Dietary interventions for the treatment of obese children and adolescents

With the rapidly increasing prevalence of childhood obesity, it is important for all practitioners to be aware of the rising problem and to be comfortable in beginning a discussion with their patients and families regarding how to address overweight. Each visit to any clinician including cardiologists and cardiac surgeons should include an accurate measure of height and weight with the calculation of body mass index (BMI) and subsequent plotting on the appropriate BMI chart. Body mass index is currently the most accepted measure of assessing overweight status. It correlates with the amount of body fat in children and with the level of health risks, particularly cardiovascular risk factors. When overweight is identified, an assessment of nutrition-related behaviors should be completed and used to help patients and families target behavior changes that are realistic and achievable. New Expert Committee Recommendations regarding the prevention, assessment, and treatment of childhood and adolescent overweight were released in December 2007. These guidelines identified key contributing factors based on current evidence. The nutrition related factors include breast-feeding, consumption of sugar-sweetened drinks, intake of fruits and vegetables, eating breakfast, eating family meals at home, frequency of eating out, intake of energy dense foods and portion sizes. This article will provide information about these contributing factors and practical solutions to discuss with patients and families to begin the process of behavior change.