Vignolo M, Rossi F, Bardazza G, Pistorio A, Parodi A, Spigno S, Torrisi C, Gremmo M, Veneselli E, Aicardi G
Pediatric Clinic, University of Genoa, G. Gaslini Institute, Genoa, Italy.
Eur J Clin Nutr. 2008 Sep;62(9):1047-57. doi: 10.1038/sj.ejcn.1602819. Epub 2007 Jun 6.
Aim of this study is to examine the 5-year follow-up results of MI PIACE PIACERMI (I like to like and please myself), a cognitive-behavioural programme intended to obtain a weight growth regulation over an extended period.
Longitudinal observational clinical study.
Hospital-based programme, through outpatient activities.
Thirty-one simple obese children, 13 boys and 18 girls, 6-12 years of age on admission.
The intervention was carried out by a multidisciplinary team (paediatrician, cognitive-behavioural psychologist, physical therapist). It employed cognitive-behavioural techniques, nutrition education, promotion of physical activity, setting a high value on free play in motion. The programme actively involves parents. The following measurements were taken on admission and at 5-year follow-up: height, weight, waist circumference, body mass index (BMI), BMI standardized (BMI-SDS), and adjusted BMI (a-BMI) as actual BMI/BMI (50th percentile)*100. Dietary habits were investigated by interview and 24-h recall. Parents completed the Family Habit Inventory and the Child Behaviour Checklist (CBCL). Motor skills were assessed by using Frostig's test.
The dropout rate was 35.5%. In subjects who completed the 5-year follow-up, the mean and s.d. of BMI-SDS and a-BMI were, respectively, 4.23+/-0.71 and 54.7%+/-9.0 at baseline and 2.74+/-0.85 and 43.2%+/-17.3 at the last visit. Waist circumference decreased. Family habits improved significantly. Total energy intake was significantly reduced. Emotional and social aspects of obesity-related behaviours showed positive changes. Motor skills globally improved.
The study provides further evidence that positive persistent results may be obtained in obese children with treatment programmes combining a lifestyle centred approach, parental involvement, nutrition education and cognitive-behavioural strategies.
本研究旨在探讨“我喜欢取悦自己”（MI PIACE PIACERMI）这一认知行为项目的5年随访结果，该项目旨在长期实现体重增长调节。
纵向观察性临床研究。
基于医院的项目，通过门诊活动开展。
31名单纯性肥胖儿童，入院时年龄6至12岁，其中13名男孩，18名女孩。
由多学科团队（儿科医生、认知行为心理学家、物理治疗师）实施干预。采用认知行为技术、营养教育、促进身体活动、高度重视自由运动游戏。该项目积极让家长参与。在入院时和5年随访时进行以下测量：身高、体重、腰围、体重指数（BMI）、标准化BMI（BMI-SDS）以及调整后的BMI（a-BMI），即实际BMI/（第50百分位数的BMI）×100。通过访谈和24小时回顾调查饮食习惯。家长完成家庭习惯量表和儿童行为检查表（CBCL）。使用弗罗斯蒂格测试评估运动技能。
失访率为35.5%。在完成5年随访的受试者中，BMI-SDS和a-BMI的均值及标准差在基线时分别为4.23±0.71和54.7%±9.0，在最后一次随访时分别为2.74±0.85和43.2%±17.3。腰围减小。家庭习惯显著改善。总能量摄入显著减少。与肥胖相关行为的情感和社会方面呈现积极变化。运动技能总体上有所提高。
该研究进一步证明，对于肥胖儿童，采用以生活方式为中心的方法、家长参与、营养教育和认知行为策略相结合的治疗方案可取得持续的积极效果。
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