Lauren Fiechtner1,2, Ines Castro1, Erika R Cheng3, Mona Sharifi4, Monica W Gerber1,5, Man Luo1, Don Goldmann6, Megan Sandel7, Jason Block8,9, E John Orav9,10, Elsie M Taveras1,10. 1. Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts, USA. 2. Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts, USA. 3. Children's Health Services Research, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA. 4. Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA. 5. Fred Hutch Cancer Research Center, Seattle, WA, USA. 6. Institute for Healthcare Improvement, Boston, Massachusetts, USA. 7. Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA. 8. Harvard Center for Population and Developmental Medicine, Boston, Massachusetts, USA. 9. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. 10. Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: To examine characteristics and lifestyle behaviours associated with achieving clinically important weight loss (CIWL) in two paediatric weight management interventions (PWMIs). METHODS: We examined 1010 children enrolled in the STAR and Connect for Health trials. We defined achieving CIWL as any participant who had decreased their BMI z-score by ≥0.2 units over 1 year. Using log-binomial regression we examined associations of child and household characteristics and lifestyle behaviours with achieving CIWL. RESULTS: In multivariable analyses, children with severe obesity had a lower likelihood of achieving CIWL compared to children without severe obesity (RR: 0.68 [95% CI: 0.49, 0.95]). Children who were ≥10 years were less likely to achieve CIWL (RR: 0.56 [95% CI: 0.42, 0.74]) vs those 2-6 years of age. Children who consumed <1 sugary beverage per day at the end of the intervention were more likely to achieve CIWL vs those who did not meet the goal (RR: 1.36 [95% CI 1.09-1.70]). CONCLUSION: In this analysis of children enrolled in PWMIs, achieving CIWL was associated with younger age, not having severe obesity and consuming fewer sugary beverages at the end of the intervention. Focusing on intervening earlier in life, when a child is at a lower BMI, and reducing sugary beverages could allow for more effective PWMI's.
OBJECTIVE: To examine characteristics and lifestyle behaviours associated with achieving clinically important weight loss (CIWL) in two paediatric weight management interventions (PWMIs). METHODS: We examined 1010 children enrolled in the STAR and Connect for Health trials. We defined achieving CIWL as any participant who had decreased their BMI z-score by ≥0.2 units over 1 year. Using log-binomial regression we examined associations of child and household characteristics and lifestyle behaviours with achieving CIWL. RESULTS: In multivariable analyses, children with severe obesity had a lower likelihood of achieving CIWL compared to children without severe obesity (RR: 0.68 [95% CI: 0.49, 0.95]). Children who were ≥10 years were less likely to achieve CIWL (RR: 0.56 [95% CI: 0.42, 0.74]) vs those 2-6 years of age. Children who consumed <1 sugary beverage per day at the end of the intervention were more likely to achieve CIWL vs those who did not meet the goal (RR: 1.36 [95% CI 1.09-1.70]). CONCLUSION: In this analysis of children enrolled in PWMIs, achieving CIWL was associated with younger age, not having severe obesity and consuming fewer sugary beverages at the end of the intervention. Focusing on intervening earlier in life, when a child is at a lower BMI, and reducing sugary beverages could allow for more effective PWMI's.
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