Tertiary level management of overweight and obese children and adolescents—Does intensive dietetic intervention using a moderate protein intake have a positive impact on weight control in children?

Abstract

Aims: To review weight loss outcomes (change in BMI z score) in a tertiary (dietetic) clinical practice, to determine if number of appointments or time between appointments is associated with outcome, to determine gender or age differences in outcome, to determine correlation between level of obesity and attrition rate and to review clinical practice dependent upon outcome. Methods: A retrospective audit with analysis of patient data collected June 2005—September 2009. Data included: Anthropometry, biochemistry, comorbidities and referral source on 210 patients (52% females). Patients attended for assessment and education on a structured moderate-protein diet. Reviews are scheduled monthly for up to 5 visits. Results: Significant reduction in BMI z score for boys at all appointments (p < 0.001). Significant reduction in BMI z score for girls by the fifth appointment (p = 0.036). Significant reduction in pre-adolescent BMI z scores at all appointments (p < 0.001). High attrition rate (50%) after the first appointment but 20% still returning for the fifth appointment. Changes in BMI z score ranging from −0.28 to −0.13. No correlation between changes in BMI z score and duration or number of clinic appointments. Conclusions: Tertiary level dietary treatment of childhood obesity using a structured moderate protein intake and regular reviews has a positive influence on childhood obesity. These findings will assist in service improvement and development of best practice guidelines for treatment of childhood obesity in a tertiary clinic setting. Funding source: None.