Long-Term Effects of the RealFit Intervention on Body Composition, Aerobic Fitness, and Behavior

Abstract

Background: RealFit is a 13-week weight reduction program for youth that focuses on nutrition, physical activity (PA), psychology, and parental participation. The short-term effectiveness of the RealFit intervention, in terms of body composition, aerobic fitness, and dietary and PA behavior, having been proven, the present study evaluated the long-term effects of the intervention.Methods: The study had a quasi-experimental design. Height, weight, waist circumference, aerobic fitness, and self-reported dietary and PA behavior were assessed at baseline (T 0 ), immediately after the 13-week RealFit intervention (T 1 ), after 5 months (T 2 ), and 1 year (T 3 ) of follow-up. A total of 86 adolescents participated in the intervention group. The control group (n = 32) comprised overweight adolescents who did not receive any treatment.Results: One year after the RealFit intervention, significant decreases in BMI z-score (mean difference [MD]: -0.39) and waist circumference (MD, -3.24) were found. The comparison between the intervention and control groups, controlling for confounders, resulted in a significant difference (BMI z-score: -0.41; 95% confidence interval [CI]: -0.67 to -0.15; waist circumference: -8.07; 95% CI: -11.58 to -4.56). The results for dietary and PA behavior consistently showed favorable changes in the intervention group.Conclusions: The RealFit intervention appears to have significant favorable long-term effects on BMI z-score and waist circumference. These changes in body composition obviously represent changes in adolescents' energy balance-related behavior. Taking all results and limitations into account, it may cautiously be concluded that RealFit is an effective weight loss intervention.

A systematic review of community‐based interventions for the treatment of adolescents with overweight and obesity

“…Study, program and participant characteristics are reported in Table . Half of the programs were from the United States (US; n = 11) with the remainder from Europe ( n = 7) , Australia ( n = 2) and the United Kingdom (UK; n = 1) . The programs were evaluated as controlled trials ( n = 15), both randomized ( n = 10) and non‐randomized ( n = 5) , and as pre–post case series ( n = 6) .…”

“…Study quality was assessed to be weak for five programs ; moderate for eight ; and strong for eight . More than half of the programs were rated as being weak for selection bias ( n = 11) , as they involved self‐referrals from community advertisements and public service announcements, as is commonplace for community interventions, and thus participants were not selected at random from the eligible population.…”

“…Table summarizes the effectiveness of programs according to secondary outcomes (detailed data on these outcomes, and their measurement are included in Table S5). Eight programs each reported a secondary outcome of interest at the end of the intervention and following a period of follow‐up ; however, 43% of programs ( n = 9) did not report any secondary outcomes of interest either post‐program, or at any stage of follow‐up . Programs most commonly reported changes in physical activity ( n = 6; ) and changes in measures of sedentary lifestyle ( n = 5; ) and diet/eating behaviours ( n = 5; ) at the end of the intervention period, while other secondary outcomes (self‐esteem and quality of life, n = 4 programs each) were less frequently reported at this time.…”

“…Half of the programs were from the United States (US; n = 11) (28,30,31,33,(36)(37)(38)(39)(40)(41)(42)46,49,50) with the remainder from Europe (n = 7) (26,27,29,32,34,35,47,48,55), Australia (n = 2) (43-45,51-54) and the United Kingdom (UK; n = 1) (25). The programs were evaluated as controlled trials (n = 15), both randomized (n = 10) (28,30,31,(34)(35)(36)(37)(38)(39)41,(43)(44)(45)48,55) and non-randomized (n = 5) (26,27,29,42,47,(51)(52)(53)(54), and as pre-post case series (n = 6) (25,…”

“…Programs were largely multicomponent, comprising nutrition and physical activity content, termed healthy lifestyle interventions (Lifestyle) (25)(26)(27)(28)(29)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(48)(49)(50)(51)(52)(53)(54)(55). More than half of these 18 Lifestyle programs (56%; n = 10) had an additional psychological component (Psych), e.g.…”