Do physicians discuss needed diet and nutrition health topics with adolescents?

Department of Pediatrics, University of Rochester School of Medicine, Rochester, New York, USA.
Journal of Adolescent Health (Impact Factor: 3.61). 05/2006; 38(5):608.e1-6. DOI: 10.1016/j.jadohealth.2005.06.009
Source: PubMed


Preventive services guidelines recommend screening all adolescents for diet habits, physical activity and growth, counseling underweight teens about body image and dieting patterns, and counseling overweight or obese teens about dietary habits and exercise. In this study, we assess whether adolescents at risk for overweight or for eating disorders have discussed recommended diet and nutrition topics with their physicians.
We surveyed 14-18-year-old adolescents who had been seen for well care in primary care pediatric and family medicine practices. Adolescents self-reported their weight, height, body image, dieting habits, and issues they had discussed with their clinicians. Body mass index (BMI) was used to define those "at risk for an eating disorder" (< 5% BMI), "at risk of becoming overweight" (85%-95% BMI), and "overweight" (> 95% BMI).
A total of 8384 adolescents completed surveys (72% completion rate). Nearly one-third of adolescents were "at risk" or overweight. Females were less likely to be overweight than males (9.4% vs. 15.7%; p < .001). Although 26.4% were attempting to lose weight, only 12.2% of all teens were actually overweight. Exercise and restricting intake were the preferred methods of weight loss. Physicians routinely discussed adolescents' weight during visits, and were more likely to discuss it with those "at risk" (p < .001). Body image was more often discussed with girls than with boys (52% vs. 44.6%, p < .001) and with those at risk (51.6% vs. 45.5%; p < .001). Discussion of healthy eating and weight loss occurred more often with adolescents "at risk" for becoming overweight (p < .001).
Many adolescents are at risk for being overweight or are currently overweight, confirming the importance of clinicians discussing diet and nutrition health topics with all teens. Many adolescents also misclassify their body image, and hence perceive their body image to be different from their actual BMI; clinicians should discuss body image with all adolescents, not just those at risk for eating disorders. Better interventions are needed to promote healthy nutrition and physical activity to all adolescents.

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    • "In general, girls were more likely to receive assessments of weight-related factors. Consistently, girls were more likely to report having discussed body image with their physicians [42]. Similarly, we observed a greater proportion of girls than boys received each assessment except WC and BMI. "
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    ABSTRACT: Few studies have examined how common physicians assess various weight-related variables and patient characteristics that predict such assessments based on adolescents' reports. To examine how common adolescents received weight-related physical measurements and lifestyle enquiries (dietary habits and physical activity) from private practitioners and to identify factors associated with these assessments. In the Hong Kong Student Obesity Surveillance (HKSOS) project, 33692 students (44.9% boys; mean age 14.8, SD 1.9 years, age range 11--18) from 42 randomly selected schools completed an anonymous questionnaire. The students were asked "In the past 12 months, has any private practitioners (or their nurses) measured or asked about these items?" Response options included height, weight, waist circumference (WC), blood pressure (BP), BMI, diet, and physical activity. Weight status was based on self-reported weight and height. Logistic regression was used to identify student characteristics associated with each assessment. Analyses were conducted using STATA 10.0. Among 13283 students who had doctor consultations in the past 12 months, 37.9% received physical measurements or lifestyle enquiries, with weight (20.8%), height (16.8%) and blood pressure (11.5%) being the most common, followed by diet (8.1%), BMI (6.3%), WC and physical activity (both 4.6%). In general, adolescents who were female, older, underweight or overweight/obese, had parents with higher education level, and had actively asked private practitioners for advice about weight were more likely to receive assessments of weight-related factors. Weight-related factors in adolescents were infrequently assessed by private practitioners in Hong Kong. Generally, unhealthy weight, higher parental education and advice-seeking by adolescents predicted these assessments.
    Full-text · Article · Sep 2013 · BMC Family Practice
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