Efficacy of U.S. paediatric obesity primary care guidelines: two randomized trials

Pediatr Obes. 2012 Feb;7(1):28-38. doi: 10.1111/j.2047-6310.2011.00005.x. Epub 2011 Dec 13.


Objective: The objective of this study was to examine the efficacy of U.S. primary care paediatric obesity treatment recommendations, within two randomized trials.

Methods: Between November 2005 to September 2007, 182 families (children aged 4-9 years, body mass index [BMI] ≥85th percentile) were recruited for two separate trials and randomized within trial to a 6-month intervention. Each trial had one intervention that increased child growth-monitoring frequency and feedback to families (GROWTH MONITORING). Each trial also had two interventions, combining GROWTH MONITORING with an eight-session, behavioural, parent-only intervention targeting two energy-balance behaviours (Trial 1: reducing snack foods and sugar-sweetened beverages [DECREASE], and increasing fruits, vegetables and low-fat dairy [INCREASE]; Trial 2: decreasing sugar-sweetened beverages and increasing physical activity [TRADITIONAL] and increasing low-fat milk consumption and reducing television watching [SUBSTITUTES]). Child standardized BMI (ZBMI) and energy intake were assessed at 0, 6 and 12 months.

Results: In both trials, main effects of time were found for ZBMI, which decreased at 6 and 12 months (P < 0.01). In Trial 1, ZBMI reduced from 0 to 6 months, which was maintained from 6 to 12 months (ΔZBMI 0 to 12 months = -0.12 ± 0.22). In Trial 2, ZBMI reduced from 0 to 6 and from 6 to 12 months (ΔZBMI 0-12 months = -0.16 ± 0.31). For energy intake, main effects of time were found in both trials and intake reduced from 0 to 6 months (P < 0.05), with Trial 1 reducing intake from 0 to 12 months (P < 0.05).

Conclusions: All interventions improved weight status. Future research should examine effectiveness and translatability of these approaches into primary care settings.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Child
  • Child Development
  • Child, Preschool
  • Cost-Benefit Analysis
  • Diet, Reducing
  • Energy Intake
  • Exercise / physiology
  • Female
  • Humans
  • Male
  • Obesity / prevention & control
  • Obesity / therapy*
  • Outcome and Process Assessment, Health Care*
  • Pediatrics / standards*
  • Practice Guidelines as Topic / standards*
  • Primary Health Care / standards*
  • Treatment Outcome
  • United States
  • Weight Loss