Nutrition advice for women with obesity – a collective responsibility
References
1. Sean Wharton, David C.W. Lau, Michael Vallis, et al. Obesity in adults: a clinical practice guideline. CMAJ 2020;192:E875-E891.
Mark A. Hanson, Chandni Maria Jacob, Moshe Hod, et al. The FIGO pregnancy obesity and nutrition initiative (PONI). Int J Gynecol Obstet. 2019; 147: 131– 133.
Jacob CM, Killeen SL, McAuliffe FM et al. Prevention of noncommunicable diseases by interventions in the preconception period: A FIGO position paper for action by healthcare practitioners. Int J Gynecol Obstet. 2020; 151(Suppl 1): 6– 15.
McAuliffe FM, Killeen SL, Jacob CM, et al. Int J Gynecol Obstet. 020;151(Suppl 1):16–36.
ACOG Committee Opinion No. 680 Summary: The Use and Development of Checklists in Obstetrics and Gynecology. Obstet Gynecol. 2016; 128: 1200.
Wharton et al. provide a comprehensive resource for effective and ethical obesity management, across many populations and patient circumstances[1]. The specific focus on adult women living with obesity is welcomed, especially as pregnancy, preconception and postpartum are some of the most critical life-course timepoints for the prevention of non-communicable diseases across multiple generations[2]. The authors outline that where possible, adults living with obesity, which includes women of reproductive age, should have access to a registered dietitian for individualized medical nutrition therapy[1]. This is an excellent recommendation, and we also consider it important to advocate that all healthcare providers who see women with obesity, have an opportunity to promote healthy weight and nutrition[3,4]. Due to the growing prevalence of obesity and the associated demand on dietetic services, other healthcare professionals must capitalize on their contact with women and promote healthy behaviour change. It is important that nutrition is seen as a collective global responsibility and is embedded into multi-disciplinary health services, systems and policies[3,4]. The authors recommend that primary care physicians encourage and support pregnant women with obesity to consume a healthy dietary pattern[1]. Advice on how physicians can implement this into their practice, however, is lacking in this review. During pregnancy, women with obesity should be advised to follow a diet that not only manages gestational weight gain but also meets their complex and dynamic nutritional needs for fetal growth and development[4]. The use of checklists in clinical practice has been encouraged by medical organisations[5]. The FIGO Nutrition Checklist is a purposively designed and brief nutritional questionnaire for women before or during pregnancy. It includes questions on personal dietary requirements or practices (e.g. vegan diet), body mass index, diet quality and micronutrients. It can therefore support clinicians who lack dietetic training to implement some of the recommendations outlined by the authors including the provision of dietary advice that is personalized, nutritionally adequate and culturally acceptable. To date, the FIGO Nutrition Checklist has been used in three separate countries in Europe and Asia and adapted to local requirements[2].
We would welcome if Canada would consider use of the FIGO nutrition checklist in supporting healthcare professionals address nutrition and weight at each contact.