A Tailored Family-Based Obesity Intervention: A Randomized Trial

Abstract

OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care.METHODS: Two hundred and six overweight and obese (BMI $85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months.RESULTS: BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed.CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.

How to reduce parental provision of unhealthy foods to 3‐ to 8‐year‐old children in the home environment? A systematic review utilizing the Behaviour Change Wheel framework

“…Given control groups were primarily waitlist, physical activity or parenting style focused controls, BCTs for control groups are not presented in the tables. Only three of the control groups targeted dietary change with BCTs: 4.1 Instruction on how to perform the behaviour , 2.2 Feedback on behaviour and 3.1 Social support (unspecified) .…”

Impact of a 6‐month family‐based weight management programme on child food and activity behaviours: short‐term and long‐term outcomes of the PEACH™ intervention

“… also reported a reduction in high fat/sugar foods (8.5 serves per day) at 12 months after a 6‐month intervention involving 12 children, which used the Traffic Light approach to define a healthy diet and in addition set goals for the reduction of high fat/sugar foods to no more than 10 serves per week. A recent New Zealand intervention in 206 overweight 4‐ to 8‐year‐olds used the CDQ as the dietary tool . Small improvements in those receiving tailored care relative to those in usual care were observed for fruit and vegetable score (increase of 1.0) and non‐core foods (decrease of 0.3) at 24 months.…”

Results From New Zealand’s 2016 Report Card on Physical Activity for Children and Youth

“…Data were derived from 8 studies, 15,[17][18][19][20][21][22][23] in total comprising 3363 sociodemographically diverse children and youth from Auckland, Wellington, Christchurch, and Dunedin cities. On average, 54% of children in these studies participated in at least 60 minutes of MVPA per day.…”

“…Data for 8 regional studies totaling 6329 participants from Auckland, Wellington, Christchurch, and Dunedin cities supplemented the calculation of this score. 15,[17][18][19][20][21][22][23] With the exception of 1 study, all assessed multiple measures of screen time. Across these studies, an average of 49% of children and youth met the recommendation of watching less than 2 hours of screen time daily, with a range of 17% to 96%.…”