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Nutrition in acute and chronic diseases

Parent and child characteristics associated with treatment non-response to a short- versus long-term lifestyle intervention in pediatric obesity

European Journal of Clinical Nutrition volume 77, pages 127–134 (2023)Cite this article

Subjects

Abstract

Background/Objectives

This study aimed to identify the factors associated with short- or long-term non-response to an obesity intervention in children and adolescents.

Subjects/Methods

In this observational study, a total of 242 children and adolescents (sex- and age-specific body mass index (BMI) ≥ 85th percentile) were divided into three groups according to the BMI z-score change after 6 (n = 163) and 24 months (n = 110) of participating in an obesity intervention: responders, low responders, and non-responders if the BMI z-score decrease was ≥0.25, 0 to 0.25, and if it increased, respectively.

Results

Short-term non-response was associated with higher maternal psychosocial stress (OR = 2.34, 95% CI [1.07–5.11]) and adolescence (>11 years; OR = 2.40, 95% CI [1.10–5.22]). The odds of long-term non-response were reduced by an increased vegetable consumption of more than five dishes per week (OR = 0.21, 95% CI [0.07–0.69]) and an hour of increased sleep duration during weekends (OR = 0.14, 95% CI [0.04–0.53]).

Conclusions

Short-term non-response was associated with child and maternal characteristics, whereas long-term non-response was associated with actual lifestyle changes such as sleep duration and vegetable consumption. Children with obesity may benefit from an hour of weekend catch-up sleep in lowering the risk of long-term treatment non-response. An individualized approach should be considered for children of older age and mothers with a higher level of stress, as they may not benefit from a conventional short-term lifestyle intervention.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This research was funded by the Korea Disease Control and Prevention Agency [grant number: 2016ER6405]. This work was supported by the Korea Disease Control and Prevention Agency [grant number: 2016ER6405].

Author information

Authors and Affiliations

  1. Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon-si, Gangwon-do, Republic of Korea

    Sarah Woo

  2. Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea

    Hong Ji Song & Kyung Hee Park

  3. Department of Preventive Medicine, College of Medicine, Jeju National University, Jeju-si, Jeju Special Self-Governing Province, Republic of Korea

    Jung-Kook Song

  4. University College, Yonsei University International Campus, Incheon, Republic of Korea

    YoonMyung Kim

  5. Department of Medical Nutrition, Kyung Hee University, Yongin-si, Gyeonggi-do, Republic of Korea

    Hyunjung Lim

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Contributions

KHP and SW conceptualized the study, performed formal analysis and created the original draft. KHP, SW, YMK, and HJL participated in designing the research protocol and conducting the investigation. KHP, SW, HJS, and JKS contributed to data interpretation and critical revision of the manuscript. All authors have approved the final manuscript.

Corresponding author

Correspondence to Kyung Hee Park.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study was conducted in accordance with the ethical guidelines regarding human participants that were approved by the Institutional Review Board of Hallym University Sacred Heart Hospital (no. 2016-I135). All participants and their primary caretakers provided written informed consent. Informed consent was obtained from all subjects involved in the study.

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Woo, S., Song, H.J., Song, JK. et al. Parent and child characteristics associated with treatment non-response to a short- versus long-term lifestyle intervention in pediatric obesity. Eur J Clin Nutr 77, 127–134 (2023). https://doi.org/10.1038/s41430-022-01207-1

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