G H Hofsteenge1, M J M Chinapaw2, H A Delemarre-van de Waal3, P J M Weijs4. 1. Nutrition & Dietetics, Dept. of Internal Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: A.Hofsteenge@vumc.nl. 2. EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands; Dept. of Public and Occupational Health, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. 3. Dept. of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands; Dept. of Paediatrics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. 4. Nutrition & Dietetics, Dept. of Internal Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands; Dept. of Nutrition & Dietetics, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
Abstract
BACKGROUND & AIMS: Few studies evaluating treatment of adolescent obesity have been published. Therefore, long-term effects of the Go4it group treatment for obese adolescents were examined. METHODS:Obese adolescents (11-18 years) visiting an outpatient paediatric obesity clinic were randomly assigned to 1) intervention group (Go4it) or 2) current regular care i.e. referral to a dietician in the home care setting (controls). Linear mixed models analysis was performed to evaluate intervention effects. Effect modification by sex, age and ethnicity was checked. Outcome measures included body mass index standard deviation score (BMIsds), body composition and metabolic components at 6 and 18 months follow-up. RESULTS: 122 adolescents, 71 Go4it and 51 controls, with a mean BMIsds of 2.9 ± 0.5 were randomised. At 18 months a modest significant reduction in BMIsds (between group difference: -0.16; 95%CI: -0.30, -0.02; p = .028) was observed. None of the other body composition or metabolic components showed significant treatment effects. Ethnicity was a significant effect modifier. Posthoc analysis showed a large significant reduction on BMIsds (between group difference: -0.35; 95%CI: -0.64, -0.07) at 18 months for obese adolescents from western descent, while no effect was observed for adolescents from non-western descent. Significant treatment effects were also observed for systolic and diastolic blood pressure, as well as HDL cholesterol level, but only for obese adolescents from western descent. CONCLUSIONS: Go4it showed promising long-term effects on BMIsds compared with regular care in obese adolescents. Larger benefits were achieved for adolescents of western ethnicity. This trial was registered at www.trialregister.nl with the Netherlands Trial Register as ISRCTN27626398.
RCT Entities:
BACKGROUND & AIMS: Few studies evaluating treatment of adolescent obesity have been published. Therefore, long-term effects of the Go4it group treatment for obese adolescents were examined. METHODS:Obese adolescents (11-18 years) visiting an outpatient paediatric obesity clinic were randomly assigned to 1) intervention group (Go4it) or 2) current regular care i.e. referral to a dietician in the home care setting (controls). Linear mixed models analysis was performed to evaluate intervention effects. Effect modification by sex, age and ethnicity was checked. Outcome measures included body mass index standard deviation score (BMIsds), body composition and metabolic components at 6 and 18 months follow-up. RESULTS: 122 adolescents, 71 Go4it and 51 controls, with a mean BMIsds of 2.9 ± 0.5 were randomised. At 18 months a modest significant reduction in BMIsds (between group difference: -0.16; 95%CI: -0.30, -0.02; p = .028) was observed. None of the other body composition or metabolic components showed significant treatment effects. Ethnicity was a significant effect modifier. Posthoc analysis showed a large significant reduction on BMIsds (between group difference: -0.35; 95%CI: -0.64, -0.07) at 18 months for obese adolescents from western descent, while no effect was observed for adolescents from non-western descent. Significant treatment effects were also observed for systolic and diastolic blood pressure, as well as HDL cholesterol level, but only for obese adolescents from western descent. CONCLUSIONS: Go4it showed promising long-term effects on BMIsds compared with regular care in obese adolescents. Larger benefits were achieved for adolescents of western ethnicity. This trial was registered at www.trialregister.nl with the Netherlands Trial Register as ISRCTN27626398.
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