Yesterday we presented data indicating that the prevalence of severe obesity in children has increased and suggested families will have to be involved to deal with weight issues in young children. A study presented online in JAMA Pediatrics and described by MedPage Today demonstrated just how difficult successful involvement might be.
Dr. Jess Haines from the University of Guelph in Ontario and colleagues from Harvard Medical School enrolled 121 low income, mostly Hispanic and African-American families in a randomized study to improve household routines that are associated with childhood obesity. Each family had a child between 2 and 5 years of age. Fifty-five percent of the families had incomes under $20,000 per year, and nearly half of the children were overweight or obese.
Fifty-five families (the intervention group) were coached at home to increase the frequency of family meals, decrease TV viewing on both weekdays and weekends, increase children s sleep duration, and were advised to remove TVs from rooms where children slept. The families were followed for 6 months, and each child s Body Mass Index (BMI) was assessed at the beginning and end of the study. In addition, parents reported on the other interventions that had been encouraged in the coaching program.
Children in the intervention group had BMIs that, on average, were 0.4 points lower than those of kids in the control group whose families received no coaching. There was no difference between groups in the number of family meals per week, total TV viewing, or in the percent of children who had televisions in their bedrooms. There was a significantly increased sleep duration in the intervention group, and a slight but significant decline in BMIs of the intervention group, while the BMIs of the controls increased by 0.21 points in the 6 months of the study.
ACSH s Dr. Ruth Kava comments This study seems to show that even family coaching over 6 months had little impact on behaviors that affect children s body weight. The fact that the BMIs of the children in the intervention group decreased may give some reason to hope. However, it is not clear whether the BMIs (calculated as body weight divided by the height squared) decreased because the children lost weight, or because the children grew. It may be the case, she continued, that in order to make such interventions effective, we may need to increase the length of time they are employed, or offer some sort of incentive to help families adhere to the suggested changes.