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Long-Term Effect of a Hospital-Based Intervention Program on BMI Trajectories in Danish Children and Adolescents With
Mette Fogh1,2, Jane Nautrup Østergaard1, Rasmus Møller Jørgensen1,3
1Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Insights
Hospital-based lifestyle interventions for childhood obesity show initial success in reducing Body Mass Index z-score (BMIz). However, these benefits for pediatric weight management are not sustained long-term, highlighting the need for ongoing support.
Area of Science:
- Pediatrics
- Public Health
- Clinical Research
Background:
- Childhood obesity presents significant health and psychosocial challenges, often extending into adulthood.
- Hospital-based lifestyle interventions offer intensive support but lack robust long-term effectiveness data.
- Evaluating sustained impact of such interventions is crucial for pediatric weight management strategies.
Purpose of the Study:
- To assess the long-term changes in Body Mass Index z-score (BMIz) in children and adolescents with overweight/obesity.
- To compare the effectiveness of a hospital-based lifestyle intervention against matched controls over 6 years.
- To analyze BMI trajectories and identify factors influencing intervention outcomes.
Main Methods:
- A matched prospective cohort study involving 1897 children and adolescents (ages 5-15).
- Intervention group received family-centered lifestyle guidance (diet, activity, sleep, screen time).
- BMIz trajectories analyzed using mixed-effects models with linear splines, adjusting for socioeconomic factors.
Main Results:
- The intervention group showed greater BMIz reduction at 6 and 12 months compared to controls.
- A rebound in BMIz was observed from 12 to 36 months, with continued increases up to 72 months.
- Intervention benefits on BMIz were evident up to 12 months post-intervention but not sustained at 6 years.
Conclusions:
- Hospital-based lifestyle interventions can improve pediatric BMIz in the short term.
- Long-term effectiveness of these interventions for sustained weight management remains a challenge.
- Further research is needed to develop strategies for maintaining intervention effects in childhood obesity.
Abstract:
Childhood obesity is associated with adverse health and psychosocial outcomes, often persisting into adulthood. Hospital-based lifestyle interventions may provide intensive support, but evidence on long-term effectiveness is limited. To evaluate changes in Body Mass Index z-score (BMIz) among children and adolescents with overweight and obesity participating in a hospital-based intervention compared to matched controls. This matched prospective cohort study includes children and adolescents aged 5-15 years. The intervention consisted of a family-centered hospital-based lifestyle program focusing on diet, physical activity, sleep and screen time management. Controls were matched on age, sex, weight category, and calendar year. BMI trajectories were analyzed using mixed effects models with linear splines, adjusting for socioeconomic factors from national registries. A total sample size of 1897 children and adolescents was included (325 intervention, 1572 controls). The intervention group achieved a higher reduction in BMIz during the first 6 months (-0.74 SD/years, 95% CI: -0.89; -0.60) and up to 12 months (-0.31 SD/years, -0.45; -0.16), compared to controls. From 12 to 36 months, a rebound in BMIz occurred (0.14, SD/years, 0.10; 0.17), and continued to rise through 72 months. The intervention was associated with improvements in BMIz up to 12 months after the intervention. However, the effects were not sustained at 6 years of follow-up. Trial Registration: Clinicaltrials.Gov identifier: NCT05790174.
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