Abstract
BACKGROUND:
The Freiburg Intervention Trial for Obese Children (FITOC) is an interdisciplinary, outpatient program for obese children consisting of regular physical exercise and comprehensive dietary and behavioral education. Parental involvement is required. The study is designed as a longitudinal, nonrandomized clinical observation study. An 8-month intensive phase preceded a follow-up phase of 1 y or longer.
METHODS:
Data were collected from 31 groups comprising 496 children (267 girls, 229 boys), with an average age of 10.5 y. Body height and weight, fasting total-cholesterol (CH), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and physical performance were measured initially and after 8.5 months. A group of n=35 obese children (16 girls, 19 boys) who did not take part in this intervention program served as controls.
RESULTS:
After the intensive intervention phase, body mass index (BMI, kg/m2) as well as BMI deviation scores (BMI-SDS) decreased in both sexes (P<0.001). In the controls, BMI increased (P<0.001) and BMI-SDS remained constant. Whereas CH was only significantly lower (P<0.01) in boys after 8.5 months, LDL-C decreased significantly in both sexes. HDL-C tended to increase in both sexes (not significant). The controls showed no significant changes in CH, LDL-C and HDL-C. The fitness levels (W/kg body weight) improved in the intervention group (P<0.001), but not in the control group.
CONCLUSIONS:
The results indicate that obese children can be successfully treated in such an intervention program. BMI-SDS and risk factors decreased and physical performance improved. To maintain therapeutical success, we highly recommended that these children enroll in community-based exercise programs in order to help them maintain a more active lifestyle after the follow-up phase.
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References
Flegal KM . The obesity epidemic in children and adults: current evidence and research issues. Med Sci Sports Exerc 1999; 31: S509–S514.
World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i–253.
Robinson TN . Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA 1999; 282: 1561–1567.
Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, Laird N . Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Arch Pediatr Adolesc Med 1999; 153: 409–418.
Srinivasan SR, Bao W, Wattigney WA, Berenson GS . Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996; 45: 235–240.
Freedman DS, Shear CL, Burke GL, Srinivasan SR, Webber LS, Harsha DW, Berenson GS . Persistence of juvenile-onset obesity over eight years: the Bogalusa Heart Study. Am J Public Health 1987; 77: 588–592.
Braddon FE, Rodgers B, Wadsworth ME, Davies JM . Onset of obesity in a 36 year birth cohort study. BMJ (Clin Res Ed) 1986; 293: 299–303.
Guo SS, Roche AF, Chumlea WC, Gardner JD, Siervogel RM . The predictive value of childhood body mass index values for overweight at age 35 y. Am J Clin Nutr 1994; 59: 810–819.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH . Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997; 337: 869–873.
Wang G, Dietz WH . Economic burden of obesity in youths aged 6 to 17 years: 1979–1999. Pediatrics 2002; 109: E81.
Berg A, Korsten-Reck U . Strategien zur Verbesserung des Aktivitäts- und Ernährungsverhaltens bei Kindern und Jugendlichen. Der Lipidreport 1995; 4: 15–22.
Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnsen D, Korte W, Menner K, Müller G, Müller JM, Niemann-Pielatus A, Remer T, Schaefer F, Wittchen H-U, Zabransky S, Zellner K, Ziegler A, Hebebrand J . Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 2001; 149: 807–818.
Berg A, Jakob E, Lehmann M, Dickhuth HH, Huber G, Keul J . Aktuelle Aspekte der modernen Ergometrie. Pneumologie 1990; 44: 2–13.
Cole TJ, Green PJ . Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 1992; 11: 1305–1319.
Eliakim A, Kaven G, Berger I, Friedland O, Wolach B, Nemet D . The effect of a combined intervention on body mass index and fitness in obese children and adolescents—a clinical experience. Eur J Pediatr 2002; 161: 449–454.
Bailey RC, Olson J, Pepper SL, Porszasz J, Barstow TJ, Cooper DM . The level and tempo of children's physical activities: an observational study. Med Sci Sports Exerc 1995; 27: 1033–1041.
Wilmore JH, Costill DL . Physiology of sports and exercise. Campaign: Hum Kinet 1994.
van Lenthe FJ, Kemper HC, van Mechelen W, Post GB, Twisk JW, Welten DC, Snel J . Biological maturation and the distribution of subcutaneous fat from adolescence into adulthood: the Amsterdam Growth and Health Study. Int J Obes Relat Metab Disord 1996; 20: 121–129.
Sorva R, Kuusi T, Dunkel L, Taskinen MR . Effects of endogenous sex steroids on serum lipoproteins and postheparin plasma lipolytic enzymes. J Clin Endocrinol Metab 1988; 66: 408–413.
Beaglehole R . Oestrogens and cardiovascular disease. BMJ 1988; 297: 571–572.
Zonderland ML, Erich WB, Peltenburg AL, Bernink MJ, Havekes L, Thijssen JH . Plasma lipoprotein profile in relation to sex hormones in premenarcheal athletes. Int J Sports Med 1986; 7: 241–245.
Suter E, Hawes MR . Relationship of physical activity, body fat, diet, and blood lipid profile in youths 10–15 y. Med Sci Sports Exerc 1993; 25: 748–754.
Boreham C, Twisk J, Murray L, Savage M, Strain JJ, Cran G . Fitness, fatness, and coronary heart disease risk in adolescents: the Northern Ireland Young Hearts Project. Med Sci Sports Exerc 2001; 33: 270–274.
Tolfrey K, Campbell IG, Batterham AM . Exercise training induced alterations in prepubertal children's lipid–lipoprotein profile. Med Sci Sports Exerc 1998; 30: 1684–1692.
Lauer RM, Lee J, Clarke WR . Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study. Pediatrics 1988; 82: 309–318.
Kavey RE, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K . American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003; 107: 1562–1566.
Molnar D, Livingstone B . Physical activity in relation to overweight and obesity in children and adolescents. Eur J Pediatr 2000; 159 (Suppl 1): S45–S55.
Goran MI, Gower BA, Nagy TR, Johnson RK . Developmental changes in energy expenditure and physical activity in children: evidence for a decline in physical activity in girls before puberty. Pediatrics 1998; 101: 887–891.
Berkey CS, Rockett HR, Gillman MW, Colditz GA . One-year changes in activity and in inactivity among 10- to 15-year-old boys and girls: relationship to change in body mass index. Pediatrics 2003; 111: 836–843.
Trost SG, Kerr LM, Ward DS, Pate RR . Physical activity and determinants of physical activity in obese and non-obese children. Int J Obes Relat Metab Disord 2001; 25: 822–829.
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH . Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 327: 1350–1355.
Lake JK, Power C, Cole TJ . Women's reproductive health: the role of body mass index in early and adult life. Int J Obes Relat Metab Disord 1997; 21: 432–438.
Gortmaker SL, Cheung LW, Peterson KE, Chomitz G, Cradle JH, Dart H, Fox MK, Bullock RB, Sobol AM, Colditz G, Field AE, Laird N . Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving. Arch Pediatr Adolesc Med 1999; 153: 975–983.
Harrell JS, McMurray RG, Gansky SA, Bangdiwala SI, Bradley CB . A public health vs a risk-based intervention to improve cardiovascular health in elementary school children: the Cardiovascular Health in Children Study. Am J Public Health 1999; 89: 1529–1535.
Nader PR, Stone EJ, Lytle LA, Perry CL, Osganian SK, Kelder S, Webber LS, Elder JP, Montgomery D, Feldman HA, Wu M, Johnson C, Parcel GS, Luepker RV . Three-year maintenance of improved diet and physical activity: the CATCH cohort. Child and Adolescent Trial for Cardiovascular Health. Arch Pediatr Adolesc Med 1999; 153: 695–704.
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Korsten-Reck, U., Kromeyer-Hauschild, K., Wolfarth, B. et al. Freiburg Intervention Trial for Obese Children (FITOC): results of a clinical observation study. Int J Obes 29, 356–361 (2005). https://doi.org/10.1038/sj.ijo.0802875
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DOI: https://doi.org/10.1038/sj.ijo.0802875