epartment of Nutrition and Dietetics, Flinders University, Adelaide, Australia.
Pediatrics. 2011 Feb;127(2):214-22. doi: 10.1542/peds.2009-1432. Epub 2011 Jan 24.
To evaluate a healthy lifestyle intervention to reduce adiposity in children aged 5 to 9 years and assess whether adding parenting skills training would enhance this effect.
We conducted a single-blinded randomized controlled trial of prepubertal moderately obese (International Obesity Task Force cut points) children, aged 5 to 9 years. The 6-month program targeted parents as the agents of change for implementing family lifestyle changes. Only parents attended group sessions. We measured BMI and waist z scores and parenting constructs at baseline, 6, 12, 18, 24 months.
Participants (n = 169; 56% girls) were randomized to a parenting skills plus healthy lifestyle group (n = 85) or a healthy lifestyle-only group (n = 84). At final 24-month assessment 52 and 54 children remained in the parenting skills plus healthy lifestyle and the healthy lifestyle-only groups respectively. There were reductions (P < .001) in BMI z score (0.26 [95% confidence interval: 0.22-0.30]) and waist z score (0.33 [95% confidence interval: 0.26-0.40]). There was a 10% reduction in z scores from baseline to 6 months that was maintained to 24 months with no additional intervention. Overall, there was no significant group effect. A similar pattern of initial improvement followed by stability was observed for parenting outcomes and no group effect.
Using approaches that specifically target parent behavior, relative weight loss of ∼10% is achievable in moderately obese prepubertal children and can be maintained for 2 years from baseline. These results justify an investment in treatment as an effective secondary obesity-prevention strategy.
评估一种健康生活方式干预措施，以减少 5 至 9 岁儿童的肥胖程度，并评估是否增加育儿技能培训会增强这种效果。
我们进行了一项针对青春期前中度肥胖（国际肥胖工作组切点）儿童（年龄 5 至 9 岁）的单盲随机对照试验。该 6 个月的项目以父母为改变家庭生活方式的代理人。只有父母参加小组会议。我们在基线、6 个月、12 个月、18 个月和 24 个月时测量 BMI 和腰围 z 分数以及育儿结构。
参与者（n = 169；56%为女孩）被随机分为育儿技能加健康生活方式组（n = 85）或健康生活方式组（n = 84）。在最终的 24 个月评估中，52 名和 54 名儿童分别留在育儿技能加健康生活方式组和健康生活方式组。BMI z 分数（0.26 [95%置信区间：0.22-0.30]）和腰围 z 分数（0.33 [95%置信区间：0.26-0.40]）均有下降（P <.001）。从基线到 6 个月，z 分数降低了 10%，在没有额外干预的情况下，这一降低持续到 24 个月。总体而言，组间无显著差异。育儿结果也观察到类似的初始改善后稳定的模式，且无组间差异。
采用专门针对父母行为的方法，在青春期前中度肥胖的儿童中可以实现约 10%的相对体重减轻，并且可以从基线开始维持 2 年。这些结果证明了将治疗作为一种有效的二级肥胖预防策略进行投资是合理的。
