Journal of the Academy of Nutrition and Dietetics
From the AcademyPosition PaperPosition of the Academy of Nutrition and Dietetics: Interventions for the Prevention and Treatment of Pediatric Overweight and Obesity
Section snippets
Scope of Paper
This position paper expands on the 2006 position paper7 by including the following:
- 1.
an overview of the problem;
- 2.
a summary of six evidence-based reviews conducted through 2009 on obesity prevention and related behaviors through school-based interventions;
- 3.
an updated review of additional primary, secondary, and tertiary childhood obesity prevention and treatment literature from 2006 through April 2012 not included in the school-based reviews; and
- 4.
recommendations.
Material in this position paper
Need for Pediatric Obesity Prevention and Treatment
Healthy People 2010 goals identified reducing the proportion of overweight and obesity in children and adolescents as a key health indicator, however, this was not achieved.15 No significant change in obesity prevalence by age group was observed between 1999-2000 and 2009-2010.1 Although a “leveling off” of obesity in youth is preferable to continual increases, the prevalence rates are still alarmingly high. In addition, certain race and ethnic groups are disproportionately affected. In
Review of Evidence
The focus of this position paper is to provide guidance and recommendations for interventions targeting overweight or obesity prevention or treatment based on the available evidence. The core of this review is the 2009 evidence-based analysis conducted by the Academy on review articles examining the effectiveness of school-based interventions for nutrition education, for physical activity, and multilevel interventions, including both nutrition and physical activity on both adiposity and
Challenges
Although significant progress in prevention and treatment of child and adolescent obesity has been made, several challenges remain, including identification of methods to effectively employ systems-level approaches; reimbursement for RDs and medical nutritional therapy for pediatric obesity treatment; optimal roles for dietetic technicians, registered (DTRs) in child obesity-prevention and treatment efforts; changes in the macro-environment of food availability and marketing to reinforce
Summary and Recommendations
For prevention of child and adolescent overweight and obesity, school-based evidence reviews, recent studies, and current recommendations all indicate the importance of multilevel approaches that involve various components or sectors of influence. Consistent messages across these sectors are critical and can be reinforced through community-level interventions and social marketing. For weight management, comprehensive, multicomponent interventions that include diet, physical activity, behavioral
References (150)
- et al.
Global and physical self-esteem and body dissatisfaction as mediators of the relationship between weight status and being a victim of bullying
J Adolesc
(2009) - et al.
Severe obesity and selected risk factors in a sixth grade multiracial cohort: The HEALTHY study
J Adolesc Health
(2010) - et al.
Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents
J Pediatr
(2004) Systematic review of childhood obesity prevention
J Pediatr Nurs
(2008)- et al.
Reductions in the energy content of meals served in the Chilean National Nursery School Council Program did not consistently decrease obesity among beneficiaries
J Nutr
(2008) - et al.
Reducing obesity in early childhood: Results from Romp & Chomp, an Australian community-wide intervention program
Am J Clin Nutr
(2010) - et al.
A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: A realistic synthesis of the evidence
Public Health
(2007) - et al.
Impact of garden-based youth nutrition intervention programs: A review
J Am Diet Assoc
(2009) - et al.
Physical activity across the curriculum (PAAC): A randomized controlled trial to promote physical activity and diminish overweight and obesity in elementary school children
Prev Med
(2009) - et al.
Report on childhood obesity in China (8): Effects and sustainability of physical activity intervention on body composition of Chinese youth
Biomed Environ Sci
(2010)
Promoting healthy lifestyles among adolescent boys: The Fitness Improvement and Lifestyle Awareness Program RCT
Prev Med
New moves-preventing weight-related problems in adolescent girls a group-randomized study
Am J Prev Med
After-school program impact on physical activity and fitness: A meta-analysis
Am J Prev Med
U.S. school travel, 2009 an assessment of trends
Am J Prev Med
Physical activity levels of children who walk, cycle, or are driven to school
Am J Prev Med
Sedentary behavior and obesity development in children and adolescents
Nutr Metab Cardiovasc Dis
Media, social networking, and pediatric obesity
Pediatr Clin North Am
Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth
J Am Diet Assoc
Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents
J Pediatr
Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010
JAMA
Health-related quality of life of severely obese children and adolescents
JAMA
Relationship between sleep apnea, fat distribution, and insulin resistance in obese children
J Clin Sleep Med
Health consequences of obesity in youth: Childhood predictors of adult disease
Pediatrics
Tracking of childhood overweight into adulthood: A systematic review of the literature
Obes Rev
Position of the American Dietetic Association: Individual-, family-, school-, and community-based interventions for pediatric overweight
J Am Diet Assoc
Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive school nutrition services
J Am Diet Assoc
Position of the American Dietetic Association: Local support for nutrition integrity in schools
J Am Diet Assoc
Position of the American Dietetic Association: Benchmarks for nutrition in child care
J Am Diet Assoc
Position of the American Dietetic Association: Child and adolescent nutrition assistance programs
J Am Diet Assoc
Position of the American Dietetic Association: Nutrition guidance for healthy children aged 2 to 11 years
J Am Diet Assoc
Position of the American Dietetic Association: Weight management for adults
J Am Diet Assoc
Position of the American Dietetic Association: Promoting and supporting breastfeeding
J Am Diet Assoc
Outcomes and costs of primary care surveillance and intervention for overweight or obese children: The LEAP 2 randomized controlled trial
BMJ
The cost-effectiveness of a school-based overweight program
Int J Behav Nutr Phys Act
Economic analysis of a school-based obesity prevention program
Obes Res
Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation
Creating healthy food and eating environments: Policy and environmental approaches
Annu Rev Public Health
The economics of childhood obesity
Health Aff (Millwood)
Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report
Pediatrics
CDC growth charts: United States
Adv Data
Clinical tracking of severely obese children: A new growth chart
Pediatrics
Clinical measures of adiposity and percentage fat loss: Which measure most accurately reflects fat loss and what should we aim for?
Arch Dis Child
Preventing Childhood Obesity: Health in the Balance
State requirements and recommendations for school-based screenings for body mass index or body composition
Prev Chronic Dis
Utility of waist circumference percentile for risk evaluation in obese children
Int J Pediatr Obes
Ethnic group differences in waist circumference percentiles among U.S. children and adolescents: Estimates from the 1999-2008 National Health and Nutrition Examination Surveys
Metab Syndr Relat Disord
Cited by (218)
Assessment of an intervention for preventing pediatric overweight and obesity through the World Café technique: A qualitative study
2024, Journal of Pediatric NursingFuel for Fun Process Evaluation Reveals Strong Implementation and Approval with Varied Parent Engagement
2023, Journal of Nutrition Education and BehaviorTreatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews
2022, Journal of the Academy of Nutrition and DieteticsPrevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews
2022, Journal of the Academy of Nutrition and Dietetics
This Academy of Nutrition and Dietetics position was adopted by the House of Delegates Leadership Team on December 22, 2006 and reaffirmed on July 7, 2009. This position is in effect until December 31, 2017. Requests to use portions of the position or republish in its entirety must be directed to the Academy at [email protected].
Authors: Deanna M. Hoelscher, PhD, RD, LD, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX; Shelley Kirk, PhD, RD, LD, Center for Better Health and Nutrition/HealthWorks!, The Heart Institute at Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Lorrene Ritchie, PhD, RD, Atkins Center for Weight and Health, University of California, Berkeley, CA; Leslie Cunningham-Sabo, PhD, RD, Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
Reviewers: Mary Beth Arensberg, PhD, RD, LD, FADA (Abbott Nutrition Products Division, Columbus, OH); Jeanne Blankenship, MS, RD (Academy Policy Initiatives & Advocacy, Washington, DC); Academy Quality Management Committee (Terry Brown, MBA, MPH, RD, LD, CNSC, Medical City Hospital, Dallas, TX); Sharon Denny, MS, RD (Academy Knowledge Center, Chicago, IL); Public Health Community Nutrition dietetic practice group (Nicole Larson, PhD, MPH, RD, University of Minnesota, Minneapolis, MN); School Nutrition Services dietetic practice group (The University of Mississippi, Oxford, MS); Melissa Pflugh Prescott, MS, RD, CDN (Nutrition Consultant, New York, NY); Katryn Soltanmorad, RD (Tahoe Truckee Unified School District, Truckee, California); Alison Steiber, PhD, RD (Academy Research & Strategic Business Development, Chicago, IL); Weight Management dietetic practice group (Samantha Weiss, MPH, RD, LD, ARAMARK, Round Rock, TX); Pediatric Nutrition dietetic practice group (Tsun-Min “Mimi” Wu, MS, RD, New York City Department of Health and Mental Hygiene, New York, NY).
Academy Positions Committee Workgroup: Aida Miles, MMSc, RD, LD (chair); Karen P. Lacey, MS, RD, CD; Nancy Cooperman, MS, RD, CDN (content advisor).
Assistance in formatting and referencing provided by Whitney E. Chlon; Christina Ly, MPH; Tiffni E. Menendez, MPH, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX.