Short- and Long-Term Beneficial Effects of a Combined Dietary–Behavioral–Physical Activity Intervention for the Treatment of Childhood Obesity

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Abstract
Background. Obesity has become the most common pediatric chronic disease in the modern era. Early prevention and treatment of childhood and adolescent obesity is mandated. Surprisingly, however, only a minor fraction of obese children participate in weight reduction interventions, and the longer-term effects of these weight-reduction interventions among children have not been elucidated. Objective. To examine prospectively the short- and long-term effects of a 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, body composition, dietary and leisure-time habits, fitness, and lipid profiles among obese children. Methods. In this randomized prospective study, 24 obese subjects completed the 3-month intervention and were compared with 22 obese, age- and gender-matched, control subjects. Results. At 3 months, there were significant differences in changes in body weight (−2.8 ± 2.3 kg vs 1.2 ± 2.2 kg), BMI (−1.7 ± 1.1 kg/m2 vs −0.2 ± 1.0 kg/m2), body fat percentage (from skinfold tests; −3.3 ± 2.6% vs 1.4 ± 4.7%), serum total cholesterol level (−24.6 ± 15.1 mg/dL vs 0.8 ± 18.7 mg/dL), low-density lipoprotein cholesterol level (−23.3 ± 15.2 mg/dL vs −3.7 ± 17.3 mg/dL), and fitness (215 ± 107 seconds vs 50 ± 116 seconds) in the intervention group versus the control group. After a 1-year follow-up period, there were significant differences between the intervention group (n = 20) and the control group (n = 20) in body weight (0.6 ± 6.0 kg vs 5.3 ± 2.7 kg), BMI (−1.7 ± 2.3 kg/m2 vs 0.6 ± 0.9 kg/m2), and body fat percentage. There was a significant increase in leisure-time physical activity among the intervention participants, compared with a decrease among the control subjects. Conclusions. Our data demonstrate the short- and longer-term beneficial effects of a combined dietary-behavioral-physical activity intervention among obese children. These results highlight the importance of multidisciplinary programs for the treatment of childhood obesity and emphasize their encouraging long-term effects.