Nutritional Assessment |
Food/Nutrition-related history | Assess eating patterns | 13 | [8,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36] |
Assess food quality and quantity (including portion sizes and overeating) | 7 | [8,22,23,24,27,28,31,33,34,36] |
Assess the presence of sugar-sweetened beverages and juices | 7 | [8,22,23,24,25,26,27,31,33,34] |
Assess meals structure and distribution | 7 | [8,22,23,24,25,27,28,31,33,34] |
Assess meals context and environment | 6 | [26,27,28,29,33,34,36] |
Assess the presence of snacking | 3 | [27,28,31] |
Anthropometric measurements | Calculate BMI | 13 | [8,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36] |
Analyze growth curves | 11 | [8,25,26,27,28,29,30,31,32,33,34,36] |
Assess the factors conducting to a weight gain | 2 | [30,31] |
Assess the precocity of the adiposity rebound | 1 | [28] |
Biochemical data, medical tests and procedures | Interpret of blood pressure | 10 | [8,25,26,27,28,29,31,32,33,34,36] |
Interpret of blood lipids | 10 | [8,25,26,27,28,29,30,32,33,34,36] |
Analyze blood glucose | 9 | [8,25,26,27,28,29,30,32,36] |
Assess hepatic tests | 7 | [25,26,27,28,29,32,36] |
Nutrition-focused physical findings | Assess the presence of acanthosis nigricans | 7 | [8,26,27,29,31,33,34,35] |
Assess sleep | 6 | [8,27,28,30,31,33,34] |
Assess food sensations | 1 | [28] |
Physical activity | Assess physical activity level | 12 | [8,22,23,24,25,26,28,29,30,31,32,33,34,35,36] |
Assess sedentary behaviors (especially the screen time) | 11 | [8,22,23,24,25,26,27,28,29,30,31,33,34,35] |
Client history | Assess comorbidities | 11 | [8,25,26,27,29,30,31,32,33,34,35,36] |
Assess family history | 12 | [8,25,26,27,28,29,30,31,32,33,34,35] |
Assess mental health | 8 | [8,22,23,24,26,30,31,32,33,34,35] |
Assess social/family environment | 8 | [22,23,24,25,26,28,30,31,32,35] |
Assess parental feeding practices (restrictive, permissive, pressure to eat, food as reward) | 3 | [22,23,24,26,28] |
Eating Disorders screening | Screen for eating disorders | 9 | [8,22,23,24,26,28,29,30,31,35,36] |
Assess the presence of Binge Eating Disorders | 5 | [8,26,28,31,36] |
Change motivation | Assess motivation and readiness to change | 9 | [8,25,27,28,29,30,31,32,33,34,35] |
Nutritional Diagnosis |
| No guideline referred to nutritional diagnosis. | 0 | |
Nutritional Intervention |
Meal structure | Structure eating with 3 meals and 2 snacks per day | 5 | [2,8,31,35,36] |
Avoid snacking | 3 | [8,26,36] |
Food balance | Promote fruit and vegetable consumption | 7 | [8,26,27,29,33,34,35,36] |
Balance diet and eating habits | 6 | [25,28,30,32,33,34,36] |
Avoid high energy density and low nutritional density foods (fast-foods, take-out, sugar sweetened beverages and juices) | 5 | [2,26,29,33,34,36] |
Do not forbid any food | 3 | [28,31,35] |
Avoid sugar sweetened beverages and juices | 4 | [8,26,29,33,34] |
Limit sugar sweetened beverages and juices consumption | 3 | [27,35,36] |
Portion sizes | Follow national recommendations | 4 | [29,33,34,35,36] |
Diets | Avoid any type of restrictive diet | 8 | [8,22,23,24,25,28,32,33,34,35,36] |
Follow the “stop/traffic light diet” (The traffic light diet divides food groups into 3 categories: green (low-energy, high-nutrient foods, may be eaten often), yellow (moderate-energy foods, may be eaten in moderation), and red (high-energy, low-nutrient foods, should be eaten sparingly). [38] | 4 | [22,23,24,25,30,36] |
Meal environment | Eat as a family | 6 | [8,27,29,30,31,35] |
Avoid screen during meals | 3 | [27,31,35] |
Offer healthy foods at home | 1 | [31] |
Food sensations | Work on the recognition and respect of the food sensations | 6 | [2,28,30,31,35,36] |
Family implication | Families should be included in the treatment | 14 | [2,8,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36] |
Family behavior should not be different than the child with excess weight to avoid stigmatization | 8 | [2,8,27,28,30,32,33,34,35] |
Lifestyle intervention | Multifactorial treatment including the food balance, the physical activity and the behavior management | 10 | [2,22,23,24,26,28,29,30,31,32,33,34,35] |
Physical activity | At least 60 min of moderate to vigorous activity per day (at least 10 min per session) | 10 | [2,8,27,28,29,30,31,32,35,36] |
Importance of the child’s choice and pleasure in the activity | 8 | [8,25,27,29,30,32,33,34,35] |
Sedentarity | Reduce non-academic screen time to max. 2 h both in week days and weekend days | 8 | [2,8,26,27,29,30,33,34,35] |
Behavior management | Practice stimulus control | 8 | [2,22,23,24,25,29,30,32,33,34,35] |
Use motivational counseling | 8 | [2,8,25,26,27,28,29,30] |
Set SMART objectives with the child and/or the parents | 8 | [2,8,25,29,30,31,33,34,35] |
Introduce behavior and objectives self-monitoring | 7 | [2,8,25,29,30,33,34,35] |
Care coordination and implication | Dietitian | 7 | [8,22,23,24,25,26,27,28,30] |
Pediatrician | 6 | [8,25,27,28,29,30] |
Other professionals | | Details in Table S1 |
Interdisciplinary teams | 3 | [24,25,30] |
Pharmacotherapy | Recommend to use Orlistat in specific conditions but warn about its low efficacy | 11 | [8,22,23,24,25,26,29,30,31,32,33,34,35,36] |
Bariatric surgery | In general, not recommended. Indications and contraindications were different between guidelines. | | Details in Table S1 |
Comorbidities | Consider comorbidities during the intervention | 9 | [8,26,27,28,29,30,32,35,36] |
Nutritional Monitoring and evaluation |
Follow-up | Individual or group follow-up depending on the child’s situation | 2 | [22,23,24,36] |
Long-term follow-up | 4 | [2,25,31,32] |
Monitoring indicators | Monitor anthropometric measurements | 10 | [2,8,22,23,24,26,28,29,31,33,34,35,36] |
Monitor food balance and physical activity | 4 | [8,29,31,36] |
Monitor changes according to the objectives | 1 | [28] |
Weight management | Weight stabilization for growing children | 7 | [22,23,24,26,27,28,29,31,32] |