Weight management program improves body fat levels, diabetes risk factors for overweight children

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Public release date: 26-Jun-2007

http://www.eurekalert.org/pub_releases/2007-06/jaaj-wmp062107.php

Contact: Peart

JAMA and Archives Journals

Weight management program improves body fat levels, diabetes risk

factors for overweight children

Children who participated in a family-based weight management program

designed for inner-city minority children had better outcomes regarding

weight gain, body fat, body mass index (BMI) and insulin sensitivity

compared to children who received traditional weight counseling in a

clinic, according to a study in the June 27 issue of JAMA, a theme issue

on chronic diseases of children.

Savoye, R.D., CD.-N., C.D.E., of Yale University, New Haven, Conn.,

presented the findings of the study at a JAMA media briefing in New York.

The percentage of children and adolescents in the U.S. who are

overweight has increased significantly in recent years, up to 17 percent

in 2004, and with an even higher prevalence among African American and

Hispanic youth (18 percent - 26 percent). The epidemic of childhood

obesity has been accompanied by an increase of type 2 diabetes among

adolescents, and is more common in African American and Hispanic youth.

“Since an overweight child has a high probability of becoming an

overweight adult, the grave concerns for the long-term health of obese

children are well justified,” the authors write. Few studies have

reported successful weight control interventions in children and

adolescents.

This one-year randomized clinical trial, conducted May 2002 - September

2005, evaluated the effectiveness of a weight management program, Bright

Bodies, in comparison to routine care provided at a pediatric obesity

clinic. This weight management program is a family-based, intensive

lifestyle intervention that has been specially tailored for the needs of

inner-city minority children. The primary aim of the study was to

compare changes in BMI, body composition, insulin sensitivity, blood

pressure, and lipid profiles.

The study included 209 overweight children (BMI greater than the 95th

percentile for age and sex), ages 8 to 16 years of mixed ethnic groups.

A total of 135 participants (60 percent) completed six months of the

study, 119 (53 percent) completed 12 months. Participants were randomly

assigned to either a control or weight management group. The control

group (n = 69) received traditional clinical weight management

counseling every six months, and the weight management group (n = 105)

received an intensive family-based program including exercise, nutrition

education and behavior modification. Intervention occurred bi-weekly the

first six months and bi-monthly thereafter to mimic a “maintenance

phase” of the program.

The researchers found that while average body weight was essentially

unchanged from baseline after 12 months in the weight management group

(+.67 lbs.), BMI change was -1.7. In contrast, the control group gained

16.94 pounds and increased their BMI by 1.6 units. Percent and total

body fat were reduced in the weight management group, and increased in

the control group. The difference between the two groups in changes in

BMI (-3.3), body weight (-16.3 lbs.), body fat (-20.3 lbs.), and percent

body fat (-6.0 percent) after 12 months were significantly different.

Total cholesterol improved in the weight management group, but not in

the control group.

The difference between the two groups in insulin sensitivity, a

parameter that measures the risk of the development of type 2 diabetes,

was also significantly different at 12 months. The weight management

group had an increase in insulin sensitivity, which is associated with a

decreased risk of the development of type 2 diabetes.

“As illustrated by the outcomes in the control group in this study,

simple education about health risks of obesity and routine counseling

regarding diet and exercise are insufficient to prevent the seemingly

inexorable increases in BMI, body weight, and body fat observed in

traditionally treated overweight children,” the authors write. “In

contrast to conventional wisdom regarding the futility of changing the

lifestyle of overweight children, we have shown that a family-based

program that uses nutrition education, behavior modification, and

supervised exercise can lower BMI, improve body composition, and

increase insulin sensitivity.”

“The success of the Bright Bodies program undoubtedly relates, in part,

to the frequent contacts between families and the professional staff.

While the program was very successful in treating overweight children,

the expense incurred in operating such a program is substantial. Future

work for our group includes cost-benefit analyses, as this would be

helpful for pediatric clinicians or health management organizations that

are considering offering similar services to overweight children and

adolescents.”

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(JAMA. 2007;297:2697-2704. Available pre-embargo to the media at

www.jamamedia.org)

--

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