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A combined nutritional-behavioral-physical activity intervention for the treatment of childhood obesity – a 7-year summary

  • Dan Nemet EMAIL logo , Lital Levi , Michal Pantanowitz and Alon Eliakim
Published/Copyright: January 24, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 5-6

Abstract

We assessed the effect of a weight management program on body weight, body mass index (BMI), BMI percentile, and fitness in obese children and adolescents. The study was designed as a longitudinal, non-randomized, clinical experience of 3, 6, and 12 months combined dietary-behavioral-exercise intervention. Seven hundred and forty-nine obese children (age, 6–16 years) participated in a 3 months program. Three hundred and fifty-nine of them completed a 6 months intervention and 147 completed a 1 year intervention. Sixty-seven age- and maturity-matched obese children who did not participate in the structured program served as controls. Body weight, BMI, and fitness were evaluated at baseline, and after 3, 6, and 12 months intervention. Body weight, BMI, and BMI percentiles were significantly reduced (p<0.05) and endurance time significantly increased (p<0.0005) following the 3 months intervention. Obese children who continued the program for 6 months maintained decreases in BMI percentiles and further improved endurance time. In contrast, obese children in the control group gained weight, increased their BMI, and had a less significant improvement in fitness. Parental obesity (both parents), degree of obesity (BMI >97%), and more than one prior weight loss attempt were associated with lower decreases, whereas sex and pubertal status had no influence, on BMI percentiles changes. Children without parental overweight had significantly greater decreases in BMI compared with children with both parents showing obesity. In summary, a combined, structured multidisciplinary intervention for childhood obesity led to decreased body weight, BMI, and BMI percentiles, and to improved fitness.

Keywords: childhood; exercise; multidisciplinary intervention; obesity
Corresponding author: Dan Nemet, MD, MHA, Department of Pediatrics, Meir Medical Center, 59 Tshernichovski St., Kfar-Saba 44281, Israel, Phone: +972-9-7471596, Fax: +972-9-741303, E-mail:

References

1. Dietz WH. Reversing the tide of obesity. Lancet 2011;378: 744–6.10.1016/S0140-6736(11)61218-XSearch in Google Scholar

2. Robinson TN. Television viewing and childhood obesity. Pediatr Clin North Am 2001;48:1017–25.10.1016/S0031-3955(05)70354-0Search in Google Scholar

3. Schonfeld-Warden N, Warden CH. Pediatric obesity: an overview of etiology and treatment. Pediatr Clin North Am 1997;44: 339–61.10.1016/S0031-3955(05)70480-6Search in Google Scholar

4. Barlow SE; the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120(Suppl 4): S164–92.10.1542/peds.2007-2329CSearch in Google Scholar

5. Berenson GS, Srinivasan SR, Bao W, Newman WP, III, Tracy RE, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998;338:1650–6.10.1056/NEJM199806043382302Search in Google Scholar

6. Mossberg HO. 40-year follow-up of overweight children. Lancet 1989;2:491–3.10.1016/S0140-6736(89)92098-9Search in Google Scholar

7. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992;327:1350–5.10.1056/NEJM199211053271904Search in Google Scholar

8. Whitlock EP, O’Connor EA, Williams SB, Beil TL, Lutz KW. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics 2010;125:e396–418.10.1542/peds.2009-1955Search in Google Scholar

9. Lissau I, Overpeck MD, Ruan WJ, Due P, Holstein BE, et al. Body mass index and overweight in adolescents in 13 European countries, Israel, and the United States. Arch Pediatr Adolesc Med 2004;158:27–33.10.1001/archpedi.158.1.27Search in Google Scholar

10. Rosner B, Prineas R, Loggie J, Daniels SR. Percentiles for body mass index in U.S. children 5 to 17 years of age. J Pediatr 1998;132:211–22.10.1016/S0022-3476(98)70434-2Search in Google Scholar

11. Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, et al. Television viewing as a cause of increasing obesity among children in the United States, 1986–1990. Arch Pediatr Adolesc Med 1996;150:356–62.10.1001/archpedi.1996.02170290022003Search in Google Scholar

12. Roberts SB, Savage J, Coward WA, Chew B, Lucas A. Energy expenditure and intake in infants born to lean and overweight mothers. N Engl J Med 1988;318:461–6.10.1056/NEJM198802253180801Search in Google Scholar

13. Zurlo F, Ferraro RT, Fontvielle AM, Rising R, Bogardus C, et al. Spontaneous physical activity and obesity: cross-sectional and longitudinal studies in Pima Indians. Am J Physiol 1992; 263(2 Pt 1):E296–300.10.1152/ajpendo.1992.263.2.E296Search in Google Scholar

14. Goran MI, Reynolds KD, Lindquist CH. Role of physical activity in the prevention of obesity in children. Int J Obes Relat Metab Disord 1999;23(Suppl 3):S18–33.10.1038/sj.ijo.0800880Search in Google Scholar

15. Votruba SB, Horvitz MA, Schoeller DA. The role of exercise in the treatment of obesity. Nutrition 2000;16:179–88.10.1016/S0899-9007(99)00264-6Search in Google Scholar

16. Nemet D, Barzilay-Teeni N, Eliakim A. Treatment of childhood obesity in obese families. J Pediatr Endocrinol Metab 2008;21:461–7.10.1515/JPEM.2008.21.5.461Search in Google Scholar

17. Nemet D, Ben Haim I, Pantanowits M, Eliakim A. Effects of a combined intervention for treating severely obese prepubertal children. J Pediatr Endocrinol Metab 2013;26:91–6.10.1515/jpem-2012-0225Search in Google Scholar

18. Golan M, Weizman A. Familial approach to the treatment of childhood obesity: conceptual mode. J Nutr Educ 2001;33:102–7.10.1016/S1499-4046(06)60173-5Search in Google Scholar

19. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869–73.10.1056/NEJM199709253371301Search in Google Scholar PubMed

20. Nemet D, Barkan S, Epstein Y, Friedland O, Kowen G, et al. Short- and long-term beneficial effects of a combined dietary-behavioral-physical activity intervention for the treatment of childhood obesity. Pediatrics 2005;115:e443–9.10.1542/peds.2004-2172Search in Google Scholar PubMed

21. Epstein LH, Valoski AM, Kalarchian MA, McCurley J. Do children lose and maintain weight easier than adults: a comparison of child and parent weight changes from six months to ten years. Obes Res 1995;3:411–7.10.1002/j.1550-8528.1995.tb00170.xSearch in Google Scholar PubMed

22. Epstein LH. Methodological issues and ten-year outcomes for obese children. Ann NY Acad Sci 1993;699:237–49.10.1111/j.1749-6632.1993.tb18854.xSearch in Google Scholar PubMed

Received: 2013-8-26
Accepted: 2013-12-2
Published Online: 2014-1-24
Published in Print: 2014-5-1

©2014 by Walter de Gruyter Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original articles
  3. Assessment of hearing in children with type 1 diabetes mellitus
  4. Insulin resistance and lipid profiles in HIV-infected Thai children receiving lopinavir/ritonavir-based highly active antiretroviral therapy
  5. Increased hunger and speed of eating in obese children and adolescents
  6. Glucagon and insulin cord blood levels in very preterm, late preterm and full-term infants
  7. Thyroid function in late preterm infants in relation to mode of delivery and respiratory support
  8. Prevalence of vitamin D deficiency and its related factors in children and adolescents living in North Khorasan, Iran
  9. Asymmetric dimethyl L-arginine, nitric oxide and cardiovascular disease in adolescent type 1 diabetics
  10. A combined nutritional-behavioral-physical activity intervention for the treatment of childhood obesity – a 7-year summary
  11. The effect of earlier puberty on cardiometabolic risk factors in Afro-Caribbean children
  12. Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006
  13. Serum uric acid: relationships with biomarkers in adolescents and changes over 1 year
  14. Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka
  15. Investigation of adropin and leptin levels in pediatric obesity-related nonalcoholic fatty liver disease
  16. Diseases accompanying congenital hypothyroidism
  17. Molecular diagnosis of a Chinese pedigree with α-mannosidosis and identification of a novel missense mutation
  18. Are the characteristics of thyroid cancer different in young patients?
  19. Unsaturated fatty acids and insulin resistance in childhood obesity
  20. Effect of genetic subtypes and growth hormone treatment on bone mineral density in Prader-Willi syndrome
  21. KCNJ11 gene mutation analysis on nine Chinese patients with type 1B diabetes diagnosed before 3 years of age
  22. Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China
  23. Patient reports
  24. A novel activating ABCC8 mutation underlying neonatal diabetes mellitus in an infant presenting with cerebral sinovenous thrombosis
  25. Endocrinological anomalies in a patient with 12q14 microdeletion syndrome. Completing phenotype of this exceptional short stature condition
  26. Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke
  27. Effect of ethosuximide on cortisol metabolism in the treatment of congenital adrenal hyperplasia
  28. Absence of WNT4 gene mutation in a patient with MURCS association
  29. Identification of a novel insulin receptor gene heterozygous mutation in a patient with type A insulin resistance syndrome
  30. Adrenal insufficiency in association with congenital nephrotic syndrome: a case report
  31. Diabetic lipemia presenting as eruptive xanthomas in a child with autoimmune polyglandular syndrome type IIIa
  32. A case report of nephrogenic diabetes insipidus with idiopathic Fanconi syndrome in a child who presented with vitamin D resistant rickets
  33. Letter to the Editor
  34. Hyperbilirubinemia in neonates of diabetic mothers: an indirect biomarker of organ damage?
https://doi.org/10.1515/jpem-2013-0349
Keywords for this article
childhood; exercise; multidisciplinary intervention; obesity

Articles in the same Issue

  1. Frontmatter
  2. Original articles
  3. Assessment of hearing in children with type 1 diabetes mellitus
  4. Insulin resistance and lipid profiles in HIV-infected Thai children receiving lopinavir/ritonavir-based highly active antiretroviral therapy
  5. Increased hunger and speed of eating in obese children and adolescents
  6. Glucagon and insulin cord blood levels in very preterm, late preterm and full-term infants
  7. Thyroid function in late preterm infants in relation to mode of delivery and respiratory support
  8. Prevalence of vitamin D deficiency and its related factors in children and adolescents living in North Khorasan, Iran
  9. Asymmetric dimethyl L-arginine, nitric oxide and cardiovascular disease in adolescent type 1 diabetics
  10. A combined nutritional-behavioral-physical activity intervention for the treatment of childhood obesity – a 7-year summary
  11. The effect of earlier puberty on cardiometabolic risk factors in Afro-Caribbean children
  12. Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006
  13. Serum uric acid: relationships with biomarkers in adolescents and changes over 1 year
  14. Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka
  15. Investigation of adropin and leptin levels in pediatric obesity-related nonalcoholic fatty liver disease
  16. Diseases accompanying congenital hypothyroidism
  17. Molecular diagnosis of a Chinese pedigree with α-mannosidosis and identification of a novel missense mutation
  18. Are the characteristics of thyroid cancer different in young patients?
  19. Unsaturated fatty acids and insulin resistance in childhood obesity
  20. Effect of genetic subtypes and growth hormone treatment on bone mineral density in Prader-Willi syndrome
  21. KCNJ11 gene mutation analysis on nine Chinese patients with type 1B diabetes diagnosed before 3 years of age
  22. Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China
  23. Patient reports
  24. A novel activating ABCC8 mutation underlying neonatal diabetes mellitus in an infant presenting with cerebral sinovenous thrombosis
  25. Endocrinological anomalies in a patient with 12q14 microdeletion syndrome. Completing phenotype of this exceptional short stature condition
  26. Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke
  27. Effect of ethosuximide on cortisol metabolism in the treatment of congenital adrenal hyperplasia
  28. Absence of WNT4 gene mutation in a patient with MURCS association
  29. Identification of a novel insulin receptor gene heterozygous mutation in a patient with type A insulin resistance syndrome
  30. Adrenal insufficiency in association with congenital nephrotic syndrome: a case report
  31. Diabetic lipemia presenting as eruptive xanthomas in a child with autoimmune polyglandular syndrome type IIIa
  32. A case report of nephrogenic diabetes insipidus with idiopathic Fanconi syndrome in a child who presented with vitamin D resistant rickets
  33. Letter to the Editor
  34. Hyperbilirubinemia in neonates of diabetic mothers: an indirect biomarker of organ damage?
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