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Short- and long-term beneficial effects of a combined dietary-behavioral-physical activity intervention for the treatment of childhood obesity
Nemet D, Barkan S, Epstein Y, Friedland O, Kowen G, Eliakim A
Pediatrics 2005 Apr;115(4 Pt 1):E443-E449
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Obesity has become the most common pediatric chronic disease in the modern era. Early prevention and treatment of childhood and adolescent obesity is mandated. Surprisingly, however, only a minor fraction of obese children participate in weight reduction interventions, and the longer-term effects of these weight-reduction interventions among children have not been elucidated. OBJECTIVE: To examine prospectively the short- and long-term effects of a 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, body composition, dietary and leisure-time habits, fitness, and lipid profiles among obese children. METHODS: In this randomized prospective study, 24 obese subjects completed the 3-month intervention and were compared with 22 obese, age- and gender-matched, control subjects. RESULTS: At 3 months, there were significant differences in changes in body weight (-2.8 +/- 2.3 kg versus 1.2 +/- 2.2 kg), BMI (-1.7 +/- 1.1 kg/m2 versus -0.2 +/- 1.0 kg/m2), body fat percentage (from skinfold tests; -3.3 +/- 2.6% versus 1.4 +/- 4.7%), serum total cholesterol level (-24.6 +/- 15.1 mg/dL versus 0.8 +/- 18.7 mg/dL), low-density lipoprotein cholesterol level (-23.3 +/- 15.2 mg/dL versus -3.7 +/- 17.3 mg/dL), and fitness (215 +/- 107 seconds versus 50 +/- 116 seconds) in the intervention group versus the control group. After a 1-year follow-up period, there were significant differences between the intervention group (n = 20) and the control group (n = 20) in body weight (0.6 +/- 6.0 kg versus 5.3 +/- 2.7 kg), BMI (-1.7 +/- 2.3 kg/m2 versus 0.6 +/- 0.9 kg/m2), and body fat percentage. There was a significant increase in leisure-time physical activity among the intervention participants, compared with a decrease among the control subjects. CONCLUSIONS: Our data demonstrate the short- and longer-term beneficial effects of a combined dietary-behavioral-physical activity intervention among obese children. These results highlight the importance of multidisciplinary programs for the treatment of childhood obesity and emphasize their encouraging long-term effects.
Reproduced with permission from Pediatrics. Copyright by the American Academy of Pediatrics.

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