Weight-loss programs can help even very young children slim down, and it
appears that acting early may improve the odds of success, according to a pair
of new studies. "What they are showing is a pretty consistent trend that if we were
to intervene early, we could really have an effect on changing the trajectory
of weight gain in children," said Dr. Elsie Taveras, a pediatrician at
Harvard Medical School and Boston Children's Hospital, who co-wrote an
editorial on the findings.
In one study, Dutch scientists found that heavy three- to five-year-olds
saw continued benefits from a weight-loss intervention at least several months
after it ended. And a report from Sweden shows overweight and obese children
under 10 were much more likely to slow their weight gain than were adolescents
getting similar behavioral treatments.
The two studies were released Monday in the Archives of Pediatrics &
Adolescent Medicine. Excessive pounds in childhood often stay on into
adulthood, where they have been linked to heart disease, diabetes and other
health problems.
Taveras said there is mounting evidence that paying attention to young
kids may be a promising way to stem the global obesity epidemic. In 2008, more
than a third of U.S. youths were either overweight or obese, according to the
Centers for Disease Control and Prevention. The numbers have also been on the
rise in Europe, although they are still lower than in the U.S.
The Dutch researchers, led by Dr. Gianni Bocca of Beatrix Children's
Hospital in Groningen, studied 75 heavy children who had been randomly assigned
to get either usual care or an intensive weight-loss program. The program
lasted four months and involved 25 sessions with dietary advice, exercise and,
for the parents only, behavioral counseling. A year after the study began, kids
in the intervention group had gained 4.2 pounds on average, and those who got
usual care had added another 6.8 pounds.
While that difference could have been due to chance, there was a
statistically reliable difference in body mass index, or BMI, a measure of
height in relation to weight. Children in the intervention group went one unit
down in BMI, while the others saw no change. In adults, a healthy BMI is
between 18.5 and 25. "The magnitude of the effect, especially initially
after the intervention, wasn't very large, but what needs to be taken into
account was that these children were growing," Taveras told Reuters
Health. "What these interventions are showing is that you can have an
effect, and hopefully these interventions are changing the trajectory the
children were headed towards."
PARTICULARLY
TOUGH CASES?
She also cautioned that the Swedish findings, led by Pernilla Danielsson
of Karolinska Institutet in Stockholm, were based on observations instead of an
experiment. That means it's possible that the youngsters between 14 and 16, who
saw no or little effect of the behavioral treatment, could have been
particularly tough cases. Still, Taveras said, there is good evidence that
heavy kids who start weight-loss programs early have an easier time slimming
down.
Weight-loss programs for kids are available from healthcare providers
across the country and are often covered by insurance, she said, adding that
interested families could ask their pediatrician or check with local public
health departments. The government is also funding research that takes a more
comprehensive approach to keeping children's weight healthy. The Childhood
Obesity Research Demonstration, for example, includes sites in three states and
attacks the problem at various levels. At the Massachusetts site, Taveras said
primary care doctors, child care centers and schools are all involved in the
efforts. "I hope that in a few years there will be more examples of
programs that aren't just clinical that we can send families to," she
said.
Chicago Tribune
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