The Diabetes and Obesity Program, Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA, USA.
Child Obes. 2022 Jan;18(1):56-66. doi: 10.1089/chi.2021.0090. Epub 2021 Aug 12.
Few weight management interventions target young children with obesity from low-income minority families. To conduct a nonrandomized, pragmatic, pilot study of an adapted, evidence-based, weight management program (Kids N Fitness [KNF]) customized for children ages 3-7 years (Kids N Fitness Jr. [KNF-JR]) on changes in adiposity, nutrition, and physical activity behaviors. One hundred eighty children (ages 3-16) with ≥85th percentile BMI and their parents participated in one of two 6-week weight management interventions dependent on the child's age: KNF-JR: 3-7 or regular KNF: 8-16. Comparisons were made between baseline anthropometrics and health questionnaire responses, and those from weeks 6 to 18. Two-sample tests for equality of proportions with continuity were used to measure proportions of success between KNF-JR and KNF. At week 6, both cohorts showed a mean decrease in BMI z-score (zBMI) of -0.02 ( = 0.3 for KNF-JR [ = 43]; = 0.02 for KNF [ = 59], with no significant group differences. Among program completers, 75% of KNF-JR and 83% of KNF maintained or lowered zBMI at week 18 (within-group difference < 0.01). On average across all participants, at week 18 vs. baseline, improvements occurred in screen time ( < 0.01 KNF-JR, < 0.02 KNF), sweetened beverage intake ( < 0.01 KNF-JR, = 0.03 KNF), physical activity ( < 0.01 KNF-JR and KNF), and water ( = 0.01 KNF-JR, non-significant KNF) and vegetable ( < 0.01 KNF-JR, = 0.02 KNF) consumption. This pilot demonstrated that an evidence-based weight management program can be adapted for all age groups and results in improved BMI status. Larger, randomized controlled trials are needed to verify effectiveness and sustained impact.
很少有针对来自低收入少数民族家庭的肥胖幼儿的体重管理干预措施。本研究旨在对一项经过改编的、基于证据的体重管理计划(Kids N Fitness [KNF])进行非随机、实用、试点研究,该计划专门针对 3-7 岁儿童(Kids N Fitness Jr. [KNF-JR]),评估其对肥胖、营养和身体活动行为的影响。共有 180 名(年龄 3-16 岁)体块指数(BMI)≥第 85 百分位数的儿童及其父母参与了两种为期 6 周的体重管理干预措施之一,具体取决于儿童的年龄:KNF-JR:3-7 岁或常规 KNF:8-16 岁。比较了基线人体测量和健康问卷的回复,以及第 6 周到 18 周的回复。使用两样本比例检验和连续性检验来测量 KNF-JR 和 KNF 之间的成功率比例。在第 6 周时,两个队列的 BMI 标准差评分(zBMI)都有平均下降(KNF-JR:-0.02 [ = 0.3,KNF-JR:43 人;KNF:-0.02 [ = 0.02,KNF:59 人],组间差异无统计学意义。在完成方案的参与者中,KNF-JR 组有 75%和 KNF 组有 83%的人在第 18 周时保持或降低了 zBMI(组内差异 < 0.01)。在所有参与者中,与基线相比,在第 18 周时,屏幕时间(KNF-JR: < 0.01,KNF: < 0.02)、含糖饮料摄入量(KNF-JR: < 0.01,KNF: = 0.03)、体力活动(KNF-JR: < 0.01,KNF:KNF)和水(KNF-JR: = 0.01,KNF 无显著差异)和蔬菜(KNF-JR: < 0.01,KNF: = 0.02)的摄入量均有所改善。该试点研究表明,一项基于证据的体重管理计划可以适用于所有年龄段的人群,并可改善 BMI 状况。需要更大规模的随机对照试验来验证其有效性和持续影响。