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Effects on metabolic health after a 1-year-lifestyle intervention in overweight and obese children: a randomized controlled trial
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
2012 (English)In: Journal of Nutrition and Metabolism, ISSN 2090-0724, E-ISSN 2090-0732, Vol. 2012, 913965Article in journal (Refereed) Published
Abstract [en]

Objective. To evaluate the effect of a family-based intervention on anthropometric and metabolic markers in overweight and obese children. Methods. Overweight or obese 8-12 years olds (n = 93) were randomized into intervention or control groups. The intervention group participated in a program aiming for lifestyle changes regarding food habits and physical activity. Anthropometric measures and venous blood samples were collected from all children at baseline and after 1 year. Results. BMI z-scores decreased in both groups, 0.22 (P = 0.002) and 0.23 (P = 0.003) in intervention and control group, respectively, during the 1-year study, but there was no difference in BMI between the groups at 1-year measurement (P = 0.338). After 1 year, there was a significant difference in waist circumference, waist/hip ratio, and apolipoprotein B/A1 ratio between intervention and control group. Conclusions. The intervention had limited effects on anthropometrics and metabolic markers, which emphasizes the need of preventing childhood overweight and obesity.

Place, publisher, year, edition, pages
2012. Vol. 2012, 913965
National Category
Other Social Sciences not elsewhere specified
Research subject
Food and Nutrition
Identifiers
URN: urn:nbn:se:umu:diva-37509DOI: 10.1155/2012/913965Scopus ID: 2-s2.0-84873828297OAI: oai:DiVA.org:umu-37509DiVA: diva2:360976
Available from: 2010-11-05 Created: 2010-11-05 Last updated: 2017-06-08Bibliographically approved
In thesis
1. Promoting physical activity among overweight and obese children: Effects of a family-based lifestyle intervention on physical activity and metabolic markers
Open this publication in new window or tab >>Promoting physical activity among overweight and obese children: Effects of a family-based lifestyle intervention on physical activity and metabolic markers
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity.

Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water.

Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period.

Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children.

Place, publisher, year, edition, pages
Umeå: Institutionen för Kostvetenskap, 2010. 64 p.
Keyword
intervention: children: overweight: obestiy: physical activity
National Category
Food Science Physiotherapy
Research subject
Physiotherapy; Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-37511 (URN)978-91-7459-102-6 (ISBN)
Public defence
2010-12-10, Hörsal C, Samhällsvetarhuset, Umeå Universitet, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Projects
SELFH
Available from: 2010-11-19 Created: 2010-11-05 Last updated: 2011-01-26Bibliographically approved
2. Dietary and metabolic effects of a 2-year lifestyle intervention in overweight and obese children
Open this publication in new window or tab >>Dietary and metabolic effects of a 2-year lifestyle intervention in overweight and obese children
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Childhood overweight and obesity have increased during the past decades and there is a need for effective intervention programs both for treatment and prevention to interrupt the increased trend. Overweight and obesity result from a combination of genetic predisposition and lifestyle where an imbalance in energy intake (EI) and total energy expenditure (TEE) is the key factor. The objective of this thesis is to evaluate the impact of a 2-year lifestyle intervention on food habits, anthropometry and metabolic markers on children with overweight and obesity.

Methods Overweight and obese children 8-12 years old were recruited to participate in a 2-year randomized controlled trial (RCT). One hundred and five children agreed to participate and were randomized into one intervention group and one control group. Both groups participated in the same measurements while the intervention group also participated in a lifestyle program aiming at improving food habits and increasing physical activity. The first year of the program consisted of 14 group sessions and the second year of the intervention was web-based. Food habits were assessed at baseline and at endpoint by a diet history interview (DHI) and by a 4-day food record at 1-year measurement. At baseline 22 randomly chosen children were included in a validation study to validate reported EI against TEE measured by doubly labeled water (DLW) method and SenseWear Armband Pro 2 and 3 (version 5.1) (SWA). Anthropometric and biochemical parameters were measured at baseline, 1-year and endpoint.

Results The DHI underestimated EI by 14% when validated against measured TEE by DLW and SWA. At the 1-year measurement the intervention group had a lower intake of fat (g and E%), monounsaturated fat (MUFA) (g) and polyunsaturated fat (PUFA) (g and E%) compared to the control group. At endpoint the intervention group had a lower intake of fat (g), MUFA (g) and cholesterol compared to the control group. Children in the intervention group consumed less sugar sweetened beverages at endpoint and had increased their intake of keyhole labeled foods compared to the control group. During the first year the growing children in both groups remained stable with respect to BMI and had decreased their BMI zscore.

Conclusion The 2-year lifestyle intervention resulted in some improvements regarding food habits, but overall the effects on anthropometrics and metabolic markers were limited. This strongly supports that efforts should primarily be aimed at primary prevention of childhood overweight and obesity.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, Institutionen för kostvetenskap, 2011. 68 p.
National Category
Food Science
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-43679 (URN)978-91-7459-141-5 (ISBN)
Public defence
2011-06-10, Hörsal C, Samhällsvetarhuset, Umeå universitet, 90187 Umeå, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-05-09 Created: 2011-05-05 Last updated: 2011-05-09Bibliographically approved

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Waling, MariaBäcklund, CatharinaLind, TorbjörnLarsson, Christel

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