A long-term follow-up of treatment for young children with obesity: a randomized controlled trial.
Int J Obes (Lond)
; 47(11): 1152-1160, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37723272
ABSTRACT
BACKGROUND:
Early childhood obesity interventions supporting parents have the largest effects on child weight status. However, long-term follow-ups are lacking.OBJECTIVE:
To examine weight status 48 months after obesity treatment initiation for 4- to 6-year-olds.METHODS:
177 families were recruited to the More and Less study, a 12-month randomized controlled trial (RCT) conducted in Sweden (2012-2017); 6 children were excluded due to medical diagnoses. Thus, 171 families (non-Swedish origin 59%, university degree 40%) were eligible for this 48-month follow-up with modified intention-to-treat (n = 114 had 48-month data, n = 34 dropped out, n = 23 lost to follow-up). The RCT compared 3 treatment approaches a 10-week parent support program (1.5 h/w) with follow-up booster sessions (PGB) or without (PGNB), and standard outpatient treatment (ST). Treatment effects on primary outcome (BMI-SDS) and secondary outcomes (BMI, %IOTF25 i.e., the distance, in percent, above the cut-off for overweight) were assessed. Clinically significant reduction of BMI-SDS (≥0.5) was assessed with risk ratio. Sociodemographic factors and attendance were examined by three-way interactions.RESULTS:
After 48 months (mean 50 months, range 38-67 months) mean (95% CI) BMI-SDS was reduced in all groups PGB -0.45 (-0.18 to -0.73, p < 0.001), PGNB -0.34 (-0.13 to -0.55, p < 0.001), ST -0.25 (-0.10 to -0.40, p < 0.001), no significant difference between groups. A clinically significant reduction of BMI-SDS ≥ 0.5 was obtained in 53.7% of PGB which was twice as likely compared to ST, 33.0%, RR 2.03 (1.27 to 3.27, p = 0.003), with no difference to PGNB, 46.6% (p = 0.113). %IOTF25 was unchanged from baseline for PGB 4.50 (-1.64 to 10.63), and significantly lower compared to ST 11.92 (8.40 to 15.44) (p = 0.043). Sociodemographics or attendance had no effect.CONCLUSION:
The intensive parent-support early childhood obesity intervention led to better weight status outcomes over time, though BMI-SDS alone did not reflect this. Further research should investigate how to assess weight changes in growing children. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov, NCT01792531 .
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obesidade Infantil
Tipo de estudo:
Clinical_trials
Limite:
Child
/
Child, preschool
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Int J Obes (Lond)
Assunto da revista:
METABOLISMO
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Suécia