Dataset Information

Population-based childhood overweight prevention: outcomes of the 'Be active, eat right' study.

ABSTRACT:

Objective

An overweight prevention protocol was used in the 'Be active, eat right' study; parents of overweight children (5 years) were offered healthy lifestyle counseling by youth health care professionals. Effects of the protocol on child BMI and waist circumference at age 7 years were evaluated.

Methods

A cluster RCT was conducted among nine youth health care centers in the Netherlands. Parents of overweight, not obese, children received lifestyle counseling and motivational interviewing according to the overweight prevention protocol in the intervention condition (n?=?349) and usual care in the control condition (n?=?288). Measurements were made of child height, weight and waist circumference at baseline and at a two-year follow-up; parents completed questionnaires regarding demographic characteristics. Linear mixed models were applied; interaction terms were explored.

Results

The analyzed population consisted of 38.1% boys; mean age 5.7 [sd: 0.4] years; mean BMI 18.1 [sd: 0.6], the median number of counseling sessions in the intervention condition was 2. The regression model showed no significant difference in BMI increase between the research conditions at follow-up (beta -0.16; 95% CI:-0.60 to 0.27; p?=?0.463). There was a significant interaction between baseline BMI and research condition; children with a baseline BMI of 17.25 and 17.50 had a smaller increase in BMI at follow-up when allocated to the intervention condition compared to control condition (estimated adjusted mean difference -0.67 [se: 0.30] and -0.52 [se: 0.36]).

Conclusion

Mildly overweight children (baseline BMI 17.25 and 17.50) in the intervention condition showed a significantly smaller increase in BMI at follow-up compared to the control condition; there was no overall difference between intervention and control condition. Future research may explore and evaluate improvements of the prevention protocol.

Trial registration

Current Controlled Trials ISRCTN04965410.

SUBMITTER: van Grieken A

PROVIDER: S-EPMC3669240 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Population-based childhood overweight prevention: outcomes of the 'Be active, eat right' study.

van Grieken Amy A Veldhuis Lydian L Renders Carry M CM Borsboom Gerard J GJ van der Wouden Johannes C JC Hirasing Remy A RA Raat Hein H

PloS one 20130531 5

<h4>Objective</h4>An overweight prevention protocol was used in the 'Be active, eat right' study; parents of overweight children (5 years) were offered healthy lifestyle counseling by youth health care professionals. Effects of the protocol on child BMI and waist circumference at age 7 years were evaluated.<h4>Methods</h4>A cluster RCT was conducted among nine youth health care centers in the Netherlands. Parents of overweight, not obese, children received lifestyle counseling and motivational i ...[more]

PMID: 23741491

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Project description:BackgroundThis study evaluates the effects of an intervention performed by youth health care professionals on child health behaviors. The intervention consisted of offering healthy lifestyle counseling to parents of overweight (not obese) 5-year-old children. Effects of the intervention on the child having breakfast, drinking sweet beverages, watching television and playing outside were evaluated.MethodsData were collected with the 'Be active, eat right' study, a cluster randomized controlled trial among nine youth health care centers in the Netherlands. Parents of overweight children received lifestyle counseling according to the intervention protocol in the intervention condition (n = 349) and usual care in the control condition (n = 288). Parents completed questionnaires regarding demographic characteristics, health behaviors and the home environment at baseline and at 2-year follow-up. Cluster adjusted regression models were applied; interaction terms were explored.ResultsThe population for analysis consisted of 38.1% boys; mean age 5.8 [sd 0.4] years; mean BMI SDS 1.9 [sd 0.4]. There were no significant differences in the number of minutes of outside play or television viewing a day between children in the intervention and the control condition. Also, the odds ratio for having breakfast daily or drinking two or less glasses of sweet beverages a day showed no significant differences between the two conditions. Additional analyses showed that the odds ratio for drinking less than two glasses of sweet beverages at follow-up compared with baseline was significantly higher for children in both the intervention (p < 0.001) and the control condition (p = 0.029).ConclusionsComparison of the children in the two conditions showed that the intervention does not contribute to a change in health behaviors. Further studies are needed to investigate opportunities to adjust the intervention protocol, such as integration of elements in the regular well-child visit. The intervention protocol for youth health care may become part of a broader approach to tackle childhood overweight and obesity.Trial registrationCurrent Controlled Trials ISRCTN04965410.

Project description:BackgroundBody mass index (BMI) is a common indirect method to assess weight status among children. There is evidence that BMI data alone can underestimate overweight-related health risk and that waist circumference (WC) should also be measured. In this study we investigated the agreement between BMI and WC and BMI and the waist-height ratio (WHtR) when used to identify overweight among children.MethodsThis cross-sectional population-based study uses baseline data from 5-year-olds (n?=?7703) collected by healthcare professionals for the 'Be active, eat right' study.ResultsAccording to age-specific and sex-specific cut-off points for BMI (IOTF, 2000) and WC (Fredriks et al., 2005), the prevalence of overweight (obesity included) was 7.0% and 7.1% among boys, and 11.6% and 10.1% among girls, respectively. For the WHtR the 90th percentile was used as the cut-off point. Among boys, observed proportion of agreement between BMI and WC classification was 0.95, Cohen's kappa 0.58 (95% CI; 0.53-0.63), and proportions of positive and negative agreement were 0.61 and 0.97, respectively. Observed proportion of agreement between BMI and WHtR classification was 0.92, Cohen's kappa 0.46 (95% CI; 0.41-0.51), and proportions of positive and negative agreement were 0.51 and 0.95. Children identified as overweight according to WC were relatively tall, and children classified as overweight according to the WHtR only were relatively short (comparable results for girls).ConclusionsThere is moderate agreement between BMI and measures of WC on the presence of overweight among 5-year-olds. If BMI data and cut-offs continue to be used, then part of the group of children identified as overweight according to WC and the WHtR will be omitted. Follow-up of the children classified as overweight according to BMI only, WC only, and WHtR only, will give indications whether WC should be measured in addition to BMI or whether WC should only be measured in certain subgroups (e.g. relatively tall or short children) to identify and monitor overweight in children. This may improve early identification and prevention of overweight and overweight-related health problems in children.

Project description:ObjectivesTo assess how outcomes associated with participation in a family-based weight management intervention (MEND 7-13, Mind, Exercise, Nutrition..Do it!) for childhood overweight or obesity implemented at scale in the community vary by child, family, neighbourhood and MEND programme characteristics.Methods/subjectsIntervention evaluation using prospective service level data. Families (N=21,132) with overweight children are referred, or self-refer, to MEND. Families (participating child and one parent/carer) attend two sessions/week for 10 weeks (N=13,998; N=9563 with complete data from 1788 programmes across England). Sessions address diet and physical activity through education, skills training and motivational enhancement. MEND was shown to be effective in obese children in a randomised controlled trial (RCT). Outcomes were mean change in body mass index (BMI), age- and sex-standardised BMI (zBMI), self-esteem (Rosenberg scale) and psychological distress (Strengths and Difficulties Questionnaire) after the 10-week programme. Relationships between the outcome and covariates were tested in multilevel models adjusted for the outcome at baseline.ResultsAfter adjustment for covariates, BMI reduced by mean 0.76 kg m(-2) (s.e.=0.021, P<0.0001), zBMI reduced by mean 0.18 (s.e.=0.0038, P<0.0001), self-esteem score increased by 3.53 U (s.e.=0.13, P<0.0001) and psychological distress score decreased by 2.65 U (s.e.=0.31, P<0.0001). Change in outcomes varied by participant, family, neighbourhood and programme factors. Generally, outcomes improved less among children from less advantaged backgrounds and in Asian compared with white children. BMI reduction under service conditions was slightly but not statistically significantly less than in the earlier RCT.ConclusionsThe MEND intervention, when delivered at scale, is associated with improved BMI and psychosocial outcomes on average, but may work less well for some groups of children, and so has the potential to widen inequalities in these outcomes. Such public health interventions should be implemented to achieve sustained impact for all groups.

Dataset Information

Population-based childhood overweight prevention: outcomes of the 'Be active, eat right' study.

Objective

Methods

Results

Conclusion

Trial registration

Publications

Population-based childhood overweight prevention: outcomes of the 'Be active, eat right' study.

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