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Randomized Controlled Trial
. 2012 Feb;7(1):28-38.
doi: 10.1111/j.2047-6310.2011.00005.x. Epub 2011 Dec 13.

Efficacy of U.S. paediatric obesity primary care guidelines: two randomized trials

H A Raynor  1 , K M Osterholt, C N Hart, E Jelalian, P Vivier, R R Wing
Affiliations
Randomized Controlled Trial

Efficacy of U.S. paediatric obesity primary care guidelines: two randomized trials

H A Raynor et al. Pediatr Obes. 2012 Feb.

Abstract

Objective: The objective of this study was to examine the efficacy of U.S. primary care paediatric obesity treatment recommendations, within two randomized trials.

Methods: Between November 2005 to September 2007, 182 families (children aged 4-9 years, body mass index [BMI] ≥85th percentile) were recruited for two separate trials and randomized within trial to a 6-month intervention. Each trial had one intervention that increased child growth-monitoring frequency and feedback to families (GROWTH MONITORING). Each trial also had two interventions, combining GROWTH MONITORING with an eight-session, behavioural, parent-only intervention targeting two energy-balance behaviours (Trial 1: reducing snack foods and sugar-sweetened beverages [DECREASE], and increasing fruits, vegetables and low-fat dairy [INCREASE]; Trial 2: decreasing sugar-sweetened beverages and increasing physical activity [TRADITIONAL] and increasing low-fat milk consumption and reducing television watching [SUBSTITUTES]). Child standardized BMI (ZBMI) and energy intake were assessed at 0, 6 and 12 months.

Results: In both trials, main effects of time were found for ZBMI, which decreased at 6 and 12 months (P < 0.01). In Trial 1, ZBMI reduced from 0 to 6 months, which was maintained from 6 to 12 months (ΔZBMI 0 to 12 months = -0.12 ± 0.22). In Trial 2, ZBMI reduced from 0 to 6 and from 6 to 12 months (ΔZBMI 0-12 months = -0.16 ± 0.31). For energy intake, main effects of time were found in both trials and intake reduced from 0 to 6 months (P < 0.05), with Trial 1 reducing intake from 0 to 12 months (P < 0.05).

Conclusions: All interventions improved weight status. Future research should examine effectiveness and translatability of these approaches into primary care settings.

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Conflict of interest statement

Conflict of Interest Statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Participant Flow.
Figure 2
Figure 2
In Trial 1 a significant (p < 0.001) reduction in ZBMI occurred from 0 to 6 months and 0 to 12 months, and Trial 2 had a significant (p < 0.01) reduction in ZBMI at each time point (M ± SD).
See this image and copyright information in PMC

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