ObjectiveTo compare the effectiveness of a 2-year camp-based family treatment programme and an outpatient programme on obesity in two generations.DesignPragmatic randomised controlled trial.SettingRehabilitation clinic, tertiary care hospital and primary care.PatientsFamilies with at least one child (7–12 years) and one parent with obesity.InterventionsSummer camp for 2 weeks and 4 repetition weekends or lifestyle school including 4 days family education. Behavioural techniques motivating participants to healthier lifestyle.Main outcome measuresChildren: 2-year changes in body mass index (BMI) SD score (SDS). Parents: 2-year change in BMI. Main analyses: linear mixed models.ResultsNinety children (50% girls) were included. Baseline mean (SD) age was 9.7 (1.2) years, BMI 28.7 (3.9) kg/m2 and BMI SDS 3.46 (0.75). The summer-camp children had a lower adjusted estimated mean (95% CI) increase in BMI (−0.8 (−3.5 to −0.2) kg/m2), but the BMI SDS reductions did not differ significantly (−0.11 (−0.49 to 0.05)). The 2-year baseline adjusted BMI and BMI SDS did not differ significantly between summer-camp and lifestyle-school completers, BMI 29.8 (29.1 to 30.6) vs 30.7 (29.8 to 31.6) kg/m2 and BMI SDS 2.96 (2.85 to 3.08) vs 3.11 (2.97 to 3.24), respectively. The summer-camp parents had a small reduction in BMI (−0.9 (−1.8 to −0.03) vs −0.8 (−2.1 to 0.4) in the lifestyle-school group), but the within-group changes did not differ significantly (0.3 (−1.7 to 2.2)).ConclusionsA 2-year family camp-based obesity treatment programme had no significant effect on BMI SDS in children with severe obesity compared with an outpatient family-based treatment programme.Trial registration numberNCT01110096.

Our findings suggest that it may be more appropriate to use the percentage above a particular BMI cut-off, such as the percentage above IOTF-25, than the IOTF, WHO and BGS BMI-SDS in paediatric patients with severe obesity.

Aim: Body mass index (BMI) metrics are widely used as a proxy for adiposity in children with severe obesity. The BMI expressed as the percentage of a cut-off percentile for overweight or obesity has been proposed as a better alternative than BMI z-scores when monitoring children and adolescents with severe obesity.Methods: Annual changes in BMI, BMI z-score and the percentage above the International Obesity Task Force overweight cut-off (%IOTF-25) were compared with dual-energy X-ray absorptiometry (DXA) derived body fat (%BF-DXA) in 59 children and adolescents with severe obesity.Results: The change in %BF-DXA was correlated with the change in %IOTF-25 (r = 0.68) and BMI (r = 0.70), and somewhat less with the BMI z-score (r = 0.57). Cohen's Kappa statistic to detect an increase or decrease in %BF-DXA was fair for %IOTF-25 (j = 0.25; p = 0.04) and BMI (j = 0.33; p = 0.01), but not for the BMI z-score (j = 0.08; p = 0.5). The change in BMI was positively biased due to a natural increase with age. Conclusion: Changes in the BMI metrics included in the study are associated differentlyAbbreviations %BF, Percentage body fat; %IOTF-25, Percentage above the International Obesity Task Force definition of overweight; BMI, Body mass index; DXA, Dual-energy X-ray absorptiometry. Key notesThe percentage above the International Obesity Task Force overweight cut-off (%IOTF-25) has been suggested as an unbiased alternative with respect to age for the body mass index (BMI) or BMI z-score in children and adolescents with severe obesity. Changes in BMI, BMI z-scores and %IOTF-25 were compared with dual-energy x-ray absorptiometry of body composition. The %IOTF-25 might be a better alternative to BMI z-scores to monitor changes in adiposity.

The purpose of this study was to investigate soccer coaches' decision-making styles in relation to elite and non-elite coaching experience and level of playing history. A basic assumption was that leader efficiency in soccer is heavily dependent on the quality of the coach's decisions. Efficient decisions are related to experience, and it is not unreasonable that involvement in the soccer context is associated with differences in decision-making style. In this study, decision-making style was defined as a learned habitual response pattern exhibited by an individual when confronted with a decision situation. To assess coaches' decision-making style, we used the General Decision-Making Style (GDMS) scale. Ninety-nine male football coaches in Norway with a mean age of 41 and mean coaching experience of 13.26 years volunteered to participate in the study. The results show that soccer coaches tend to be predominantly rational or intuitive in their decision-making style, with almost no evidence of the avoidant decision-making style. Experts in a domain are characterised by greater use of intuition in their decision-making than non-experts. The results support this assumption, showing that coaches with elite coaching experience seem to have a greater preference for intuitive or rational decision-making style than do other coaches. Soccer coaches with elite-level player experience also use intuitive or rational decision-making styles significantly more often than coaches lacking such experience, suggesting a connection between involvement in a community of practice and soccer coaches' decision-making style. Further research should expand our scientific knowledge about how soccer coaches make decisions in different contexts and clarify strategies for facilitating decision-making in coaching.