Pediatric Obesity and Nutrition Counseling

Abstract

About one third of children are overweight/obese. This study examined whether these children were more likely to have nutrition counseling documented and if counseling was affected by gender or ethnicity. Method. A retrospective secondary data analysis was used to explore nutrition counseling for an insured pediatric population. A sample of 526 records met inclusion criteria. Member records were categorized based on BMI as underweight, normal weight, or overweight/obese. Results. The observed proportion of overweight/ obese children was significantly higher than the national average, 37% versus 33% respectively, P = .03. No significant difference was found in documented nutrition counseling for children with overweight/obese BMIs-Pearson χ 2 (1, N = 526) = 1.586; P = .21, Φ = 0.06. Likewise, no significant difference was found in documented nutrition counseling for overweight/obese children by race-Pearson χ 2 (1, N = 37) = 0.11; P = .74, Φ = 0.05-or gender-Pearson χ 2 (1, N = 194) = 0.35; P = .55; Φ = −0.04. In this sample, African American children were almost twice as likely to have Medicaid compared with commercial benefits-Pearson χ 2 (1, N = 114) = 13.57; P < .001; Φ = −0.35. However, no significant difference was found in documented nutrition counseling between insurance benefits-Pearson χ 2 (1, N = 194) = 0.04; P = .85; Φ = 0.01. ProblemReported increases in pediatric obesity rates, as evidenced by a body mass index (BMI*) greater than the 95th percentile, may result in higher comorbidities within the pediatric population. Comorbid conditions such as diabetes and hypertension decrease life span and negatively affect quality of life. Approximately one third of the pediatric population is overweight (>85th percentile), and half of those are considered obese (>95th percentile). 1 It is unknown how often overweight/obese children, with insurance benefits, have nutrition counseling documented and if the counseling is significantly affected by gender or ethnicity. ObjectiveThe aim of this study is to evaluate the use of nutrition counseling for weight management in overweight pediatric patients evaluated in various outpatient clinics based on weight status (as measured by BMI), gender, ethnicity, and type of insurance coverage. RationaleIt is expected that overweight/obese children will receive nutrition counseling more often than those of normal weight. Best practice, in primary care settings, indicates that all *Body mass index (BMI), which is calculated by taking the weight in pounds divided by the height in inches, divided again by the height in inches, and then multiplied by 703. BMI is then plotted on a growth curve specific for sex and age. Percentages are as follows: underweight, BMI less than the 5th percentile; normal weight, BMI between the 5th and 85th percentile; overweight, BMI between the 85th and 95th percentile; obese, BMI greater than the 95th percentile.