Effectiveness of a Kindergarten-Based Intervention for Preventing Childhood Obesity.
Pediatrics conducted a pilot study over 12 months in Guangzhou, China, aimed at demonstrating the feasibility of a multifaceted intervention for preschool children and to provide an assessment of the efficacy. The study involved 648 children, who underwent a 3-component intervention (training of staff, initiating a healthy curriculum and close collaboration with families) while the other cohort consisted of 336 children, who received routine health care and acted as the control.
By 12 months, children within the intervention group had a smaller BMIz score increase (0.24) compared to the control (0.41), the prevalence of overweight or obesity was also lower among the intervention group at the end of the study. These results add further weight to the argument that multi-component health behaviour intervention might be the most effective in reducing the burden of obesity.
Read MoreClinic and Home-Based Behavioral Intervention for Obesity in Preschoolers: A Randomized Trial
In this phase III randomised controlled trial of 151 children, published in the Journal of Pediatrics, the authors sought to investigate whether a skills-based behavioural family clinic and home-based intervention (LAUNCH) would be more effective at reducing BMI than motivational interviewing or to standard care in preschool-aged children with obesity.
LAUNCH is an 18-session clinic and home, family-based behavioral weight management intervention. Motivational interviewing was a parent only intervention consisting of 18 sessions over 6 months and focused on making changes to the child’s caregiver by encouraging diet and activity changes. Standard care informed caregivers of their child’s weight status during the recruitment process, but neither the children nor caregivers received any treatment.
LAUNCH demonstrated a mean (±SD) decrease in BMIz of −0.32 (±0.33) while motivational interviewing yielded a decrease of −0.05 (±0.27), standard care yielded a decrease of −0.13 (±0.31). Children in motivational interviewing and standard care gained almost triple the amount of weight during the 6-month period as children in LAUNCH. This slowing of weight gain resulted in a 4.45% decrease in percent overweight for LAUNCH, while both motivational interviewing and standard care increased in their percent overweight by 2.43% and 1.45%, respectively. Thus, the decrease in BMIz for LAUNCH was not only statistically significant, but clinically meaningful as well.
Read MorePilates and aerobic training improve levels of depression, anxiety and quality of life in overweight and obese individuals
It is common knowledge that exercise can play an important role in treating the physical parts of obesity, however the emotional benefits are less often talked about. In this study, published by the Brazilian journal Arquivos de Neuro-Psiquiatria 63 overweight or obese patients were randomly split into 3 groups, a control group (n=20), a Pilates group (n=22) and a walking group (n=21). The two exercise groups had to complete three, 60-minute sessions per week of their exercise. There were three psychological assessments conducted on each patient looking at quality of life, depression, state-anxiety and trait-anxiety. These were conducted before and after the 8 weeks.
The Walking group showed improvements in the quality of life domains of social functioning (20.3%) and mental health (21.8%). In addition, there were significant decreases in the levels of depression (35.2%), trait-anxiety (15.1%), and state-anxiety (18.5%).
For the Pilates group, improvements were observed in the quality of life domains of vitality (28%), social functioning (29.2%) and mental health (19%). In addition, there were significant decreases in the levels of depression (27.5%) and trait-anxiety (14.1%).
In some patients with obesity, emotional malfunction seems to inhibit the positive perception of the physical benefits of exercise. An alternative approach could point towards the mental and emotional benefits of exercise; this may be the trigger/motivator for people’s perception of physical activity programs to change and thus be taken up more enthusiastically.
Read MoreEffect of 7 days of exercise on exogenous carbohydrate oxidation and insulin resistance in children with obesity
It has been shown in adults that the capacity to match carbohydrate (CHO) oxidation with carbohydrate availability, known as metabolic flexibility (MetFlex), may be important for type 2 diabetes prevention. Improved MetFlex is associated with improvements to insulin resistance (IR) and can be achieved with as little as 7 days exercise.
In this small study published in the Journal of Applied Physiology and Metabolism, 12 children (8 boys and 4 girls) underwent 7 days of exercise in order to determine whether MetFlex and IR would improve. Participants underwent a combination of continuous and high intensity exercise sessions over the course of seven days. Each session consisting of 3 20-minute blocks. In spite of good adherence, no improvement to MetFlex or IR was found. The authors go on to comment that future research should investigate exercise volume, sex and pubertal effects on the responsiveness of MetFlex to exercise in children.
Read MoreSleep Health and Psychopathology Mediate Executive Deficits in Paediatric Obesity
A new study from Childhood Obesity has found that paediatric obesity is associated with impairment of some components of reward-related decision-making and executive functioning, as well as poorer sleep health and greater risk of internalising psychopathology. Obese children showed reduced ability to adapt behaviour to changing reward contingencies and also the presence of executive dysfunction under everyday behaviour regulation. There were 112 participants in the study, in which researchers conducted a range of tasks to test different psycho-metrics, using only non-food stimuli. Alongside this, parents were asked to fill out standardised questionnaires to assess sleep health, psychiatric symptoms and executive function.
The parental reports indicated that children with obesity had poorer sleep, despite equal sleep duration, and a four times greater risk of experiencing internalising psychopathology. Importantly these mediated the negative effects on everyday behavioural regulation and meta-cognitive abilities. One of the constraints of the study, that the authors highlight, is that it’s unclear whether obesity is the cause or consequence.
Further studies have been proposed which would closely monitor physiological and metabolic variables in Pre and Post weight loss subjects to disambiguate the relationship. The study authors go on to reiterate the importance of understanding this relationship as it could be a key new therapy target.
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