[Sports and nutrition--an ambulatory care program for obese children (long-term experiences)]

Sports activity (three times per week), dietary changes and modification of behavior are the basic tenets of an outpatient program run for 9- to 12-year-old adipose children since 1987. The following goals are to be attained: increase in physical performance capacity and body awareness, long-lasting change in eating habits, weight loss to less than 20% overweight compared to the age-normal, and understanding of the permanence of body weight problems. Individual dietary consultation is offered in addition to the initial examination consisting of physical examination, skin fat-fold measurement, blood chemical parameters, spiroergometry and a detailed discussion with parents and children. The eating habits of the children are recorded in a dietary history (three-day dietary protocol, questionnaire) and discussed in individual consultations with the parents and children. Moreover, the nutritional program includes regular nutritional consultations and parents' meetings every month. Cooking instructions provide practical knowledge of food preparation to preserve nutrients in an energy-reduced, tasty diet, as well as theoretical basics of nutrition. The control examinations show improvement in body-weight related performance capacity and laboratory parameters (lipid metabolism) as well as individual weight loss or stability (reference weight). Aware and controlled nutritional habits were learned especially by the children of parents who, for their part, tried to tailor their diets to be better balanced, whole-some and more need-oriented. Overall the nutritional composition improved with less energy intake. The intake of complex carbohydrates increased especially through consumption of ballast-rich müsli, as well as whole wheat bread, vegetables and fruits.(ABSTRACT TRUNCATED AT 250 WORDS)