Child Obesity Intervention Fails to Modify BMI

Emma Hitt, PhD

April 07, 2011

April 7, 2011 — An intervention targeting obesity in children reduces television viewing but does not significantly decrease body mass index (BMI) or diet-related behaviors, according to the findings of a new study.

Elsie M. Taveras, MD, MPH, with the Obesity Prevention Program, Department of Population Medicine, at Harvard Medical School in Boston, Massachusetts, and colleagues reported their findings in the April 2011 issue of the Archives of Pediatrics & Adolescent Medicine.

According to the researchers, overweight preschool-aged children "especially those with overweight parents, tend themselves to become obese as adults and are at high risk of short-term and long-term adverse outcomes."

In the current study, researchers assessed the extent to which an intervention could prevent an increase in BMI and improve obesity-related behaviors among children at increased risk for obesity.

A total of 475 children aged 2.0 to 6.9 years were included in the analysis. Participants had a BMI in the 95th percentile or higher or had at least 1 overweight parent and a BMI in the 85th to less than 95th percentile. They were randomly assigned to receive the intervention (n = 271) or usual care (n = 204), and changes in BMI and obesity-related behaviors were noted during a 1-year period.

The intervention, called "High Five for Kids," consisted of motivational interviewing of families by pediatric nurse practitioners and instruction designed to reduce television viewing and consumption of fast food and sugary drinks. Motivational interviewing consisted of four 25-minute, in-person visits and three 15-minute telephone calls during the first year. Usual care included well-child care visits and follow-up weight checks.

Compared with usual care, intervention participants had greater decreases in television viewing (−0.36 hour/day; 95% confidence interval [CI], −0.64 to −0.09; P = .01), and slightly greater decreases in consumption of fast food (−0.16 serving/week; 95% CI, −0.33 to 0.01; P = .07) and sugary drinks (−0.22 serving/day; 95% CI, −0.52 to 0.08; P = .15). There was also a smaller, but nonsignificant, change in BMI (−0.21; 95% CI, −0.50 to 0.07; P = .15) in the intervention group vs the usual-care group.

A post hoc analysis found that girls were sensitive to the intervention regarding a reduction in BMI (P = .03), but boys were not (P = .89). In addition, the intervention effect was significant among participants in households with annual incomes of $50,000 or less (P = .01) but not in higher-income households (P = .92).

"To our knowledge, the High Five for Kids study is the first randomized controlled trial in a primary care setting aimed at reducing obesity among preschool-aged children," Dr. Taveras and colleagues note.

They conclude that after 1 year, the "High Five for Kids study improved television-viewing behaviors among preschool-aged children but did not have significant effects on BMI or diet-related behaviors."

The researchers plan to evaluate the intervention effects for a longer period and "examine the components of such an intervention that are maximally effective, scalable, and cost-effective."

The study was not commercially funded. The study authors have disclosed no relevant financial relationships.

Arch Pediatr Adolesc Med. Published online April 4, 2011. Abstract


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