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Impact of a child obesity intervention on dietary intake and behaviors

Abstract

Objective:

The aims of this study were to describe the dietary intakes and food behavior changes of overweight and obese children participating in the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS) study and to describe the impact of a best practice dietary modification program.

Design:

A multicenter randomized controlled trial with allocation to one of three intervention arms: (1) parent-centered nutrition lifestyle program; (2) child-centered physical activity skill development program; or (3) both the programs.

Participants:

One hundred and sixty-five overweight, pre-pubertal children 5–9 years of age (58% female).

Measurements:

Dietary intake was assessed at baseline, 6 and 12 months post-commencement of the program using a semiquantitative food frequency questionnaire.

Results:

After 6 and 12 months, all groups improved their dietary intake, with no differences detected between groups (P>0.05). Total quantity of food (g) and kJ kg−1 decreased significantly at both time points (P<0.05). Percent energy derived from core food groups, except fruit, increased significantly at 12 months compared to baseline (P<0.05), and non-core foods decreased, with the largest decreases being for sweetened drinks (5.0±0.4 vs 2.9±0.3% of energy baseline to 12 months, P<0.001) and packaged lunch box snacks (5.4±0.3 vs 4.1±0.3% of energy baseline to 12 months, P<0.001).

Conclusion:

All treatment groups in the HIKCUPS study appear to be equally efficacious in improving dietary intake in overweight and obese children.

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References

  1. Haslam D, James WP . Obesity. Lancet 2005; 366: 1197–1209.

    Article  Google Scholar 

  2. Collins C, Warren J, Neve M, Stokes B . Measuring effectiveness of dietetic interventions in child obesity. Arch Pediatr Adolesc Med 2006; 160: 906–922.

    Article  Google Scholar 

  3. Collins C, Warren J, Neve M, McCoy P, Stokes B . Best Practice dietetic management of overweight and obesity in children and adolescents; a systematic review. Int J Evid Base Heal 2007; 5: 2–55.

    Google Scholar 

  4. Jones R, Okely A, Collins C, Morgan P, Steele J, Warren J et al. The HIKCUPS Trial: a multi site randomised controlled trial of a combined physical activity skill development and dietary modification program in overweight and obese children. BMC Public Health 2007; 7. Available at http://www.biomedcentral.com/1471-2458/7/15.

  5. Cole T, Bellizzi M, Flegal M, Dietz W . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  Google Scholar 

  6. Dietitians Association of Australia. Easy Family Eating For Healthy Kids, Pfizer: Australia 2004, Health Report Issue 12, February.

  7. Golan M, Weizman A, Apter A, Fainaru M . Parents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr 1998; 67: 1130–1135.

    Article  CAS  Google Scholar 

  8. Ajzen J . The Theory of planned behaviour. Organ Behav Hum Decis Process 1991; 50: 179–211.

    Article  Google Scholar 

  9. Gehling R, Magarey A, Daniels L . Food based recommendations to reduce fat intake: an evidence based approach to the development of a family focused child weight management program. J Paediatr Child Health 2005; 41: 112–118.

    Article  CAS  Google Scholar 

  10. Smith A, Kellet E, Schmerlaib Y . The Australian Guide To Healthy Eating. Commonwealth Department of Health and Family Services: Canberra, 1998.

  11. International standards for anthropometric assessment. International Soci for the Advancement of Kinanthropometry 2001.

  12. Lobstein T, Baur L, Uauy R . Obesity in children and young people: a crisis in public health. Obes Rev 2004; 5: 4–85.

    Article  Google Scholar 

  13. Watson J, Collins C, Sibbritt D, Dibley M, Garg M . Validation of a child and adolescent food frequency questionnaire in Australia. Proc 10th International Congress on Obesity, Sydney, Ob Rev 2006; 7: PO0534.

    Google Scholar 

  14. Schofield W, Schofiled L, James P . Predicting basal metabolic rate and new standards and review of previous work. Hum Nutr Clin Nutr 1985; 39: 5–41.

    PubMed  Google Scholar 

  15. Toran B . Energy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old. Eur J Clin Nutr 1996; 50: S37–S81.

    Google Scholar 

  16. Zuppa J, Morton H, Mehta KP . Television food advertising: counter productive to childrens health? A content analysis using the Australian Guide To Healthy Eating? Nutr Dietet 2003; 60: 78–84.

    Google Scholar 

  17. Braet C, Van Winckel M, Van Leeuwen K . Follow up results of different treatment programs for obese children. Acta Pediatr 1997; 86: 397–402.

    Article  CAS  Google Scholar 

  18. Nuutinen O, Knip M . Long term weight control in obese children: persistance of treatment outcome and metabolic changes. Int J Obes 1992; 16: 279–287.

    CAS  Google Scholar 

  19. Epstein L, Valoski A, Wing R, McCurley J . Ten-year outcomes of behavioural family based treatment for childhood obesity. Health Psychol 1994; 13: 373–383.

    Article  CAS  Google Scholar 

  20. Epstein L, Wing R, Koeske R, Valoski A . The effects of diet plus excercise on weight change in parents and children. J Consult Clin Psychol 1984; 52: 429–437.

    Article  CAS  Google Scholar 

  21. Epstein L, Wing R, Koeske R, Valoski A . Effect of parent weight on weight loss in obese children. J Consult Clin Psychol 1986; 54: 400–401.

    Article  CAS  Google Scholar 

  22. Kaskoun M, Johnson R, Goran M . Comparison of energy intake by semi-quantitative food frequency questionnaire with total energy expenditure by the doubly labeled water method in young children. Am J Clin Nutr 1994; 60: 43–47.

    Article  CAS  Google Scholar 

  23. Livingstone MB, Robson P, Wallace J . Issues in dietary assessment in children and adolescents. Br J Nutr 2004; 92: S213–S222.

    Article  CAS  Google Scholar 

  24. Jones R, Oakley A, Collins C, Morgan P, Warren J, Burrows T et al. Efficacy of HIKCUPS in reducing BMI z score at 1 year: results of a multi-site randomised trial for overweight 5–9 year olds. Obesity 2007; 15 (S1): A34-108OR.

    Google Scholar 

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Acknowledgements

HIKCUPS is funded by the Australian National Health and Medical Research Council of Australia (354101). We would like to thank participating children and parents, local schools in the Hunter and Illawarra regions of New South Wales and the Universities of Wollongong and Newcastle. We would also like to thank Sanitarium Health Food Company for supplying the breakfast cereal for the assessments.

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Correspondence to C E Collins.

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Address of institutions at which the work was carried out: University of Newcastle, Newcastle, NSW 2308, Australia; University of Wollongong, Wollongong, NSW 2522, Australia.

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Burrows, T., Warren, J., Baur, L. et al. Impact of a child obesity intervention on dietary intake and behaviors. Int J Obes 32, 1481–1488 (2008). https://doi.org/10.1038/ijo.2008.96

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