Achieving Healthy Body Weights in the Teenage Years: Evidence-based Practice Guidelines for Community Nutrition Interventions
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Background: Adolescent obesity has become a significant public health problem. Conservative estimates, based on self-reported data, indicate overweight and obesity rates among Canadian adolescents aged 12 to 17 soared from 14% in 1978/79 to 29% in 2004. This persistent upward trend has serious long-term implications on the physical and psychological well being of adolescents and accounts for billions of dollars in health care costs. For this reason, prevention has been recognized as a priority health issue. While interventions have begun to target school-aged children and adults in clinical settings, few advances have been made to halt the escalating problem among adolescents. This population has unique needs with increasing independence transitioning into adulthood. Reversing the trend requires comprehensive interventions that mitigate personal, social and environmental barriers to healthy lifestyle choices. There is currently little consensus on best practices for dietetic adolescent obesity prevention and management. Community strategies are recommended as the most efficacious and feasible way to reach the greatest number of youth and support healthy lifestyle development. Evidence based guidelines are currently not available and are needed to guide nutrition practice in this area. Methods: A thorough systematic review and evidence analysis yielded 48 prevention and treatment interventions meeting the studies inclusion criteria. The evidence was graded and drafted into recommendations and an algorithm guideline displaying how each recommendation relates to nutrition intervention. A panel of independent, national experts assessed the guidelines for validity, acceptability and applicability with a tool adapted from the AGREE Collaborations Appraisal of Guidelines for Research and Evaluation Instrument. These experts covered different areas of expertise, including community nutrition, public health, adolescent health, academia and endocrinology. Results: The research findings confirm the need for comprehensive strategies, which include components of nutrition education and physical activity, address social and environmental influences and use schools as delivery vehicles for health promotion and health education. For obesity treatment interventions, promising strategies incorporated diet plans, family involvement and behaviour modification techniques in multidisciplinary interventions. Computer based strategies and peer modelling may also be developmentally appropriate strategies for health promotion health in the adolescent population. Conclusions: The results of this study indicate several interventions conducted over the past 10 years have had a positive effect in preventing or reducing adolescent obesity over the short and/or long term. The findings support the development of comprehensive, multi-disciplinary obesity prevention and treatment interventions and the use of peer modeling, family based and computer based strategies.
Teenagers , Obesity in adolescence , Nutrition , Body weight