Al-Daghri Nasser M, Amer Osama E, Khattak Malak N K, Hussain Syed D, Alkhaldi Ghadah, Alfawaz Hanan A, Elsaid Mohamed A, Sabico Shaun
Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia.
Children (Basel). 2023 Aug 25;10(9):1449. doi: 10.3390/children10091449.
Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to the lifestyle educational program and target outcomes, obesity, and hypertension. A total of 363 (nonadherent, = 179; adherent, = 184) Saudi school adolescents aged 12-18 were recruited from 60 schools in Riyadh City, Saudi Arabia. Anthropometrics, lipid profile, and blood glucose were measured at baseline and post-intervention. The level of adherence was based on the number of attended educational sessions, and participants were grouped accordingly into two groups: adherent group (attended ≥ 3 sessions) and nonadherent group (attended 1-2 sessions) out of a total of five sessions. Results demonstrated that significantly more participants in the adherent group achieved the primary program goal of reducing obesity indices [body weight, body mass index (BMI), and BMI z-score] than the nonadherent group. Additionally, among adherent obese participants, BMI z-score significantly decreased after the 12-month intervention (post-intervention: 1.5 ± 0.7 vs. baseline: 1.7 ± 0.6, < 0.05), while the trend in BMI z-score modestly increased in the nonadherent obese participants post-intervention (post-intervention: 1.8 ± 0.7 vs. baseline: 1.7 ± 0.6, > 0.05). Moreover, there was a substantial reduction in hypertension prevalence only in the adherent group ( = 0.003) and among adherent obese participants in particular ( = 0.03). Furthermore, adherence to session attendance was higher in girls than boys, which led to better outcomes among girls than boys. For the secondary outcomes, lipid profile indices increased in both groups, while no changes were observed in the glycemic profile. In conclusion, greater adherence to educational sessions achieved modest but favorable weight changes and improved blood pressure among obese adolescents. Future intervention studies should take into consideration the need to improve attendance to enhance adherence to the program among adolescents at risk.
在上个世纪，儿童肥胖已成为一种全球性的流行病，会导致短期和长期的健康问题，增加儿童发病和死亡的风险。这项为期12个月的以学校为基础的肥胖管理教育项目旨在评估坚持生活方式教育项目的效果以及目标结果，即肥胖和高血压情况。从沙特阿拉伯利雅得市的60所学校招募了363名12至18岁的沙特在校青少年（非坚持组，n = 179；坚持组，n = 184）。在基线和干预后测量人体测量学指标、血脂谱和血糖。坚持程度根据参加教育课程的次数来确定，参与者被相应地分为两组：坚持组（参加≥3次课程）和非坚持组（参加1 - 2次课程），总共五节课程。结果表明，与非坚持组相比，坚持组中显著更多的参与者实现了降低肥胖指数（体重、体重指数（BMI）和BMI z评分）的主要项目目标。此外，在坚持干预的肥胖参与者中，12个月干预后BMI z评分显著下降（干预后：1.5±0.7 vs. 基线：1.7±0.6，P < 0.05），而非坚持干预的肥胖参与者干预后BMI z评分呈适度上升趋势（干预后：1.8±0.7 vs. 基线：1.7±0.6，P > 0.05）。此外，仅在坚持组中高血压患病率大幅下降（P = 0.003），特别是在坚持干预的肥胖参与者中（P = 0.03）。此外，女孩的课程出席率高于男孩，这导致女孩比男孩有更好的结果。对于次要结果，两组的血脂谱指标均有所上升，而血糖谱未观察到变化。总之，更高的课程出席率在肥胖青少年中实现了适度但有利的体重变化并改善了血压。未来的干预研究应考虑到需要提高出席率，以增强有风险的青少年对该项目的坚持程度。
