Echoes from ECO 2024 Expert opinion Weight management

Niamh Arthurs: Food habits among children and adolescent with obesity

Echoes from ECO2024 - Niamh Arthurs - YINI

YINI attended the 2024 ECO congress to gather scientific updates and expert’s advice on the role of diet and dairy in the management and prevention of obesity. The congress offered a great opportunity to meet with experts from various fields of expertise. Here Niam Arthurs, pediatric dietitian and researcher in the area of child and adolescent obesity based in Dublin, Ireland, speaks about her research on child obesity.

Key messages:

  • Understanding children’s and parents’ eating habits is crucial for creating effective, personalized dietary treatments for childhood obesity.
  • The study aims at allowing dietitians to identify key target points such as the fact that many children and teenagers are not meeting the recommended daily intakes for calcium.
  • Addressing misinformation and providing evidence-based recommendations, such as the FDA claim about the role of yogurt in the prevention of type 2 diabetes, can help dietitians’ design personalized dietary treatments, especially in the context of childhood obesity.

 

Can you introduce yourself and tell us what you work on?

I’m a senior pediatric dietitian and researcher in the area of child and adolescent obesity based in Dublin, Ireland. My team works on food habits among children with obesity. Our main objective is to gather intelligence about our young patients’ habits before implementing any obesity treatment in order to maximize the effectiveness of personalized dietary approaches.

Firstly, we examine the nutritional quality of children’s reported food and fluid intakes. For this specific aspect, we use a 28-item food frequency questionnaire, conducted with the parents.

Secondly we evaluate the level of parental knowledge about nutrition, their self-reported cooking confidence and their relationship to food consumption. Ultimately, these elements guide us in determining the relationship between parental nutritional knowledge and children’s dietary habits. That is the basis for tailoring personalized treatment.

What have you learned about personalized dietary treatment for children with obesity using this method?

Getting a baseline idea about what children and teenagers are actually eating, combined with parents’ nutrition knowledge and their ease with cooking preparations allowed us to avoid making assumptions about children’s environments. This truly helped us make the connection between gathered information and its relationship with food consumption.

Our study found that parents who reported lower levels of cooking confidence tended to have households with higher consumption of convenience meals and takeaway foods. For dietitians aiming at framing their patients’ specific needs, such elements represent key targets for designing their interventions.

Assessing levels of knowledge in nutrition also enables understanding of general food and nutrient recommendations knowledge. We observed that the consumption of dairy products was a lot lower than the recommended amounts, in all age groups. From 5- to 88-year-olds, only about over 50% of the studied population met the recommended daily intakes for dairy products.

In Ireland, dairy products are the main source of calcium in children’s and teenagers’ diets. This nutrient is of pivotal importance during this age of growth. However, none of the 9- to 16-year-olds included in the survey met the recommended daily intakes for calcium, from either dairy products or other calcium-rich foods.

Again, the study aims at identifying such key target points to let dietitians design relevant interventions.

How do these results translate in your day-to-day consultation?

Expanding on the earlier example of calcium deficiency, the study highlighted that our interventions need to focus more on dairy products. This implies addressing the myths around dairy products and exploring with the families the reasons why they do not consume enough dairy products, particularly children and teenagers.

In this instance, it appears that a lot of the parents simply do not know what the recommendations for dairy foods are – i.e. 3 portions of dairy foods per day from up to 8 years, and 5/day after 8 years old, in Ireland – nor what a serving size corresponds to.

That information is crucial for health and nutrition literacy, and we need to incorporate it more into our one-on-one consultations and group education programs to ensure that individuals are receiving adequate levels of necessary knowledge.

Do you provide them with simple ways to incorporate more dairy into their meals?

This is where tailoring comes in. It’s important to understand what children and teenagers are currently eating to make small, specific suggestions for incorporating more dairy. For example, many children begin skipping breakfast when they transition from primary to secondary school, often due to time constraints or lack of appetite. However, breakfast is an important opportunity to consume calcium-rich foods.

We can suggest alternatives such as eating something once they get to school or choosing quicker options for the morning to overcome time barriers. Additionally, they can incorporate more calcium-rich foods into their lunch. For instance, they could add cheese to their sandwiches or bring pouch yogurts, which are convenient and less likely to burst in their bags. Drinkable yogurts are also a good option. These types of recommendations are often more acceptable and practical for their routines.

In March 2024, the FDA published a qualified health claim about the role of yogurt in the prevention of type 2 diabetes. Can this have an impact on the recommendations? Do you think it can be an opportunity for patients?

It’s incredibly valuable to have strong, evidence-based claims because there’s so much misinformation surrounding dairy foods. For instance, myths about dairy contributing to acne, containing hormones, or causing inflammation are not supported by scientific evidence. Unfortunately, the science community isn’t reaching these target groups effectively. Families are increasingly getting their information from social media, so we need to be much louder in our communication. Having well-supported claims can help us do that.

Moreover, these claims are particularly significant in our world today, where we face rising rates and high prevalence of conditions like type 2 diabetes. These conditions can severely impact an individual’s quality of life and health if not properly managed. Strong, scientifically-backed claims not only help us communicate more effectively but also attract media attention. This can encourage individuals, families, and teenagers who might be avoiding calcium-rich foods, such as dairy products, to reconsider their choices.

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