Recommendations Summary
Pediatric Weight Management (PWM) Assessing Foods and Pediatric Overweight
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.
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Recommendation(s)
PWM: Foods Associated with an Increased Risk of Overweight
Dietary factors that may be associated with an increase in the risk of overweight and should be included in Nutrition Assessment are: increased total dietary fat intake and increased calorically sweetened beverages. ADA Evidence Analysis has shown that these factors are positively associated with childhood overweight.
Rating: Strong
ImperativePWM: Foods Associated with an Decreased Risk of Overweight
Dietary factors that may be associated with a decrease in the risk of overweight and should be included in Nutrition Assessment are: increased fruit and vegetable intake. ADA Evidence Analysis has shown that these factors may be negatively associated with childhood overweight
Rating: Strong
ImperativePWM: Assessment - Total Energy Intake and 100% Fruit Juice
Dietitians should be aware of the research on the following dietary factors when carrying out their Nutrition Assessment: reported total energy intake and 100% fruit juice intake. ADA Evidence Analysis has found that these factors may or may not be related to pediatric overweight, but the research is still unclear on the relationship.
Rating: Fair
ImperativePWM: Assessment - Dairy and Calcium
Dietitians should be aware of the observational research that indicates an inadequate intake of dairy and calcium may be related to an increase in the risk of pediatric overweight. Consideration should be given to including dairy and calcium intake as part of the nutrition assessment.
Rating: Fair
Imperative-
Risks/Harms of Implementing This Recommendation
None
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Conditions of Application
The above topics were selected for evidence analysis. However:
- The practitioner should not limit their 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
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Potential Costs Associated with Application
None
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Recommendation Narrative
Evidence analysis was carried out on several foods associated with pediatric overweight.
All factors are based only on observational (association) research and do not include research on interventions.
The following foods and nutrients were associated with an increased risk of pediatric overweight:
- increased total dietary fat intake (Grade II)
- calorically sweetened beverages (Grade II)
- inadequate intake of dairy and calcium (both Grade III)
The following foods and nutrients were associated with a decreased risk of pediatric overweight:
- increased fruit and vegetable intake (Grade II)
The following foods and nutrients may not be related to pediatric overweight. A relationship may or may not, in fact, exist, but research has not been able to determine this definitively.
- reported total energy intake (Grade II)
- 100% fruit juice intake (Grade II)
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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 indispensible for responsible dietetic practice.
With the exception of the evidence on dairy and calcium, all grades for the food and nutrient associations with childhood overweight were a Grade II. Additionally, while there is no risk to the patient/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/client.
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Minority Opinions
None
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Risks/Harms of Implementing This Recommendation
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Supporting Evidence
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).
Is intake of calcium related to adiposity in children?
Is intake of dairy related to adiposity in children?
Is intake of 100% fruit juice related to adiposity in children?
Is intake of fruits and vegetables related to adiposity in children?
Is intake of calorically-sweetened beverages related to adiposity in children?
Is intake of dietary fat associated with adiposity in youth?
Is total energy (caloric) intake associated with higher risk or prevalence of overweight among children?
In children, does using beverages with non-nutritive sweeteners (saccharin, aspartame, acesulfame-K, sucralose, neotame) in a calorie-restricted or ad libitum diet affect energy balance?-
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References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
None
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References