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October 2007
Evidence-Based Tip
The Obesity Epidemic: Guidance from Practice Guidelines
Last month, we looked for evidence about the effectiveness of programs aimed at preventing and reducing obesity. We found studies and a systematic review of programs for children, many of which were school based. This month, let's take a look at what we can learn from our practice guidelines.
There are several places to go to look for practice guidelines. The most obvious is the American Academy of Pediatrics. However, finding practice guidelines is a little less than obvious on the web site! Once on the home page [http://www.aap.org], scroll down to find a box on the right-hand side that says "For Medical Professionals." The second link is to "Policy Statements and Practice Guidelines." There you can find not only guidelines, but also clinical and technical reports.
Because obesity is a hot topic today, there is an easier way to find AAP's information about obesity. Again, from the AAP home page, about halfway down the page on the left, there is a section for "Children's Health Topics" where "Obesity" is listed. That offers professional as well as parent information, and provides a link to a special website developed by the AAP for this subject with a link to a dedicated space for AAP Obesity Resources.
There are other places to look for guidelines on obesity, such as the National Guideline Clearinghouse. Despite its name, it contains guidelines from private and public, national and international sources.
Practice guidelines are often published as articles in journals. To locate those articles in PubMed, do your subject search as usual, then use the "Type of Article" limit to select "Practice Guideline. Don't forget to limit by "Ages" to children, instead of using an age as a search term.
When looking at guidelines, one must always ask how the guidelines were formed, and on what the recommendations are based. The AAP Policy Statement "Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity" punctuates its recommendations with references to the evidence. In the section "Prevention of Overweight in Children and Youth" references the Cochrane systematic review discussed in last month's EBM Tip. A guideline is only as good as the evidence on which it is based!
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