A new diet-exercise therapy in our obese-child clinic.

Because a large percentage of childhood obesity may persist into adulthood and cause a hotbed of so-called seijin-byoh (adult diseases), its treatment should also be considered from the viewpoint of seijin-byoh prophylaxis. Most obese children, however, are awkward in their movements, in spite of binge eating or bulimia, and unable to carry out any severe exercise-diet therapy. For such subjects, we have designed a new practicable procedure, and obtained excellent results for the last five years. The main principle of our procedure is that the control of caloric intake is relaxed as much as possible after due consideration of a child's growth in height: no restriction for mild, 10-15% of the requirement for moderate, and 20-25% for severe obese children, respectively. The ratio of protein/energy is established at a higher level than usual, while that of fat/energy at a lower level. For exercise, walking is the most easy and important exercise and the proper speeds for individuals are converted from the same amount of movement determined at the 1st increase point of serum lactate values, where the proportion of movement-energy originating from body fat reaches the highest percentage at about 75%. Our new procedure is supported also by the fact that the reduction in body weight combines with the improvement in measurement values of fatty metabolites without any change in values of proteins.