Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews

Abstract

This Academy of Nutrition and Dietetics Position Paper reports current evidence on pediatric overweight and obesity prevention interventions and discusses implications for registered dietitian nutritionists (RDNs). An overview of current systematic reviews provided evidence-based results from a range of nutrition interventions according to developmental age group (ages 2 to 5, 6 to 12, and 13 to 17 years). Twenty-one current systematic reviews of nutrition interventions demonstrated a beneficial effect of nutrition and physical activity interventions on body mass index measures and no adverse events were identified. RDNs impart nutrition expertise in a wide range of settings to provide comprehensive care for children and adolescents as their nutrition and developmental needs change over time. This Position Paper outlines the current roles of, and proposed directions for, RDNs engaged in pediatric overweight and obesity prevention. Prevention of pediatric overweight and obesity requires comprehensive strategies ranging from policy-level to individuallevel interventions in settings that will have the most beneficial impact for children according to their developmental stage. This Position Paper advocates for increased availability of nutrition and food access programs and interventions to reduce risk of pediatric obesity and associated adverse health outcomes both now and for future generations.

Overview of Systematic Reviews of Health Interventions for the Prevention and Treatment of Overweight and Obesity in Children

“…In accordance with previous similar overviews, the participation of the community, parents, and school was an enabler for the intervention [ 12 ]. Our analysis similarly identified the importance of school-based interventions composed of PA and nutrition/diet.…”

“…A high volume of evidence related to children and adolescents had been identified in recent years and could represent an obstacle for decision makers [ 11 ]. Previous studies have suggested school-based interventions for the prevention of this condition [ 12 , 13 ], and they identified that most common treatments involved lifestyle interventions (i.e., regulated screen time for children) [ 14 , 15 ]. Additionally, it was reported that interventions (diet, family behavior, PA promotion, supervised exercise, lifestyle, or multicomponent interventions) were associated with a reduction in BMI [ 11 ].…”

Infant Obesity Prevention Programs for Underrepresented Mothers in a Home Visiting Program: A Qualitative and Community-Engaged Needs Assessment

“…These findings are consistent with previous literature in other pediatric obesity interventions that demonstrated positive health-related benefits of individualized approaches. 65,66 Further, it is important for these interventions to provide consistent nutritional information and remain up to date with recommendations when providing information to families; stakeholders in the needs assessment noted that families often hear conflicting information regarding nutrition and feeding. With feeding and nutrition guidelines constantly evolving and not always being consistent across providers and healthcare organizations, it may be difficult for families to determine which guidelines to follow, representing a systems-level barrier to healthy feeding and eating.…”

Integrated Approaches to Combatting Childhood Obesity

“…First of all, schools should not allow inappropriate foods and beverages to be sold or marketed within the school environment (e.g., a ban of vending machines), while providing education about healthy eating patterns [17, 74]. Examples of such integrated prevention strategies are in place in different countries.…”