Pediatric Weight Management (PWM) Assessing Family Climate Factors
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
PWM: Family Climate - Increased Risk of Overweight or Obesity
Family climate factors that may be associated with an increase in the risk of pediatric obesity and should be included in Nutrition Assessment are: Parental dietary disinhibition and restraint, negative aspects of family functioning (such as lack of parental support or over-possessiveness) and parental concern about child’s weight status. ADA Evidence Analysis has shown that these factors are positively associated with childhood overweight or obesity.
PWM: Family Climate - Decreased Risk of Overweight or Obesity
Family climate factors that may be associated with a decrease in the risk of pediatric obesity and should be included in Nutrition Assessment are: Positive aspects of family functioning (such as family cohesion, expressiveness, democratic style, parental support and cognitive stimulation at home). ADA Evidence Analysis has shown that these factors may be negatively associated with childhood overweight or obesity.
PWM: Family Climate - Relationship Unclear
Dietitians should be aware of the research on the following family climate factor when carrying out their Nutrition Assessment: Household food insecurity. ADA Evidence Analysis has found that this factor may not be related to pediatric overweight or obesity or that the research is still unclear on the relationship.
Risks/Harms of Implementing This Recommendation
Conditions of Application
The above topics were selected for evidence analysis. However:
- The practitioner should not limit her assessment to these factors
- Modification of these factors should be considered when developing the nutrition prescription
- Evidence analysis on other factors is currently underway and will be added to the guideline as they are finished.
Potential Costs Associated with Application
- Evidence analysis was carried out on several family climate factors associated with pediatric overweight or obesity
- All factors are based only on observational (association) research and do not include research on interventions
- The following family climate factors were associated with an increased risk of pediatric overweight or obesity:
- The following family climate factors were associated with a decreased risk of pediatric overweight or obesity:
- The following family climate factors may not be related to pediatric overweight or obesity. A relationship may or may not, in fact, exist, but research has not been able to determine this definitively.
- Household food insecurity (Grade II).
Recommendation Strength Rationale
No direct research was analyzed regarding the benefits of knowledge-based assessment and intervention practices. However, the work group felt strongly that knowledge of relevant scientific research is indispensable for responsible dietetic practice.
The majority of grades for the family climate factors associated with childhood overweight or obesity were a Grade III. However, while there is no risk to the patient or client with respect to the practitioner's knowledge of these factors, the dietitian's ignorance of this research could result in substantial risk to the patient or client.
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
Are parental attitudes towards their own dietary intakes (Dietary restraint & disinhibition) associated with higher risk or prevalence of overweight among children?
Is family functioning associated with higher risk or prevalence of overweight among children?
Is parental concern about or criticism of their child's weight status associated with higher risk or prevalence of overweight among children?
What is the relationship between household food insecurity and childhood overweight?
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References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process