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Evaluation of a comprehensive intervention with a behavioural modification strategy for childhood obesity prevention:

Jing-jing Wang^1,2, Wing-chung Patrick Lau³, Hai-jun Wang⁴

¹Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China. wangjj@life.hkbu.edu.hk.

BMC Public Health

|December 5, 2015

Insights

A comprehensive lifestyle intervention significantly reduced body fat and improved blood pressure in overweight Chinese children. This combined diet and physical activity approach showed greater benefits than single-modality interventions.

Area of Science:

Pediatrics
Public Health
Behavioral Science

Background:

Childhood obesity is a global epidemic requiring effective lifestyle interventions.
A comprehensive intervention combining diet and physical activity (PA) was developed using social cognitive behavior modification.
The intervention utilized accelerometry and dietary diaries for monitoring and feedback.

Purpose of the Study:

To develop and implement a comprehensive lifestyle intervention for overweight and obese children.
To evaluate the effectiveness of the comprehensive intervention compared to diet-only, PA-only, and control groups.

Main Methods:

A pilot study with a non-randomized cluster design involved 438 children aged 7-12 years in Beijing.
Participants were assigned to one of four groups: comprehensive, PA only, diet only, or control.
Intervention effects on adiposity, blood pressure, and biochemical markers were analyzed using linear mixed models.

Main Results:

The comprehensive intervention group showed a significant decrease in body fat percentage (-1.01%) compared to other groups.
Significant reductions in systolic (-4.37 mmHg) and diastolic (-5.50 mmHg) blood pressure were observed in the comprehensive group.
Positive changes in fasting glucose were noted, but lipid metabolism indicators and BMI/waist circumference changes were not significant.

Conclusions:

The comprehensive lifestyle intervention demonstrated superior effects on body fat and blood pressure in Chinese children compared to diet or PA alone.
The intervention did not significantly impact biochemical lipid metabolism indicators.
Further randomized controlled trials and long-term follow-up are recommended to validate these findings.

Read full analysis

Abstract

Background:

With regard to the global childhood obesity epidemic, it is imperative that effective lifestyle interventions are devised to combat childhood obesity. This paper describes the development and implementation of a comprehensive (a combination of diet and physical activity (PA)), social cognitive behaviour modification intervention using accelerometry and a dietary diary to tackle child overweight and obesity. The comprehensive intervention effect was evaluated in a comparison with diet only, PA only and a no-treatment control group.

Methods:

A pilot study was conducted with a non-randomized cluster design. Four hundred thirty-eight overweight and obese children aged 7-12 years from ten primary schools in Beijing were recruited to receive a one-year intervention. Participants were allocated into one of four groups: the comprehensive intervention group; the PA only group (Happy 10 program); the diet only group (nutrition education program); and a control group. The effects of intervention on adiposity, blood pressure, and biochemical indicators were assessed by examining 2-way interactions (time × intervention) in linear mixed models. Means and 95 % confidence intervals (CI) for the adjusted changes between post-intervention and baseline relative to changes in the control group were calculated and reported as effect sizes.

Results:

The percentage of body fat in the comprehensive intervention group showed a significant relative decrease (adjusted change: -1.01 %, 95 % CI: (-1.81, -0.20) %) compared with the PA only, diet only or control groups (P < 0.001). Systolic blood pressure significantly decreased in the comprehensive intervention group (adjusted change: -4.37 mmHg, 95 % CI: (-8.42, -0.33) mmHg), as did diastolic blood pressure (adjusted change: -5.50 mmHg, 95 % CI (-8.81, -2.19) mmHg) (P < 0.05). Compared with the other two intervention groups and the control group, positive adjusted changes in fasting glucose in the comprehensive group were found, although not for the biochemical lipid metabolism indicators. Positive but non-significant adjusted changes in body mass index and waist circumference were observed.

Conclusions:

Compared with the diet or PA only intervention groups, the current comprehensive program had superior positive effects on body fat percentage and blood pressure but not on the biochemical lipid metabolism indicators in Chinese overweight and obese children. Future randomized controlled trials and long-term follow-up studies are required to elaborate the findings of the current intervention.

Trial Registration:

ClinicalTrials.gov identifier: NCT02228434.

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