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McDarby F, Looney K. The effectiveness of group-based, parent-only weight management interventions for children and the factors associated with outcomes: a systematic review. Int J Obes (Lond) 2024; 48:3-21. [PMID: 37821651 DOI: 10.1038/s41366-023-01390-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Obesity in Childhood is a significant public health issue, which requires both a preventative and treatment approach. International guidelines continue to recommend family-focused, multicomponent, childhood weight management programmes and many studies have investigated their effectiveness, however, findings have been mixed and primarily based on weight. Thus, the aim of this review was to assess the effectiveness of group-based parent-only interventions on a broad range of child health-related outcomes and to investigate the factors associated with intervention outcomes. METHODS An electronic database search was conducted using CINAHL, Medline, PsychINFO, Embase and the Cochrane Database of Systematic Reviews: 522 articles were identified for full text review and 15 studies were selected. The quality of studies were appraised and data were synthesised according to the review aims. RESULTS Parent-only group interventions are effective in changing children's weight status, as well as other outcomes such as health behaviours and self-esteem, although these were reported inconsistently. Parent-only interventions were generally found to be similar to parent-child interventions, and minimal contact interventions but better than a waiting list control. Factors found to be associated with treatment outcomes, included session attendance, the child's age and weight at baseline, socioeconomic status of families and modification to the home food environment. The methodological quality of the studies included in the review was low, with only six studies rated to be methodologically adequate. CONCLUSIONS Parent-only interventions may be an effective treatment for improving the health status of children and their families, particularly when compared with waitlist controls. However, results need to be interpreted with caution due to the low quality of the studies and the high rates of non-completion.
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Affiliation(s)
- Fionna McDarby
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Kathy Looney
- School of Psychology, University College Dublin, Dublin, Ireland.
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Szczyrska J, Brzeziński M, Szlagatys-Sidorkiewicz A. Long-term effects of 12-month integrated weight-loss programme for children with excess body weight- who benefits most? Front Endocrinol (Lausanne) 2023; 14:1221343. [PMID: 38027174 PMCID: PMC10656687 DOI: 10.3389/fendo.2023.1221343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
The aim of the study was to assess long-term effects of the 12-month integrated weight-loss programme in children with excess body weight. We also attempted to identify the determinants of intervention effectiveness. Two groups were included in the analysis: 241 children with excess body weight who participated in the full 12-month intervention (full participation group) and 891 children with excess body weight who did not participate in the intervention (no participation group). Changes in BMI SDS, SBP SDS, DBP SDS and post-exercise HR with a follow-up period of 4 years between this groups were compared. In the full participation group, the reduction in mean BMI SDS was greater, we also observed significantly higher decrease in DBP SDS. Subgroup analysis by age category and sex showed a significant difference in the change in mean BMI SDS (from baseline to follow-up) in the subgroup of younger children and in the subgroup of younger girls. In the subgroup of younger girls significantly higher decrease in DBP SDS and SBP was also observed. Younger children, who participated in the intervention at age 6, particularly girls, benefited the most.
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Affiliation(s)
- Joanna Szczyrska
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Gdansk, Poland
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Desmet M, Fillon A, Thivel D, Tanghe A, Braet C. Attrition rate and predictors of a monitoring mHealth application in adolescents with obesity. Pediatr Obes 2023; 18:e13071. [PMID: 37680003 DOI: 10.1111/ijpo.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/14/2023] [Accepted: 07/10/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Integrating mobile health (mHealth) into paediatric obesity treatment can provide opportunities for more personalized and lifetime treatment. However, high attrition rates pose a significant challenge. The current study attempts to better understand attrition by exploring (1) attrition rates of a monitoring mHealth application for usage over 14 days and (2) testing predictors of attrition in adolescents with obesity. METHODS Participants were 69 adolescents between 12 and 16 years old who engaged in a multidisciplinary obesity treatment centre (either outpatient or inpatient) in two countries (Belgium and France). To assess the attrition rates, frequency distributions were used. To test the predictors of attrition, zero-inflated negative binomial regression was performed. RESULTS Attrition rates were high, in the outpatient group, more than half of the participants (53.3%) used the app for only 0-7 days. In the inpatient group, this percentage was 24.1%. Only deficits in initiating (a component of executive functions) were a negative predictor of attrition, indicating that deficits in initiating lead to lower attrition rates. CONCLUSIONS This study provides evidence for high attrition rates in mHealth interventions for adolescents with obesity and was the first to investigate psychological predictors of attrition to an mHealth monitoring tool in adolescents with obesity in treatment. Findings regarding predictors of attrition should be approached with caution due to the small sample size.
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Affiliation(s)
- Maurane Desmet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Alicia Fillon
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary behaviors (ONAPS), Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary behaviors (ONAPS), Clermont-Ferrand, France
| | | | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Davison GM, Monocello LT, Lipsey K, Wilfley DE. Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:589-603. [PMID: 37683261 PMCID: PMC10586458 DOI: 10.1080/15374416.2023.2251164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. METHOD Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. RESULTS Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). CONCLUSIONS Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.
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Affiliation(s)
- Genevieve M. Davison
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Lawrence T. Monocello
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kim Lipsey
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Öztürk G, Kolcu M. Are child and parent health behaviors associated with childhood obesity? A descriptive and methodological study. J Pediatr Nurs 2023; 72:99-105. [PMID: 37494855 DOI: 10.1016/j.pedn.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE This study was conducted to determine the relationship between child and parents' health behaviors and childhood obesity. In addition, an adaptation of the Turkish version of the Family Health Behavior Scale (FHBS) was performed in this study. DESIGN AND METHODS This is a descriptive and methodological study. The research sample consisted of 358 parents who have a child between the ages of 5 and 12 studying in one of the seven state schools at the kindergarten, primary, and secondary school levels in Istanbul. Data were collected between February 2022 to May 2022 using the Parent and Child Descriptive Information Form, the Family Nutrition and Physical Activity (FNPA) Screening Tool, and the FHBS. IBM SPSS 25.0 (IBM, Armonk, NY, USA) and SPSS AMOS 21.0 software were used to analyze the data. RESULTS It was found that the confirmatory factor analysis result of FHBS confirmed the original structure of the scale, and Cronbach's Alpha coefficient was calculated as 0.80. A positive correlation was found between the parents' total scores of FNPA and FHBS (r:0.511, p < 0.001). CONCLUSIONS It is recommended to evaluate the child and their parents holistically in preventing and managing childhood obesity. School health nurses should plan family-centered interventions to improve health behaviors and carry out these interventions with a multidisciplinary team. Moreover, it has been determined that FHBS is a valid and reliable measurement tool for the Turkish population.
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Affiliation(s)
- Gizem Öztürk
- Fenerbahçe University, Faculty of Health Sciences, Nursing Department, Istanbul, Turkey
| | - Merve Kolcu
- Department of Public Health Nursing, Hamidiye Faculty of Nursing, University of Health Sciences-Turkey, Istanbul, Turkey.
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Baygi F, Djalalinia S, Qorbani M, Larrabee Sonderlund A, Kousgaard Andersen MK, Thilsing T, Heitmann BL, Nielsen JB. The effect of psychological interventions targeting overweight and obesity in school-aged children: a systematic review and meta-analysis. BMC Public Health 2023; 23:1478. [PMID: 37537523 PMCID: PMC10398924 DOI: 10.1186/s12889-023-16339-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Multi-component psychological interventions may mitigate overweight and obesity in children and adolescents. Evidence is, however, scattered on the effectiveness of such interventions. This study aims to review the available evidence on the effectiveness of multi-component psychological interventions on anthropometric measures of school-aged children with overweight or obesity. METHODS We systematically searched international databases/search engines including PubMed and NLM Gateway (for MEDLINE), Web of Science, SCOPUS, and Google Scholar up to November 2022 for relevant articles pertaining to psychological weight-loss interventions targeting school-aged children. Two reviewers screened and extracted pertinent data. The quality of included studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials. Random effect meta-analysis was used to calculate, and pool standardized mean differences (SMD). We distinguished between intervention and maintenance effects. Intervention effects were defined as the mean change in outcome measurement detected between baseline and post-treatment. Maintenance effects were defined as the mean change in outcome measurement between post-treatment and last follow-up. RESULTS Of 3,196 studies initially identified, 54 and 30 studies were included in the qualitative and quantitative syntheses, respectively. Most studies reported on group-based interventions. The significant effects of intervention on BMI z-score (SMD -0.66, 95% CI: -1.15, -0.17) and WC (SMD -0.53, 95% CI: -1.03, -0.04) were observed for interventions that centered on motivational interviewing and cognitive behavioral therapy, respectively. Mean BMI and WC did not differ significantly between post-treatment and last follow-up measurement (maintenance effect), indicating that an initial weight loss obtained through the intervention period could be maintained over time. CONCLUSIONS Findings indicate that motivational interviewing and cognitive behavioral therapy as interventions to reduce BMI z-score (generalized obesity) and waist circumference (abdominal obesity) are effective and durable. However, detailed analyses on individual components of the interventions are recommended in future effectiveness studies.
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Affiliation(s)
- Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Shirin Djalalinia
- Ministry of Health and Medical Education, Deputy of Research & Technology, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Anders Larrabee Sonderlund
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Trine Thilsing
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies, the Parker Institute, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- Section for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Bo Nielsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Mast A, Peña A, Bolch CA, Shaibi G, Vander Wyst KB. Sex differences in response to lifestyle intervention among children and adolescents: Systematic review and meta-analysis. Obesity (Silver Spring) 2023; 31:665-692. [PMID: 36762579 DOI: 10.1002/oby.23663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Little is known about sex differences in response to lifestyle interventions among pediatric populations. The purpose of this analysis was to evaluate sex differences in adiposity following lifestyle interventions among children and adolescents with overweight or obesity aged 6 to 18 years old. METHODS Searches were conducted in PubMed, Web of Science, and MEDLINE (from inception to March 2021), and references from included articles were examined. Eligibility criteria included children and adolescents aged 6 to 18 years with overweight or obesity, randomization to a lifestyle intervention versus a control group, and assessment of at least one adiposity measure. Corresponding authors were contacted to obtain summary statistics by sex (n = 14/49). RESULTS Of 89 full-text articles reviewed, 49 (55%) were included, of which 33 (67%) reported statistically significant intervention effects on adiposity. Only two studies (4%) evaluated sex differences in response to lifestyle intervention, reporting conflicting results. The results of the meta-regression models demonstrated no significant differences in the treatment effect between male and female youth for weight (beta = -0.05, SE = 0.18, z = -0.28, p = 0.8), BMI (beta = 0.03, SE = 0.14, z = 0.19, p = 0.85), BMI z score (beta = -0.04, SE = 0.18, z = -0.23, p = 0.82), percentage body fat (beta = -0.11, SE = 0.16, z = -0.67, p = 0.51), and waist circumference (beta = -0.30, SE = 0.25, z = -1.18, p = 0.24). CONCLUSIONS The meta-analysis revealed that youth with overweight or obesity do not demonstrate a differential response to lifestyle intervention in relation to adiposity-related outcomes.
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Affiliation(s)
- Alexis Mast
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona, USA
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Charlotte A Bolch
- Office of Research and Sponsored Programs, Midwestern University, Glendale, Arizona, USA
| | - Gabriel Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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Spence ND, Newton AS, Keaschuk RA, Ambler KA, Holt NL, Jetha MM, Mushquash AR, Rosychuk RJ, Sharma AM, Spence JC, Ball GDC. Parents as Agents of Change in Managing Pediatric Obesity: A Randomized Controlled Trial Comparing Cognitive Behavioral Therapy versus Psychoeducation Interventions. Child Obes 2023; 19:71-87. [PMID: 35442813 DOI: 10.1089/chi.2021.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Obesity interventions for parents of children with obesity can improve children's weight and health. This randomized controlled trial (RCT) evaluated whether a parent-based intervention based on cognitive behavioral therapy (CBT) principles was superior to a parent-based intervention based on a psychoeducation program (PEP) in improving children's obesity. Methods: This study was a pragmatic, two-armed, parallel, superiority RCT. Conducted at a Canadian outpatient pediatric obesity management clinic (September 2010-January 2014), this trial included families with children 8-12 years with an age- and sex-specific BMI ≥85th percentile. The 16-week manualized interventions were similar in content and delivered to parents exclusively, with different theoretical underpinnings. The primary outcome was children's BMI z-score at postintervention (4 months). Secondary outcomes included anthropometric, lifestyle, psychosocial, and cardiometabolic variables. Data were collected at preintervention (0 months), postintervention (4 months), 10, and 16 months. Intention-to-treat analysis using linear mixed models was used to assess outcomes. Results: Among 52 randomly assigned children, the mean age (standard deviation) was 9.8 (1.7) years and BMI z-score was 2.2 (0.3). Mean differences in BMI z-score were not significantly different between the CBT (n = 27) and PEP (n = 25) groups from 0 to 4-, 10-, and 16-month follow-up. At 4 months, the mean difference in BMI z-score from preintervention between the CBT (-0.05, 95% CI = -0.09 to 0.00) and PEP (-0.04, 95% CI = -0.09 to 0.01) groups was -0.01 (95% CI = -0.08 to 0.06, p = 0.80). Similar results were found across all secondary outcomes. Conclusions: Our CBT-based intervention for parents of children with obesity was not superior in reducing BMI z-score vs. our PEP-based intervention.
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Affiliation(s)
- Nicholas D Spence
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada.,Department of Health and Society, University of Toronto, Toronto, Ontario, Canada
| | - Amanda S Newton
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel A Keaschuk
- Alberta Health Services, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Kathryn A Ambler
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas L Holt
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Mary M Jetha
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Aislin R Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Rhonda J Rosychuk
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Arya M Sharma
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 189] [Impact Index Per Article: 189.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
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Skinner AC, Staiano AE, Armstrong SC, Barkin SL, Hassink SG, Moore JE, Savage JS, Vilme H, Weedn AE, Liebhart J, Lindros J, Reilly EM. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part I: Interventions. Pediatrics 2023; 151:190447. [PMID: 36622110 DOI: 10.1542/peds.2022-060642] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
Abstract
The objective of this technical report is to provide clinicians with evidence-based, actionable information upon which to make assessment and treatment decisions for children and adolescents with obesity. In addition, this report will provide an evidence base to inform clinical practice guidelines for the management and treatment of overweight and obesity in children and adolescents. To this end, the goal of this report was to identify all relevant studies to answer 2 overarching key questions: (KQ1) "What are clinically based, effective treatments for obesity?" and (KQ2) "What is the risk of comorbidities among children with obesity?" See Appendix 1 for the conceptual framework and a priori key questions.
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Affiliation(s)
- Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Amanda E Staiano
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Sarah C Armstrong
- Departments of Pediatrics and Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Shari L Barkin
- Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Sandra G Hassink
- Medical Director, American Academy of Pediatrics, Institute for Healthy Childhood Weight, Wilmington, Delaware
| | - Jennifer E Moore
- Institute for Medicaid Innovation, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Pennsylvania State University, Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - Helene Vilme
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Ashley E Weedn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
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12
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Putter KC, Jackson B, Thornton AL, Willis CE, Goh KMB, Beauchamp MR, Benjanuvatra N, Dimmock JA, Budden T. Perceptions of a family-based lifestyle intervention for children with overweight and obesity: a qualitative study on sustainability, self-regulation, and program optimization. BMC Public Health 2022; 22:1534. [PMID: 35953799 PMCID: PMC9373481 DOI: 10.1186/s12889-022-13956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family-based lifestyle interventions (FBLIs) are an important method for treating childhood weight problems. Despite being recognized as an effective intervention method, the optimal structure of these interventions for children's overweight and obesity has yet to be determined. Our aim was to better understand participants' (a) implementation of behaviour strategies and long-term outcomes, (b) perceptions regarding the optimal structure of FBLIs, and (c) insights into psychological concepts that may explain the success of these programs. METHODS Purposive sampling was used to recruit participants. We conducted focus groups as well as one-to-one interviews with parents (n = 53) and children (n = 50; aged 7-13, M = 9.4 yr, SD = 3.1) three months following their involvement in a 10-week, multi-component, FBLI involving education and activities relating to healthy nutrition, physical activity, and behavior modification. Using an interpretivist approach, a qualitative study design was employed to examine participant experiences. RESULTS We identified three higher-order categories: (a) participants' program experiences and perceptions (b) lifestyle changes post-program, and (c) recommendations for optimizing family-based programs. Themes identified within these categories included (a) support and structure & content, (b) diet and physical activity, and (c) in-program recommendations and post-program recommendations. CONCLUSIONS We identified several challenges that can impair lasting behavior change (e.g., physical activity participation) following involvement in a FBLI. On optimizing these programs, participants emphasized fun, interactive content, interpersonal support, appropriate educational content, and behavior change techniques. Concepts rooted in motivational theory could help address calls for greater theoretical and mechanistic insight in FBLIs. Findings may support research advancement and assist health professionals to more consistently realize the potential of these interventions.
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Affiliation(s)
- Kaila C Putter
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Ashleigh L Thornton
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western, Perth, Australia.,Kids Rehab WA, Perth Children's Hospital, Nedlands, Australia
| | - Claire E Willis
- Sports & Exercise Science, La Trobe University, Melbourne, Australia
| | - Kong Min Bryce Goh
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia
| | - Mark R Beauchamp
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Nat Benjanuvatra
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia
| | - James A Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia. .,Telethon Kids Institute, Perth, WA, Australia.
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Coto J, Graziano PA. Targeting Pediatric Obesity via a Healthy Lifestyle Summer Camp Intervention: How Necessary Is a Parenting Component? Child Obes 2022; 18:350-359. [PMID: 34905411 DOI: 10.1089/chi.2021.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Pediatric obesity represents a significant public health concern, especially for Hispanic school-aged children. This study examined via a randomized trial the efficacy of a family-based intervention [Healthy Lifestyle Summer Camp and Parenting program (HLSC+HLPP)] compared with a child-based camp intervention [Healthy Lifestyle Summer Camp (HLSC)] on improving child and parent health outcomes. Methods: Participants included 24 children (n = 11 HLSC+HLPP; n = 13 HLSC) with a mean age of 6.17 years (range 4-9 years) who were mostly Hispanic (87.5%) and were classified as overweight or obese, and their primary caregiver. Various anthropometric, physical activity, nutrition, and parenting outcomes were collected pre-/post-intervention. Results: Results indicated that both interventions were feasible and acceptable. There were no statistically significant differences between groups; however, both groups demonstrated a decrease in child BMI z-score (HLSC+HLPP: g = -0.31; HLSC: g = -0.31) and increase in child fitness (HLSC+HLPP: g = 1.70; HLSC: g = 1.77), nutritional health classification (HLSC+HLPP: g = 1.54; HLSC: g = 0.82), nutrition expressive knowledge (HLSC+HLPP: g = 1.03; HLSC: g = 1.06), and parental monitoring (HLSC+HLPP: g = 0.51; HLSC: g = 0.49) after the intervention. Conclusions: These findings highlight the feasibility, acceptability, and improvement of child health outcomes after both interventions. Future research should examine group differences during a follow-up period as well as employ a larger sample.
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Affiliation(s)
- Jennifer Coto
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Paulo A Graziano
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
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14
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Thomas LN, Donadio A, Carnevale T, Neal P. Improved management of pediatric obesity in the primary care setting through implementation of the healthy care for healthy kids obesity toolkit. J Pediatr Nurs 2022; 65:e115-e125. [PMID: 35484005 DOI: 10.1016/j.pedn.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/14/2022] [Accepted: 04/07/2022] [Indexed: 12/11/2022]
Abstract
Pediatric obesity has become a major health care concern over the last several decades. This condition can lead to detrimental life-long physical and mental comorbidities. Pediatric primary care providers have a unique opportunity to both prevent and treat pediatric obesity in their clinics. However, discussing this topic with families can be uncomfortable and time consuming. Time efficient resources to educate and increase confidence are needed to improve the management of pediatric obesity. This quality improvement project integrated the Healthy Care for Healthy Kids by the National Institute for Children's Healthcare Quality (2014) into the electronic medical record at a pediatric primary care office in rural East Tennessee. This toolkit included handouts, management algorithms, and provider education for pediatric obesity. After an 8-week implementation period, improvements in lab draws and evaluation of a family''s readiness to change were noted. Overall, providers reported the toolkit was helpful and improved patient interaction. Currently, the clinic is still utilizing the integrated resources and handouts.
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Affiliation(s)
- Logan N Thomas
- College of Nursing, East Tennessee State University, United States.
| | - Andrew Donadio
- College of Nursing, Tennessee Technological University, United States
| | - Teresa Carnevale
- College of Nursing, Tennessee Technological University, United States
| | - Penelope Neal
- College of Nursing, Tennessee Technological University, United States
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15
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Johnson CM, Sharkey JR, Umstattd Meyer MR, Gómez L, Allicock MA, Prochnow T, Beltrán E, Martinez L. Designing for Multilevel Behavior Change: A Father-Focused Nutrition and Physical Activity Program for Mexican-Heritage Families in South Texas Border Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910117. [PMID: 34639420 PMCID: PMC8508574 DOI: 10.3390/ijerph181910117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022]
Abstract
Fathers significantly influence family functioning, as coparents and partners, and must be part of family-based approaches to behavioral health interventions or programs. But little is known regarding how to support Latino fathers in health promotion within their family systems, specifically for Latino families living in border communities. Program development was embedded in a larger community-based grant and part of a longstanding academic-community collaboration. An interdisciplinary research team applied theories related to health behavior, family systems, behavior change, and community engagement to develop a father-focused and family-centered behavioral program for Mexican-heritage fathers and children living near the Texas-Mexico border to support changes in nutrition and physical activity at the individual and family levels. Promotoras de salud (trained community health workers) delivered the program through group sessions, check-in calls, and at-home activities. Group session activities were designed to engage family triads and dyads using experiential education related to nutrition and physical activity, like cooking lessons and active play, over a six-week period. Future research can use the program approach and curricula as a roadmap for designing context-specific and culturally-relevant programs for Latino families. Additional research is needed to explore how approaches like this can support families and their health goals.
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Affiliation(s)
- Cassandra M. Johnson
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, San Marcos, TX 78666, USA
- Correspondence: ; Tel.: +1-(512)-245-9196
| | - Joseph R. Sharkey
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843, USA; (J.R.S.); (L.G.); (E.B.); (L.M.)
| | - M. Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76706, USA;
| | - Luis Gómez
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843, USA; (J.R.S.); (L.G.); (E.B.); (L.M.)
| | - Marlyn A. Allicock
- The University of Texas Health Science Center, Department of Health Promotion and Behavioral Sciences, Houston School of Public Health-Dallas Regional Campus, Dallas, TX 75207, USA;
| | - Tyler Prochnow
- Department of Health and Kinesiology, College of Education and Human Development, Texas A&M University, College Station, TX 77843, USA;
| | - Elva Beltrán
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843, USA; (J.R.S.); (L.G.); (E.B.); (L.M.)
| | - Luz Martinez
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843, USA; (J.R.S.); (L.G.); (E.B.); (L.M.)
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16
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Langarizadeh M, Sadeghi M, As'habi A, Rahmati P, Sheikhtaheri A. Mobile apps for weight management in children and adolescents; An updated systematic review. PATIENT EDUCATION AND COUNSELING 2021; 104:2181-2188. [PMID: 33573915 DOI: 10.1016/j.pec.2021.01.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Considering inconclusive data regarding the possible effects of mobile applications on anthropometric measures (e.g. body mass index (BMI), body weight, waist circumference, fat mass) and physical activity (e.g. steps or METS) in paediatric subjects, the present systematic review was conducted to clarify this issue. METHODS Online databases including PubMed, Scopus, ISI Web of Science, Embase, and Ovid were searched, and also a hand search through Google Scholar, PsycINFO, and grey literature was done up to December 2020 to find all relevant studies. RESULTS Nine studies were included in this review (n = 978 participants). Five of the studies utilized a mobile app as an independent intervention. Using mobile applications resulted in a lower body mass index in two studies, while only one study reported a decrease in body weight. Besides, significant improvement in physical activity as evidenced by higher step count was reported by only one study. CONCLUSION Nevertheless, the findings from these primary studies, although slightly mixed, provide support for further research with the implementation of mobile apps as an additional approach for combating childhood obesity. PRACTICE IMPLICATIONS We recommend to raise attention towards and interest in the mobile app for childhood obesity prevention and treatment.
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Affiliation(s)
- Mostafa Langarizadeh
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Malihe Sadeghi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran; Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran.
| | - Atefeh As'habi
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran; Department of Nutrition, School of Nutrition and Food Sciences, Semnan University of Medical Sciences, Semnan, Iran.
| | - Pakzad Rahmati
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Abbas Sheikhtaheri
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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17
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Varagiannis P, Magriplis E, Risvas G, Vamvouka K, Nisianaki A, Papageorgiou A, Pervanidou P, Chrousos GP, Zampelas A. Effects of Three Different Family-Based Interventions in Overweight and Obese Children: The "4 Your Family" Randomized Controlled Trial. Nutrients 2021; 13:341. [PMID: 33498894 PMCID: PMC7911878 DOI: 10.3390/nu13020341] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/31/2022] Open
Abstract
Childhood overweight and obesity prevalence has risen dramatically in the past decades, and family-based interventions may be an effective method to improve children's eating behaviors. This study aimed to evaluate the effectiveness of three different family-based interventions: group-based, individual-based, or by website approach. Parents and school aged overweight or obese children, 8-12 years of age, were eligible for the study. A total of 115 children were randomly allocated in one of the three interventions, and 91 completed the study (79% compliance); Group 1 (n = 36) received group-based interventions by various experts; Group 2 (n = 30) had interpersonal family meetings with a dietitian; and Group 3 (n = 25) received training through a specifically developed website. Anthropometric, dietary, physical activity, and screen time outcomes were measured at baseline and at the end of the study. Within-group comparisons indicated significant improvement in body weight, body mass index (BMI)-z-score, physical activity, and screen time from baseline in all three study groups (p < 0.05). Furthermore, total body fat percentage (%TBF) was also decreased in Groups 2 and 3. Between-group differences varied with body weight and %TBF change, being larger in Group 3 compared to Groups 1 and 2, in contrast to BMI-z-score, screen time, and health behaviors, which were significantly larger in Group 2 than the other two groups. In conclusion, personalized family-based interventions are recommended to successfully improve children's lifestyle and body weight status.
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Affiliation(s)
- Panagiotis Varagiannis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Grigoris Risvas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Katerina Vamvouka
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Adamantia Nisianaki
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Anna Papageorgiou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Panagiota Pervanidou
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece; (P.P.); (G.P.C.)
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - George P. Chrousos
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece; (P.P.); (G.P.C.)
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
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Curtis RG, Olds T, Fraysse F, Dumuid D, Hendrie GA, Esterman A, Brown WJ, Ferguson T, Lagiseti R, Maher CA. Annual rhythms in adults' lifestyle and health (ARIA): protocol for a 12-month longitudinal study examining temporal patterns in weight, activity, diet, and wellbeing in Australian adults. BMC Public Health 2021; 21:70. [PMID: 33413247 PMCID: PMC7791783 DOI: 10.1186/s12889-020-10054-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Almost one in three Australian adults are now obese, and the rate continues to rise. The causes of obesity are multifaceted and include environmental, cultural and lifestyle factors. Emerging evidence suggests there may be temporal patterns in weight gain related, for example, to season and major festivals such as Christmas, potentially due to changes in diet, daily activity patterns or both. The aim of this study is to track the annual rhythm in body weight, 24 h activity patterns, dietary patterns, and wellbeing in a cohort of Australian adults. In addition, through data linkage with a concurrent children's cohort study, we aim to examine whether changes in children's body mass index, activity and diet are related to those of their parents. METHODS A community-based sample of 375 parents aged 18 to 65 years old, residing in or near Adelaide, Australia, and who have access to a Bluetooth-enabled mobile device or a computer and home internet, will be recruited. Across a full year, daily activities (minutes of moderate to vigorous physical activity, light physical activity, sedentary behaviour and sleep) will be measured using wrist-worn accelerometry (Fitbit Charge 3). Body weight will be measured daily using Fitbit wifi scales. Self-reported dietary intake (Dietary Questionnaire for Epidemiological Studies V3.2), and psychological wellbeing (WHOQOL-BREF and DASS-21) will be assessed eight times throughout the 12-month period. Annual patterns in weight will be examined using Lowess curves. Associations between changes in weight and changes in activity and diet compositions will be examined using repeated measures multi-level models. The associations between parent's and children's weight, activity and diet will be investigated using multi-level models. DISCUSSION Temporal factors, such as day type (weekday or weekend day), cultural celebrations and season, may play a key role in weight gain. The aim is to identify critical opportunities for intervention to assist the prevention of weight gain. Family-based interventions may be an important intervention strategy. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry, identifier ACTRN12619001430123 . Prospectively registered on 16 October 2019.
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Affiliation(s)
- Rachel G Curtis
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Gilly A Hendrie
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Adelaide, SA, Australia
| | - Adrian Esterman
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Ty Ferguson
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Rajini Lagiseti
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Carol A Maher
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.
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Duncanson K, Shrewsbury V, Burrows T, Chai LK, Ashton L, Taylor R, Gow M, Ho M, Ells L, Stewart L, Garnett S, Jensen ME, Nowicka P, Littlewood R, Demaio A, Coyle DH, Walker JL, Collins CE. Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta‐analysis. J Hum Nutr Diet 2020; 34:147-177. [DOI: 10.1111/jhn.12831] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Affiliation(s)
- K. Duncanson
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - V. Shrewsbury
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - T. Burrows
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - L. K. Chai
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- Centre for Children’s Health Research Institute of Health and Biomedical Innovation Exercise and Nutrition Queensland University of Technology South Brisbane QLD Australia
| | - L. Ashton
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - R. Taylor
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - M. Gow
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. Ho
- School of Nursing The University of Hong Kong Pokfulam Hong Kong
| | - L. Ells
- School of Clinical and Applied Sciences Leeds Beckett University Leeds UK
- Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence Middlesbrough UK
| | - L. Stewart
- Appletree Healthy Lifestyle Consultancy Perth UK
| | - S. Garnett
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. E. Jensen
- Priority Research Centre Grow Up Well and Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
| | - P. Nowicka
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
| | - R. Littlewood
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - A. Demaio
- Victorian Health Promotion Foundation Carlton South VIC Australia
| | - D. H. Coyle
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The George Institute for Global Health University of New South Wales Sydney NSW Australia
| | - J. L. Walker
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - C. E. Collins
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The University of Newcastle Centre for Evidence Based Healthcare Informing Research (CEBHIR): a Joanna Briggs Institute Centre of Excellence Callaghan NSW Australia
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20
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Hayba N, Elkheir S, Hu J, Allman-Farinelli M. Effectiveness of Lifestyle Interventions for Prevention of Harmful Weight Gain among Adolescents from Ethnic Minorities: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6059. [PMID: 32825394 PMCID: PMC7503574 DOI: 10.3390/ijerph17176059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 01/08/2023]
Abstract
The escalating obesity among adolescents is of major concern, especially among those from an ethnic minority background. The adolescent period offers a key opportunity for the implementation of positive lifestyle behaviours as children transition to adulthood. The objective of this review was to examine the effectiveness of lifestyle interventions for adolescents and their impact in ethnic and racial minorities for the prevention of overweight and obesity. Seven electronic databases were searched from 2005 until March 2019 for randomized controlled trials of lifestyle programs conducted in this population. The main outcome was change in Body Mass Index (BMI) z-score (kg/m2) or change in BMI and secondary outcomes were changes in physical activity and diet. Thirty studies met the inclusion criteria. Seven studies reported and/or conducted subgroup analysis to determine if ethnic/racial group affected weight change. None demonstrated an overall decrease in BMI z-score. However, six of the seven demonstrated changes in secondary measures such as fruit and vegetable intake and screen time. Results did not differ by ethnic/racial group for primary and secondary outcomes. Overweight and obesity prevention among adolescents from ethnic minorities is an area that needs further research. There is a lack of interventions that include analyses of effectiveness in ethnic minorities.
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Affiliation(s)
- Nematullah Hayba
- Discipline of Nutrition and Dietetics, School of Life and Environmental Science, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; (S.E.); (J.H.); (M.A.-F.)
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21
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McGavock J, Chauhan BF, Rabbani R, Dias S, Klaprat N, Boissoneault S, Lys J, Wierzbowski AK, Sakib MN, Zarychanski R, Abou-Setta AM. Layperson-Led vs Professional-Led Behavioral Interventions for Weight Loss in Pediatric Obesity: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2010364. [PMID: 32658289 PMCID: PMC7358915 DOI: 10.1001/jamanetworkopen.2020.10364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE The appropriate approach for weight loss among children and adolescents with overweight and obesity remains unclear. OBJECTIVE To evaluate the difference in the treatment outcomes associated with behavioral weight loss interventions led by laypersons and professionals in comparison with unsupervised control arms among children and adolescents with overweight and obesity. DATA SOURCES For this systematic review and meta-analysis, the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, the Cochrane Library, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases were searched from January 1, 1996, to June 1, 2019. STUDY SELECTION Included in this study were randomized clinical trials (RCTs) of behavioral interventions lasting at least 12 weeks for children and adolescents (aged 5-18 years) with overweight and obesity. Exclusion criteria included non-RCT studies, interventions lasting less than 12 weeks, adult enrollment, participants with other medical diagnoses, pharmacological treatment use, and articles not written in English. Two of 6 reviewers independently screened all citations. Of 25 586 citations, after duplicate removal, 78 RCTs (5780 participants) met eligibility criteria. DATA EXTRACTION AND SYNTHESIS A bayesian framework and Markov chain Monte Carlo simulation methods were used to combine direct and indirect associations. Random-effects and fixed-effect network meta-analysis models were used with the preferred model chosen by comparing the deviance information criteria. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES The immediate and sustained changes in weight and body mass index (BMI) standardized mean difference (SMD) were primary outcomes planned before data collection began, whereas waist circumference and percent body fat were secondary outcomes. The hypothesis being tested was formulated before the data collection. RESULTS Of 25 586 citations retrieved, we included 78 RCTs (5780 participants), with a follow-up of 12 to 104 weeks. Compared with the control condition, random-effects models revealed that professional-led weight loss interventions were associated with reductions in weight (mean difference [MD], -1.60 kg [95% CI, -2.30 to -0.99 kg]; 68 trials; P < .001) and BMI (SMD, -0.30 [95% CI, -0.39 to -0.20]; 59 trials; P < .001) that were not sustained long term (weight MD, -1.02 kg [95% CI, -2.20 to 0.34 kg]; 21 trials; P = .06; BMI SMD, -0.12 [95% CI, -0.46 to 0.21]; 20 trials; P < .001). There was no association between layperson-led interventions and weight loss in the short-term (MD, -1.40 kg [95% CI, -3.00 to 0.26 kg]; 5 trials; P = .05) or long-term (MD, -0.98 kg [95% CI, -3.60 to 1.80 kg]; 1 trial; P = .23) compared with standard care. No difference was found in head-to-head trials (professional vs layperson MD, -0.25 kg [95% CI -1.90 to 1.30 kg]; 5 trials; P = .38). CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis found that professional-led weight loss interventions were associated with short-term but not sustained weight reduction among children and adolescents with overweight or obesity, and the evidence for layperson-led approaches was insufficient to draw firm conclusions.
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Affiliation(s)
- Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Bhupendrasinh F. Chauhan
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- I. H. Asper Clinical Research Institute, St. Boniface Hospital Research Centre, Winnipeg, Manitoba, Canada
| | - Rasheda Rabbani
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
| | - Sofia Dias
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Nika Klaprat
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Sara Boissoneault
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Justin Lys
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
| | | | - Mohammad Nazmus Sakib
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ryan Zarychanski
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
- Department of Haematology and Medical Oncology, CancerCare Manitoba, Winnipeg, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
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22
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Smith JD, Fu E, Kobayashi MA. Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities. Annu Rev Clin Psychol 2020; 16:351-378. [PMID: 32097572 PMCID: PMC7259820 DOI: 10.1146/annurev-clinpsy-100219-060201] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Childhood obesity has become a global pandemic in developed countries, leading to a host of medical conditions that contribute to increased morbidity and premature death. The causes of obesity in childhood and adolescence are complex and multifaceted, presenting researchers and clinicians with myriad challenges in preventing and managing the problem. This article reviews the state of the science for understanding the etiology of childhood obesity, the preventive interventions and treatment options for overweight and obesity, and the medical complications and co-occurring psychological conditions that result from excess adiposity, such as hypertension, nonalcoholic fatty liver disease, and depression. Interventions across the developmental span, varying risk levels, and service contexts (e.g.,community, school, home, health care systems) are reviewed. Future directions for research are offered with an emphasis on translational issues for taking evidence-based interventions to scale in a manner that will reduce the public health burden of the childhood obesity pandemic.
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Affiliation(s)
- Justin D Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA; ,
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA
| | - Emily Fu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA; ,
| | - Marissa A Kobayashi
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida 33136, USA;
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23
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St George SM, Agosto Y, Rojas LM, Soares M, Bahamon M, Prado G, Smith JD. A developmental cascade perspective of paediatric obesity: A systematic review of preventive interventions from infancy through late adolescence. Obes Rev 2020; 21:e12939. [PMID: 31808277 PMCID: PMC6980892 DOI: 10.1111/obr.12939] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 01/03/2023]
Abstract
The goals of this systematic review were to identify and describe paediatric obesity prevention interventions from infancy to late adolescence and to provide recommendations for future intervention research in light of a recently proposed developmental cascade (DC) model of paediatric obesity. We conducted an electronic search of randomized controlled trials with a minimum 6-month postintervention follow-up published between 1995 and 2019. We included 74 interventions: prenatal/infancy (n = 4), early childhood (n = 11), childhood (n = 38), early to mid-adolescence (n = 18), and late adolescence (n = 3). Infancy and early childhood trials targeted early feeding and positive parenting skills. Half of the childhood and adolescence trials were school based and used universal prevention strategies; those classified as selective or indicated prevention tended to involve the family for more intensive lifestyle modification. Less than 10% of studies followed participants over long periods of time (greater than or equal to 5 years), and only 16% and 31% of studies assessed intervention mediators and moderators, respectively. We recommend that future interventions focus on early prevention, assess long-term intervention effects, use a standardized taxonomy for defining intervention behavioural strategies, assess underlying mechanisms of action and intervention moderators, target parent and family management strategies across development, and increase scientific equity. We also provide specific recommendations regarding intervention targets for each developmental stage.
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Affiliation(s)
- Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Yaray Agosto
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida
| | - Lourdes M Rojas
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Mary Soares
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Monica Bahamon
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Justin D Smith
- Department of Psychiatry and Behavioral Sciences, Department of Preventive Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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24
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Arlinghaus KR, O'Connor DP, Johnston CA. Frequency of school-based intervention needed to improve weight outcomes of Mexican-American adolescents with overweight or obesity: a randomized controlled trial. Pediatr Obes 2019; 14:e12568. [PMID: 31368249 DOI: 10.1111/ijpo.12568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/10/2019] [Accepted: 07/05/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Efficacious school-based interventions among ethnic minority youth are often intensive and difficult to disseminate. OBJECTIVE This parallel, open-label-randomized controlled trial aimed to compare changes in adolescent-standardized body mass index (zBMI) from a school-based obesity intervention given 0, 1, 3, or 5 days a week. METHODS Mexican-American youth (n = 243) with overweight or obesity were recruited from a Houston school district and randomized to receive an obesity intervention with established efficacy 0 (control), 1, 3, or 5 d/wk (respectively, equating to 0, 40, 120, or 200 min of contact each week). In each condition, 80% of intervention time was allocated to physical activity and 20% to nutrition, with behavioural modification overlaid throughout. zBMI was calculated from directly measured height and weight. A linear mixed model evaluated differences in zBMI over time between conditions. RESULTS Participants were 12.02 ± 0.57 years old with a zBMI of 1.80 ± 0.46 at baseline. Among those with complete data at 1 year (n = 203), a significant condition by time interaction was indicated (F = 9.42, P < .001). Those who received the intervention 3 or 5 d/wk had significantly greater decreases in zBMI than control (respectively, -0.19 zBMI units/y; 95% CI, -0.28 to -0.11; and -0.18 zBMI units/y; 95% CI, -0.27 to -0.10, both P < .001). No differences were found between 3 and 5 d/wk (95% CI, -0.09-0.08, P = .87). CONCLUSIONS The intervention provided 3 d/wk resulted in similar zBMI improvements as the intervention provided 5 d/wk. This information can be used to develop scalable school-based obesity interventions.
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Affiliation(s)
| | - Daniel P O'Connor
- Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, Texas
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25
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Brown AW, Altman DG, Baranowski T, Bland JM, Dawson JA, Dhurandhar NV, Dowla S, Fontaine KR, Gelman A, Heymsfield SB, Jayawardene W, Keith SW, Kyle TK, Loken E, Oakes JM, Stevens J, Thomas DM, Allison DB. Childhood obesity intervention studies: A narrative review and guide for investigators, authors, editors, reviewers, journalists, and readers to guard against exaggerated effectiveness claims. Obes Rev 2019; 20:1523-1541. [PMID: 31426126 PMCID: PMC7436851 DOI: 10.1111/obr.12923] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/13/2019] [Accepted: 07/14/2019] [Indexed: 12/16/2022]
Abstract
Being able to draw accurate conclusions from childhood obesity trials is important to make advances in reversing the obesity epidemic. However, obesity research sometimes is not conducted or reported to appropriate scientific standards. To constructively draw attention to this issue, we present 10 errors that are commonly committed, illustrate each error with examples from the childhood obesity literature, and follow with suggestions on how to avoid these errors. These errors are as follows: using self-reported outcomes and teaching to the test; foregoing control groups and risking regression to the mean creating differences over time; changing the goal posts; ignoring clustering in studies that randomize groups of children; following the forking paths, subsetting, p-hacking, and data dredging; basing conclusions on tests for significant differences from baseline; equating "no statistically significant difference" with "equally effective"; ignoring intervention study results in favor of observational analyses; using one-sided testing for statistical significance; and stating that effects are clinically significant even though they are not statistically significant. We hope that compiling these errors in one article will serve as the beginning of a checklist to support fidelity in conducting, analyzing, and reporting childhood obesity research.
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Affiliation(s)
- Andrew W Brown
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Douglas G Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Tom Baranowski
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, Texas
| | - J Martin Bland
- Department of Health Sciences, University of York, York, UK
| | - John A Dawson
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas
| | | | - Shima Dowla
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kevin R Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew Gelman
- Department of Statistics and Department of Political Science, Columbia University, New York, New York
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Wasantha Jayawardene
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Scott W Keith
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Eric Loken
- Neag School of Education, University of Connecticut, Storrs, Connecticut
| | - J Michael Oakes
- Department of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - June Stevens
- Departments of Nutrition and Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, New York
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
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26
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Carriere C, Thibault H, Barat P, Guemazi-Kheffi F, Mellouet-Fort B, Ancillon L, Bertrand AM, Quinart S, Guilmin-Crépon S, Arsan A, Lestournelle A, Brument R, Saison-Canaple C, Renel L, Daussac A, Jouret B, Negre V, Tauber M. Short-term and long-term positive outcomes of the multidisciplinary care implemented by the French health networks for the prevention and care of paediatric overweight and obesity. Pediatr Obes 2019; 14:e12522. [PMID: 30990572 DOI: 10.1111/ijpo.12522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/17/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The nine French regional health networks for the prevention and care of paediatric obesity offer a 2-year program of multidisciplinary primary care (medical, dietetical, psychological, adapted physical activity) based on multicomponent lifestyle interventions. OBJECTIVES To assess the short-term and long-term impact of care management. METHODS The impact of the multidisciplinary care was assessed by changes in the body mass index (BMI) Z score during the period of the care, and at least 2 years after the end. Anthropometric data were collected at baseline and at the end of the care either through a digital medical file or through direct phone contacts with the referring. Long-term outcomes were assessed through studies relative to post follow-up evaluation. RESULTS At the end of the period of the care in a network, 72.9% of 6947 children had decreased their BMI Z score from 3.6 ± 1.0 DS at baseline to 3.3 ± 1.1 DS at the end. The four studies relative to long-term evaluation showed a pursuit of the decrease of BMI Z score during the 5.1 years after the beginning of the care. CONCLUSIONS The care provided by regional French networks for prevention and care of paediatric obesity induce a reduction of BMI that continues afterwards.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lise Renel
- RéPPOP Manche, Cherbourg-Octeville, France
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27
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Lee J, Jeongeun K, Ahjung B, Meiling J, Meihua P, Kyungryeon K, Hyeoiyun L. Application Design for Child Obesity Management Based on Users' Preferences and Needs. West J Nurs Res 2019; 42:356-364. [PMID: 31328657 DOI: 10.1177/0193945919862797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study aimed to investigate the constructive preferences and needs of children and guardians in a child obesity management application, and to suggest and visualize the key features of its design. To reflect users' preferences and needs, the questionnaires used in this study were developed in four stages: draft, validity test, review, and final version. The survey was conducted with fifth and sixth grade children who are overweight or obese and their guardians. Differences were observed by gender and between children and guardians with respect to children's perceived body shape, technology experience and preferences, preferred obesity management method, application design, exercise and diet-related features, preferred partner for obesity management, and preferred reward after mission completion. Our study suggests and visualizes the key features of a child obesity management application for both children and guardians based on their preferences and needs, which can be utilized by both application developers and researchers.
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Affiliation(s)
- Jisan Lee
- Catholic University of Pusan College of Nursing, Busan, Republic of Korea
| | - Kim Jeongeun
- Seoul National University, College of Nursing, Seoul, Republic of Korea.,Seoul National University, Research Institute of Nursing Science, Seoul, Republic of Korea
| | - Byun Ahjung
- Seoul National University, College of Nursing, Seoul, Republic of Korea
| | - Jin Meiling
- Seoul National University, College of Nursing, Seoul, Republic of Korea
| | - Piao Meihua
- Seoul National University, College of Nursing, Seoul, Republic of Korea
| | | | - Lee Hyeoiyun
- Seoul National University, College of Nursing, Seoul, Republic of Korea.,Catholic University of Korea, Yeouido ST. Mary's Hospital, Seoul, Republic of Korea
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28
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Conlon RPK, Hurst KT, Hayes JF, Balantekin KN, Stein RI, Saelens BE, Brown ML, Sheinbein DH, Welch RR, Perri MG, Schechtman KB, Epstein LH, Wilfley DE. Child and parent reports of children's depressive symptoms in relation to children's weight loss response in family-based obesity treatment. Pediatr Obes 2019; 14:e12511. [PMID: 30664829 PMCID: PMC6546528 DOI: 10.1111/ijpo.12511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/16/2018] [Accepted: 12/03/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies of the association between children's depressive symptoms and obesity treatment response show mixed results. Different measurement may contribute to the inconsistent findings, as children's depressive symptoms are often based on parent-report about their child rather than child self-report. OBJECTIVES We assessed both child- and parent-report of child depressive symptoms as predictors of children's obesity treatment response. METHODS Children with overweight/obesity (body mass index [BMI] ≥ 85th percentile; N = 181) and their parents reported on children's depressive symptoms prior to family-based behavioral weight loss treatment. RESULTS Child percent overweight reduction from baseline to post-treatment was not predicted by child self-reported depressive symptoms or parent-report of child symptoms (P > 0.80), but was significantly predicted by the interaction between child self-report and parent-report on child (β = 0.14, P = 0.05). In analyses using clinical cutoffs, amongst children with high self-reported symptoms, those whose parents reported low child depressive symptoms had greater reduction in percent overweight (t = 2.67, P = 0.008), whereas amongst children with low self-reported symptoms, parent ratings were not associated with treatment outcome. CONCLUSIONS Including both child self-report and parent-report of child depressive symptoms may inform obesity care. Research is needed to examine differences amongst child and parent depressive symptom reports and strategies to address symptoms and optimize pediatric obesity treatment.
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Affiliation(s)
| | - Kelly T. Hurst
- National Center for Weight and Wellness, Washington, DC, USA
| | | | | | | | - Brian E. Saelens
- Seattle Children’s Research Institute and the University of Washington, Seattle, WA, USA
| | - Mackenzie L. Brown
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Michael G. Perri
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Leonard H. Epstein
- School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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29
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Bean MK, Thornton LM, Jeffers AJ, Gow R, Mazzeo SE. Impact of motivational interviewing on engagement in a parent-exclusive paediatric obesity intervention: randomized controlled trial of NOURISH+MI. Pediatr Obes 2019; 14:e12484. [PMID: 30515995 PMCID: PMC6474345 DOI: 10.1111/ijpo.12484] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Attrition and treatment adherence are notorious challenges in paediatric obesity interventions. OBJECTIVE To evaluate if brief, pretreatment motivational interviewing (MI) can improve retention (at baseline, post-assessment and follow-up assessment) and adherence (i.e. attendance) in a parent-exclusive paediatric obesity intervention. METHODS MI was implemented with parents as an adjunct to a larger randomized controlled trial of Nourishing Our Understanding of Role-modeling to Improve Support and Health (NOURISH+ ), a parent intervention for children with overweight ages 5-11 years. Parents (N = 112) were randomized to receive two MI sessions (one telephone and one in person) or reminder calls. RESULTS Parents (91% women; 52% African American) who completed one telephone MI session were more likely to attend baseline (74%) compared with parents who received reminder calls only (53%, p < .001). After a second MI session, there were no group differences in treatment initiation (p > .05). Treatment attendance, post or 4-month follow-up assessment completion did not differ between conditions (p > .05). CONCLUSION One MI session implemented prior to treatment can improve baseline attendance; a second MI session did not enhance these effects. A single-session telephone-based MI pretreatment might be a cost and time-effective strategy to enhance recruitment efforts. Further strategies to address retention and treatment attendance are needed.
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Affiliation(s)
- Melanie K. Bean
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amy J. Jeffers
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
| | - Rachel Gow
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA,Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Suzanne E. Mazzeo
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA,Department of Psychology, Virginia Commonwealth University, Richmond, VA
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30
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Hayes JF, Balantekin KN, Conlon RPK, Brown ML, Stein RI, Welch RR, Perri MG, Schechtman KB, Epstein LH, Wilfley DE, Saelens BE. Home and neighbourhood built environment features in family-based treatment for childhood obesity. Pediatr Obes 2019; 14:e12477. [PMID: 30378768 PMCID: PMC6379099 DOI: 10.1111/ijpo.12477] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Family-based behavioural weight loss treatment (FBT) for childhood obesity helps families develop strategies to facilitate healthy choices in their home and other environments (e.g. home neighbourhood). The current study examines how the home food environment, both pre-FBT and post-FBT, and the neighbourhoods in which families live are associated with child weight and weight-related outcomes in FBT. METHODS Parent-child dyads (n = 181) completed a 16-session FBT programme and completed home environment, anthropometric and child dietary/activity assessments at pre-FBT and post-FBT. Parents reported on availability of food, electronics and physical activity equipment in the home. The neighbourhood food and recreation environments around each dyad's residence was characterized using existing data within a geographic information system. RESULTS Families successfully made healthy home environment modifications during FBT. Regression models showed reducing RED (e.g. high-energy-dense and low-nutrient-dense) foods and electronics in the home during FBT had positive effects on child weight and weight-related outcomes. No neighbourhood food or recreation environment variables were significantly related to outcomes, although having a larger density of public recreation spaces was associated with increases in physical activity at the trend-level. CONCLUSIONS Modifying the home environment, specifically reducing RED foods and electronics, may be particularly important for FBT success.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Brian E. Saelens
- Seattle Children’s Research Institute and the University of Washington
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31
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Vidmar AP, Pretlow R, Borzutzky C, Wee CP, Fox DS, Fink C, Mittelman SD. An addiction model-based mobile health weight loss intervention in adolescents with obesity. Pediatr Obes 2019; 14:e12464. [PMID: 30117309 PMCID: PMC6338524 DOI: 10.1111/ijpo.12464] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Clinical approaches to treating childhood obesity can be expensive and poorly reimbursed, and often produce suboptimal results. It has been theorized that overeating may have addictive qualities, and a sizable number of adolescents with obesity endorse addictive habits. Interestingly, few weight management interventions have tested techniques founded in addiction medicine principles. We therefore performed a pilot study of an addiction model based mHealth weight loss intervention in adolescents. METHODS Adolescents with obesity were recruited from an multidisciplinary weight management clinic (EMPOWER). Adolescents without significant obesity comorbidities, who exhibited signs of addictive eating, based on the Yale Food Addiction Scale, were enrolled in a pilot study of an interactive, addiction-based, weight loss smartphone app with coaching (http://clinicaltrials.gov: NCT02689154). The app was designed to help subjects omit problem foods, avoid snacking and reduce meal size. A contemporary cohort of adolescents who completed the EMPOWER program were evaluated. Feasibility of recruitment, adherence, retention rates, BMI change and cost of intervention were examined. RESULTS Eighteen participants were recruited to app intervention. App participants had higher retention (100% vs. 37%) and lower total cost per patient ($855.15 vs. $1428.00) than the EMPOWER clinic participants. App participants exhibited a significant decrease in zBMI and %BMIp95 over the 6 months (p < 0.001 and p = 0.001), which was comparable to the age-matched EMPOWER program completers (p = 0.31 and p = 0.06). CONCLUSIONS An addiction medicine-based mHealth intervention targeted for adolescents was feasible to implement, resulted in high retention and adherence rates, and reduced zBMI and %BMIp95 in a more cost-effective manner than an in-clinic intervention.
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Affiliation(s)
- A. P. Vidmar
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern CaliforniaLos AngelesCAUSA
| | | | - C. Borzutzky
- Division of Adolescent and Young Adult MedicineChildren's Hospital Los Angeles and Keck School of Medicine of the University of Southern CaliforniaLos AngelesCAUSA
| | - C. P. Wee
- CTSI Biostatics CoreSaban Research InstituteLos AngelesCAUSA
| | - D. S. Fox
- Department of Pharmaceutical and Health EconomicsSchool of Pharmacy of the University of Southern CaliforniaLos AngelesCAUSA
| | - C. Fink
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern CaliforniaLos AngelesCAUSA
| | - S. D. Mittelman
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern CaliforniaLos AngelesCAUSA
- Present address:
Department of Pediatrics, Division of Endocrinology at the UCLA Children's Discovery and Innovation Institute, David Geffen School of MedicineUniversity of California Los AngelesLos AngelesCAUSA
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32
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Ball GDC, Kebbe M. Preventing and managing paediatric obesity: a special edition on randomized controlled trials. Pediatr Obes 2018; 13:635-638. [PMID: 30362290 DOI: 10.1111/ijpo.12482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 12/18/2022]
Affiliation(s)
- G D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - M Kebbe
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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Dawson JA, Brown AW, Allison DB. The stated conclusions are contradicted by the data, based on inappropriate statistics, and should be corrected: comment on 'intervention for childhood obesity based on parents only or parents and child compared with follow-up alone'. Pediatr Obes 2018; 13:656-657. [PMID: 30092611 PMCID: PMC6203607 DOI: 10.1111/ijpo.12431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/15/2018] [Indexed: 11/28/2022]
Affiliation(s)
- John A. Dawson
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX 79409
| | - Andrew W. Brown
- Department of Applied Health Sciences, School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405
| | - David B. Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405
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