Department of Paediatric Nutrition Medicine, Vestische Youth Hospital, University of Witten/Herdecke, Dr. F. Steiner Str. 5, Datteln, Germany.
Clin Nutr. 2010 Jun;29(3):331-6. doi: 10.1016/j.clnu.2009.12.010. Epub 2010 Jan 27.
BACKGROUND & AIMS: Randomized controlled trials (RCT) have demonstrated the effectiveness of lifestyle interventions in obese children. However, the effectiveness of interventions for overweight, but no obese children has not been demonstrated yet by RCTs.
A total of 66 overweight (BMI>90th< or =97th percentile) children (mean age 11.5+/-1.6 years, 58% females, mean BMI 23.4+/-1.5kg/m(2)) were randomized into a control group (CG) (n=32; no intervention for a duration of 6 months) or intervention group (IG) (n=34; 6 months intervention "Obeldicks light" based on physical activity, nutrition education, and behaviour counselling). BMI, waist circumference, skinfold thickness, bioimpedance analyses, blood pressure, physical activity based on questionnaires, and three-day-weighed dietary records were determined at baseline (T0) and 6 months (T1) later. Degree of overweight was calculated as BMI-SDS. Comparisons were performed on an intention-to-treat approach.
The drop-out rate was 3% in IG and 16% in CG. At T1, 94% of the children in IG decreased their BMI-SDS and 24% of them were normal weight. The changes between T0 and T1 in BMI-SDS differed significantly (p<0.001) between IG and CG (CG: +0.05+/-0.19 BMI-SDS; IG: -0.26+/-0.22 BMI-SDS). Similar findings were observed for blood pressure, waist circumference, skinfold thickness, and fat mass based on bioimpedance analyses. In the IG, energy, fat and sugar intake decreased significantly between T0 and T1, while no significant changes were observed in the CG.
The lifestyle intervention was associated with an improvement of dietary patterns and was effective in reducing degree of overweight, fat mass, waist circumference, and blood pressure.
随机对照试验(RCT)已经证明了生活方式干预在肥胖儿童中的有效性。然而,对于超重但不肥胖的儿童,RCT 尚未证明干预的有效性。
共有 66 名超重(BMI>第 90 至<第 97 百分位)的儿童(平均年龄 11.5+/-1.6 岁,58%为女性,平均 BMI 为 23.4+/-1.5kg/m2)被随机分为对照组(CG)(n=32;不干预 6 个月)或干预组(IG)(n=34;6 个月的“Obeldicks 轻量版”干预,基于体力活动、营养教育和行为咨询)。在基线(T0)和 6 个月(T1)后测定 BMI、腰围、皮褶厚度、生物阻抗分析、血压、基于问卷的体力活动和三天称重饮食记录。超重程度计算为 BMI-SDS。采用意向治疗方法进行比较。
IG 的脱落率为 3%,CG 的脱落率为 16%。在 T1 时,IG 组的 94%儿童 BMI-SDS 降低,24%的儿童体重正常。IG 和 CG 之间 BMI-SDS 的变化在 T0 和 T1 之间有显著差异(p<0.001)(CG:+0.05+/-0.19 BMI-SDS;IG:-0.26+/-0.22 BMI-SDS)。血压、腰围、皮褶厚度和基于生物阻抗分析的脂肪量也观察到类似的变化。在 IG 中,T0 至 T1 期间能量、脂肪和糖的摄入量显著减少,而 CG 中则没有显著变化。
生活方式干预与改善饮食模式有关,可有效降低超重程度、脂肪量、腰围和血压。