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Weight-loss intervention shows promise in children and their families

A family-based child weight-management programme delivered by non-specialists was well attended and resulted in beneficial changes in participants’ physical, behavioural and psychological outcomes, researchers report.

The study

A study of 274 overweight or obese children aged 5–7 years and their family members who participated in the 10-week MEND (Mind, Exercise, Nutrition… Do it!) 5–7 healthy lifestyle intervention, held in 37 community venues across the UK.

MEND 5–7 is a multicomponent weight management programme involving weekly group sessions, each lasting one hour 45 minutes. The sessions are held in community settings such as sports centres and schools, for groups of 8–15 children and their parents or carers.

Each session is made up of four components, namely: ‘power time’, a joint child and parent/carer snack time designed to help parents encourage their children to adopt healthier foods; ‘healthy families’, another joint activity that focuses on everyday play and active family lifestyles and healthy family eating at home; ‘active play’, a child-only session focused on fun and active participation with an emphasis on supporting children to have positive experiences of being active; and a ‘parent/carer workshop’ involving group discussions about healthy eating and practical training on understanding food and drink labels, fat and sugar content of foods and drinks and portion sizes and managing fussy eating, as well as learning about family rules and routines, reducing screen time and overcoming barriers to physical activity.

Researchers measured children’s physical activity and sedentary behaviours and body weight and height before and after the programme. In addition, they assessed both children’s and parents/carers’ fruit and vegetable consumption, parents/carers’ perceptions of their children’s emotional difficulties and parents’/carers’ parenting self-efficacy using standardised instruments.

The findings

The mean attendance rate was 73%, while the mean retention rate, based on children attending at least seven sessions, was 70%. 

By the end of the ten weeks, children had achieved significant reductions in body mass index (mean reduction, 0.5 kg/m2), waist circumference (mean, 0.9 cm) and child total difficulties score on the Strengths and Difficulties Questionnaire – Parent’s Version, a widely used measure of emotional distress in children and adolescents. They had also reduced the amount of time spent watching TV (mean, 3.4  hours less each week) and time spent in sedentary activities (4.1 less hours per week), and increased their physical activity levels (2.9 more hours each week).

In addition, both children and parents had significant increased their intake of at least five fruit and vegetables each day, while parents’/carers reported significant improvements on all domains of parenting self-efficacy.

What this means for GPs

The researchers say their findings warrant further investigation in different settings and across varying ethnic socioeconomic groups, with a view to scaling up the programme to provide weight management pathways nationally. They conclude: ‘This study demonstrates that a community-based intervention delivered by non-obesity specialists has a potentially valuable contribution to make as part of a comprehensive care pathway for families of overweight and obese children.’

BMJ Open 2013; 3:e002607

MEND website


          

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