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多学科家庭为基础的儿童肥胖治疗方案(家庭项目)的有效性。

Effectiveness of a multi-disciplinary family-based programme for treating childhood obesity (the Family Project).

机构信息

Department of Nutrition and Dietetics, Jersey, Channel Islands, UK.

出版信息

Eur J Clin Nutr. 2011 Aug;65(8):903-9. doi: 10.1038/ejcn.2011.43. Epub 2011 Apr 13.

Abstract

BACKGROUND/OBJECTIVES: To determine if a multi-component family focused education package is more effective than a waiting list control group in treating overweight and obese children.

SUBJECTS/METHODS: A 2-year randomised controlled trial; 65 overweight and obese children aged 6-14 years were allocated to active intervention in either the first or second year, with body composition monitoring alone in the control period. Anthropometric measurements were undertaken at six monthly intervals and a 7-day food and activity diary were issued.

RESULTS

Over the 2 years of the study body mass index (BMI) SDS (z score) fell significantly in the intervention/control (I/C) group, but not in the control/intervention (C/I) group. The difference between groups was 0.3, which was borderline significant (95% confidence interval (95% CI) -0.62 to 0.02, P=0.06) before adjusting for potential confounding factors. Thirty-three percent of the I/C group and 12% of the C/I group achieved the target reduction of 0.5 BMI SDS. The I/C group had a significantly greater reduction in the percentage with a BMI above the 99.6th centile at 24 months (P=0.04) and gained 5.7 kg less over the time of the study. There were no significant differences between groups for mean percentage attendance at physical activity sessions (I/C group=24.1%, 95% CI, 15.4-32.9; C/I group=31.7%, 95% CI, 22.4-41.1, P=0.229).

CONCLUSIONS

Children given active intervention followed by body composition monitoring alone reduced their BMI SDS, and fewer children were classified as grossly overweight by the end of the study. If these findings are true, there are important implications for the provision of services managing overweight in the community.

摘要

背景/目的:确定多组分家庭为重点的教育套餐是否比等待名单对照组更能有效治疗超重和肥胖儿童。

受试者/方法:一项为期 2 年的随机对照试验;将 65 名年龄在 6-14 岁的超重和肥胖儿童分为主动干预组,分别在第 1 年或第 2 年接受干预,对照组在对照期仅进行身体成分监测。每 6 个月进行一次人体测量,发放 7 天的食物和活动日记。

结果

在研究的 2 年内,干预/对照组(I/C 组)的体重指数(BMI)标准差评分(z 评分)显著下降,但对照组/干预组(C/I 组)没有下降。调整潜在混杂因素后,两组之间的差异为 0.3,具有边缘显著性(95%置信区间(95%CI)-0.62 至 0.02,P=0.06)。I/C 组中有 33%的儿童和 C/I 组中有 12%的儿童达到了 BMI 标准差降低 0.5 的目标。24 个月时,I/C 组中 BMI 超过第 99.6 百分位数的儿童比例显著降低(P=0.04),且在研究期间体重减轻了 5.7 公斤。两组之间的平均出席体育活动课程的百分比没有显著差异(I/C 组=24.1%,95%CI,15.4-32.9;C/I 组=31.7%,95%CI,22.4-41.1,P=0.229)。

结论

接受主动干预后仅进行身体成分监测的儿童降低了 BMI 标准差评分,研究结束时,更多的儿童被归类为明显超重。如果这些发现是真实的,那么这对社区中管理超重人群的服务提供具有重要意义。

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