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Dieting in children referred to the paediatric outpatient clinic
T W de Vries1, N Wierdsma, J van Ede
1Department of Paediatrics, Medical Centre Leeuwarden-Noord, The Netherlands. famtt.devries@worldonline.nl
Insights
One in eight children seen at a pediatric clinic have been on a diet, often started before age two. While most parents found diets effective with no issues, some diets had serious implications without medical evidence.
Area of Science:
- Pediatric Nutrition
- Dietary Interventions in Children
- Child Health Outcomes
Background:
- Dietary interventions are sometimes necessary for children but can lead to medical and psychosocial issues.
- Understanding the frequency, reasons, and effectiveness of pediatric diets is crucial.
Purpose of the Study:
- To determine the prevalence of dietary interventions in children referred to a general pediatric outpatient clinic.
- To investigate the types of diets, reasons for their use, and parental perceptions of effectiveness and problems.
Main Methods:
- A structured questionnaire was administered to parents of newly referred pediatric patients.
- Data collected included patient demographics, diet history (type, duration, age of initiation), reasons for dieting, and perceived effectiveness and problems.
- Exclusion criteria included non-Dutch speaking parents, children younger than 3 months, and emergency cases.
Main Results:
- Out of 907 included patients, 13.7% (124 children) were or had been on a diet.
- Diets were often initiated before age two (60%) and continued for over a year (50%).
- Common diets included cow's milk-free (62%), egg-free (20%), lactose-free (14%), no sugar (20%), and no coloring additives (20%). Gastrointestinal, dermal, and behavioral symptoms were primary reasons.
Conclusions:
- Approximately one in eight children referred to a general pediatric clinic have undergone dietary interventions.
- Most parents reported positive outcomes and no significant problems associated with the diets.
- The study highlights the need for evidence-based dietary recommendations and open discussion with parents regarding potential medical and psychosocial implications.
Unlabelled:
Dietary interventions are sometimes necessary, even in young children; however, adhering to a diet can cause medical and psychosocial problems. Therefore, insight into frequency, reasons, and effectiveness is important. To establish the prevalence of dieting in children referred to a general paediatric outpatient clinic, parents of newly referred patients were given a structured questionnaire. Excluded were children whose parents did not speak Dutch, those younger than 3 months and emergency cases. Of 1826 patients, 907 (511 boys, 56%; median age 5 years, range 0-18 years) were included; 124 (13.7%, 95% CI 11.5%-15.9%) were or had been on a diet, more boys than girls (82/511 versus 42/396, P=0.02). In 60% of patients, the diet was started before the age of 2 years, 50% had been dieting longer than a year. Diets most used were: cow's milk free (62%), egg-free (20%), lactose-free (14%), no sugar (20%) and no colouring additives (20%). Reasons for dieting were gastrointestinal (51%), dermal (51%) and behavioural (27%) symptoms or complaints. Dieting was considered effective by the parents in 65% of cases and 61% reported no problems.
Conclusion:
One in eight children, referred to a general paediatric outpatient clinic is or has been dieting. Most parents reported positive effects with no problems. Some children were on a difficult-to-keep diet with serious medical and psychosocial implications, without being tested. Scientific evidence for dieting should be sought and the results discussed with the parents.