Position of the Academy of Nutrition and Dietetics: Medical Nutrition Therapy Behavioral Interventions Provided by Dietitians for Adults With Overweight or Obesity, 2024.

Providing interventions that facilitate improvement of dietary intake and other health behaviors can improve nutrition-related outcomes in adults with overweight or obesity. Medical nutrition therapy (MNT) behavioral interventions require expertise from registered dietitian nutritionists or international equivalents (dietitians), which no other health care provider can provide for adults with obesity. Current evidence supports the role of MNT behavioral interventions for adults with overweight or obesity as an effective treatment option, when appropriate for and desired by the client.

Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline.

Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved.

Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis.

Background: Obesity is associated with a multitude of comorbidities and considerable health care costs.

Objective: The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as "dietitian").

Methods: This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity.

The National Health and Nutrition Examination Survey's Food Insecurity Questionnaire Completed by Children: Effects of Assessment Mode (Classroom versus Interview).

The National Health and Nutrition Examination Survey's food insecurity questionnaire was administered to 155 children (77 African American, 65 White, 13 "Other" [7 Hispanic; 6 mixed races]) in grade 4 twice, 28-32 days apart. Test-retest reliabilities were modest and somewhat similar for assessment mode (classroom, interview) and subgroup variables (gender, race, socioeconomic status, academic achievement, body mass index percentile, social desirability). As academic achievement increased, White and Other children reported less food insecurity, and African-American children reported slightly less.

Fourth-grade children's dietary reporting accuracy by meal component: Results from a validation study that manipulated retention interval and prompts.

We examined reporting accuracy by meal component (beverage, bread, breakfast meat, combination entrée, condiment, dessert, entrée, fruit, vegetable) with validation-study data on 455 fourth-grade children (mean age = 9.92 ± 0.41 years) observed eating school meals and randomized to one of eight dietary recall conditions (two retention intervals [short, long] crossed with four prompts [forward, meal-name, open, reverse]).

Fourth-Grade Children's Reporting Accuracy for Amounts Eaten at School-Provided Meals: Insight from a Reporting-Error-Sensitive Analytic Approach Applied to Validation Study Data.

Background: Validation studies that have directly assessed reporting accuracy for amounts eaten have provided results in various ways.

Objective: To analyze amount categories of a reporting-error-sensitive approach for insight concerning reporting accuracy for amounts eaten.

Design: For a cross-sectional validation study, children were observed eating school-provided breakfast and lunch, and randomized to one of eight 24-hour recall conditions (two retention intervals [short and long] crossed with four prompts [forward, meal name, open, and reverse]).

Children's school-breakfast reports and school-lunch reports (in 24-h dietary recalls): conventional and reporting-error-sensitive measures show inconsistent accuracy results for retention interval and breakfast location.

Validation-study data were analysed to investigate retention interval (RI) and prompt effects on the accuracy of fourth-grade children's reports of school-breakfast and school-lunch (in 24-h recalls), and the accuracy of school-breakfast reports by breakfast location (classroom; cafeteria). Randomly selected fourth-grade children at ten schools in four districts were observed eating school-provided breakfast and lunch, and were interviewed under one of eight conditions created by crossing two RIs ('short'--prior-24-hour recall obtained in the afternoon and 'long'--previous-day recall obtained in the morning) with four prompts ('forward'--distant to recent, 'meal name'--breakfast, etc., 'open'--no instructions, and 'reverse'--recent to distant).

Validation of Interviewer-Assisted Recall for Measuring Minutes of Moderate to Vigorous Physical Activity in Elementary School Children, Grades 3 and 5.

Objective: To test the validity of interviewer-administered recall for measuring moderate to vigorous physical activity (MVPA) in third- and fifth-grade children who reported physical activity (PA) only or both PA and diet, using a short (same-day recall in the afternoon) or long (previous-day recall in the morning) retention interval.

Methods: Randomly selected children (n = 95) wore an accelerometer 1 day in school. Interviews occurred in the afternoon of the day on which the accelerometer was worn or on the next morning.

Test-Retest Reliability of the National Health and Nutrition Examination Survey's 5-Item Food Insecurity Questionnaire Completed by Fourth-Grade Children.

Objective: To examine test-retest reliability and internal consistency of a 5-item food insecurity questionnaire used in the National Health and Nutrition Examination Survey (NHANES).

Methods: Researchers administered NHANES's questionnaire in the classroom to 92 fourth-grade children (74 African American; 48 girls) in 2 sessions 27-30 days apart in spring, 2011. Each classroom administration lasted 5-10 minutes.

Effectiveness of Prompts on Fourth-Grade Children's Dietary Recall Accuracy Depends on Retention Interval and Varies by Gender.

Background: Dietary recall accuracy is related to retention interval (RI) (i.e., time between to-be-reported meals and the interview), and possibly to prompts.

Children's Social Desirability: Effects of Test Assessment Mode.

This study examined a recently developed short version of the Children's Social Desirability (CSD-S) scale with 157 fourth-grade children. Of interest was a) whether one-month test-retest reliability would vary as a function of test assessment mode (interview or classroom), gender, race, SES, and BMI percentile, and b) whether the degree of social desirability would vary as a function of these same variables. The CSD-S scale showed good test-retest reliability for both interview and classroom assessment modes (.

Retention Interval and Prompts: Creation and Cross-Sectional Pilot-Testing of Eight Interview Protocols to Obtain 24-Hour Dietary Recalls from Fourth-Grade Children.

Background: Any 24-hour dietary recall (24hDR) has a retention interval and prompts. No research has investigated their combined effect.

Objective: Eight 24hDR protocols, constructed by crossing two retention intervals (prior-24-hour recall obtained in afternoon and previous-day recall obtained in morning) with four prompts (forward [distant-to-recent], reverse [recent-to-distant], meal-name [eg, breakfast, lunch, etc], and open [no instructions]), were pilot-tested.

Misclassification of fourth-grade children's participation in school-provided meals based on parental responses relative to administrative daily records.

Although many studies have relied on parental responses concerning children's school-meal participation, few studies have evaluated parental response accuracy. We investigated misclassification of fourth-grade children's participation in school-meal programs based on parental responses relative to administrative daily records using cross-sectional study data collected for 3 school years (2004-05, 2005-06, and 2006-07) for 1,100 fourth-grade children (87% black; 52% girls) from 18 schools total in one district. Parents reported children's usual school-meal participation on paper consent forms.

A validation study concerning the effects of interview content, retention interval, and grade on children's recall accuracy for dietary intake and/or physical activity.

Background: Practitioners and researchers are interested in assessing children's dietary intake and physical activity together to maximize resources and minimize subject burden.

Objective: Our aim was to investigate differences in dietary and/or physical activity recall accuracy by content (diet only; physical activity only; diet and physical activity), retention interval (same-day recalls in the afternoon; previous-day recalls in the morning), and grade (third; fifth).

Design: Children (n=144; 66% African American, 13% white, 12% Hispanic, 9% other; 50% girls) from four schools were randomly selected for interviews about one of three contents.

Test-retest reliability of a short form of the children's social desirability scale for nutrition and health-related research.

Objective: To examine test-retest reliability and internal consistency of the Children's Social Desirability Short (CSD-S) scale, consisting of 14 items from the Children's Social Desirability scale.

Methods: The previously validated CSD-S scale was classroom administered to 97 fourth-grade children (80% African American; 76% low socioeconomic status) in 2 sessions a month apart. Each classroom administration lasted approximately 5 minutes.

A pilot study of the effects of interview content, retention interval, and grade on accuracy of dietary information from children.

Objective: Investigate differences in dietary recall accuracy by interview content (diet only or diet and physical activity), retention interval (same day or previous day), and grade (third or fifth).

Methods: Thirty-two children observed eating school-provided meals and interviewed once each; interview content and retention interval randomly assigned. Multivariate analysis of variance on rates for omissions (foods observed but unreported) and intrusions (foods reported but unobserved); independent variables: interview content, retention interval, grade.

There is no relationship between academic achievement and body mass index among fourth-grade, predominantly African-American children.

School-based initiatives to combat childhood obesity may use academic performance to measure success. This cross-sectional study investigated the relationship between academic achievement and body mass index percentile, socioeconomic status (SES), and race by linking existing datasets that are not routinely linked. Data from a school-based project (with National Institutes of Health funding) concerning dietary recall accuracy were linked with data from the state's Department of Education through the state's Office of Research and Statistics.

Explaining the positive relationship between fourth-grade children's body mass index and energy intake at school-provided meals (breakfast and lunch).

Background: A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school-provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades.

Methods: Fourth-grade children (N = 465) from Columbia, SC, were observed eating school-provided breakfast and lunch on 1 to 4 days per child.

Examining variations in fourth-grade children's participation in school-breakfast and school-lunch programs by student and program demographics.

Purpose/objectives: Analyses were conducted to examine variations in fourth-grade children's participation in school-breakfast and school-lunch programs by weekday, month, socioeconomic status, absenteeism, sex, and school-breakfast location.

Methods: Fourth-grade children were participants in a dietary-reporting validation study during the 2005-2006 or 2006-2007 school years in 17 or 8 schools, respectively, in one South Carolina school district. For the two respective school years, school-breakfast location was the classroom for six and seven schools, and for the remaining schools, the cafeteria.

Secondary analyses of data from 4 studies with fourth-grade children show that sex, race, amounts eaten of standardized portions, and energy content given in trades explain the positive relationship between body mass index and energy intake at school-provided meals.

Results from a 2012 article showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals. To help explain that positive relationship, secondary analyses investigated (1) whether the relationship differed by sex and race and (2) the relationship between BMI and 6 aspects of school-provided meals--amounts eaten of standardized portions, energy content given in trades, energy intake received in trades, energy intake from flavored milk, energy intake from a la carte ice cream, and breakfast type. Data were from 4 studies conducted 1 per school year (1999-2000 to 2002-2003).