Control nutrition with your palm: the secret of healthy diet under the palm rule

Author: Zeng Yaxing Beijing Children's Hospital, Capital Medical University

Reviewer: Wu Di, Chief Physician, Beijing Children's Hospital, Capital Medical University, Standing Committee Member, Diabetes Branch, Beijing Medical Association

In recent years, with the development of the economy and the improvement of people's living standards, the nutritional health of children and adolescents in my country has gradually improved. However, at the same time, due to changes in dietary structure and lifestyle, coupled with the popularity of electronic products, unbalanced nutrition and insufficient physical activity among children and adolescents, the incidence of obesity and diabetes has increased rapidly.

The National Health Commission and 14 other departments have jointly formulated the "Healthy China Action - Diabetes Prevention and Control Action Implementation Plan (2024-2030)", which has included children and adolescents as the key population for diabetes. It also emphasizes the control of related risk factors such as obesity, restricts the sale of sugary drinks on campus and avoids the sale of high-sugar and high-fat foods. At the same time, it carries out universal education on diabetes prevention and control to improve the health literacy of children and adolescents.

Diabetes complications can affect multiple organs such as blood vessels, eyes, kidneys, and feet, and cause high rates of disability and mortality. If weight gain during childhood is not effectively controlled, it will not only increase the risk of diabetes, but also affect children and adolescents' motor skills, skeletal muscle development, and have adverse effects on their mental health, thus placing a heavy burden on individuals, families, and society.

The occurrence of obesity and diabetes is related to multiple factors such as dietary nutrition, physical activity and genetics, among which dietary nutrition is considered to be the key factor. The main difference between children and adolescents and adults in dietary management is that children and adolescents need to meet the needs of growth and development in particular, rather than simply controlling the amount of food they eat. A reasonable diet should include controlling the total amount, balanced nutrition, and eating small and frequent meals to ensure adequate daily intake of carbohydrates, fats and proteins. So, how can we make children "eat well, eat scientifically, and eat healthily"? Is there a simple and easy-to-learn method to help everyone understand the principles of dietary intake and dietary distribution?

Figure 1 Copyright image, no permission to reprint

The Dietary Guidelines for Chinese Residents (2022) clearly states that according to the dietary pyramid, daily meals should include cereals, vegetables, fruits, livestock, poultry, fish, eggs, milk, and legumes, with the three major nutrients accounting for roughly 10% to 15% protein, 20% to 30% fat, and 55% to 65% carbohydrates. It is recommended to consume an average of more than 12 kinds of food per day and more than 25 kinds per week, and to make reasonable combinations.

How to quickly calculate the total energy required per day? We can use the "calorie calculation formula" to quickly calculate the total energy required per day. Daily total energy (kcal) = 1000 + age × (70-100). For the coefficient selection in the formula, it is recommended to calculate 100 for children aged 1-3 years old, 90 for children aged 3-6 years old, 80 for children aged 7-10 years old, and 70 for those over 10 years old. However, it should be noted that when making individual adjustments based on the degree of obesity, the total calories should not be less than 800kcal.

How to achieve a balanced diet? We usually use the food exchange method to match and adjust the diet, but it is more complicated in actual application. In contrast, the "palm rule" is simpler and easier to use. A pair of hands can roughly determine the amount of food a person should consume at each meal: carbohydrates (staple foods such as steamed buns, flower rolls, rice, etc.) are recommended to be 1 fist-sized per meal, 2 to 3 fist-sized per day; the amount of fruit is about 200 grams, equivalent to 1 fist-sized; protein food is about the size of the palm and the thickness of the little finger; the amount of a handful of hands (raw food) is about 500 grams, 1 to 2 handfuls per day, mainly non-starchy vegetables; fat intake needs to be limited, thumbs up, only the amount of fat on the tip of a finger is needed per day. Using your own hands, you can basically determine the amount of food you need every day.

Figure 2 Copyright image, no permission to reprint

When dining out, we recommend that you use the "plate method" to estimate the amount and structure of food for each meal. Prepare a shallow plate with a diameter of about 22.7 cm, divide it into four parts, place non-starchy vegetables on the top half, and place proteins and carbohydrates on the other quarters. The plate method is simple, practical and easy to implement. It is conducive to controlling total calories and ensuring the rationality of the diet structure and nutritional balance. It is a practical trick for obese and diabetic patients to control weight and blood sugar.

The "Healthy China Action - Diabetes Prevention and Control Action Implementation Plan (2024-2030)" specifically points out: Promote the transformation from "disease-centered" to "health-centered", form a lifestyle, ecological environment and social environment that are conducive to diabetes prevention and control, reduce deaths and disabilities caused by diabetes and its complications, improve the health level of the people, and lay an important foundation for jointly building and sharing a healthy China. Let us use scientific methods and humanistic care to let children learn to control nutrition.