I came across these great articles today that summarized recent studies on obese pediatric patients.
This article summarizes a study that that compared three different eating plans. The compared plans all had similar outcomes, but the researchers found that children have the hardest time sticking to low carb diets.
This study found that children who have parents that model weight loss and healthy behaviors. In this study, parents weight loss "was the most important predictor of child weight loss".
Parents should lead by example in weight loss.
Thursday, March 15, 2012
Friday, March 2, 2012
5-2-1-0 Guideline
 Source: www.let'sgo.org |
| Source: www.letsgo.org |
The 5-2-1-0 guideline was created by the American Academy of Pediatrics (AAP) in Partnership with First Lady, Michelle Obama's Let's Move! initiative.
The 5-2-1-0 plan is an easy to remember guideline for promoting four healthy behaviors:
- 5: Eat 5 or more fruits and vegetables every day.
- 2: TV and computer play screen time to 2 hours or less every day. Under age 2, no screen time.
- 1: Participate in at least 1 hour of physical activity every day.
- 0: Aim for 0 sugar-sweetened drinks every day, restrict soda pop, sports drinks, and fruit drinks. Instead, drink water and 3-4 servings a day of skim or 1% milk.
Thursday, March 1, 2012
Resources
A project that was completed for an obesity interventions class.
I envisioned teaching to a group audience. It may be useful in that setting
Module 1: Self Image
Being an overweight or obese kid is difficult. They struggle with self-esteem and are at higher risk for psychological disorders, such as depression, anxiety, and disordered eating. Addressing physical appearance is a difficult topic for even the most seasoned healthcare provider. Starting out with this module, which starts an open dialogue about self-image is helpful in navigating those difficult discussions ahead. Take time to listen. Each child and family will tell a different story.
This can be used with all of the modules in the series
From The Module:
For Providers:
Module 2: Portion Control and MyPlate.gov Guidelines
Fantastic patient education about each food group in detail.
Eat Right Nutrition Tips
Handouts written by the Academy of Nutrition and Dietetics
Eat Right Nutrition Tips
Handouts written by the Academy of Nutrition and Dietetics
(some Spanish)
Module 3 Physical Activity Guidelines
What do you think of when you hear the word exercise? Most patients envision running on a treadmill or lifting weights, which in all honesty, does not sound fun. Exercise when described in that context may be overwhelming to an obese child who already struggles with self esteem issues and lags behind their peers. I recently saw a young boy in clinic who was clearly excited about football, but was embarrassed when it came to conditioning because he had a difficult time doing situps. So he quit. How do we motivate youth to participate? Clearly there are some activities that can appeal to all. Some studies found that encouraging less screen time was more effective that encouraging more exercise. The trick is to make activity fun and parents are a big part of that. It may take some work finding physical activity that will fit into every one's schedule, but it is clearly an important part of setting up lifelong fitness habits. Encouraging at least an hour a day of physical activity is the key component of this module. Additionally, a recent Utah survey of providers found that we are better at recommending exercise to our pediatric patients, when we are actually exercising ourselves.
For the Provider:
this link has a toolkit where you can order free educational materials in different languages
Module 4: The StopLight Diet
While most experts discourage the use of the word "diet" when addressing food related lifestyle changes, the Stoplight Diet or program is one of the most widely used "diets" used in pediatric obesity research. There are several programs available that are similar to and utilize the same principles of the Stoplight Diet, they are included below. Any diet modifications for children should be adopted and embraced by all family members and should be easy to use and follow. The book is out of print but can be easily purchased at retailers like Amazon or Half.com. It is a bit outdated, but still easy to use and gives the parents and child an idea of what foods belong in the green, yellow, and red categories.
If the family prefers online monitoring of food intake here are online resources
SparkPeople
Supertracker Website from the USDA
FitDay
Stoplight Diet Contract
Evidence for Using the Traffic Light Diet
Dietary Recommendations from the American Academy of Pediatrics
Other Resources:
Trim Kids Book
Bright Bodies
Shapedown Program
Motivational Interviewing
Billing for Providers
One of the most important components to implementing any program into practice is reimbursement. Even though it may be of benefit to the patient, providers can't spend valuable time counseling patients, only to have these services denied by insurance companies. Under the Affordable Health Care Act of 2010, insurances are required to cover obesity prevention and treatment as a preventative service, which generally means no out of pocket expense to the patient. This overcomes barriers for provider reimbursement and patient payment.
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