A low-glycemic index diet in the treatment of pediatric obesity.

CONTEXT: Conventional dietary approaches for the treatment of obesity have generally yielded disappointing results. OBJECTIVE: To examine the effects of a low-glycemic index (GI) diet compared with a standard reduced-fat diet in the management of pediatric obesity. DESIGN: Retrospective cohort study of children attending an outpatient pediatric obesity program from September 1997 to December 1998. SETTING: Academic medical center. PARTICIPANTS: One hundred seven obese but otherwise healthy children. MAIN OUTCOME MEASURES: Changes in body mass index (BMI [calculated as weight in kilograms divided by the square of height in meters]) and body weight from first to last clinic visit. RESULTS: A total of 64 patients received the low glycemic index diet and 43 received the reduced-fat diet for 4.3 vs 4.2 months' mean duration of follow-up, with 3.3 vs 3.3 mean number of visits, respectively. Body mass index (-1.53 kg/m(2) [95% confidence interval, -1.94 to -1.12] vs -0.06 kg/m(2) [-0.56 to + 0. 44], P<.001) and body weight (-2.03 kg [95% confidence interval -3. 19 to -0.88] vs +1.31 kg [ -0.11 to + 2.72], P<.001) decreased more in the low-GI group compared with the reduced-fat group. In multivariate models, these differences remained significant (P<.01) after adjustment for age, sex, ethnicity, BMI or baseline weight, participation in behavioral modification sessions, and treatment duration. Significantly more patients in the low-GI group experienced a decrease in BMI of at least 3 kg/m(2) (11 kg/m(2) [17. 2%] vs. 1 kg/m(2) [2.3%], P =.03). CONCLUSIONS: A low-GI diet seems to be a promising alternative to standard dietary treatment for obesity in children. Long-term randomized controlled trials of a low-GI diet in the prevention and treatment of obesity are needed.

Reactive and proactive aggression in school children and psychiatrically impaired chronically assaultive youth.

The authors proposed that reactively aggressive and proactively aggressive types of antisocial youth would differ in developmental histories, concurrent adjustment, and social information-processing patterns. In Study 1, 585 boys and girls classified into groups called reactive aggressive, proactive aggressive, pervasively aggressive (combined type), and nonaggressive revealed distinct profiles. Only the reactive aggressive groups demonstrated histories of physical abuse and early onset of problems, adjustment problems in peer relations, and inadequate encoding and problem-solving processing patterns. Only the proactive aggressive groups demonstrated a processing pattern of anticipating positive outcomes for aggressing. In Study 2, 50 psychiatrically impaired chronically violent boys classified as reactively violent or proactively violent demonstrated differences in age of onset of problem behavior, adjustment problems, and processing problems.

Mother-child interaction quality as a partial mediator of the roles of maternal depressive symptomatology and socioeconomic status in the development of child behavior problems. Conduct Problems Prevention Research Group.

This investigation examined the relation between maternal depressive symptomatology and the development of externalizing behavior problems in children by incorporating mother-child interaction quality into a series of models. A representative sample of 376 first-grade boys and girls (mean age = 6.52) from diverse backgrounds (234 from the lowest 2 socioeconomic classes) and their mothers completed an interaction task designed to measure the quality of mother-child interaction. Latent variable structural equations analyses revealed that mother-child interaction quality partially mediated the relation between maternal depressive symptomatology and child behavior problems even when the effects of socioeconomic status on both variables were taken into account. Although this model held for boys, girls, and Caucasians, the relation between maternal depression and interaction quality was not significant for African-Americans. Further investigation is required to understand the lack of generalizability of the model to African-American mother-child dyads.