Family-based nutritional intervention to improve overweight in schoolchildren: a pragmatic clinical trial

Abstract

Objective: To evaluate the effectiveness of behavior therapy and family-based dietary intervention for overweight schoolchildren. Methods: This is a pragmatic clinical trial. The intervention was carried out in a secondary care center with parent-child dyads attending the selected school. The children were overweight and aged between 5 and 12 years. They participated in 12 nutritional counseling sessions. One arm received non-directive nutritional counseling (NDC) and the other arm received directive nutritional counseling (DC) with a dietary intervention. The main outcomes evaluated were body mass index (BMI)/age, food intake, and eating behaviors. Comparisons between groups were made at baseline and at the end of the interventions using the Mann-Whitney U test. Intragroup differences were analyzed using the Wilcoxon test and Fisher's exact test or McNemar test analysis. Results: The DC arm showed a reduction in the eating behaviors of "desire to drink" and "emotional undereating" after the interventions. In addition, the frequency of fruit consumption by the caregiver was reduced. Conclusions: It was possible to provide nutritional care based on changes in eating behavior and dietary guidance using a menu. There is a need for specific training for nutritionists. In DC, there were changes in eating behaviors in favor of a reduction in food intake. There was no significant difference in the outcomes of BMI changes.