Abstract
BackgroundThough recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL). The aim of this study was to determine if a 1-year multidisciplinary, family-centered outpatient intervention based on social cognitive theory would be effective in (i) preventing further increases in BMI and BMI z-score, and (ii) improving QoL in obese children and adolescents.MethodsObese children and adolescents 8–17 years of age and their families participated in this 1-year longitudinal pilot intervention study. The intervention consisted of fifteen 90-minute educational sessions led by a dietitian, exercise specialist, and social worker. Anthropometric measures, body composition, and QoL (Pediatric Quality of Life Inventory 4.0), were assessed at baseline, 3 months, and 12 months. Laboratory values were measured at baseline and 12 months. The primary outcome measures were change in BMI and BMI z-score, secondary outcome measures included change in QoL and body composition. A paired sample t-test was used to assess within-group differences and 95% confidence intervals were reported for the mean differences.Results42 obese children and adolescents (21 girls) completed the 1-year intervention (mean age 12.8 ± 3.14 years). Mean baseline BMI was 31.96 ± 5.94 kg/m2 and BMI z-score was +2.19 ± 0.34. Baseline QoL (self-assessments and parental assessments) was impaired: mean baseline scores were 74.5 ± 16.5 and 63.7 ± 19.4 for physical functioning and 69.0 ± 14.9 and 64.0 ± 18.3 for emotional functioning, respectively. At 12 months, BMI z-score had decreased (−0.07 ± 0.11, 95% CI: −0.11 to −0.04). BMI (0.80 ± 1.57 kg/m2, 95% CI 0.31 to 1.29) and fat-free mass (4.02 ± 6.27 kg, 95% CI 1.90 to 6.14) increased, but % body fat and waist circumference did not. Both the parent-reported physical (11.3 ± 19.2, 95% CI 4.7 to 17.9) and emotional (7.7 ± 15.7, 95% CI 2.3 to 13.0) functioning QoL scores and the children's self-reported physical (5.3 ± 17.1, 95% CI 0.5 to 11.1) and emotional (7.9 ± 14.3, 95% CI 3.2 to 12.7) functioning scores significantly improved.ConclusionsFollowing a 1-year intervention, the participants’ BMI z-scores and QoL improved, while other adiposity-related measures of body composition remained unchanged.Trial registrationUMIN Clinical Trials Registry UMIN000015622.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-014-0296-1) contains supplementary material, which is available to authorized users.
Highlights
Though recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL)
Many major physical and psychological comorbidities are associated with childhood obesity, including hypertension, dyslipidemia, impaired glucose tolerance, obstructive sleep apnea, and depression [3,4,5]
Studies implementing a comprehensive set of multidisciplinary lifestyle interventions that focus on the whole family and incorporate changes in diet, physical activity, and behavior have been found to reduce the degree of obesity in affected children [10,11,12]
Summary
Though recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL). The aim of this study was to determine if a 1-year multidisciplinary, family-centered outpatient intervention based on social cognitive theory would be effective in (i) preventing further increases in BMI and BMI z-score, and (ii) improving QoL in obese children and adolescents. Studies have shown that quality of life (QoL) in this population is impaired [6,7]. Studies implementing a comprehensive set of multidisciplinary lifestyle interventions that focus on the whole family and incorporate changes in diet, physical activity, and behavior have been found to reduce the degree of obesity in affected children [10,11,12]. The availability and accessibility of such interventions is limited, at a community level, and their effects vary substantially, depending on the design of the intervention, the participants’ age, the level of parental involvement, and other factors [10]
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