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OBESITY PREVENTION & CONTROL IN THE PEDIATRIC SETTING

OBESITY PREVENTION & CONTROL IN THE PEDIATRIC SETTING. Ariana Raufi Warren Alpert Medical School of Brown University Hasbro Children’s Hospital. Topics To Cover. The Problem: childhood obesity epidemic When/ how to intervene? Challenges Intervention: Pediatric counseling.

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OBESITY PREVENTION & CONTROL IN THE PEDIATRIC SETTING

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  1. OBESITY PREVENTION &CONTROL IN THE PEDIATRIC SETTING Ariana Raufi Warren Alpert Medical School of Brown University Hasbro Children’s Hospital

  2. Topics To Cover • The Problem: childhood obesity epidemic • When/ how to intervene? • Challenges • Intervention: Pediatric counseling

  3. Obesity among Children Entering Kindergarten, Rhode Island, 2001-2007

  4. Do you see a problem here?

  5. Obesity is a Problem. Where to intervene? • Family behaviors/habits • School lunches • Community resources: parks, safe activity centers • Availability of healthy foods in local stores • Creation of obesity clinics • After school programs • Soda Tax, governmental influences • Obesity treatment programs • Pediatrician influence

  6. When to intervene? Promote healthy nutrition in early childhood • Window of opportunity: infancy to early childhood • Prevention! • Food preference development • Younger children: visit pediatrician more frequently • Parents have more control over feeding /activity • Good parenting in the early yearspositive impact later • Parents are a child’s first teachers • Eating is LEARNED BEHAVIOR: • Exposure & Repetition

  7. Role of Families Home food environment: essential Food preferences, habits, activity, family meals, TV Parental Modeling Parenting Style Children are unable to eat foods not available to them! Most parents  misperceive their child’s weight /level of physical activity Parents will NOT seek help if they do not recognize their child has a problem! Chiang, Evelyn. "Parent Perceptions of Children's Weight Status, Nutrition, and Activity Levels." ICAN: Infant, Child, and Adolescent Nutrition. 1.4 (2009): 220-224. Print.

  8. Pediatricians Matter! • Study by Hernandez et al. in Clinical Pediatrics • Absence of pediatrician commentary on child weight was the strongest predictor of misclassifying child body image (8-fold increase) • Pediatricians = highly favored as the most valued weight advisors • Most valued methods for understanding child weight = • Growth curves • Pediatrician comment

  9. Improving Primary Care Counseling • Intervention: maximize the role of pediatricians • What to say? • Sessions on evidence-based nutrition for every age • Clarify the “agent of change” – most often the parent, not the child • How to say it? • Sessions on motivational interviewing – techniques to facilitate behavior change • Identify the situation • Assess readiness to change • Assess confidence

  10. General Principles • An ounce of prevention… • Make healthy eating habits a focus of all well visits…prenatal to adolescence • Identify unhealthy habits before they lead to obesity • Do not be afraid to talk about obesity • Rome was not built in a day!

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