Pediatric Weight Management (PWM): A Scoping Review (2020)
Child Nutrition Scoping Review: A Systems Level Approach
Welcome to the Child Nutrition Scoping Review. To inform upcoming Position Paper updates on child nutrition, this review aimed to determine the availability and scope of recent evidence on nutrition interventions and longitudinal exposures for children who are healthy or who have cardiometabolic risk or disease using a systems-level perspective.
Prevention and treatment of child overweight and obesity requires a broad systems-level approach that is difficult to address in its entirety in the context of a systematic review. There has been considerable recent research on prevention and treatment of cardiometabolic risk and disease in the pediatric population. An evidence scoping review was conducted to determine availability and nature of literature examining nutrition interventions and exposures for the pediatric population across social-ecological levels in order to provide a comprehensive resource for practitioners and inform updated Academy positions on child nutrition.
In pediatric individuals (2-<18 years of age) with or without cardiometabolic risk or disease, what is the availability of recent evidence-based practice guidelines, systematic reviews and positions examining the influence of nutrition interventions or longitudinal exposures within at least one level of the social ecological model, including individual level, home & family level, school and community level and policy level?
The social ecological framework describes as a systems-level approach to prevent and treat diet-related health conditions and was used to categorize and synthesize studies included in this scoping review.
Eligibility Criteria and Search Plan
Target Population: Pediatric individuals (2-<18 years of age) with or without cardiometabolic risk or disease.
Interventions: Any nutrition intervention at the policy, community, school, family or individual level, including dietary intake.
Outcomes: All nutrition-related outcomes including dietary intake, intermediate outcomes (e.g.: glucose homeostasis measures, blood pressure), and health outcomes (e.g. mortality, academic outcomes, dental caries, gastrointestinal symptoms, adverse events).
Locations: Economically developed countries, as defined by United Nations criteria.
Search Dates: January 1, 2017 - April 14, 2020.
Study Designs: Evidence-based practice guidelines, systematic reviews, and organization positions.
Databases: Medline Complete; CINAHL Complete; Cochrane Database of Systematic Reviews (CDSR); and Food Science Source. Authors additionally hand-searched public health databases and websites for evidence-based practice guidelines and organization position/consensus papers not published in peer-reviewed journals.
Scoping Review Results and Conclusion
- 169 articles were included in this scoping review, including six evidence-based practice guidelines, 141 systematic reviews and 22 organization position/consensus statements.
- The highest density of systematic reviews focused on the effects of dietary intake (n= 58) as well as nutrition and multi-disciplinary interventions that aimed to intervene with an individual child or family through counseling or education (n=54).
- There were slightly fewer systematic reviews reporting interventions or longitudinal exposures at the school and community levels (n=51).
- The least frequently examined levels of interventions or exposures were at the policy level (n=12).
- There is a a considerable body of recent systematic reviews addressing a wide variety of child nutrition interventions and exposures ranging from dietary intake to public policy.
- Systematic reviews that describe the strength of evidence using standard, high-quality methods can be used to inform registered dietitians about the current, systems-level evidence on preventing and treating cardiometabolic risk factors in children and adolescents.