Rachael W Taylor1, Adell Cox2, Lee Knight2, Deirdre A Brown3, Kim Meredith-Jones4, Jillian J Haszard5, Anna M Dawson6, Barry J Taylor6, Sheila M Williams7. 1. Departments of Medicine, rachael.taylor@otago.ac.nz. 2. Paediatric Services, Southern District Health Board, Dunedin, New Zealand; and. 3. School of Psychology, Victoria University of Wellington, Dunedin, New Zealand. 4. Departments of Medicine. 5. Human Nutrition. 6. Women's and Children's Health, and. 7. Preventive and Social Medicine, University of Otago, Dunedin, New Zealand;
Abstract
OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care. METHODS:Two hundred and six overweight and obese (BMI ≥85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months. RESULTS:BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed. CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.
RCT Entities:
OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care. METHODS: Two hundred and six overweight and obese (BMI ≥85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months. RESULTS: BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed. CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.
Authors: Lucia Magee; Lucy P Goldsmith; Umar A R Chaudhry; Angela S Donin; Charlotte Wahlich; Elizabeth Stovold; Claire M Nightingale; Alicja R Rudnicka; Christopher G Owen Journal: JAMA Pediatr Date: 2022-09-12 Impact factor: 26.796
Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Flora Tzelepis; Rebecca J Wyse; Kate M Bartlem; Rachel Sutherland; Erica L James; Courtney Barnes; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2019-11-07
Authors: Rebecca K Hodder; Fiona G Stacey; Kate M O'Brien; Rebecca J Wyse; Tara Clinton-McHarg; Flora Tzelepis; Erica L James; Kate M Bartlem; Nicole K Nathan; Rachel Sutherland; Emma Robson; Sze Lin Yoong; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2018-01-25
Authors: Emma Mead; Tamara Brown; Karen Rees; Liane B Azevedo; Victoria Whittaker; Dan Jones; Joan Olajide; Giulia M Mainardi; Eva Corpeleijn; Claire O'Malley; Elizabeth Beardsmore; Lena Al-Khudairy; Louise Baur; Maria-Inti Metzendorf; Alessandro Demaio; Louisa J Ells Journal: Cochrane Database Syst Rev Date: 2017-06-22
Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Rebecca J Wyse; Tara Clinton-McHarg; Flora Tzelepis; Erica L James; Kate M Bartlem; Nicole K Nathan; Rachel Sutherland; Emma Robson; Sze Lin Yoong; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2018-05-17