Clinical Question: Can a specific p...

Clinical Question: Can a specific program of diet and exercise be the effect in sustained weight loss in children?

Setting: Outpatient (primary care)

cogitation Design: Randomized controlled trial (nonblinded)

Allocation: Uncertain

Synopsis: The researchers conducting this application of mind began with 54 obese children between six and 16 years of age. The children were assigned randomly to a mastery group that received a single nutrition counseling session or to an active treatment arrange Active treatment consisted of heavy-duty dietary and exercise modification for three month It is not clear whether allocation to treatment collections was concealed, and it is possible that children more likely to answer to treatment were enrolled preferentially.

The dietary intervention consisted of six meetings above a three-month period with parents and the child. These counseling sessions focused upon food choices, nutrition information, and change in behavior. The children were placed upon a diet of approximately 30 percent fewer calories than the reported intake or 15 percent fewer calories than the estimated daily required intake. The exercise program was directioned two hours per week by dint of physicians who were former members of the Israeli national track and field team and consisted of games focusing upon endurance; the children were encouraged to add an extra 30 to 45 minutes of walking or other exercise by week. Analysis was per protocol and not according to intention to treat. Because of dropout early during the intervention period and in the following one-year follow-up, the groups dwindled to 20 patients each.

After three month of diet and exercise intervention, the children in the treatment dispose lost an average 2.8 kg (62 lb) whereas the children in the reign over group gained an average of 11 kg (24 lb) material substance mass index and body fat percentage also declined in children in the intervention assemblage Over the one year of follow-up children in the restrain group gained an average of 52 kg (114 lb); the children in the intervention collection gained an average of 06 kg (13 lb; P < 05) corpse mass index increased in the check group but decreased in the intervention dispose Other significant differences at undivided year included lower body fat percentage, amount of exercise activity, and endurance time upon a treadmill. Both groups reported a decrease in the time exhausted watching television or playing video games, from an average of 45 to 48 hours by day to 3.3 to 34 hours for day one year later.

Bottom Line: An intensive three-month program of dietary counseling, a hypocaloric diet, and structur exercise can cause weight los in children that is sustained from one side of to the other one year. More important, the program present the appearanceed to increase the amount of exercise the children performed, and this increase was sustained after the intervention was discontinued.

(Level of Evidence: 2b)

subject of attention Reference: Nemet D, et al. Short- and long-term beneficial tenors of a combined dietary-behavioral-physical activity intervention for the treatment of childhood obesity. Pediatrics April 2005;115:e443-9

Used with permission from Shaughnessy AF. Intense diet-behavior-physical activity effective for obese children. Accessed online June 1 2005 at: http://www InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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