Focus on Overweight and Obesity Prevention and Management
Article Outline
Developing evidence-based approaches to address the multi-faceted problem of overweight and obesity in children has become part of a broad signature initiative by the National Association of Pediatric Nurse Practitioners (NAPNAP) on many levels. The reduction of childhood obesity has been identified as a clinical outcome measure for NAPNAP's strategic direction and plan for 2009–2012. Obesity also has been named as one of the clinical priorities in NAPNAP's research agenda.
From a preventative standpoint, much of the work of NAPNAP's Breastfeeding Education Special Interest Group (SIG) clearly relates to the prevention of overweight and obesity in older children. This past spring, the formation of a new SIG on Childhood Obesity Prevention also was announced. Most notable of NAPNAP's efforts has been the development of the Healthy Eating and Activity Together (HEAT) clinical practice guideline, which offers culturally appropriate interventions that enhance the family's ability to achieve the ideal balance between nutrition and physical activity to support optimal growth and wellness (Please go to http://www.napnap.org for further information about all of these initiatives!).
Going forward, these multiple approaches and areas of emphasis will be necessary to address a complex clinical problem that still often appears intractable. The prevalence of children who are obese has risen from 4% in 1971 to 15% in 2007 (Rosenbaum, 2007). The incidence of the consequences of obesity in children—obstructive sleep apnea, orthopedic problems, type 2 diabetes, hypertension, and premature cardiovascular disease—also has increased. More than 50% of adolescents who are overweight meet the criteria for the metabolic syndrome (insulin resistance, hypertension, hyperlipidemia, and abdominal obesity) (Gardner, Gardner, & Sowers, 2008).
With all of this information as part of a broader context, we now are pleased to present our second “themed” issue on the management of overweight and obesity in children and adolescents. The four original articles published in this issue address assessment and management processes. The research results reported by De La O and colleagues indicate that the majority of parents of overweight children tend to underestimate their child's weight. Small and associates report their findings of barriers to effective management of childhood weight problems as self-reported by pediatric nurse practitioners. The companion article by Gance-Cleveland and her team outline changes in reported knowledge and intent to improve provider practices following brief training on the HEAT guidelines. Finally, Zenzen presents a comprehensive integrative review of school-based childhood obesity prevention programs.
In addition to the original articles presented here, you also will note that many of the departments address specific clinical issues relating to overweight in children. My thanks to all of the contributors and department editors for this issue. Our critical challenge remains to incorporate these clinical findings into practice and to document the effectiveness of our interventions.
References
PII: S0891-5245(09)00108-4
doi:10.1016/j.pedhc.2009.04.006
© 2009 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
