Computer-assisted tools alert pediatricians to obese patients

Electronic health records and embedded tools can alert and direct pediatricians so they can better manage the weight of children and teenagers, according to a new Kaiser Permanente study published online in The Journal of Pediatrics.

Researchers analyzed visits for nearly 740,000 children and adolescents ages 2 to 17 to evaluate the impact of computer-assisted decision tools and found that extracting information from the electronic health record substantially improves the identification and diagnosis of overweight and obesity among children and adolescents, and also facilitated exercise and nutrition counseling.

"By using electronic medical record tools we can diagnose and address obesity-related issues at a population level rather than just among a few families. These are great tools that could be implemented by physicians in a variety of clinical settings to better diagnose and manage obesity among children and adolescents," said study lead author Karen Coleman, PhD, from Kaiser Permanente's Southern California Department of Research & Evaluation.

The prevalence of obesity has increased sharply in children and adolescents in the last 30 years, with at least 18 percent of 12- to 19-year-olds now considered obese. To address this dramatic increase, the American Academy of Pediatrics Expert Committee guidelines recommended standardized approaches to the identification and treatment of overweight and obese children and adolescents as well as prevention of overweight and obesity among an at-risk population in clinical settings. To date, these guidelines have been inconsistently or poorly implemented.

For this reason the Kaiser Permanente Southern California Pediatric Weight Management Initiative was implemented in 2008 to improve adherence to these guidelines and to ensure that KPSC met the Healthcare Effectiveness Data and Information Set (commonly known as HEDIS) requirements for the measurement of pediatric height and weight and exercise and nutrition counseling for children and adolescents.

"One of the first steps in dealing with any epidemic is finding successful ways to identify the patients at risk. The pediatric obesity epidemic is no exception. Tools such as these will be a great help to the primary care pediatrician, and will allow not only earlier assessment, but can help direct the providers to the recommended testing and treatment," said study co-author Amy Porter, MD, Kaiser Permanente Southern California pediatrician.

Top tips to promote healthy childhood eating

Have regular family meals. Knowing dinner is served at approximately the same time every night and that the entire family will be sitting down together is comforting and enhances appetite. Breakfast is another great time for a family meal, especially since kids who eat breakfast tend to do better in school.
Cook more meals at home. Eating home cooked meals is healthier for the whole family and sets a great example for kids about the importance of food. Restaurant meals tend to have more fat, sugar, and salt. Save dining out for special occasions.. Children enjoy helping adults grocery shop, selecting what goes in their lunch box, and preparing dinner. It's also a chance for you to teach them about the nutritional values of different foods, and (for older children) how to read food labels.. Keep plenty of fruits, vegetables, whole grain snacks, and healthy beverages (water, milk, pure fruit juice) around and easily accessible so kids become used to reaching for healthy snacks instead of empty calorie snacks like soda, chips, or cookies.. Don’t insist your child cleans the plate, and never use food as a reward or bribe.