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一项基于社区的动机性个性化生活方式干预措施,旨在降低肥胖青少年的体重指数:健康饮食与生活方式计划(HELP)随机对照试验的结果。

A community-based motivational personalised lifestyle intervention to reduce BMI in obese adolescents: results from the Healthy Eating and Lifestyle Programme (HELP) randomised controlled trial.

作者信息

Christie Deborah, Hudson Lee Duncan, Kinra Sanjay, Wong Ian Chi Kei, Nazareth Irwin, Cole Tim J, Sovio Ulla, Gregson John, Kessel Anthony S, Mathiot Anne, Morris Stephen, Panca Monica, Costa Silvia, Holt Rebecca, Viner Russell M

机构信息

University College London Hospitals and UCL Institute of Epidemiology and Health Care, London, UK.

Great Ormond Street Hospital for Children, London, UK.

出版信息

Arch Dis Child. 2017 Aug;102(8):695-701. doi: 10.1136/archdischild-2016-311586. Epub 2017 Jul 7.

Abstract

OBJECTIVE

Approximately 7% of children and young people aged 5-15 years in the UK have obesity at a level likely to be associated with comorbidities. The majority of multicomponent lifestyle programmes have limited applicability and generalisability for British adolescents.The Healthy Eating and Lifestyle Programme (HELP) was a specific adolescent-focused intervention, designed for obese 12 to 18-year-olds seeking help to manage their weight. Participants were randomised to the 12-session HELP intervention or standard care. The primary outcome was difference in mean body mass index (BMI) (kg/m) between groups at week 26 adjusted for baseline BMI, age and sex.

SUBJECTS

174 subjects were randomised (87 in each arm), of whom 145 (83%) provided primary outcome data at week 26.

RESULTS

At week 26 there were no significant effects of the intervention on BMI (mean change in BMI 0.18 kg/m for the intervention arm, 0.25 kg/m for the control arm; adjusted difference between groups: -0.11 kg/m (95% CI -0.62 to 0.40), p=0.7). At weeks 26 and 52 there were no significant differences between groups in any secondary outcomes.

CONCLUSION

At minimum this study reinforces the need for higher level, structured interventions to tackle the growing public health burden of obesity in the UK and internationally.The HELP intervention was no more effective than a single educational session for reducing BMI in a community sample of obese adolescents.Further work is needed to understand how weight management programmes can be delivered effectively to young people from diverse and deprived backgrounds in which childhood obesity is common. The study has significant implications in terms of informing public health interventions to tackle childhood obesity.

TRIAL REGISTRATION NUMBER

ISRCTN: ISRCTN99840111.

摘要

目的

在英国,约7%的5至15岁儿童和青少年肥胖程度可能与合并症相关。大多数多成分生活方式项目对英国青少年的适用性和推广性有限。健康饮食与生活方式项目(HELP)是一项专门针对青少年的干预措施,针对寻求体重管理帮助的12至18岁肥胖青少年设计。参与者被随机分为接受为期12节的HELP干预或标准护理。主要结局是在第26周时,根据基线体重指数、年龄和性别调整后,两组之间平均体重指数(BMI,kg/m²)的差异。

受试者

174名受试者被随机分组(每组87人),其中145人(83%)在第26周提供了主要结局数据。

结果

在第26周时,干预对BMI没有显著影响(干预组BMI的平均变化为0.18kg/m²,对照组为0.25kg/m²;两组之间的调整差异为-0.11kg/m²(95%CI -0.62至0.40),p=0.7)。在第26周和第52周时,两组在任何次要结局方面均无显著差异。

结论

至少本研究强化了在英国和国际上应对日益增长的肥胖公共卫生负担需要更高水平、结构化干预措施的必要性。在肥胖青少年社区样本中,HELP干预在降低BMI方面并不比单次教育课程更有效。需要进一步开展工作,以了解如何有效地为来自肥胖现象常见的不同和贫困背景的年轻人提供体重管理项目。该研究对为应对儿童肥胖的公共卫生干预措施提供信息具有重要意义。

试验注册号

ISRCTN:ISRCTN99840111。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0323/5537518/129ba4372542/archdischild-2016-311586f01.jpg

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