A family-centered lifestyle intervention for obese six- to eight-year-old children: Results from a one-year randomized controlled trial conducted in Montreal, Canada.

Abstract

Childhood obesity interventions should be family-centered and focused on lifestyle behaviours that achieve sustainable reductions in adiposity. The primary objective of this randomized controlled trial was to test a family-centered lifestyle intervention using Canada's Food and Physical Activity (PA) Guidelines to reduce body mass index-for-age z-scores (BAZ) in overweight and obese (OW/OB) children. Children (n = 78; ages 6-8.5 years) were randomized to standard (StnTx) or modified (ModTx) interventions or control (Ctrl). Measurements at baseline and every three months for one year included: anthropometry, BAZ, waist circumference (WC), and dual-energy X-ray absorptiometry scans for percent body fat (%BF), fat mass (FM) and trunk fat mass. Fatty acids measured by gas chromatography were used to assess compliance to the milk and alternatives interventions during the first six months. Six intervention sessions were based on Canada's Food and PA Guidelines and individualized to meet the needs of the family. ModTx were advised to consume four milk and alternatives/day versus the recommended two (StnTx) and to preferentially engage in daily weight-bearing PA. Ctrl were provided the guidelines. Baseline anthropometry did not differ among groups. At 12 months (n = 73), all groups increased height (p < 0.001) and lean mass (p < 0.001). ModTx decreased BAZ (p < 0.001); %BF decreased in ModTx (p = 0.018), but not in StnTx (p = 0.997) or Ctrl (p = 0.998). FM, WC and trunk fat mass all significantly increased in Ctrl (p < 0.001). At baseline and three months, fatty acids did not differ among groups, however they did decrease in ModTx at six months [C14:0 (-0.07%, p = 0.053), C15:0 (-0.04%, p = 0.049), C17:0 (-0.09%, p = 0.036)]. Participating in a family centered-lifestyle intervention that focused on Canadian dietary and PA Guidelines and emphasized increasing milk and alternatives and weight-bearing PA had positive effects on reducing adiposity in OW/OB children. Guidelines are appropriate for the obese pediatric population but need to be individualized to meet the needs of the family. Additional studies are warranted to test the use of biochemical indices to assess compliance to milk and alternative intakes in OW/OB children participating in lifestyle interventions.