Echoes from ECO 2024 Expert opinion Weight management

Odysseas Androutsos – Dietary guidelines for childhood obesity

Odysseas Androutsos - dietary guidelines for children

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 Odysseas Androutsos, Associate Professor at the Department of Nutrition and Dietetics at the University of Thessaly, speaks about his work on the dietary guidelines for children.

Key messages:

  • Childhood obesity has significantly increased over the past decade, necessitating urgent attention and the development of comprehensive guidelines by experts at ESDN Obesity, EFAD, and IASO for treating obesity in children and adolescents.
  • Effective obesity treatment plans for children and adolescents must prioritize a holistic, patient-centered approach, incorporating long-term strategies, medical nutrition therapy, and the inclusion of nutrient-dense foods like yogurt, fruits, and vegetables to support overall health and growth.
  • Dietitians can access the latest obesity treatment guidelines on the EASO and EFAD websites, and are encouraged to collaborate in multidisciplinary teams, gather feedback through qualitative research, and implement these evidence-based recommendations into daily practice to optimize patient outcomes.

Can you introduce yourself?

I’m an Associate Professor at the Department of Nutrition and Dietetics at the University of Thessaly and Director of the Lab of Clinical Nutrition and Dietetics.

You just gave your presentation at the ECO 2024. What should our readers know about your work?

Based on recent findings, it is evident that childhood obesity has significantly increased over the past decade. The prevalence of obesity in adolescence has quadrupled since the 1990s. According to the latest figures provided by the World Health Organization (WHO), 37 million children under the age of 5 and 390 million children and adolescents worldwide are overweight, with 160 million of them living with obesity.

The severity of this issue requires urgent attention. To address these rising trends, my colleagues and I at the European Specialist Dietetic Network (ESDN) Obesity, under the European Federation of the Association of Dietitians (EFAD), in collaboration with the International Association for the Study of Obesity (IASO), have developed the latest guidelines for treating obesity in childhood and adolescence.

Could you outline the key principles recommended in these guidelines?

First and foremost, it is essential to recognize obesity as a disease. Therefore, healthcare professionals need to focus on intensive and long-term strategies to optimize treatment for young individuals. Instead of solely concentrating on weight loss or the maintenance of weight loss, we must consider patient-centered health outcomes. This holistic approach aims to achieve results that impact overall health and disease management.

Furthermore, through the implementation of these long-term and regular interventions, we emphasize medical nutrition therapy to maintain an energy deficit and sustain the weight loss achieved. Concurrently, our optimized approach ensures the provision of essential nutrients to develop healthy diet plans. These plans will not only lead to initial weight loss but also help in maintaining a healthy weight over time.

What are the key considerations and strategies for developing effective obesity treatment plans for children and adolescents?

While focusing on weight management, it is equally important to ensure that children and adolescents receive optimal nutritional intake to meet their requirements. This is crucial from our perspective. We must promote and incorporate low-energy, nutrient-dense foods, such as yogurt, fruits and vegetables, into their diet plans. Replacing energy-dense foods like salty snacks and sweets with healthier options is essential, not only during main meals but also in intermediate meals and breakfast.

Evidence from literature and our recommendations shows, for example, that increasing fruit intake by 0.5 servings and vegetable intake by 1.5 servings per day can be sustained over a long period. Our treatment approach must be personalized, as a one-size-fits-all strategy is ineffective. Specific, measurable, and time-related goals should be set for each patient to meet their unique needs and expectations.

Working in multidisciplinary teams is vital. Collaboration among pediatricians, dietitians, nutritionists, physical education experts, psychologists, and other professionals ensures optimal results. This team approach addresses psychological, social, and physical health aspects of obesity.

Role modeling is another crucial aspect. It extends beyond healthcare professionals to include families, parents, caregivers, teachers, and others in the child’s social environment. Promoting healthy role models is essential. Additionally, using non-stigmatizing, person-first language is important. We must respect and work individually with each person to optimize our efforts.

The care environment must be safe and welcoming, making children and adolescents feel comfortable and happy. These are the main pillars of creating a healthy environment for providing care. Overall, these are the core goals of the medical nutrition therapy described in our recommendations.

What is the place of dairy products in the guidelines, and more specifically yogurt?

Dairy products are an integral part of a healthy dietary pattern and should certainly be included when prescribing healthy diets for children. Their inclusion is not solely for the treatment of overweight or obesity; rather, dairy should be a regular component of the diet plan for all children and adolescents.

In the context of obesity treatment, dairy products provide essential nutrients crucial for growth in children and adolescents, such as proteins and calcium. Additionally, yogurt offers beneficial ferments that positively affect gut microbiota, which play a significant role in maintaining a healthy diet. Incorporating these microbial benefits is an important aspect of effective obesity treatment.

Do you have a message for dietitians on how they can effectively utilize these guidelines?

Dietitians looking to utilize these guidelines can easily access them. The guidelines are uploaded and freely available on the websites of EASO and EFAD. Anyone interested can simply click on the links to access the information. Our committee is also open to any questions and future networking opportunities to optimize the implementation of these recommendations.

Additionally, it is important to note that we are actively working with healthcare professionals to gather their feedback. Through qualitative research methods, such as interviews and focus groups, we are collecting their views and suggestions on how to enhance the implementation of these guidelines. While we have compiled the best available evidence, another crucial step is optimizing the guidelines’ uptake and integration into health systems across Europe, ensuring they are effectively implemented in daily practice.

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