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马来西亚儿童肥胖治疗良好实践方法的随机对照试验:马来西亚儿童肥胖治疗试验(MASCOT)

Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian Childhood Obesity Treatment Trial (MASCOT).

作者信息

Wafa Sharifah W, Talib Ruzita A, Hamzaid Nur H, McColl John H, Rajikan Roslee, Ng Lai O, Ramli Ayiesah H, Reilly John J

机构信息

University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

出版信息

Int J Pediatr Obes. 2011 Jun;6(2-2):e62-9. doi: 10.3109/17477166.2011.566340. Epub 2011 May 23.

DOI:10.3109/17477166.2011.566340
PMID:21604965
Abstract

CONTEXT

Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world.

AIM

To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia.

METHODS

Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days).

RESULTS

The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group.

CONCLUSIONS

Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.

摘要

背景

西方世界以外很少有针对儿童肥胖治疗干预措施的随机对照试验(RCT)。

目的

在马来西亚吉隆坡,测试一种针对儿童肥胖的良好实践干预措施对体重状况和其他结果的影响是否会大于对照条件。

方法

对107名7至11岁肥胖儿童进行评估者盲法RCT治疗干预。干预强度相对较低(26周内接触8小时,基于小组),旨在通过行为改变咨询改变儿童久坐行为、身体活动和饮食。在基线和干预开始后六个月测量结果。主要结果是BMI z评分,其他结果是体重变化、健康相关生活质量(儿童生活质量量表)、客观测量的身体活动和久坐行为(通过Actigraph加速度计测量5天)。

结果

与对照组相比,干预对BMI z评分没有显著影响。与对照组相比,干预组体重增加显著减少(分别为+1.5千克和+3.5千克,t检验p<0.01)。健康相关生活质量以及客观测量的身体活动和久坐行为的变化有利于干预组。

结论

治疗与体重增加率降低以及身体活动和生活质量改善相关。可能需要更长期、更密集的干预措施以实现更实质性的生活方式改变,从而带来更大的益处。

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