Preventive activities in general practice 7th edition

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Screening tests of unproven benefit

Appendices

There is a lack of evidence for the effectiveness of interventions in clinical practice to reduce childhood obesity. Some consensus guidelines recommend that height, weight and head circumference should be measured at each visit and plotted on appropriate centile charts (head circumference until 36 months of age and body mass index [BMI] from 2 years of age).¹⁰⁰ There is evidence that GPs may underestimate the prevalence of paediatric overweight in their practice, and universal measurement of height, weight and calculation of BMI can identify all children at risk of overweight.¹⁰¹

There is evidence of some success in community based efforts to prevent and treat childhood obesity.^102,103

Growth, overweight and obesity
Who is at higher risk of overweight or obesity?	What should be done?	How often?	Level of evidence and references
Average risk	Measure height and weight, calculate BMI and plot on BMI for age chart	Opportunistically, as recommended in the local child health record	V C 83,96 104-107
High risk Early adiposity An overweight parent A history of gestation affected by diabetes Children from a Middle Eastern background¹⁰⁸	Measure and chart growth and BMI Promote healthy eating, physical activity and limited small screen recreation	Opportunistically	V C 96

Growth, overweight and obesity

Who is at higher risk of overweight or obesity?

What should be done?

How often?

Level of evidence and references

Average risk

Measure height and weight, calculate BMI and plot on BMI for age chart

Opportunistically, as recommended in the local child health record

V C 83,96
104-107

High risk

Early adiposity
An overweight parent
A history of gestation affected by diabetes
Children from a Middle Eastern background¹⁰⁸

Measure and chart growth and BMI
Promote healthy eating, physical activity and limited small screen recreation

Opportunistically

V C 96

Growth, overweight and obesity: Intervention
Intervention	Technique	References
Measure and chart growth. Calculate and plot BMI on BMI for age charts	Height, weight and head circumference These should be measured at each surveillance visit and plotted on appropriate centile charts (head circumference until 36 months of age and BMI from 2 years of age) Care needs to be taken when interpreting velocities Ensure equipment accurate and regularly calibrated	83,96,104,105,107 109,110
Promote healthy eating and activity	Provide dietary advice using the Dietary guidelines for Australian children including: eat plenty of vegetables, legumes and fruits (two serves of fruit and five of vegetables each day ) eat plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain include lean meat, fish, poultry and/or alternatives include milk, yoghurt, cheese and/or alternatives choose water as a drink; limit soft drink, fruit juice and cordial limit snack foods eat breakfast every day limit portion sizes Limit sedentary screen time <2 hours per day (includes watching TV, playing video games and use of computers) Encourage moderate to vigorous physical activity for at least 60 minutes each day including aerobic, muscle, and bone strengthening components	96-98

Growth, overweight and obesity: Intervention

Intervention

Technique

References

Measure and chart growth. Calculate and plot BMI on BMI for age charts

Height, weight and head circumference

These should be measured at each surveillance visit and plotted on appropriate centile charts (head circumference until 36 months of age and BMI from 2 years of age)
Care needs to be taken when interpreting velocities
Ensure equipment accurate and regularly calibrated

83,96,104,105,107
109,110

Promote healthy eating and activity

Provide dietary advice using the Dietary guidelines for Australian children including:
- eat plenty of vegetables, legumes and fruits (two serves of fruit and five of vegetables each day )
- eat plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain
- include lean meat, fish, poultry and/or alternatives
- include milk, yoghurt, cheese and/or alternatives
- choose water as a drink; limit soft drink, fruit juice and cordial
- limit snack foods
- eat breakfast every day
- limit portion sizes
Limit sedentary screen time <2 hours per day (includes watching TV, playing video games and use of computers)
Encourage moderate to vigorous physical activity for at least 60 minutes each day including aerobic, muscle, and bone strengthening components

96-98

Guidelines for preventive activities in general practice 7th edition

Full index

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Oral hygiene

Glaucoma

Urinary incontinence

Osteoporosis

Screening tests of unproven benefit

References

Appendices

Glossary

Acronyms

Acknowledgements

Disclaimer

Growth, overweight and obesity