Golan Moria, Kaufman Vered, Shahar Danit R
School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel.
Br J Nutr. 2006 May;95(5):1008-15. doi: 10.1079/bjn20061757.
There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6-11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P=0.02) as well as at the 1-year follow-up meeting. The differences between groups at both times were significant (P<0.05). A greater reduction in food stimuli in the home (P<0.05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28 % of the variability in the children's weight status change, the treatment group explained another 10 %, and the improvement in the obesogenic load explained 11 % of the variability. These results suggest that omitting the obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.
人们普遍认为，预防和治疗儿童肥胖的干预措施应涉及家庭；然而，儿童参与的程度却很少受到关注。本研究的目的是评估通过以家庭为基础的以健康为中心的干预措施来治疗儿童肥胖的相对疗效，该干预措施分别针对父母一方与父母和肥胖儿童双方。32个有6至11岁肥胖儿童的家庭被随机分组，参与者接受了为期6个月的关于健康生活方式的综合教育和行为计划。这些组在主要改变因素上有所不同：仅针对父母一方与针对父母和肥胖儿童双方。在两组中，都鼓励父母培养权威的育儿方式（父母既坚定又支持；在环境改变中发挥领导作用并适当给予孩子自主权）。只有针对仅父母一方的干预措施在项目结束时（P = 0.02）以及在1年随访会议时导致超重百分比显著降低。两组在这两个时间点的差异均具有统计学意义（P < 0.05）。仅父母一方的组中家庭食物刺激的减少更为明显（P < 0.05）。在两组中，父母的体重状况均未改变。回归分析表明，课程出席率解释了儿童体重状况变化中28%的变异性，治疗组解释了另外10%，致肥胖因素负荷的改善解释了11%的变异性。这些结果表明，让肥胖儿童不积极参与以健康为中心的项目可能有利于减肥以及促进肥胖儿童的健康生活方式。
