Pediatric Weight Management
Nutrition Assessment
PWM: Assessment of Fast Food Meal Frequency in Children and Teens
The registered dietitian nutritionist (RDN) should assess the frequency of fast-food intake of overweight or obese children and teens. Limited evidence in populations eight years to 16 years of age at baseline suggests that higher frequency of fast-food consumption, particularly more than twice a week is associated with increased adiposity; BMI Z-score; or risk of obesity during childhood, adolescence and during the transition from adolescence into adulthood. (Weak, Imperative)
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Nutrition Intervention
PWM: RDN in Multicomponent Pediatric Weight Management Interventions
The RDN should be an integral part of multi-component pediatric weight management interventions. A strong body of research indicates that short-term (six-month) and long-term (two-year) decreases in body mass index (BMI) and BMI Z-scores for all age categories were more likely to be achieved when an RDN or psychologist/mental health provider were involved in multi-component weight management interventions that included diet and nutrition [including medical nutrition therapy (MNT)], physical activity and behavioral components. (Strong, Imperative)
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PWM: Multicomponent Pediatric Weight Management Interventions
When providing pediatric weight management, the RDN should ensure the multi-component interventions include diet/nutrition MNT, physical activity and behavioral components. A strong body of research indicates that short-term (six-month) and long-term (two-year) decreases in body mass index (BMI) and BMI Z-scores for all age categories were more likely to be achieved when an RDN or mental health professional were involved in the multi-component pediatric weight management interventions that included the above three major components. (Strong, Imperative)
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PWM: Family Participation in Multicomponent Pediatric Weight Management Interventions
The RDN should encourage family participation as an integral part of a multi-component pediatric weight management intervention for children of all ages, including teens. A strong body of research indicates that family involvement as part of a multi-component pediatric weight management intervention is highly consistent with positive weight status outcomes at both six months and 12 months. (Strong, Imperative)
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PWM: Length of Treatment in Multicomponent Pediatric Weight Management Interventions
The RDN should ensure the multi-component pediatric weight management intervention is at least six months in duration. Research indicates that shorter term (less than six months) interventions were not consistently associated with positive weight status at 12 months. At least six months of treatment was associated with longer-term positive weight status outcomes, especially when group pediatric weight management sessions were included and it occurred in a clinic. (Fair, Imperative)
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PWM: Treatment Setting in Multicomponent Pediatric Weight Management Interventions
The RDN can provide multi-component pediatric weight management interventions either within the clinic or outside the clinic setting. Research indicates that positive weight status outcomes occur in either setting, especially when the interventions are multi-component, include group pediatric weight management sessions and have family involvement. (Fair, Imperative)
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PWM: Group Sessions in Multicomponent Pediatric Weight Management Interventions
The RDN can include group sessions and family participation as part of the multi-component pediatric weight management interventions. Multi-component intensive interventions that included group pediatric weight management sessions and included family participation were consistently associated with shorter-term (six-month) and longer-term (12-month) positive weight status outcomes. (Fair, Imperative)
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PWM: Individual Sessions in Multicomponent Pediatric Weight Management Interventions
The RDN can include individual sessions as part of the multi-component pediatric weight management intervention. Treatment that relied exclusively on individual pediatric weight management sessions with or without family participation was associated with shorter-term positive weight status outcomes. Information about the longer-term impact on weight status are mixed. (Fair, Imperative)
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PWM: Fast Food Meal Frequency in Children and Teens
If the overweight or obese child or teen consumes fast-food meals, the RDN should encourage reduction in the frequency of fast-food intake to less than twice a week. Limited evidence in populations eight to 16 years of age at baseline, suggests that higher frequency of fast-food consumption, particularly more than twice a week is associated with increased adiposity; BMI Z-score; or risk of obesity during childhood, adolescence and during the transition from adolescence into adulthood. (Weak, Conditional)
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Recommendation Grading
Overview
Title
Pediatric Weight Management
Authoring Organization
Academy of Nutrition and Dietetics
Publication Month/Year
December 7, 2017
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
The purpose of this article is to convey evidence-based recommendations for PWM nutrition interventions that reduce adiposity, prevent additional weight gain, and maintain improvements in adiposity.
Inclusion Criteria
Adolescent, Child, Infant
Health Care Settings
Ambulatory, Outpatient
Intended Users
Dietician nutritionist, nurse, nurse practitioner, physician, physician assistant
Scope
Prevention, Management
Diseases/Conditions (MeSH)
D009765 - Obesity, D000068959 - Body Weight Maintenance
Keywords
pediatric, Weight Management
Source Citation
Henry, B. W., Ziegler, J., Parrott, J. S., & Handu, D. (2018). Pediatric Weight Management Evidence-Based Practice Guidelines: Components and Contexts of Interventions. Journal of the Academy of Nutrition and Dietetics, 118(7), 1301–1311.e23. doi:10.1016/j.jand.2017.08.007