Frequency of Nutrition Counseling in an Overweight and Obese Adolescent Urban Population and its Effect on Health Related Outcomes

Background: Adolescent overweight and obesity is a condition affecting individuals locally and nationwide. Data from the Georgia State Department of Public Health indicate that 31% of high school students are overweight or obese. Contributing factors to this condition include lifestyle and environment, which influence diet and exercise. Through nutrition counseling, these decisions can be addressed and modified to promote a more healthful lifestyle. The purpose of this study is to describe outcomes related to multiple nutrition counseling sessions with an outpatient registered dietitian (RD) compared to only one visit with the RD and a follow up with a Primary Care Physician (PCP). Methods: As a retrospective chart review, inclusion criteria included overweight and obese boys and girls who were at or above the 85th percentile for age and gender when plotted on the Center for Disease Control and Prevention (CDC) growth charts. Data were collected on patients aged 11-20 years who participated in one of four outpatient clinics located in Atlanta, GA and who had attended one or more sessions with the dietitian from 2/11/13 to 3/23/15. Outcome measures included change in BMI, BMI z- score, serum hemoglobin A1C , serum triglycerides, and serum total cholesterol. Results: A total of 22 participants were included in the study. Out of the 22 participants, 10 had seen a RD and followed up with a PCP (Group 1) and 12 had seen the RD multiple times (Group 2). The median initial BMI was 25.16(range 24.49-29.53, Group1) and 33.79(range 30.79-41.37, Group 2). The median initial BMI Z score was 1.69(range 1.52-2.06, Group 1) and 2.38 (range 2.27-2.67, Group 2). The mean age was 13.20 years (Group 1) and 14.58 years (Group 2). Mann Whitney U tests found that there were no significant differences between the groups in change in BMI (p=0.692) but change in BMI z-score showed a slower rate of increase in Group 2 compared to Group 1(0.002 vs. 0.115; p=0.092). Conclusions: This study concludes that multiple sessions with the outpatient RD may be beneficial in slowing the rate of BMI z-score increase in an overweight and obese urban adolescent populatio