Current Recommendations for Nutritional Management of Overweight and Obesity in Children and Adolescents: A Structured Framework.

Shawna Pfeifflé,Magali Volery,Sophie Bucher Della Torre,Claire Pijollet,Ludivine Soguel,Maaike Kruseman,Fabien Pellegrino

doi:10.3390/nu11020362

Abstract

Nutritional management is an important component of the treatment of pediatric overweight and obesity, but clinicians struggle to keep abreast with the abundant literature. Therefore, our aim is to provide a tool that integrates the current recommendations and clinical expertise to assist dietitians and other practitioners in their decision making about the nutritional management of pediatric overweight and obesity. To construct this practice-based evidence-informed framework, we conducted a systematic review of the guidelines on nutritional management of pediatric overweight or obesity in 2 databases and in the grey literature. We analyzed and synthesized recommendations of 17 guidelines. We selected the recommendations that were common to at least 30% of the guidelines and added by consensus the recommendations relevant to clinical expertise. Finally, we structured the framework according to the Nutritional Care Process in collaboration with a specialized team of dietitians who assessed its validity in clinical practice. The framework contributes to facilitate the integration of evidence-based practice for dietitians by synthesizing the current evidence, supporting clinical expertise, and promoting structured care following Nutrition Care Process model for children and adolescents with obesity.

Highlights

Obesity in children and adolescents reaches alarming rates and the World Obesity Federation and the World Health Organization are calling to action in order to reduce the prevalence of pediatric obesity and its many associated physical, psychological, and social consequences [1]
Dietitians adhere to evidence-based practice (EBP) that is about, according to the International Confederation of Dietetic Associations, “asking questions, systematically finding research evidence, and assessing the validity, applicability and importance of that evidence
The aim of this paper is to describe the development of this tool and in particular to: (1) provide a review of the evidence on the dietary and nutritional management of pediatric overweight and obesity, (2) synthesize these evidences into recommendations fitting the Nutritional Care Process (NCP)-model and (3) propose a framework, drawn from the literature, adapted and expended with professional expertise, for the nutritional management of pediatric obesity

Summary

Introduction

Obesity in children and adolescents reaches alarming rates and the World Obesity Federation and the World Health Organization are calling to action in order to reduce the prevalence of pediatric obesity and its many associated physical, psychological, and social consequences [1]. Risk factors for obesity in children and adolescents are numerous and interact with a high level of complexity. Treatments integrating multiple targets at various levels are deemed the most effective for weight management: i.e., lifestyle interventions including diet, physical activity and behavior changes, and, for patients under 12 years old, targeting the whole family [2,3,4,5,6,7]. Qualified dietitians can contribute effectively to this complex task by providing their expertise on nutritional assessment, diagnosis, intervention and evaluation [8]. Dietitians adhere to evidence-based practice (EBP) that is about, according to the International Confederation of Dietetic Associations, “asking questions, systematically finding research evidence, and assessing the validity, applicability and importance of that evidence

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