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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".