Abstract
BackgroundWith regard to the global childhood obesity epidemic, it is imperative that effective lifestyle interventions are devised to combat childhood obesity. This paper describes the development and implementation of a comprehensive (a combination of diet and physical activity (PA)), social cognitive behaviour modification intervention using accelerometry and a dietary diary to tackle child overweight and obesity. The comprehensive intervention effect was evaluated in a comparison with diet only, PA only and a no-treatment control group.MethodsA pilot study was conducted with a non-randomized cluster design. Four hundred thirty-eight overweight and obese children aged 7–12 years from ten primary schools in Beijing were recruited to receive a one-year intervention. Participants were allocated into one of four groups: the comprehensive intervention group; the PA only group (Happy 10 program); the diet only group (nutrition education program); and a control group. The effects of intervention on adiposity, blood pressure, and biochemical indicators were assessed by examining 2-way interactions (time × intervention) in linear mixed models. Means and 95 % confidence intervals (CI) for the adjusted changes between post-intervention and baseline relative to changes in the control group were calculated and reported as effect sizes.ResultsThe percentage of body fat in the comprehensive intervention group showed a significant relative decrease (adjusted change: −1.01 %, 95 % CI: (−1.81, −0.20) %) compared with the PA only, diet only or control groups (P < 0.001). Systolic blood pressure significantly decreased in the comprehensive intervention group (adjusted change: −4.37 mmHg, 95 % CI: (−8.42, −0.33) mmHg), as did diastolic blood pressure (adjusted change: −5.50 mmHg, 95 % CI (−8.81, −2.19) mmHg) (P < 0.05). Compared with the other two intervention groups and the control group, positive adjusted changes in fasting glucose in the comprehensive group were found, although not for the biochemical lipid metabolism indicators. Positive but non-significant adjusted changes in body mass index and waist circumference were observed.ConclusionsCompared with the diet or PA only intervention groups, the current comprehensive program had superior positive effects on body fat percentage and blood pressure but not on the biochemical lipid metabolism indicators in Chinese overweight and obese children. Future randomized controlled trials and long-term follow-up studies are required to elaborate the findings of the current intervention.Trial registrationClinicalTrials.gov identifier: NCT02228434Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2535-2) contains supplementary material, which is available to authorized users.
Highlights
With regard to the global childhood obesity epidemic, it is imperative that effective lifestyle interventions are devised to combat childhood obesity
For overweight and obese children and adolescents, specific strategies are required because these children are more likely to have unhealthy dietary habits [9] and are less inclined to participate in physical activity (PA) initiatives [10]
During the implementation of interventions, nutrition education or PA interventions are considered crucial for preventing weight gain
Summary
With regard to the global childhood obesity epidemic, it is imperative that effective lifestyle interventions are devised to combat childhood obesity. Overweight children have been found to be 4.5 times and 2.4 times more likely than normal or underweight children to have elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively [4]. These children are more likely to have increased risks for heart disease and various chronic diseases later in life, such as hyperlipidaemia, hyperinsulinaemia, hypertension, and type 2 diabetes [5, 6]. Programs including either diet alone or PA alone have shown limited effectiveness for weight loss; it is suggested that interventions acting on both energy intake and energy output are more likely to be effective than those targeting only one aspect [11]
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