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Role of Dietary Factors and Food Habits in the Development of Childhood Obesity: A Commentary by the ESPGHAN Committee on Nutrition

Agostoni, Carlo*,3; Braegger, Christian; Decsi, Tamas; Kolacek, Sanja§; Koletzko, Berthold||,3; Mihatsch, Walter; Moreno, Luis A#; Puntis, John**; Shamir, Raanan††,1; Szajewska, Hania‡‡; Turck, Dominique§§,2; van Goudoever, Johannes||||ESPGHAN Committee on Nutrition

Journal of Pediatric Gastroenterology and Nutrition: June 2011 - Volume 52 - Issue 6 - p 662–669
doi: 10.1097/MPG.0b013e3182169253
Position Paper

This Comment by the Committee on Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition aims to provide a summary of the role of nutrition-related factors on obesity prevention in children ages 2 to 18 years. This Comment emphasizes that dietary interventions should be incorporated into a multidisciplinary strategy for obesity prevention. No single nutrient has been unequivocally associated with the development of obesity. Methodological limitations in study design and the complex nature of obesity must be taken into account when interpreting the association with reported dietary factors. Energy intake should be individually determined, taking into account energy expenditure and growth. Preferential intake of slowly absorbed carbohydrates and limiting the ingestion of rapidly absorbed carbohydrates and simple sugars should be promoted. No specific recommendations for macronutrient intakes to prevent obesity can be made. Plant foods can be used as the main food contributors to a well-balanced diet with adequate monitoring of nutrient intake. Plain water should be promoted as the main source of fluids for children instead of sugar-sweetened beverages. Children should eat at least 4 meals, including breakfast, every day. Regular family meals should be encouraged. Regular consumption of fast food with large portion sizes and high energy density should be avoided. Healthy food options should be promoted for snacking. Food portion sizes should be appropriate for age and body size. Nutrition and lifestyle education aimed at the prevention of obesity should be included in the routine care of children by health care professionals.

*Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS Ca' Granda—Ospedale Maggiore Policlinico, Milan, Italy

University Children's Hospital, Zurich, Switzerland

Department of Paediatrics, University of Pecs, Pecs, Hungary

§University Hospital “Sister of Mercy,” University Children's Hospital Zagreb, Zagreb, Croatia

||Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany

Department of Paediatrics, Deaconry Hospital, Schwaebisch Hall, Germany

#Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain

**Leeds General Infirmary, Leeds, UK

††Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

‡‡Medical University of Warsaw, Warsaw, Poland

§§Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

||||Pediatrics, VU University Medical Center, Amsterdam, The Netherlands.

1Committee Chair;

2Committee Secretary;


Received 4 January, 2011

Accepted 14 January, 2011

Address correspondence and reprint requests to Dr Luis A. Moreno, E.U. Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain (e-mail:

Conflicts of interest are posted at

Copyright 2011 by ESPGHAN and NASPGHAN