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June 25, 2007 -- Childhood obesity may be no match for families that work together on weight control, a new study shows.
The study, published in The Journal of the American Medical Association, isn't about putting overweight children on a restrictive diet.
Instead, it's about building a healthy lifestyle for parents and kids alike.
"The parents were key. Parents were the major agent of change in the home," Yale University researcher Mary Savoye, RD, CD-N, CDE, told reporters.?
Those changes, detailed in Savoye's study, took effort. But they paid off by helping overweight kids lose extra body fat, lower their risk of developing type 2 diabetes, and learn healthy lifestyle habits.
"The secret is it's an educational process," Savoye says. "My guess is they will continue to do well because now they can make informed decisions about better food choices."
Americans of all ages, including children, are increasingly becoming overweight. Extra pounds make health problems, including diabetes and high blood pressure, more likely.
"Since an overweight child has a high probability of becoming an overweight adult, the grave concerns for the long-term health of obese children are well justified," Savoye's team writes.
Savoye and colleagues studied 209 overweight children aged 8 to 16 in inner-city New Haven, Conn.
First, the kids got a thorough checkup that included measuring their height, weight, blood pressure, and cholesterol. Next, the researchers randomly split the kids into two groups.
One group of kids was assigned to participate -- with a parent or caregiver -- in an intensive lifestyle program called Bright Bodies for one year.
The other group of children saw a doctor, dietitian, and social worker for checkups every six months and received counseling on nutrition and exercise.
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Children and their caregivers in the Bright Bodies group attended sessions twice weekly for the first six months and twice monthly for the second six months.
In the sessions, they learned about nutrition, goal setting, self-awareness, and coping skills. The kids also got supervised group exercise sessions, which focused on making fitness fun.
Exercise included dancing, jumping rope, and playing basketball and flag football.
Their parents were taught how to make their home environment supportive of weight control. For instance, they learned not to single out the overweight child, but to make weight control a family project.
"You'd be surprised how many parents think it's OK to sit on the sofa with a bag of chips, and the child has to be having diet Jell-0, for example," Savoye says. "We want to break that separation, and the parents really enjoy that piece of it."
Sixty percent of the kids completed six months of the study and 53% finished the yearlong study.
Children are growing, so it's normal for them to gain some weight. That's why the researchers focused on the children's BMI (body mass index), which relates height to weight.
During the study, the kids in the Bright Bodies program shed 1.7 points off
their average BMI. They also lost about 8 pounds of body fat and improved their
sensitivity to insulin, a hormone that controls blood sugar.
The results suggest that those children had lowered their risk of developing type 2 diabetes.
In contrast, kids in the comparison group added 1 point to their BMI and gained some 12 pounds of body fat. Five children in the group also developed insulin resistance, which can lead to type 2 diabetes.
If children in the comparison group had seen their doctors more often, they might have shown more improvement, Savoye notes.
The study didn't show much change in the children's blood pressure or levels of "good" or "bad" cholesterol. Those levels were "close to normal" to begin with, Savoye says, so the researchers didn't expect big changes in those measurements during the study.
The Bright Bodies program is ongoing in New Haven, Conn. Savoye is working with colleagues on guidelines for setting up programs similar to Bright Bodies.