Testing the effect of summer camp on excess summer weight gain in youth from low-income households: a randomized controlled trial

Abstract

Background Children from racial and ethnic minority groups, low-income households, and those with overweight or obesity gain more weight during the summer than the school year. Summer day camps, which offer routine opportunities for physical activity and regular meal and snack times, have potential to mitigate excess weight gain. This randomized controlled trial was done to determine the feasibility and preliminary effectiveness of summer camp in preventing excess summer weight gain among youth from low-income households. Methods Children, ages 6 to 12 years, were randomized to attend 8-weeks of summer day camp (CAMP) or to experience an unstructured summer as usual (SAU) in 2017–2018. Primary feasibility outcomes included retention, engagement and completion of midsummer measures. Secondary outcomes included changes in BMIz, engagement in moderate to vigorous physical activity (MVPA) and sedentary behavior, and diet quality and energy intake from the school year to summer. Multivariable linear mixed models were used to assess group differences. Results Ninety-four participants were randomized to CAMP (n = 46) or SAU (n = 48), of whom 93.0 and 91.6% completed end of school and end of summer assessments, respectively. While CAMP participants attended only 50% of camp days offered, on average, they lost − 0.03 BMIz units while those in SAU gained 0.07 BMIz units over the summer (b = 0.10; p = .02). Group differences in change in energy intake from the school year to summer were borderline significant, as energy intake remained relatively unchanged in CAMP participants but increased among participants in SAU (p = 0.07). Conclusions Randomizing children to attend summer day camp or experience an unstructured summer as usual was effective in this low-income sample. Our findings support the potential for summer camps in mitigating excess summer weight gain. A larger randomized trial is needed explore efficacy, cost-effectiveness and longer-term effects of attending summer camp on weight and weight-related behaviors. Trial registration ClinicalTrials.gov Registration: NCT04085965 (09/2019, retrospective registration).

Comparison of Hospital Consultation and Summer Camp Lifestyle Intervention Programs for Sustained Body Weight Loss in Overweight/Obese Greek Children

“…The participation of children in both the hospital consultation and camp program “Evrostia” resulted in a significant reduction in their body weight already after two weeks, with a greater reduction in the children of the camp program. This replicated the findings of the study by Marschhoff et al and more recent studies [ 19 , 30 , 31 , 32 , 33 ]. The weakness of the classical programs to control body weight with nutritional interventions at primary care is probably because the children who receive nutritional counseling, to apply in their usual environment, results in limited conformity.…”

Differences in ​the proportion of children meeting behavior guidelines ​between summer ​and school by socioeconomic status and race

“…Children (n = 94) were randomly assigned to either attend a structured summer camp or to experience a typical summer with no access to a structured program. 53 Children assigned to attend the summer program lost 0.03 BMI z‐score units while those assigned to not attend gained 0.07 BMI z‐score units over the summer. While the differences were not statistically significant they trended in the expected direction.…”

Behavioral and social routines and biological rhythms in prevention and treatment of pediatric obesity.

“…In fact, it has been argued that there may be underlying chronobiological reasons supporting establishment of consistent sleep, eating, and activity behaviors in summer months as a means of buffering against observed weight gain (see Moreno et al, 2019, for review). However, interventions designed to provide access to summer camps (e.g., a means of enhancing structure and/or alignment of sleep and eating behaviors with circadian rhythms) found mixed benefits for weight regulation (Evans, Fernandes, Howie, Wing, & Jelalian, 2018; Hopkins et al, 2019). Beyond out-of-school time, there has been increased recognition that the timing of school itself may have important implications for pediatric health.…”