title: Increased frequency of dietitian visits is associated with improved body mass index outcomes in obese youth participating in a comprehensive pediatric weight management program.
abstract: BACKGROUND
  Comprehensive weight management (CWM) interventions are most effective for obese youth when they include multiple components, such as nutrition, physical activity, and behavioral strategies. However, effectiveness of different approaches to delivering the nutrition component is unknown. Our aim was to evaluate two dietary approaches and extent of registered dietitian (RD) involvement on outcomes of obese youth participating in a CWM program.
  
  
  METHODS
  A retrospective review of CWM patients was conducted before and after redesign of the nutrition component. The earlier clinical model (CM1) introduced a portion-controlled diet at an RD visit after the initial medical visit, whereas the later clinical model (CM2) introduced a reduced glycemic load diet at the initial medical visit. CWM patients were included if they had at least one RD visit and an initial and 3- to 6-month medical follow-up visit during CM1 or CM2. Differences between CM1 and CM2 groups regarding changes in BMI and programmatic success (BMI change ≤0) were evaluated.
  
  
  RESULTS
  Median BMI change during follow-up did not differ between CM1 (n=41) and CM2 (n=51) groups (p=0.41). In a multiple logistic regression model combining study groups, each additional RD visit was associated with a 28% increased odds of success (odds ratio [95% confidence interval]: 1.28 [1.00, 1.64]; p=0.05). The probability of success exceeded 78% with ≥1 RD visit/month versus 43% with minimal RD exposure.
  
  
  CONCLUSIONS
  Increased frequency of RD visits is associated with improved BMI outcomes in obese youth participating in a CWM program regardless of dietary intervention implemented.
authors.affiliation: 1 Heart Institute, Cincinnati Children's Hospital Medical Center , Cincinnati, OH.
authors.forename: Shelley
authors.initials: S
authors.lastname: Kirk
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Woo
authors.forename: Margaret N
authors.initials: MN
authors.lastname: Jones
authors.forename: Robert M
authors.initials: RM
authors.lastname: Siegel
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004038:Diet, Reducing; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D009752:Nutritional Status; D064686:Nutritionists; D010353:Patient Education as Topic; D063766:Pediatric Obesity / Q000517:prevention & control / Q000523:psychology*; D012189:Retrospective Studies; D061217:Weight Reduction Programs; D055815:Young Adult