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IAO 家庭计划对超重和肥胖儿童的体重减轻和代谢改变的改善:一项随机对照临床试验。

Weight Loss and Improvement of Metabolic Alterations in Overweight and Obese Children Through the IAO Family Program: A Randomized Controlled Clinical Trial.

机构信息

Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Clinic Hospital Murcia, Spain.

Nursing Department, Faculty of Nursing, Calle Campus Universitario, 16751University of Murcia, Spain.

出版信息

Biol Res Nurs. 2021 Jul;23(3):488-503. doi: 10.1177/1099800420987303. Epub 2021 Feb 1.

Abstract

Childhood obesity is a major public health concern. We wanted to evaluate the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education to achieve weight loss and improve metabolic parameters in overweight and obese children. A randomized, controlled clinical trial with long-term follow-up (24 months) was conducted at a community care center in overweight and obese individuals aged 6-12 years. A sample of 108 children was divided into an experimental and a control group receiving a standard care program. The experimental groups received a 12-month interdisciplinary program; the results were evaluated at 4 months, the end of the intervention, and at follow-up 12 months later. Anthropometric and biological marker measurements related to metabolic alterations, dyslipidemia (based on total cholesterol), hyperglycemia, fasting glycaemia, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in blood were recorded. The intervention had a significant effect ( < 0.001) in terms of decreased body mass index, skinfolds, and waist and arm circumferences. These changes were accompanied by biochemical changes underlying an improvement in metabolic parameters, such as a significant reduction in total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and hyperglycemia and a significant increase in high-density lipoprotein-cholesterol. These effects were still significant for markers of excess weight or obesity in the experimental group 12 months after the end of the intervention, suggesting that an enduring change in healthy lifestyles had been maintained period. This interdisciplinary, nurse-led program helped to reduce childhood and adolescent excess weight and obesity and had long-lasting effects.

摘要

儿童肥胖是一个主要的公共卫生关注点。我们旨在评估一种基于健康饮食、运动、认知行为疗法和健康教育的多学科方案的有效性,以实现超重和肥胖儿童的体重减轻和改善代谢参数。在社区保健中心对超重和肥胖的 6-12 岁个体进行了一项随机、对照的临床试验,具有长期随访(24 个月)。108 名儿童被分为实验组和对照组,分别接受标准护理方案和多学科方案。实验组接受为期 12 个月的跨学科方案;在 4 个月、干预结束时和 12 个月的随访时评估结果。记录了与代谢改变、血脂异常(基于总胆固醇)、高血糖、空腹血糖、甘油三酯、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇相关的人体测量和生物标志物测量。干预在降低体重指数、皮褶厚度和腰围及臂围方面具有显著效果(<0.001)。这些变化伴随着生化变化,改善了代谢参数,如总胆固醇、低密度脂蛋白胆固醇、甘油三酯和高血糖显著降低,高密度脂蛋白胆固醇显著增加。这些效果在干预结束后 12 个月,实验组的超重或肥胖标志物仍具有显著性,提示健康生活方式的持久改变得以维持。这种跨学科、由护士主导的方案有助于减轻儿童和青少年超重和肥胖,并具有持久的效果。

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