Effectiveness of individual and group programmes to treat obesity and reduce cardiovascular disease risk factors in pre‐pubertal children

Farpour‐Lambert, Nathalie J. (University Hospitals of Geneva and University of Geneva, Geneva, Switzerland) ; Martin, Xavier E. (University Hospitals of Geneva and University of Geneva, Geneva, Switzerland) ; Bucher Della Torre, Sophie (Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; University Hospitals of Geneva and University of Geneva, Geneva, Switzerland) ; von Haller, Lydia (University Hospitals of Geneva and University of Geneva, Geneva, Switzerland) ; Ells, Louisa J. (Teesside University, Middlesbrough, UK) ; Herrmann, François R. (University Hospitals of Geneva and University of Geneva, Geneva, Switzerland) ; Aggoun, Yacine (University Hospitals of Geneva and University of Geneva, Geneva, Switzerland)

Childhood obesity results in premature atherosclerosis and requires early intervention. Compare the effectiveness of 6‐month lifestyle interventions (with choice of either individual or group therapy) with standard care on body mass index (BMI) z‐score and cardiovascular disease (CVD) risks factors in children with obesity. This 6‐month randomized controlled trial with a 6‐month follow‐up included 74 pre‐pubertal children with obesity (7.5‐11.9 years) assigned randomly (2:1) to intervention or control. Families in the intervention arm choose between an individually delivered treatment (3 hours paediatrician + 4 hours dietician) or group treatment (35 hours with a multidisciplinary team). Children participated also to a weekly physical activity programme. We measured BMI, BMI z‐score; waist circumference (WC); total and abdominal fat; blood pressure; common carotid artery intima‐media thickness and incremental elastic modulus (Einc); endothelium‐dependent and independent dilation (nitroglycerin‐mediated dilation [NTGMD]) of the brachial artery; fasting plasma glucose, insulin, lipids; and high‐sensitivity C‐reactive protein (hs‐CRP). Compared to controls, at 6 months, abdominal fat and hs‐CRP were reduced in both interventions. The group intervention was also effective in reducing BMI (−0.55 kg/m2; 95% confidence interval −1.16 to 0.06) and BMI z‐score (−0.08; −0.15 to 0.00) at 6 months and BMI, BMI z‐score, WC, NTGMD, total and abdominal fat at 12 months. Abdominal fat and low‐grade inflammation were significantly decreased in both interventions. High‐intensity group treatment improved early signs of atherosclerosis in children with obesity. These findings are important for the promotion of cardiometabolic health in this population.


Keywords:
Article Type:
scientifique
Faculty:
Santé
School:
HEdS - Genève
Institute:
Aucun institut
Date:
2019-02
Pagination:
12 p.
Published in:
Clinical Obesity
Numeration (vol. no.):
2019, vol 9, e12335
DOI:
ISSN:
1758-8103
Appears in Collection:



 Record created 2020-02-11, last modified 2020-02-19

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