Abstract
Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD. We examined the effect of bi-weekly nutrition and fitness counseling delivered via smartphone over 12 months. Thirty-four youth, previously diagnosed with CHD and with overweight or obesity, participated in the intervention. They were divided into two groups depending on whether the heart disease required surgical correction (operated, n = 19) or not (non-operated, n = 15). Anthropometry, body composition cardiorespiratory exercise capacity, and cardio-metabolic risk factors were assessed at baseline, 6 months, and 12 months. Statistically significant decreases in waist circumference (WC), body mass index z-score, WC z-score, and waist to height ratio z-score were observed at 6 and 12 months in the operated group. A significant linear increase in lean body mass was observed in both groups. The study also had a high retention rate and a low attrition rate. The observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as perception of condition and self-efficacy, may influence lifestyle behaviors. The results from this pilot study clearly demonstrate the feasibility to perform a larger controlled study on remote lifestyle intervention in children with congenital heart defects and overweight or obesity.
Highlights
About one-third of children in Canada and the United States are overweight or obese, and our group and others have found that the prevalence of overweight and obesity between children with congenital heart disease (CHD) and healthy children do not differ significantly [1,2,3]
By the end of the study, body mass index (BMI)-Z decreased by 0.12, Waist circumference (WC)-Z decreased by 0.24, and waist to height ratio (WHtR)-Z decreased by 0.26
While we did not observe the same outcomes in the non-operated group, we did observe a disruption in the predicted linear increase in body mass index z-score (BMI-Z) likely attributed to the intervention
Summary
About one-third of children in Canada and the United States are overweight or obese, and our group and others have found that the prevalence of overweight and obesity between children with congenital heart disease (CHD) and healthy children do not differ significantly [1,2,3]. The numerous cardiovascular risks, and physical and psychosocial health consequences of childhood obesity are well reviewed [4, 5]. Sedentary behavior, and reduced physical activity can increase the risk of obesity and cardiovascular disease [7]. A structured lifestyle intervention for children and youth with overweight or obesity and CHD has never been completed, it has the potential to diminish cardiovascular health risks by improving nutrition, physical fitness, body composition, and related health outcomes [10]. Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD
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