Short- and long-term beneficial effects of a combined dietary-behavioral-physical activity intervention for the treatment of childhood obesity

Background. Obesity has become the most common pediatric chronic disease in the modern era. Early prevention and treatment of childhood and adolescent obesity is mandated. Surprisingly, however, only a minor fraction of obese children participate in weight reduction interventions, and the longer-term effects of these weight-reduction interventions among children have not been elucidated. Objective. To examine prospectively the short- and long-term effects of a 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, body composition, dietary and leisure-time habits, fitness, and lipid profiles among obese children. Methods. In this randomized prospective study, 24 obese subjects completed the 3-month intervention and were compared with 22 obese, age- and gender-matched, control subjects. Results. At 3 months, there were significant differences in changes in body weight (-2.8 [+ or -] 2.3 kg vs 1.2 [+ or -] 2.2 kg), BMI (-1.7 [+ or -] 1.1 kg/[m.sup.2] vs -0.2 [+ or -] 1.0 kg/[m.sup.2]), body fat percentage (from skinfold tests; -3.3 [+ or -] 2.6% vs 1.4 [+ or -] 4.7%), serum total cholesterol level (-24.6 [+ or -] 15.1 mg/dL vs 0.8 [+ or -] 18.7 mg/dL), low-density lipoprotein cholesterol level (-23.3 [+ or -] 15.2 mg/dL vs -3.7 [+ or -] 17.3 mg/dL), and fitness (215 [+ or -] 107 seconds vs 50 [+ or -] 116 seconds) in the intervention group versus the control group. After a 1-year follow-up period, there were significant differences between the intervention group (n = 20) and the control group (n = 20) in body weight (0.6 [+ or -] 6.0 kg vs 5.3 [+ or -] 2.7 kg), BMI (-1.7 [+ or -] 2.3 kg/[m.sup.2] vs 0.6 [+ or -] 0.9 kg/[m.sup.2]), and body fat percentage. There was a significant increase in leisure-time physical activity among the intervention participants, compared with a decrease among the control subjects. Conclusions. Our data demonstrate the short- and longer-term beneficial effects of a combined dietary-behavioral-physical activity intervention among obese children. These results highlight the importance of multidisciplinary programs for the treatment of childhood obesity and emphasize their encouraging long-term effects. Pediatrics 2005;115:e443-e449. URL: www. pediatrics.org/cgi/doi/10.1542/peds.2004-2172; obesity, multidisciplinary treatment, childhood, exercise.