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针对巴西低收入肥胖青少年的多学科与激励性干预治疗:试点研究

MULTIDISCIPLINARY AND MOTIVATIONAL INTERVENTION FOR THE TREATMENT OF LOW INCOME BRAZILIAN OBESE ADOLESCENTS: PILOT STUDY.

作者信息

Filgueiras Andrea Rocha, Sawaya Ana Lydia

机构信息

Universidade Federal de São Paulo, São Paulo, SP, Brasil.

出版信息

Rev Paul Pediatr. 2018 Apr-Jun;36(2):186-191. doi: 10.1590/1984-0462/;2018;36;2;00014. Epub 2018 Apr 23.

Abstract

OBJECTIVE

To test a multidisciplinary and motivational intervention for the treatment of Brazilian obese and low-income adolescents (Z score>2 BMI-for-age) that used nutritional counseling without dietary control.

METHODS

An intervention protocol was developed including periodical nutritional education workshops, individual nutritional counseling guided by the stages of eating behavior of the Trans Theoretical Model of Behavior Change, physical exercise, psychological counseling, recreational activities, and clinical follow-up for 13 months in a sample of 21 adolescents (11-17 years old).

RESULTS

The rate of treatment withdrawal (9.5%) was lower than that seen in dietary control studies (30-60%). Initially, 70% of the sample was in the pre-contemplation behavior stage and, in the end, 100% of the remaining adolescents were in the stages of action or maintenance. There was a mean reduction in BMI-for-age (p=0.038) and visceral fat (M±SD=3.67±1.19 and 2.78±0.78 cm, p=0.02, initial and final, respectively). The percentage of fat mass decreased and that of lean mass increased (42±5 and 38±8, p=0.04, 58±6 and 61±8%, p=0.03, respectively).

CONCLUSIONS

The intervention seems to be effective in generating a lifestyle change, accompanied by anthropometric profile and body composition improvement. The intervention protocol may offer easy adaptation and low-cost methodology for health services, with high adherence and low abandonment rates.

摘要

目的

测试一种多学科激励干预措施,用于治疗巴西肥胖且低收入的青少年(年龄别体重指数Z评分>2),该干预措施采用无饮食控制的营养咨询。

方法

制定了一项干预方案,包括定期营养教育工作坊、以行为改变跨理论模型饮食行为阶段为指导的个体营养咨询、体育锻炼、心理咨询、娱乐活动,以及对21名青少年(11 - 17岁)进行为期13个月的临床随访。

结果

治疗退出率(9.5%)低于饮食控制研究中的退出率(30 - 60%)。最初,70%的样本处于行为前思考阶段,最后,其余青少年中有100%处于行动或维持阶段。年龄别体重指数(p = 0.038)和内脏脂肪有平均下降(初始和最终分别为M±SD = 3.67±1.19和2.78±0.78 cm,p = 0.02)。脂肪量百分比下降,瘦体重百分比增加(分别为42±5和38±8,p = 0.04;58±6和61±8%,p = 0.03)。

结论

该干预措施似乎能有效促使生活方式改变,同时伴随人体测量指标和身体成分改善。该干预方案可为卫生服务提供易于调整且低成本的方法,具有高依从性和低放弃率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fe5/6038782/897025cbeba9/0103-0582-rpp-2018-36-2-00014-gf1.jpg

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