔸Irregular menstruation
🔸Dietary restrictions are becoming stricter.
🔸Strong obsession with weight and body shape
🔸Continuing midnight snacking / binge eating
🔸 Feeling depressed
Having a hard time going to school
My body hurts so much that I hate the idea of exercising
If you have any concerns, please feel free to discuss them during your consultation.
🌈 Important things
Don't rush
Improving your weight in a healthy way takes time.
🔸Gradually organizing the home environment
Let's start with things the family can do so that your child can continue without strain.
Accumulating small changes
Don't try to change everything at once; start with something easy to keep up.
Continue
It is important to create habits that you can maintain for a long time, rather than going on a temporary diet.
Think positively
Pay attention not only to your weight, but also to changes in your daily life, such as sleeping better, feeling less tired, moving more easily, and waking up easier in the morning.
🗓 Things you can start in the first week
Trying to change everything at once makes it hard to keep going.
First, let's start by choosing one or two from the following.
🔸 Replace sugary drinks with water or tea
🔸Eat a meal together with the family at least once a day
Walk together for 20 minutes every day
🔸 Reduce screen time by 30 minutes
🔸Reduce the number of snack types at home by one
🔸Try stopping midnight snacks for a week
🔸Go to bed 15 minutes earlier
It is important to accumulate small changes.
🌸 Finally
Let's start with a small step.
Improving your child's obesity is not something that yields results in a short period of time.
It is important to gradually create an environment throughout your household that allows you to continue without undue strain.
References
Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023;151(2):e2022060640.
U.S. Preventive Services Task Force. High Body Mass Index in Children and Adolescents: Interventions. 2024.
Nicholson WK, Silverstein M, Wong JB, et al. Interventions for High Body Mass Index in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2024.
Kelly AS, Armstrong SC, Michalsky MP, Fox CK. Obesity in Adolescents: A Review. JAMA. 2024.
Jebeile H, Kelly AS, O'Malley G, Baur LA. Obesity in Children and Adolescents: Epidemiology, Causes, Assessment, and Management. Lancet Diabetes & Endocrinology. 2022.
Paruthi S, Brooks LJ, D’Ambrosio C, et al. Recommended Amount of Sleep for Pediatric Populations. Journal of Clinical Sleep Medicine. 2016;12(6):785-786.
Ministry of Education, Culture, Sports, Science and Technology. Standard Tables of Food Composition in Japan, 20th Revised Edition, 2023 Supplement.
Ministry of Education, Culture, Sports, Science and Technology. Food Composition Database.