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Parent-child interventions most effective to reduce BMI in children with obesity

An intervention for childhood obesity that included both children and their parents, rather than the parents only, improved the children’s BMI standard deviation scores, according to results from a study conducted in Israel.

“Studies have shown that the involvement of the parents in behavioral interventions for childhood obesity yields good results owing to the parents’ ability to influence their child’s eating and physical activity habits,” Joseph Meyerovitch, MD, of the National Center for Childhood Diabetes at Schneider Children’s Medical Center of Israel, Petach Tikva, and colleagues wrote. “Interventions focused only on the parents or on both the parents and the child were more effective than interventions focused on the child alone. However, the comparative effectiveness of interventions based only on the parents and interventions based on the parents and the child is still controversial.”

The researchers conducted an open-label, randomized study of 247 children with BMI in the 85th to 98th percentiles. Patients were randomly assigned to one of three interventions: only parents (n = 89), parents and children (n = 84) and a control group, which consisted only of clinical follow-up (n = 74). Patients assigned to intervention groups met once a week with a psychologist and a dietitian for 3 months, and a pediatric endocrinologist evaluated all patients at baseline and at 3, 12 and 24 months.

In the parents-only group, 65.2% of participants completed the intervention, compared with 72.6% in the parent and child group and 66.2% in the control group (P = .554).

The children’s BMI standard deviation score decreased from 1.74 to 1.66 (P < .001) in the parents-only group, and from 1.83 to 1.76 (P = .012) in the parents and child group. Children in the control group demonstrated no significant change, the researchers wrote.

Among 45 patients in each intervention group and 37 patients in the control group who completed the 2-year follow-up period, only children assigned to the parent-child intervention demonstrated a significant decrease in BMI standard deviation score, Meyerovitch and colleagues wrote (1.56; P = .006).

Overall, the rate of children with metabolic syndrome fell from 6% at the beginning of the study to 1.5% at the 3-month mark (P = .109), the researchers reported. There were no significant differences between groups in the rate of metabolic syndrome.

“We believe that the involvement of parents and children together is important in the implementation of lifestyle changes targeted to prevent childhood obesity,” the researchers wrote. “Further studies, which will explore novel strategies, such as population-level intervention for the implementation of healthy lifestyle (ie, schools/kindergartens, media and local municipal-level resources) in addition to family intervention and medical care, are needed to determine which approach has a stronger long-term advantage in terms of preventing obesity and complications of [metabolic syndrome].”