Pediatric Preventive Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Pediatr Neonatol. 2012 Apr;53(2):90-7. doi: 10.1016/j.pedneo.2012.01.005. Epub 2012 Mar 3.
This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors.
This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2-18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged.
Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14-18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement.
Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services.
本研究旨在评估一种简单的基于办公室的方案在控制儿童肥胖及其相关心血管代谢风险因素方面的有效性，该方案旨在鼓励健康的生活方式。
这是一项非随机的 24 周生活方式改变试验，纳入了 457 名肥胖儿童和青少年，年龄 2-18 岁，除肥胖外还至少存在一个心血管代谢风险因素。该试验包括运动、饮食教育和行为改变三个部分，所有建议均由儿科医生、两名全科医生和一名护士提供。与严格的抑制性建议不同，鼓励更健康的生活方式。
共有 448 名（98.04%）入组儿童完成了试验，平均年龄为 9.6±2.9 岁。试验后，人体测量学指标和心血管代谢风险因素的平均值显著下降，高密度脂蛋白胆固醇（HDL-C）显著升高，代谢综合征的患病率从 20.8%降至 1.8%。在所有年龄组中，甘油三酯、LDL-C、舒张压和 WC 的降幅最大，14-18 岁年龄组的变化最为显著。随着 BMI 和 WC 每降低 1SD，风险因素均有显著改善。
基于办公室的动机性咨询对治疗儿童肥胖及其相关心血管代谢风险因素有效。这种方法可以在初级卫生保健系统中实施；对于人力和财力资源有限的中低收入国家，尤其值得关注。我们建议扩大护士等非医师临床医生的作用，可以帮助增加提供此类服务的时间。
