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A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Family meals on prescription as treatment for childhood obesity-a randomized controlled trial
Terese Torstensson1,2, Anna Bohlin2, Gerd Almqvist-Tangen1
1Department of Pediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Insights
The Family Meals on Prescription intervention significantly reduced BMIz in children with obesity during a 3-month trial. However, these results were not sustained long-term, highlighting the need for ongoing obesity treatment.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Public Health
Background:
- Childhood obesity is a growing concern, with lifestyle interventions alone often proving insufficient for sustained results.
- Established research indicates that regular family meals and consistent mealtime routines positively influence children's nutritional health and dietary habits.
Purpose of the Study:
- To assess the impact of the 'Family Meals on Prescription' (FMP) program on body mass index (BMI) and metabolic health in children with obesity.
- To evaluate the tolerability and effectiveness of an intensive 3-month dietary intervention utilizing a participatory approach.
Main Methods:
- A prospective randomized controlled trial involving children aged 5-15 years attending pediatric obesity clinics.
- Participants received standard lifestyle treatment, with the intervention group additionally receiving a subsidized prepacked grocery bag with recipes for five family meals weekly for 3 months.
- Primary endpoint was change in BMIz at 3, 12, and 18-24 months; secondary endpoints included tolerability, metabolic biomarkers, and meal frequency.
Main Results:
- The FMP intervention group showed a significantly greater reduction in BMIz compared to the control group after the 3-month intervention (-0.17 vs +0.01, p < 0.01).
- This significant difference in BMIz reduction was not sustained at the 18-24 month follow-up, with the control group exhibiting a greater reduction.
- The FMP intervention was found to be well-tolerated by participants.
Conclusions:
- A subsidized prepacked meal service, 'Family Meals on Prescription,' is a well-tolerated and potentially effective tool for treating childhood obesity during the intervention period.
- The lack of sustained BMIz reduction underscores the chronic nature of childhood obesity and emphasizes the critical need for long-term treatment strategies.
- Further research into extended intervention durations is warranted to determine long-term efficacy.
Abstract:
The aim with the present study was to evaluate the effects and tolerability of Family Meals on Prescription, a 3-month intensive dietary intervention with a participatory approach on body mass index (BMI) and metabolic health in children living with obesity. In this prospective randomized controlled trial, children aged 5-15 years were included from the Pediatric Obesity outpatient Clinics in Halland, Sweden. Participants were randomly assigned to receive lifestyle treatment with or without Family Meals on Prescription (FMP) consisting of a subsidized prepacked grocery bag including recipes and provisions for five Family Meals per week for 3 months. The primary endpoint was changed in BMIz after 3, 12 and 18-24 months and secondary endpoints included to assess tolerability of FMP and effects on metabolic biomarker and frequency of shared meals. Eighty-nine children (51.7% female) entered the study, 54 patients in the intervention group and 35 in the control group. There were no significant differences between the groups concerning gender, age or level of obesity at baseline. The Family Meal on Prescription intervention combined with lifestyle treatment led to a significantly greater reduction in BMIz than lifestyle treatment alone after the 3-month long intervention (- 0.17 vs + 0.01, p < 0.01); however, this difference was not sustained throughout the study period, and in fact, the control group had a greater reduction in BMIz after 18-24 months.A subsidized prepacked grocery bag may be a novel, well-tolerated and effective tool in the treatment of childhood obesity. The fact that the BMIz reduction shown at the end of the intervention did not persist over time emphasized the need of long-term treatment. Registered at clinicaltrals.gov 27 Nov 2020, retrospectively registered: clinicaltrials.gov number 19002468. https://clinicaltrials.gov/study/NCT05225350 What is Known: • Swedish data shows that lifestyle treatment alone is not sufficient for many families undergoing treatment for childhood obesity. • Regular family meals and mealtime routines have been shown to be important for nutritional health and dietary patterns in children and adolescents. What is New: • This intervention with a participatory approach involving prepacked family meals was well tolerated and led to a significant reduction in BMIz during the intervention. • That fact that these results were not sustained over time indicates a need to evaluate longer interventions, and that childhood obesity is a chronic and complex disease which requires long-time treatments.
