Childhood overweight and obesity - it's not so simple

By Loretta DiFrancesco, PhD, RD, MBA
Childhood overweight and obesity - not so simple
There are multiple causes and contributors to childhood overweight and obesity, including environmental and cultural factors. It’s not as simple as eat less and exercise more! Likewise, an approach to solving these problems must also be multi-faceted.
October 7, 2013

A Multi-Faceted Approach to a Multi-Faceted Problem

The following is a summary of the Recommendations in the Position of the Academy of Nutrition and Dietetics: Interventions for the Prevention and Treatment of Pediatric Overweight and Obesity*

There are multiple causes and contributors to childhood overweight and obesity, including environmental and cultural factors.  It’s not as simple as eat less and exercise more!  Likewise, an approach to solving these problems must also be multi-faceted.

Primary Prevention

Targeting preschool aged children and community-based settings before overweight and obesity occur.
 
Summary of recommendations:

  • Integrate education with supportive environmental change
  • Include both nutrition education and physical education
  • Build in parent engagement for younger children
  • Promote community engagement in schools and child care
  • Policies that limit food availability show promise
  • Dose and continuity are important
  • Secondary Prevention
     

Focus on children who are already overweight and obese with the same primary prevention strategies, but that are more intensive and targeted
 
Summary of effective approaches:

  • Clinical-based and clinical-linked approaches – involving the primary healthcare provider
  • Dietary – a variety of approaches, including reduced glycemic load and calorie restricted diets
  • Non (or less specific) diet approaches – emphasize healthier, nutrient dense foods and portion control
  • Tertiary Prevention

Treatment regimes requiring extensive medical supervision and monitoring

Some approaches to consider:

  • Very-low-calorie diets
  • Meal replacements
  • Pharmacotherapy
  • Weight-loss surgery

*Hoelscher et al; for the Academy Positions Committee (2013).  J Acad Nutr Diet 113:1375-1394

Loretta DiFrancesco, PhD, RD, MBA
Principal Consultant, Source!Nutrition
Toronto, ON Canada

Childhood overweight and obesity - it's not so simple

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