Changes in body composition and eating behaviors in 6- to 8-year old children with obesity participating in a family-centered lifestyle intervention: results from a 1 year randomized controlled trial
Notice bibliographique
Résumé
Background: Childhood obesity is a complex disease that is associated with health consequences. The literature supports the use of family-centered lifestyle interventions in reducing adiposity in children with obesity, however, the evidence that milk products may favorably modulate these changes are unclear. Further, few interventions include assessment of bone health in this pediatric population. This dissertation aimed to test the effects of increased milk and milk products and weight-bearing types of activity on changes in: (1) body composition; (2) bone health; and (3) eating behaviors in children with obesity participating in a 1 year (y) family-centered lifestyle intervention. Design: Data are from the McGill Youth Lifestyle Intervention with Food and Exercise (MY LIFE) study, a 1 y randomized controlled trial that took place in Montreal, QC. Eligibility included healthy children classified as overweight or obese as per the World Health Organization. Children (n = 78; ages 6–8.5 y) were randomized to either: control (Ctrl: no intervention); standard intervention (StnTx: 2 servings of milk and milk products/ day (d); meet physical activity (PA) guidelines) or modified intervention (ModTx: 4 servings of milk and milk products/ d; meet PA guidelines plus daily weight-bearing types of PA). Study visits occurred every 3 months (mo) for 1 y; interventions were held once a month for 5 mo with a follow-up session at the end of the 8th mo. Interventions were based on Canada’s Food Guide to Healthy Eating (CFG) and Canadian PA guidelines and individualized to meet the needs of the family. Ctrl received counseling after 1 y. Fasting blood samples were collected for various outcomes. Anthropometry were measured; body mass index-for-age and sex z-scores (BAZ) were calculated. Dual-energy x-ray absorptiometry scans were performed for: percent body fat (%BF), fat mass (FM), trunk FM, lean mass. Whole body (WB), lumbar spine (LS) and lumbar lateral spine (LLS) were measured for bone mineral content (BMC) and bone mineral density (BMD). Parents completed the Children’s Eating Behavior Questionnaire, reported on diet (3-day food diary) and were surveyed on PA and sedentary behaviors of their child. Fatty acids measured in erythrocytes by gas chromatography were used to assess compliance to the milk intervention during the first 6 months. Results: (Aim 1) Baseline anthropometry did not differ among groups. At 1 y, all groups increased height (p<0.001) and lean mass (p<0.001), however BAZ was significantly lower in ModTx (p<0.001); %BF was also lower in ModTx (p=0.02), but not in StnTx (p=0.99) or Ctrl (p=0.99). FM, waist circumference and trunk FM all significantly increased in Ctrl (p<0.001). ModTx significantly decreased erythrocyte fatty acids related to milk product intake by 6 mo (p<0.05). (Aim 2) Compared to baseline, 1 y measures of BMC in WB, LS, and LLS had significantly increased among all groups (p<0.001). However, WB BMD z-scores were significantly lower in Ctrl at 1 y compared to baseline (p<0.05), whereas BMD for WB and LLS were significantly increased in StnTx and ModTx (p<0.001) but not in Ctrl. Bone biomarkers did not change over time among groups. (Aim 3) At 6-mo StnTx reduced Emotional Overeating and Desire to Drink scores while Food Responsiveness scores were reduced in both StnTx and ModTx (p<0.05). At 1-y, scores for Desire to Drink in StnTx and Food Responsiveness in ModTx remained lower (p<0.05). Plasma leptin concentrations were lower in ModTx at 6-mo compared to baseline (p<0.05). Conclusion: Participating in a family-centered lifestyle intervention based on Canadian dietary and PA guidelines had positive effects on reducing adiposity while maintaining bone health and favorably changing eating behaviors in children with obesity. This study suggests that the use of national guidelines as a template for intervention platforms are appropriate, but need to be individualized to meet the needs of the family.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,003 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».