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Tailored family counseling reduces children’s BMI gain


 

FROM PEDIATRICS

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Short but regular meetings aimed at helping families develop healthier eating and activity habits can lead to modest but significant drops in overweight children’s body mass index (BMI), a recent study found.

The intervention families also made small gains in healthier habits, such as slightly increasing their fruit and vegetable intake.

“Our data demonstrate that providing families of young overweight children with regular low-intensity support can make small but significant differences to body weight and lifestyle behaviors over 2 years,” wrote Rachael W. Taylor, Ph.D., of the University of Otago in Dunedin, New Zealand, and her associates. “Children in the tailored condition had smaller gains in BMI, were more physically active, had improved diets, and reported that fewer noncore foods were available in the home than children in usual care” (Pediatrics 2015 July 20 [doi:10.1542/peds.2015-0595]).

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The researchers randomly assigned 206 children, aged 4-8 years and nearly all falling at or above the 85th percentile for their BMI, to usual care or to a set of regular personalized sessions of healthy lifestyle counseling. The families in the latter tailored intervention met with an multidisciplinary team – usually including both parents, a mentor, a dietitian, an exercise specialist, and a clinical psychologist – one time at baseline. They then met monthly the first year and quarterly the second year with a mentor. Throughout the program they received family-based, personalized guidance, set goals to work toward using behavioral strategies, and received resources as needed.

Those receiving usual care met with a researcher for 30-45 minutes at baseline and again for 15-30 minutes 6 months later. The researcher gave them generalized advice about children’s eating, physical activity, and sleep as well as personalized feedback about the diet and activity habits of their children. Total contact time in the extended intervention was 6-7 hours per family, compared with 45-75 minutes in the usual care group.

At 24 months, 181 children (88%) remained in the program. Children in the tailored program had a BMI 0.34 points lower and a BMI z score 0.12 points lower than did those in the usual care group, after accounting for baseline characteristics. The waist circumferences of children in the tailored program was also 1.5 cm smaller than were the children in the usual care group. The tailored program children also were more physically active than were the other children, but their moderate-vigorous physical activity, sedentary time, and sleep didn’t differ. Families in the tailored program had slightly higher fruit and vegetable intake.

The research was supported by the Health Research Council of New Zealand with additional funding from a Freemasons New Zealand Fellowship and a KPS Research Fellowship. The authors reported no disclosures.

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