Category: Obesity / Overweight
Introduction: Over 30% of children in the United States are overweight or obese and lower socioeconomic families are at the highest risk. The aim of this study was to determine the impact of a home-based weight management intervention for children and their parents on weight and behaviors related to energy balance, which were measured at the beginning and end of the 19 week intervention.
Methods: 16 families with a child between the ages of 2 and 6 years and a body mass index (BMI) percentile > 75th were randomized to 1) intervention (n=8 parent/child dyads) or 2) control (n=8 parent/child dyads). Dyads were randomized to 19 weeks of either: 1) a health education control group, or 2) a weight management intervention to modify diet and activity via parent training and positive child-parent interactions (intervention group). Behavioral questionnaires included the: 1) Big Five, (which measures contributing factors to childhood obesity such as consumption of sweetened beverages, fast food, family mealtimes, television or computer time, and typical physical activity); 2) Screen-time Questionnaire; 3) Food Security Questionnaire; and 4) Care Giver Feeding Styles Questionnaire (CSFQ). Analysis of covariance evaluated if change from week 0 to 19 in children’s weight and questionnaire scores differed by group (baseline values were covariates). A mediation analysis tested if change on the questionnaires mediated treatment effects for weight loss.
Results: Children’s mean+SD weight at baseline was 23.2 +8.6kg. As previously reported, the control group gained more weight (vs. intervention) from baseline to week 19 (1.44±1.01 vs. 0.3±0.7 kg, respectively, p=.01) (similar results were found for BMIz). The Big Five increased (improved) in the intervention (vs. control) from baseline to week 19 (10.0±11.2 vs. -3.8 ±10.9, p=0.04) Screen-time increased (worsened) in the control (vs. intervention) from baseline to week 19 (3.0±5.6 and 0.004±1.9 hours/day, p=0.05). Change in the Big Five was a significant mediator of weight change between the intervention and control groups (p=0.03) and larger improvements on the Big Five were associated with greater weight loss (r=-.52, p=0.05).
Conclusion: A home based weight management intervention for parents and children successfully improved the weight of children (and caregivers, data not shown). Intervention recipients reported less screen time interaction and had positive improvements in health behaviors associated with energy intake and expenditure (e.g., consumption of sweetened beverages, fast food, physical activity), the latter of which mediated the treatment effect for children’s weight change. The study found that the intervention was efficacious and it identified behaviors that can be targeted by this and other interventions.
Kelly Lynch– Pennington Biomedical Research Center
John Apolzan– Pennington Biomedical Research Center
Keely Hawkins– Pennington Biomedical Research Center
Amanda Staiano– Pennington Biomedical Research Center
Candice Myers– Pennington Biomedical Research Center
Lindsay Hall– Pennington Biomedical Research Center
Allison Davis– Pennington Biomedical Research Center
Jenelle Shanley-Chatham– Georgia State University
Corby Martin– Associate Professor, Pennington Biomedical Research Center, Baton Rouge, Louisiana