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Published in: BMC Public Health 1/2020

01-12-2020 | Obesity | Research article

Dietary habits and metabolic response improve in obese children whose mothers received an intervention to promote healthy eating: randomized clinical trial

Authors: Iris Nallely López-Contreras, Jenny Vilchis-Gil, Miguel Klünder-Klünder, Salvador Villalpando-Carrión, Samuel Flores-Huerta

Published in: BMC Public Health | Issue 1/2020

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Abstract

Background

Lifestyles habits such as eating unhealthy foodscommence at home and are associated with the development of obesity and comorbidities such as insulin resistance, metabolic syndrome, and chronic degenerative diseases, which are the main causes of death in adults. The present study compared changes in dietary habits, behaviors and metabolic profiles of obese children whose mothers attended at the hospital to group sessions, with those who received the usual nutritional consultation.

Methods

Randomized clinical trial, 177 mother/obese child pairs participated, 90 in the intervention group and 87 in the control group. The intervention group attended six group education sessions to promote healthy eating, being this an alternative of change of habits in children with obesity. The control group received the usual nutritional consultation; both groups were followed up for 3 months. Frequency of food consumption, behaviors during feeding in the house and metabolic profile was evaluated. Mixed effect linear regression models were used to evaluate the effect of the intervention on the variables of interest, especially in HOMA-IR.

Results

The intervention group reduced the filling of their dishes (p = 0.009), forcing the children to finish meals (p = 0.003) and food substitution (p <  0.001), moreover increased the consumption of roasted foods (p = 0.046), fruits (p = 0.002) and vegetables (p <  0.001). The children in the control group slightly increased HOMA-IR levels (0.51; 95% CI − 0.48 to 1.50), while the children in the intervention group significantly decreased (− 1.22; 95% CI − 2.28 to − 1.16). The difference in HOMA-IR between the control and intervention group at the end of the follow-up was − 1.67; 95% CI: − 3.11 to − 0.24.

Conclusions

The educational intervention improved some eating habits at home, as well as HOMA-IR levels; why we consider that it can be an extra resource in the management of childhood obesity.

Trial registration

Clinicaltrials.gov, NCT04374292 (Date assigned: May 5, 2020). Retrospectively registered.
Appendix
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Literature
2.
go back to reference The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27.CrossRef The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27.CrossRef
3.
go back to reference Hawkes C. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases. Glob Health. 2006;2:4.CrossRef Hawkes C. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases. Glob Health. 2006;2:4.CrossRef
4.
go back to reference Elinder LS. Obesogenic environments? Aspects on measurement and indicators. Public Health Nutr. 2008;12(3):12307–15. Elinder LS. Obesogenic environments? Aspects on measurement and indicators. Public Health Nutr. 2008;12(3):12307–15.
5.
go back to reference Edwards KL, Clarke GP. The design and validation of a spatial microsimulation model of obesogenic environments for children in Leeds, UK: SimObesity. Soc Sci Med. 2009;69:1127–34.PubMedCrossRef Edwards KL, Clarke GP. The design and validation of a spatial microsimulation model of obesogenic environments for children in Leeds, UK: SimObesity. Soc Sci Med. 2009;69:1127–34.PubMedCrossRef
7.
go back to reference Organización Mundial de la Salud. Informe de la comisión para acabar con la obesidad infantil. Génova: Suiza; 2016. Organización Mundial de la Salud. Informe de la comisión para acabar con la obesidad infantil. Génova: Suiza; 2016.
8.
go back to reference Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta nacional de salud y nutrición 2006. Cuernavaca: Instituto Nacional de Salud Pública; 2006. Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta nacional de salud y nutrición 2006. Cuernavaca: Instituto Nacional de Salud Pública; 2006.
9.
go back to reference Hernandez-Avila M, Rivera-Dommarco J, Shamah-Levy T, Cuevas-Nasu L, Gomez-Acosta LM, Gaona-Pineda EB, Romero-Martinez M, Mendez-Gomez-Humaran I, Saturno-Hernandez P, Villalpando-Hernandez S, et al. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (ENSANUT 2016). Cuernavaca: Instituto Nacional de Salud Pública; 2016. Hernandez-Avila M, Rivera-Dommarco J, Shamah-Levy T, Cuevas-Nasu L, Gomez-Acosta LM, Gaona-Pineda EB, Romero-Martinez M, Mendez-Gomez-Humaran I, Saturno-Hernandez P, Villalpando-Hernandez S, et al. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (ENSANUT 2016). Cuernavaca: Instituto Nacional de Salud Pública; 2016.
10.
go back to reference Sharma V, Coleman S, Nixon J, Sharples L, Hamilton-Shield J, Rutter H, Bryant M. A systematic review and meta-analysis estimating the population prevalence of comorbidities in children and adolescents aged 5 to 18 years. Obes Rev. 2019;20:1–9.CrossRef Sharma V, Coleman S, Nixon J, Sharples L, Hamilton-Shield J, Rutter H, Bryant M. A systematic review and meta-analysis estimating the population prevalence of comorbidities in children and adolescents aged 5 to 18 years. Obes Rev. 2019;20:1–9.CrossRef
11.
go back to reference Juárez-Lopez C, Klunder-Klunder M, Medina-Bravo P, Madrigal-Azcarate A, Mass-Diaz E, Flores-Huerta S. Insulin resistance and its association with the components of metabolic syndrome among obese children and adolescents. BMC Public Health. 2010;10(1):318.PubMedPubMedCentralCrossRef Juárez-Lopez C, Klunder-Klunder M, Medina-Bravo P, Madrigal-Azcarate A, Mass-Diaz E, Flores-Huerta S. Insulin resistance and its association with the components of metabolic syndrome among obese children and adolescents. BMC Public Health. 2010;10(1):318.PubMedPubMedCentralCrossRef
12.
go back to reference Flores-Huerta S, Klünder Klünder M, Vilchis Gil J. Sobrepeso y obesidad de los niños y adolescentes. Retos en sus causas, manejo y consecuencias. In: Nutrición y Gastroenterología Pediátrica. México: McGraw-Hill Interamericana; 2016. p. 105–14. Flores-Huerta S, Klünder Klünder M, Vilchis Gil J. Sobrepeso y obesidad de los niños y adolescentes. Retos en sus causas, manejo y consecuencias. In: Nutrición y Gastroenterología Pediátrica. México: McGraw-Hill Interamericana; 2016. p. 105–14.
13.
go back to reference Delgado-Floody P, Caamaño-Navarrete F, Martínez-Salazar C, Jerez-Mayorga D, Carter-Thuiller B, García-Pinillos F, Latorre-Román P. La obesidad infantil y su asociación con el sentimiento de infelicidad y bajos niveles de autoestima en niños de centros educativos públicos. Nutr Hosp. 2018;35:533–7.PubMed Delgado-Floody P, Caamaño-Navarrete F, Martínez-Salazar C, Jerez-Mayorga D, Carter-Thuiller B, García-Pinillos F, Latorre-Román P. La obesidad infantil y su asociación con el sentimiento de infelicidad y bajos niveles de autoestima en niños de centros educativos públicos. Nutr Hosp. 2018;35:533–7.PubMed
14.
go back to reference FAO. Human Energy Requirements. Roma: Report of a Joint FAO/WHO/UNU Expert Consultation; 2004. FAO. Human Energy Requirements. Roma: Report of a Joint FAO/WHO/UNU Expert Consultation; 2004.
15.
go back to reference Tokeras Podlipsky Tali. Evaluación del efecto del manejo nutricio en una clínica multidisciplinaria sobre los indicadores antropométricos de niños y adolescentes con sobrepeso y obesidad: Universidad Iberoamericana; 2007. Tokeras Podlipsky Tali. Evaluación del efecto del manejo nutricio en una clínica multidisciplinaria sobre los indicadores antropométricos de niños y adolescentes con sobrepeso y obesidad: Universidad Iberoamericana; 2007.
16.
go back to reference Mead EBT, Rees K, Azevedo LB, Whittaker V, Jones D, Olajide J, Mainardi GM, Corpeleijn E, O’Malley C, Beardsmore E, Al-Khudairy L, Baur L, Metzendorf M, Demaio A, Ells LJ. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev. 2017;6(6):CD012651. Mead EBT, Rees K, Azevedo LB, Whittaker V, Jones D, Olajide J, Mainardi GM, Corpeleijn E, O’Malley C, Beardsmore E, Al-Khudairy L, Baur L, Metzendorf M, Demaio A, Ells LJ. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev. 2017;6(6):CD012651.
17.
go back to reference Loveman E, Al-Khudairy L, Johnson RE, Robertson W, Colquitt JL, Mead EL, Ells LJ, Metzendorf MI. Parent-only interventions for childhood overweight or obesity in children aged 5 to 11 years (review). Cochrane Database Syst Rev. 2015;12:CD012008. Loveman E, Al-Khudairy L, Johnson RE, Robertson W, Colquitt JL, Mead EL, Ells LJ, Metzendorf MI. Parent-only interventions for childhood overweight or obesity in children aged 5 to 11 years (review). Cochrane Database Syst Rev. 2015;12:CD012008.
18.
go back to reference Arredondo EM, Ayala GX, Soto S, Slymen DJ, Horton LA, Parada H, Campbell N, Ibarra L, Engelberg M, Elder JP. Latina mothers as agents of change in children’s eating habits: findings from the randomized controlled trial entre Familia:Reflejos de Salud. Int J Behav Nutr Phys Act. 2018;15:95.PubMedPubMedCentralCrossRef Arredondo EM, Ayala GX, Soto S, Slymen DJ, Horton LA, Parada H, Campbell N, Ibarra L, Engelberg M, Elder JP. Latina mothers as agents of change in children’s eating habits: findings from the randomized controlled trial entre Familia:Reflejos de Salud. Int J Behav Nutr Phys Act. 2018;15:95.PubMedPubMedCentralCrossRef
20.
go back to reference Lazcano-Ponce E, Salazar-Martínez E, Gutiérrez-Castrellón P, Angeles-Llerenas A, Hernández-Garduño A, Viramontes JL. Ensayos clínicos aleatorizados: variantes, métodos de aleatorización, análisis, consideraciones éticas y regulación. Salud Pública de Méx. 2004;46(6):559–84.CrossRef Lazcano-Ponce E, Salazar-Martínez E, Gutiérrez-Castrellón P, Angeles-Llerenas A, Hernández-Garduño A, Viramontes JL. Ensayos clínicos aleatorizados: variantes, métodos de aleatorización, análisis, consideraciones éticas y regulación. Salud Pública de Méx. 2004;46(6):559–84.CrossRef
21.
go back to reference Golan M. Parents as agents of change in childhood obesity--from research to practice. Int J Pediatr Obes. 2006;1:66–76.PubMedCrossRef Golan M. Parents as agents of change in childhood obesity--from research to practice. Int J Pediatr Obes. 2006;1:66–76.PubMedCrossRef
22.
go back to reference Golan M, Fainaru M, Weizman A. Role of behaviour modification in the treatment of childhood obesity with the parents as the exclusive agents of change. Int J Obes. 1998;22:1217–24.CrossRef Golan M, Fainaru M, Weizman A. Role of behaviour modification in the treatment of childhood obesity with the parents as the exclusive agents of change. Int J Obes. 1998;22:1217–24.CrossRef
23.
go back to reference Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics. Vital Health Stat. 2002;11:246. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics. Vital Health Stat. 2002;11:246.
24.
go back to reference National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(suppl 2):555–76.CrossRef National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(suppl 2):555–76.CrossRef
25.
go back to reference Bacardi-Gascón M, Reveles-Rojas C, Woodward-Lopez G, Crawford P, Jiménez-Cruz A. Assessing the validity of a physical activity questionnaire developed for parents of preschool children in Mexico. J Health Popul. 2012;4:439–46. Bacardi-Gascón M, Reveles-Rojas C, Woodward-Lopez G, Crawford P, Jiménez-Cruz A. Assessing the validity of a physical activity questionnaire developed for parents of preschool children in Mexico. J Health Popul. 2012;4:439–46.
26.
go back to reference García-Cuartero B, García Lacalle C, Jiménez Lobo C. The HOMA and QUICKI indexes, and insulin and C-peptide levels in healthy children. Cut off points to identify metabolic syndrome in healthy children. Ann Pediatr. 2007;66:481–90.CrossRef García-Cuartero B, García Lacalle C, Jiménez Lobo C. The HOMA and QUICKI indexes, and insulin and C-peptide levels in healthy children. Cut off points to identify metabolic syndrome in healthy children. Ann Pediatr. 2007;66:481–90.CrossRef
27.
go back to reference Lapierre MA, Fleming-Milici F, Rozendaal E, McAlister AR, Castonguay J. The effect of advertising on children and adolescents. Pediatrics. 2017;140(s2):S152–6.PubMedCrossRef Lapierre MA, Fleming-Milici F, Rozendaal E, McAlister AR, Castonguay J. The effect of advertising on children and adolescents. Pediatrics. 2017;140(s2):S152–6.PubMedCrossRef
28.
go back to reference Costa-Font J, Mas N. “Globesity”? The effects of globalization on obesity and caloric intake. Food Policty. 2016;64:121–32.CrossRef Costa-Font J, Mas N. “Globesity”? The effects of globalization on obesity and caloric intake. Food Policty. 2016;64:121–32.CrossRef
29.
go back to reference Cai L, Wu Y, Cheskin LJ, Wilson RF, Wang Y. Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis. Obes Rev. 2014;15(12):933–44.PubMedPubMedCentralCrossRef Cai L, Wu Y, Cheskin LJ, Wilson RF, Wang Y. Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis. Obes Rev. 2014;15(12):933–44.PubMedPubMedCentralCrossRef
30.
go back to reference Garanty-Bogacka B, Syrenicz M, Goral J, Krupa B, Syrenicz J, Walczak M, Syrenicz A. Changes in inflammatory biomarkers after successful lifestyle intervention in obese children. Pol J Endocrinol. 2011;62(6):499–505. Garanty-Bogacka B, Syrenicz M, Goral J, Krupa B, Syrenicz J, Walczak M, Syrenicz A. Changes in inflammatory biomarkers after successful lifestyle intervention in obese children. Pol J Endocrinol. 2011;62(6):499–505.
31.
go back to reference Johannsen DL, Johannsen NM, Specker BL. Influence of parents’ eating behaviors and child feeding practices on children’s weight status. Obesity. 2006;14(3):431–9.PubMedCrossRef Johannsen DL, Johannsen NM, Specker BL. Influence of parents’ eating behaviors and child feeding practices on children’s weight status. Obesity. 2006;14(3):431–9.PubMedCrossRef
32.
go back to reference Barlow SE. Expert committee: expert committee recommendations regarding the prevention, assessment and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120:S164–92.PubMedCrossRef Barlow SE. Expert committee: expert committee recommendations regarding the prevention, assessment and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120:S164–92.PubMedCrossRef
33.
go back to reference Pérez F. El Medio Social como Estructura Psicológica. Reflexiones a partir del Modelo Ecológico de Bromfenbrenner. EduPsykhé Revista de Psicología y Psicopedagogía. 2004;3(2):161–77. Pérez F. El Medio Social como Estructura Psicológica. Reflexiones a partir del Modelo Ecológico de Bromfenbrenner. EduPsykhé Revista de Psicología y Psicopedagogía. 2004;3(2):161–77.
34.
go back to reference Mérida-Rios L, Márquez-Serrano M, Jiménez-Aguilar A, Barboza-Chacón L, Rueda-Neria CM, Arenas-Monreal L. Promoting fruit, vegetable and simple water consumption among mothers and teachers of preschool children: an intervention mapping initiative. Eval Program Plan. 2019;76:101675.CrossRef Mérida-Rios L, Márquez-Serrano M, Jiménez-Aguilar A, Barboza-Chacón L, Rueda-Neria CM, Arenas-Monreal L. Promoting fruit, vegetable and simple water consumption among mothers and teachers of preschool children: an intervention mapping initiative. Eval Program Plan. 2019;76:101675.CrossRef
35.
go back to reference Laurence S, Peterken R, Burns C. Fresh kids: the efficacy of a health promoting schools approach to increasing consumption of fruit and water in Australia. Health Promot Int. 2007;22(3):2018–226.CrossRef Laurence S, Peterken R, Burns C. Fresh kids: the efficacy of a health promoting schools approach to increasing consumption of fruit and water in Australia. Health Promot Int. 2007;22(3):2018–226.CrossRef
36.
go back to reference Russell SJ, Croker H, Viner RM. The effect of screen advertising on children's dietary intake: a systematic review and meta-analysis. Obes Rev. 2019;20:554–68.PubMedCrossRef Russell SJ, Croker H, Viner RM. The effect of screen advertising on children's dietary intake: a systematic review and meta-analysis. Obes Rev. 2019;20:554–68.PubMedCrossRef
37.
go back to reference Kalavainen MP, Korppi MO, Nuutinen OM. Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling. Int J Obes. 2007;31:1500–8.CrossRef Kalavainen MP, Korppi MO, Nuutinen OM. Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling. Int J Obes. 2007;31:1500–8.CrossRef
38.
go back to reference Spurrier NJ, Bell L, Wilson A, Lowe E, Golley R, Magarey AA. Minimal change in children’s lifestyle behaviours and adiposity following a home-based obesity intervention: results from a pilot study. BMC Res Notes. 2016;9:26.PubMedPubMedCentralCrossRef Spurrier NJ, Bell L, Wilson A, Lowe E, Golley R, Magarey AA. Minimal change in children’s lifestyle behaviours and adiposity following a home-based obesity intervention: results from a pilot study. BMC Res Notes. 2016;9:26.PubMedPubMedCentralCrossRef
39.
go back to reference Vilchis-Gil J, Klünder-Klünder M, Duque X, Flores-Huerta S. Decreased body mass index Z score in schoolchildren after yearlong information sessions with parents reinforced with web and mobile phone resources: Community Trial. J Med Internet Res. 2016;18(6):e174.PubMedPubMedCentralCrossRef Vilchis-Gil J, Klünder-Klünder M, Duque X, Flores-Huerta S. Decreased body mass index Z score in schoolchildren after yearlong information sessions with parents reinforced with web and mobile phone resources: Community Trial. J Med Internet Res. 2016;18(6):e174.PubMedPubMedCentralCrossRef
40.
go back to reference Davison KK, Kitos N, Aftosmes-Tobio A, Ash T, Agaronov A, Sepulveda M, Haines J. The forgotten parent: Fathers’ representation in family interventions to prevent childhood obesity. Prevent Med. 2018;111:170–6.CrossRef Davison KK, Kitos N, Aftosmes-Tobio A, Ash T, Agaronov A, Sepulveda M, Haines J. The forgotten parent: Fathers’ representation in family interventions to prevent childhood obesity. Prevent Med. 2018;111:170–6.CrossRef
41.
go back to reference Perichart-Perera O, Balas-Nakash M, Ortiz-Rodríguez V, Morán-Zenteno JA, Guerrero-Ortiz JL, Vadillo-Ortega F. Programa para mejorar marcadores de riesgo cardiovascular en escolares mexicanos. Salud Publica Mex. 2008;50:218–26.PubMedCrossRef Perichart-Perera O, Balas-Nakash M, Ortiz-Rodríguez V, Morán-Zenteno JA, Guerrero-Ortiz JL, Vadillo-Ortega F. Programa para mejorar marcadores de riesgo cardiovascular en escolares mexicanos. Salud Publica Mex. 2008;50:218–26.PubMedCrossRef
Metadata
Title
Dietary habits and metabolic response improve in obese children whose mothers received an intervention to promote healthy eating: randomized clinical trial
Authors
Iris Nallely López-Contreras
Jenny Vilchis-Gil
Miguel Klünder-Klünder
Salvador Villalpando-Carrión
Samuel Flores-Huerta
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-09339-4

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