Pediatric Weight Management

PWM: Environment (2012)

Aspects of the built environment in which individual patients live and work can seem so far removed from dietetics practice that RDs may wonder why it is important to be aware of the state of the research on topics such as:

  • Neighborhood safety,
  • Physical activity resources, or
  • Residential density.

Two key aspects of dietetics practice argue for the importance of the RD being aware of this research.

Informed Dietetics Practice

For instance, an overweight child who lives in an unsafe neighborhood with few parks or physical activity resources available in the immediate vicinity may find it substantially more difficult to meet a recommendation to increase the time spent each week in moderate or vigorous physical activity. Thus, a health professional who makes such a recommendation without being aware of the impact of the individual’s built environment risks making irrelevant recommendations.First, as outlined in the International Dietetics and Nutrition Terminology (IDNT) manual (3rd Ed.), nutrition assessment involves identifying all data relevant for identifying the nutrition related problem and formulating nutrition intervention goals (p.13). Without a clear understanding of the built environment in which a child lives, a nutrition intervention goal may be unrealistic or insensitive given the patient’s situation.

In short, without some knowledge of the built environment that may be associated with childhood overweight and obesity and RD risks making ineffective recommendations.

RD Community Responsibility

Because of these arguments, the Work Group on Pediatric Overweight determined that RDs should be made aware of different aspects of the built environment that may affect pediatric overweight and obesity. While this is a new area of research and firm conclusions elusive, the practicing RD should be aware of this research and factor it into his or her practice.Second, RDs live in communities, and as such, have a responsibility to advocate for health promoting living situations. In order to advocate for health promoting aspects of neighborhoods, schools, municipalities and state and federal policy, the RD must be aware of the best research on the relationship between aspects of the built environment and health.