Effectiveness of individual versus group programs to treat obesity and reduce cardiovascular disease risk factors in pre-pubertal children: A randomized controlled trial

Louisa Ells

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    Abstract

    Introduction: Childhood obesity results in premature atherosclerosis and
    requires early intervention.
    Objectives: Compare the effectiveness of 6-month lifestyle interventions
    (with choice of either individual or group therapy) with standard care on
    body mass index (BMI) z-score and cardiovascular disease (CVD) risks
    factors in children with obesity.
    Methods: This 6-month randomized controlled trial with a 6-month
    follow-up included 74 pre-pubertal children with obesity (7.5-11.9 years)
    assigned randomly (2:1) to intervention or control. Families in the
    intervention arm choose between an individually delivered treatment
    (3h. pediatrician + 4h. dietician) or group treatment (35h. with a
    multidisciplinary team). Children participated also to a weekly physical
    activity program. We measured: BMI, BMI-z score; waist circumference
    (WC); total and abdominal fat; blood pressure; common carotid artery
    intima-media-thickness and incremental elastic modulus (Einc);
    endothelium-dependent and independent dilation (NTGMD) of the
    brachial artery; fasting plasma glucose, insulin, lipids; high-sensitivity Creactive
    protein (hs-CRP).
    Results: Compared to controls, at 6 months, abdominal fat and hs-CRP
    were reduced in both interventions. The group intervention was alsoeffective in reducing BMI (-0.55 kg/m2; 95% CI -1.16 to 0.06) and BMIz
    (-0.08; -0.15 to 0.00) at 6 months, and BMI, BMI-z, WC, NTGMD, total
    and abdominal fat at 12 months.
    Discussion: Abdominal fat and low grade inflammation were significantly
    decreased in both interventions. High-intensity group treatment
    improved early signs of atherosclerosis in children with obesity. These
    findings are important for the promotion of cardiometabolic health in this
    population.
    Original languageEnglish
    JournalClinical obesity
    Publication statusAccepted/In press - 14 Feb 2019

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