Yvonne C Anderson1,2,3, Lisa E Wynter1, Niamh A O'Sullivan1, Cervantée E K Wild2, Cameron C Grant3,4, Tami L Cave2, José G B Derraik2,5, Paul L Hofman2,4. 1. Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand. 2. Liggins Institute, University of Auckland, Auckland, New Zealand. 3. Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand. 4. Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand. 5. A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
Abstract
OBJECTIVE: To determine whether 12-month BMI SDS reductions persisted at 24 months in a multi-disciplinary assessment and intervention program for children and adolescents with obesity, and whether secondary outcomes improved. METHODS: This was a community-based 12-month RCT in Aotearoa/New Zealand. Eligible participants were aged 5 to 16 years with BMI ≥98th centile or BMI >91st centile with weight-related comorbidities. The low-intensity control received comprehensive home-based baseline assessments and advice, and 6-monthly follow-up. The high-intensity intervention received the same assessments and advice, but also weekly multidisciplinary sessions. Primary outcome was BMI SDS at 12 months. Secondary outcomes included cardiovascular and metabolic markers. RESULTS: 121 participants (60% of participants at baseline) were assessed at 24 months. BMI SDS reduction at 12 months was lost at 24 months in the modified intention-to-treat analysis [Control -0.03 (95%CI -0.14, 0.09) and Intervention -0.02 (-0.12, 0.08); P = .93]. However, sweet drink intake was reduced, water intake increased, and there were improvements in cardiovascular fitness in the high-intensity intervention. ≥70% attendance in the high-intensity intervention resulted in a persistent BMI SDS reduction of -0.22 after 24 months (95%CI -0.38, -0.06). CONCLUSIONS: This trial was negative in terms of primary outcome at 24 months. However, high engagement led to sustained treatment effect, and there were multiple improvements in health measures.
RCT Entities:
OBJECTIVE: To determine whether 12-month BMI SDS reductions persisted at 24 months in a multi-disciplinary assessment and intervention program for children and adolescents with obesity, and whether secondary outcomes improved. METHODS: This was a community-based 12-month RCT in Aotearoa/New Zealand. Eligible participants were aged 5 to 16 years with BMI ≥98th centile or BMI >91st centile with weight-related comorbidities. The low-intensity control received comprehensive home-based baseline assessments and advice, and 6-monthly follow-up. The high-intensity intervention received the same assessments and advice, but also weekly multidisciplinary sessions. Primary outcome was BMI SDS at 12 months. Secondary outcomes included cardiovascular and metabolic markers. RESULTS: 121 participants (60% of participants at baseline) were assessed at 24 months. BMI SDS reduction at 12 months was lost at 24 months in the modified intention-to-treat analysis [Control -0.03 (95%CI -0.14, 0.09) and Intervention -0.02 (-0.12, 0.08); P = .93]. However, sweet drink intake was reduced, water intake increased, and there were improvements in cardiovascular fitness in the high-intensity intervention. ≥70% attendance in the high-intensity intervention resulted in a persistent BMI SDS reduction of -0.22 after 24 months (95%CI -0.38, -0.06). CONCLUSIONS: This trial was negative in terms of primary outcome at 24 months. However, high engagement led to sustained treatment effect, and there were multiple improvements in health measures.
Authors: Kelly G H van de Pas; Judith W Lubrecht; Marijn L Hesselink; Bjorn Winkens; François M H van Dielen; Anita C E Vreugdenhil Journal: Nutrients Date: 2022-04-25 Impact factor: 6.706
Authors: Yvonne C Anderson; Cervantée E K Wild; Paul L Hofman; Tami L Cave; Ken J Taiapa; Tania Domett; José G B Derraik; Wayne S Cutfield; Cameron C Grant; Esther J Willing Journal: BMJ Open Date: 2021-05-11 Impact factor: 2.692
Authors: Thomas S Hadley; Tami L Cave; José G B Derraik; Paul L Hofman; Yvonne C Anderson Journal: Int J Obes (Lond) Date: 2022-04-29 Impact factor: 5.551
Authors: Cervantée Ek Wild; Ngauru T Rawiri; Esther J Willing; Paul L Hofman; Yvonne C Anderson Journal: BMJ Open Date: 2020-09-06 Impact factor: 2.692