US preventive services task force recommendations on obesity in children and adolescents: can evidence translate to impact? (original) (raw)
Related papers
Recommendations for Prevention of Childhood Obesity
PEDIATRICS, 2007
The majority of US youth are of healthy weight, but the majority of US adults are overweight or obese. Therefore, a major health challenge for most American children and adolescents is obesity prevention—today, and as they age into adulthood. In this report, we review the most recent evidence regarding many behavioral and practice interventions related to childhood obesity, and we present recommendations to health care providers. Because of the importance, we also suggest approaches that clinicians can use to encourage obesity prevention among children, including specific counseling strategies and practice-based, systems-level interventions. In addition, we suggest how clinicians may interact with and promote local and state policy initiatives designed to prevent obesity in their communities.
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2013
Obesity is a major public health problem affecting more than 12 million (~17%)U.S. children. The scientific community agrees that tackling this problem must begin in childhood to reduce risk of subsequent development of cardiovascular diseases and other chronic diseases. The Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, initiated by the National Institutes of Health (NIH), is conducting intervention studies to prevent obesity in pre-schoolers and treat overweight or obese 7-13 year olds. Four randomized controlled trials plan to enroll a total of 1,700 children and adolescents (~ 50% female, 70% minorities), and are testing innovative multi-level and multi-component interventions in multiple settings involving primary care physicians, parks and recreational centers, family advocates, and schools. For all the studies, the primary outcome measure is body mass index; secondary outcomes, moderators and mediators of intervention include diet, physical activity, home and neighborhood influences, and psychosocial factors. COPTR is being conducted collaboratively among four participating field centers, a coordinating center, and NIH project offices.
Nutrients
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-comp...
Obesity Reviews, 2019
+ Prof. Altman contributed to this article prior to his untimely passing in June of 2018. His inclusion as an author here recognizes his contributions, though he was unable to approve of the final version. Disclosures Dr. Allison has received personal payments or promises for same from: Biofortis; Fish & Richardson, P.C.; HawkPartners; IKEA; Laura and John Arnold Foundation; Law Offices of Ronald Marron; Sage Publishing; Tomasik, Kotin & Kasserman LLC; Nestec (Nestlé); WW (formerly Weight Watchers International LLC). Donations to a foundation have been made on his behalf by the Northarvest Bean Growers Association and the United Soy Bean Board. Dr. Allison is an unpaid member of the International Life Sciences Institute North America Board of Trustees. Dr. Allison's institution, Indiana University, has received funds to support his research or educational activities from: Alliance for Potato Research and Education; Dairy Management Inc.; Herbalife; and the NIH. His prior institution, the University of Alabama at Birmingham, received grants, gifts or contracts from multiple food, beverage, and other for profit and non for profit organizations with interests in obesity, statistical methods, and research design. Dr. Baranowski discloses being employed by Baylor College of Medicine, his institution having NIH grants for his work, and having received speaking fees from the University of Georgia. Dr. Bland discloses that topics presented herein are related to a textbook for which he receives royalties; and has received travel accommodations from the University of Western Ontario and for the Health Services Research Board Senior Investigator Award. Dr. Brown has received travel expenses from
The rise in the rate of obesity in school-aged children, adolescents, and young adults in the last 30 years is a clear healthcare crisis that needs to be addressed. Despite recent national reports in the United States highlighting positive downward trends in the rate of obesity in younger children, we are still faced with approximately 12.7 million children struggling with obesity. Given the immediate and long-term health consequences of obesity, much time and effort has been expended to address this epidemic. Yet, despite these efforts, we still only see limited, short-term success from most interventions. Without changes to how we address childhood obesity, we will continue to see inadequate improvements in the health of our children. Clinicians and researchers need to be lobbying for evidence-based policy changes, such as those identified by systems science, in order to improve the nation's health.
Journal of Pediatric Psychology, 2014
Purpose To conduct a meta-analysis of randomized controlled trials examining the efficacy of comprehensive behavioral family lifestyle interventions (CBFLI) for pediatric obesity. Method Common research databases were searched for articles through April 1, 2013. 20 different studies (42 effect sizes and 1,671 participants) met inclusion criteria. Risk of bias assessment and rating of quality of the evidence were conducted. Results The overall effect size for CBFLIs as compared with passive control groups over all time points was statistically significant (Hedge's g ¼ 0.473, 95% confidence interval [.362, .584]) and suggestive of a small effect size. Duration of treatment, number of treatment sessions, the amount of time in treatment, child age, format of therapy (individual vs. group), form of contact, and study use of intent to treat analysis were all statistically significant moderators of effect size. Conclusion CBFLIs demonstrated efficacy for improving weight outcomes in youths who are overweight or obese. Key words children; intervention outcome; meta-analysis; obesity. Childhood obesity is a significant public health concern, with roughly 32% of children considered overweight or obese (Ogden, Carroll, Kit, & Flegal, 2012). The sequelae of pediatric obesity include comorbid medical complications, such as high blood pressure, abnormal lipid proteins, liver disease, sleep disordered breathing, and type 2 diabetes (Daniels, 2006). Overweight and obese children face increased risks for poor self-esteem and body image, peer victimization, weight stigmatization, depressive symptoms, and other psychological difficulties (Daniels, 2006; Puhl, Luedicke, & Heuer, 2011). Obesity in childhood also leads to increased risks of being obese in adulthood (Singh, Mulder, Twisk, van Mechelen, & Chinapaw, 2008). Pediatric interventions that lead to weight reductions have been associated with improvements in metabolic factors (Ebbeling, Leidig, Sinclair, Hangen, & Ludwig, 2003) and self-esteem (Janicke et al., 2008). There is a need for evidence-based pediatric obesity interventions to treat increased weight status in children and adolescents. Research to elucidate factors contributing to the continual rise in rates of pediatric obesity provides evidence of environment by gene interactions contributing to child and adolescent weight status. Studies have also shown that environmental factors can alter genetic factors associated with weight (Koletzko, Brands, Poston, Godfrey, & Demmelmair, 2012). Potential environmental factors include consuming large portions of high-calorie nutrientpoor foods, decreased engagement in physical activity, and increased time spent in sedentary behaviors (Lioret, Volatier, Lafay, Touvier, & Maire, 2009; Spear et al., 2007). One of the strongest predictors of child weight is parent weight status (Whitaker, Wright, Pepe, Seidel, & Dietz, 1997). Given that parents play a significant role in establishing patterns of eating and physical activity
Future Research Needs for Childhood Obesity Prevention Programs
2013
on the Effective Health Care Web site. We received one set of comments from the American Therapy Association (APTA). The comments were related to gaps outside the scope of the original systematic review including the study of children with special health care needs; the limited number and perspectives of the stakeholder group; and the impact of these stakeholder perspectives on the final list of highest priority research needs. While we acknowledge the many research needs in this area, the scope of this report was constrained by that of the original systematic review. These comments were considered, and no changes were made in this report.