Dietician advice for weight gain

[rainydogday]

Can anyone give advice or tips for fuelling a very sporty tall 15 year old boy. He is 6" 5 and weighs about 12st. BMI looks normal range. He plays lots of sport but has frequent episodes of fainting after or during sports - which isn't great as he feels awful and is effecting his sport. Have seen the GP a while ago and they said just as he is tall he has vaso vagal episodes. I think he needs way more meat on his bones. I just can't seem to get enough long lasting food in him. Has anyone got some food ideas that may help him put on weight and how often he should be eating. He is very partial to eating crap and I wonder if he is eating too many snacks then not his main meals. Stuck in a cycle!

What is he actually eating on an average day, it is difficult to advise without this info.

Has some kind of big bowl of cereals in the morning (either cheerios or shreddies), morning break a bagel with peanut butter and jam. Lunch chicken, cheese and salad wrap, chocolate biscuit of some kind. After school usually a chocolate milk and some more biscuits and yogurt. Tea is things like chilli and rice. Breaded fish and homemade chips with veg. Before bed another bowl of cereals and an apple.

Who has advised he needs to put on weight?

You dont say that the doctor said this?

They haven't commented only on the faints to do with being tall. Advised fluids and salt on food. This was before he sprouted upwards even more. I don't think the food he consumes is working for the amount he burns off. Athletics twice a week and rugby (in season 2/3 times a week) and then school PE on top and gym sessions. Maybe i need to actually somehow calculate what his intake should be. I just hate seeing him passing out. It really embarrasses him as he is all about the sports and fitness. (Not so much about how to eat and fuel).

Well if he is within a healthy BMI and the doctor hasnt said he needs to gain weight then I would focus elsewhere. If they have advised salt and fluids, sounds like they're saying it could be low blood pressure perhaps, did they refer on for any heart checks or anything.

No, I have made another appointment for next week. Thanks for replies

Postural hypotension is incredibly common after a major growth spurt, so the fluids/salt advice makes sense.

To me that looks about the right amount for average activity rather than for someone doing a lot of sport. I wonder if any of the sports clubs have access to dietician support to give his diet a once over to see if it has the right balance for his needs?

Ahead of the appointment I would keep a detailed food dairy and take that along with you.

I'm my early 20s I went to the GP because I was struggling with energy and took a food diary along and I thought I was doing pretty well (in recover from an eating disorder) but low energy and my weight was creeping down. The GP said my diet was brilliant if I was on the top side of the healthy weight and was trying to limit any gains but not enough to maintain and nudge my weight up from the bottom of the healthy range. I had 6m of eating 2 breakfasts (toast and porridge for example) a proper meal for both lunch and dinner rather than sandwiches/wraps for lunch and some healthy snacks mid morning, afternoon and in the evening. It made quite a difference to my energy levels but not a huge difference to my weight but it did reverse the drifting down and I was now easily maintaining my weight. After a few months I dropped the second breakfast and after 6 months I was ok with sandwiches for lunch time.

My nephew was like this - still is apparently in late 30's. He has protein shakes made with milk a couple of times a day as he finds it hard to consume enough volume of food to maintain his weight.

Oh and also I know of several young men who have 2 dinners - one with family and then they cook themselves another dinner later on. Both DD's boyfriends do this (not same area of the country so not social contagion) and one of them has 3 evening meals by preference - he will eat early with his GP's, eat with M and D and then cook himself another meal later on 😳

Glad I had girls!!

Unless he has an absolute ton of fish for his evening meal, that's less protein than I eat at 8.5 stone. I would add in eggs and also something like chicken breast in chunks, mix in some yoghurt and spices, cook a load in the oven/air fryer. Then he can snack on that in the evening rather than nutritionally poor cereal.

I wonder if part of the issue might be that he is burning up those carbs quickly without enough protein? Omelette, toast and fruit would be a much better breakfast. And a wrap for lunch really doesn't seem enough for that size and level of sport! Could you try to find out some info about what professional sports people eat? (Warning - could be expensive for you!!!)

Thank you so much for your replies. We have some information through his sport but it's lots around Protien and balance. He goes through stages of protein shakes etc but then didn't like them! I know protein keeps you going for longer but i know it sounds mad but I thought needs some actual fat in him for reserves. We have had a chat and he has started on porridge before bed (he used to have it as a baby)! Then agreed to have full fat Greek yogurt instead of low fat high protein (expensive) fitness type ones. Massive teenage boys are expensive to feed!!!

I think the other problem he has is pre match nerves and he doesn't seem to want to eat much

I’m not sure I’d assume he needs to put weight on.
If he’s fainting I’d get blood tests and blood pressure etc
Make sure he’s getting water and salt. My friend has POTS and she said even eating some salt and vinegar crisps and salt when cooking veg can make a small but worthwhile difference.

I’ve been naturally skinny all my life, and in middle age I’ve finally got to my desired weight, but early teens to 30s were really tough. For me, I think I need a high protein diet, I probably ate too much carbs before, and I don’t think that adds weight for me. Everyone is different, some people pile the weight on with carbs, but definitely for me a higher protein diet helped me gain weight. Also, I had really bad gut health, but after treatment and probiotics I put on weight, I think the bad bacteria were stealing calories from me. If he struggles to gain muscle despite exercise this could indicate gut health is affecting him, lots of fiber (plants), probiotics, kefir, unpaturised cheese etc will help get his gut health in better balance and help him get the most out of the food he is eating.

If you have been told '"lots around protein", I really don't see how the changes you have talked about will actually increase his protein intake. Porridge better than cereal though.

Has anyonr mentioned having an ECG done? Please push for this urgently if not.

When I was younger I went through a phase of low blood sugar and so does my dad
Basically go really shaky, feel sick and light headed like I will pass out and a feeling of needing sugar. Also go grey/incredibly pale

If I eat more fat and protein I don't get it
So
Jam on toast for breakfast - bad
Scrambled eggs and butter on toast - fine

I have to balance it at every meal so I never eat carbs alone, always with protein. Also keep glucose tablets in my bag just in case

@BaffledOnceAgain I am going to ask for this at the Drs next week. My DD had these and heart scans as they queried Marfans as she was tall and thin. He is very tall but no other markers. Now a bit paranoid about the fainting. It is probably a fuel or fitness thing but want to be safe.

@rainydogday if it's easier you can get a free cardiac check with this charity
You just book

www.c-r-y.org.uk/screening/#:~:text=CRY%20offers%20subsidised%20cardiac%20screening,an%20ECG%20(electrocardiogram)%20test.

Push hard. My DH died aged 39 of an inherited heart condition he knew nothing about. The only symptom was a couple of brief faints in his teens. If he'd had an ECG, he'd still be alive. Not saying this to worry you, but if it helps you focus on persuading the GP, then I hope telling you was the right thing to do. We screened 100 young people recently in my DH's memory and the cardiologist referred any repeat fainters to our local cardiology team for checking. Lots of teens faint and most don't have a problem, but let's make sure your DS is okay.

This is the charity we just held a screening day through, and they were brilliant, but for any young person experiencing symptoms, there is no need to wait. The GP surgery can do an ECG on the spot.

@BaffledOnceAgain definitely - just with some doctors it's virtually impossible to get an appointment so 2 options then
I've heard they're meant to be really good

My 6'3" 18yo is not an athlete, goes to the gym once a week, is not over weight, but eats more than yours. He also forgets to drink between meals.

He doesn't tend to have much breakfast, but could easily eat two dinners in the evening.

I encourage him to eat protein-rich foods for snacks. Peanut butter, eggs, cheese etc. It's pretty normal for us to find an empty tin of fish in the morning, because he's been peckish in the middle of the night.