Srivastav Prateek, K Vaishali, Bhat H Vinod, Broadbent Suzanne
Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
The Apollo University, Chittoor, Andhra Pradesh, 517127, India.
F1000Res. 2024 Aug 1;13:859. doi: 10.12688/f1000research.153483.1. eCollection 2024.
Determine the effects of a multifactorial lifestyle intervention on physical activity (PA), BMI and health-related quality of life (QoL) in obese and overweight adolescents.
Nine schools in India were clustered randomly in a 12-month study with students allocated to a multifactorial intervention (MFI), or exercise only (EX) or control (CON) group. Participants were adolescents aged 11-16 years (n=671). In the MFI group, adolescents and their parents received lifestyle education using a validated booklet combined with a PA intervention for school students. The EX group received school-based PA only; the CON group continued regular activities. Primary outcomes were PA levels measured with the PAQ-A, and BMI; the secondary outcome was health-related QoL. A linear regression statistical model was used to analyse time, group effects and interactions, with Bonferroni correction for within-group differences at baseline (T0) and at 12-weeks (T1) (post-intervention), 6-month (T2) and 12-month (T3) follow-ups.
Significant time and group effects observed for all groups with PA scores (p<0.001), with MFI group having largest increase in PA; with BMI (p<0.001) and MFI showing the least gain in BMI; and HRQOL (p<0.001), with MFI group showing greatest improvement in scores. There were significant increases in PA at T1 and T3 time-points with the EX group, and at T3 time-point only for MFI and CON, with MFI group showing largest increase in HRQOL scores. BMI increased significantly for all groups at T2 (MFI p=0.001, EX p<0.001) and T3 (p<0.001), while HRQOL increased significantly for both MFI and EX at both follow-ups (p<0.001).
School-based lifestyle MFI was more effective for improving PA, lifestyle behaviours and HRQOL than exercise alone for adolescents, although BMI was not reduced. MFI with PA could be an effective school-based approach for behaviour modification but BMI has limitations for measuring body composition changes.
CTRI/2019/04/018834 (30/04/2019).
确定多因素生活方式干预对肥胖和超重青少年身体活动（PA）、体重指数（BMI）及健康相关生活质量（QoL）的影响。
在印度的9所学校进行了一项为期12个月的研究，将学生随机分为多因素干预组（MFI）、仅运动组（EX）或对照组（CON）。参与者为11至16岁的青少年（n = 671）。在MFI组中，青少年及其父母使用经过验证的手册接受生活方式教育，并对学生进行PA干预。EX组仅接受基于学校的PA干预；CON组继续进行常规活动。主要结局指标为用PAQ - A测量的PA水平和BMI；次要结局指标为健康相关QoL。采用线性回归统计模型分析时间、组效应及交互作用，并对基线（T0）、干预后12周（T1）、6个月（T2）和12个月（T3）随访时的组内差异进行Bonferroni校正。
所有组的PA得分均观察到显著的时间和组效应（p < 0.001），MFI组的PA增加最多；BMI方面（p < 0.001），MFI组的BMI增加最少；HRQOL方面（p < 0.001），MFI组的得分改善最大。EX组在T1和T3时间点PA显著增加，MFI组和CON组仅在T3时间点PA显著增加，MFI组的HRQOL得分增加最大。所有组在T2（MFI组p = 0.001，EX组p < 0.001）和T3（p < 0.001）时BMI显著增加，而MFI组和EX组在两次随访时HRQOL均显著增加（p < 0.001）。
对于青少年，基于学校的生活方式多因素干预在改善PA、生活方式行为和HRQOL方面比单纯运动更有效，尽管BMI未降低。多因素干预结合PA可能是一种有效的基于学校的行为改变方法，但BMI在测量身体成分变化方面存在局限性。
CTRI/2019/04/018834（2019年4月30日）
