Nutritional Disorders Telehealth Network Project
Diet Interventions - Overweight
Strategies to decrease calories (or increase activity level) are used to stabilize a child’s nutritional status (e.g., improved weight to height ratio) and promote improved health status. Calories are avoided by removing calorie rich foods/beverages when menu planning. Another strategy is to decrease the typical volume of intake by the child at meal and snack times.
Even though a child may carry excess weight, medical providers should consider the risk of micro and macro nutrition imbalances and/or deficiencies. Many children are consuming diets of poor nutritional quality and limited variety. Our goal is to provide strategies which will correct and/or prevent imbalances through food selection changes or supplements.
Behavioral methods are useful in increasing food variety in youth who are overweight or obese. Behavioral methods include the use of repeated exposure to new foods and varied textures, positive reinforcement for trying new foods or textures, and use of ignoring (extinction procedures) or punishment for reducing unwanted behaviors related to trying new foods and textures. The goal of these methods is to increase the child’s acceptance of a variety of foods, thereby improving the quality of their oral intake.
To advise family’s on appropriate dietary intake one must first consider the developmental age of a child and understand the “normal” fluctuations in dietary habits. Typically, children who are overweight have achieved the developmental milestones for eating the full range of foods (beyond a developmental age of two or older). However, some children have developmental conditions that might affect their accepted foods (e.g., mental retardation, pervasive developmental disorders & autism, genetic conditions including Prader Willi Syndrome).
Eliminate the dietary practice of excess consumption of sweetened beverages (including fruit juice).
Tracking of dietary intake can offer additional nutrition details to the providers in their treatment of nutrition disorders.
Stimulus control strategies are a type of behavioral interventions for weight management that are supported by research as being efficacious. Stimulus control strategies involve identification and modification of environmental factors that influence eating patterns. The goal of stimulus control strategies is to reduce environmental characteristics or situations that serve to trigger maladaptive eating behaviors, such as excessive oral caloric intake.