Skip to main content
Top
Published in: BMC Pediatrics 1/2014

Open Access 01-12-2014 | Research article

The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents - a longitudinal pilot intervention study

Authors: Dirk E Bock, Tracy Robinson, Jamie A Seabrook, Meghan Rombeek, Kambiz Norozi, Guido Filler, Ralf Rauch, Cheril L Clarson

Published in: BMC Pediatrics | Issue 1/2014

Login to get access

Abstract

Background

Though recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL). The aim of this study was to determine if a 1-year multidisciplinary, family-centered outpatient intervention based on social cognitive theory would be effective in (i) preventing further increases in BMI and BMI z-score, and (ii) improving QoL in obese children and adolescents.

Methods

Obese children and adolescents 8–17 years of age and their families participated in this 1-year longitudinal pilot intervention study. The intervention consisted of fifteen 90-minute educational sessions led by a dietitian, exercise specialist, and social worker. Anthropometric measures, body composition, and QoL (Pediatric Quality of Life Inventory 4.0), were assessed at baseline, 3 months, and 12 months. Laboratory values were measured at baseline and 12 months. The primary outcome measures were change in BMI and BMI z-score, secondary outcome measures included change in QoL and body composition. A paired sample t-test was used to assess within-group differences and 95% confidence intervals were reported for the mean differences.

Results

42 obese children and adolescents (21 girls) completed the 1-year intervention (mean age 12.8 ± 3.14 years). Mean baseline BMI was 31.96 ± 5.94 kg/m2 and BMI z-score was +2.19 ± 0.34. Baseline QoL (self-assessments and parental assessments) was impaired: mean baseline scores were 74.5 ± 16.5 and 63.7 ± 19.4 for physical functioning and 69.0 ± 14.9 and 64.0 ± 18.3 for emotional functioning, respectively. At 12 months, BMI z-score had decreased (−0.07 ± 0.11, 95% CI: −0.11 to −0.04). BMI (0.80 ± 1.57 kg/m2, 95% CI 0.31 to 1.29) and fat-free mass (4.02 ± 6.27 kg, 95% CI 1.90 to 6.14) increased, but % body fat and waist circumference did not. Both the parent-reported physical (11.3 ± 19.2, 95% CI 4.7 to 17.9) and emotional (7.7 ± 15.7, 95% CI 2.3 to 13.0) functioning QoL scores and the children's self-reported physical (5.3 ± 17.1, 95% CI 0.5 to 11.1) and emotional (7.9 ± 14.3, 95% CI 3.2 to 12.7) functioning scores significantly improved.

Conclusions

Following a 1-year intervention, the participants’ BMI z-scores and QoL improved, while other adiposity-related measures of body composition remained unchanged.

Trial registration

UMIN Clinical Trials Registry UMIN000015622.
Appendix
Available only for authorised users
Literature
1.
go back to reference Roberts KC, Shields M, De Groh M, Aziz A, Gilbert JA: Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2011, 2012 (23): 37-41. Roberts KC, Shields M, De Groh M, Aziz A, Gilbert JA: Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2011, 2012 (23): 37-41.
2.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012, 307: 483-490. 10.1001/jama.2012.40.CrossRefPubMed Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012, 307: 483-490. 10.1001/jama.2012.40.CrossRefPubMed
3.
go back to reference Abrams P, Levitt Katz LE: Metabolic effects of obesity causing disease in childhood. Curr Opin Endocrinol Diabetes Obes. 2011, 18: 23-27. 10.1097/MED.0b013e3283424b37.CrossRefPubMed Abrams P, Levitt Katz LE: Metabolic effects of obesity causing disease in childhood. Curr Opin Endocrinol Diabetes Obes. 2011, 18: 23-27. 10.1097/MED.0b013e3283424b37.CrossRefPubMed
4.
go back to reference Weiss R, Caprio S: The metabolic consequences of childhood obesity. Best Pract Res Clin Endocrinol Metab. 2005, 19: 405-419. 10.1016/j.beem.2005.04.009.CrossRefPubMed Weiss R, Caprio S: The metabolic consequences of childhood obesity. Best Pract Res Clin Endocrinol Metab. 2005, 19: 405-419. 10.1016/j.beem.2005.04.009.CrossRefPubMed
5.
go back to reference Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, Zitman FG: Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010, 67: 220-229. 10.1001/archgenpsychiatry.2010.2.CrossRefPubMed Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, Zitman FG: Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010, 67: 220-229. 10.1001/archgenpsychiatry.2010.2.CrossRefPubMed
6.
go back to reference Griffiths LJ, Parsons TJ, Hill AJ: Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes. 2010, 5: 282-304. 10.3109/17477160903473697.CrossRefPubMed Griffiths LJ, Parsons TJ, Hill AJ: Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes. 2010, 5: 282-304. 10.3109/17477160903473697.CrossRefPubMed
7.
go back to reference Wang F, Wild TC, Kipp W, Kuhle S, Veugelers PJ: The influence of childhood obesity on the development of self-esteem. Health Rep. 2009, 20: 21-27.PubMed Wang F, Wild TC, Kipp W, Kuhle S, Veugelers PJ: The influence of childhood obesity on the development of self-esteem. Health Rep. 2009, 20: 21-27.PubMed
8.
go back to reference Singh AS, Mulder C, Twisk JW, Van Mechelen W, Chinapaw MJ: Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008, 9: 474-488. 10.1111/j.1467-789X.2008.00475.x.CrossRefPubMed Singh AS, Mulder C, Twisk JW, Van Mechelen W, Chinapaw MJ: Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008, 9: 474-488. 10.1111/j.1467-789X.2008.00475.x.CrossRefPubMed
9.
go back to reference Herman KM, Craig CL, Gauvin L, Katzmarzyk PT: Tracking of obesity and physical activity from childhood to adulthood: the Physical Activity Longitudinal Study. Int J Pediatr Obes. 2009, 4: 281-288. 10.3109/17477160802596171.CrossRefPubMed Herman KM, Craig CL, Gauvin L, Katzmarzyk PT: Tracking of obesity and physical activity from childhood to adulthood: the Physical Activity Longitudinal Study. Int J Pediatr Obes. 2009, 4: 281-288. 10.3109/17477160802596171.CrossRefPubMed
10.
go back to reference Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD: Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009, 1: Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD: Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009, 1:
11.
go back to reference Barlow SE: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007, 120 (Suppl 4): S164-S192. 10.1542/peds.2007-2329C.CrossRefPubMed Barlow SE: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007, 120 (Suppl 4): S164-S192. 10.1542/peds.2007-2329C.CrossRefPubMed
12.
go back to reference Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2006, 2007 (176): S1-13. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2006, 2007 (176): S1-13.
13.
go back to reference Kuczmarski RJ, Odgen C, Guo S: CDC growth charts for the United States, Methods and development. Vital Health Stat. 2000, 2002 (11): 1-190. Kuczmarski RJ, Odgen C, Guo S: CDC growth charts for the United States, Methods and development. Vital Health Stat. 2000, 2002 (11): 1-190.
14.
go back to reference Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004, 31: 143-164. 10.1177/1090198104263660.CrossRefPubMed Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004, 31: 143-164. 10.1177/1090198104263660.CrossRefPubMed
15.
go back to reference Epstein LH, Roemmich JN, Raynor HA: Behavioral therapy in the treatment of pediatric obesity. Pediatr Clin North Am. 2001, 48: 981-993. 10.1016/S0031-3955(05)70352-7.CrossRefPubMed Epstein LH, Roemmich JN, Raynor HA: Behavioral therapy in the treatment of pediatric obesity. Pediatr Clin North Am. 2001, 48: 981-993. 10.1016/S0031-3955(05)70352-7.CrossRefPubMed
16.
go back to reference Eating well with Canada's Food Guide. HC Pubublication. 2011, Health Canada, Ottawa, ON Eating well with Canada's Food Guide. HC Pubublication. 2011, Health Canada, Ottawa, ON
18.
go back to reference Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C: Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005, 115: e500-e503. 10.1542/peds.2004-1921.CrossRefPubMed Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C: Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005, 115: e500-e503. 10.1542/peds.2004-1921.CrossRefPubMed
19.
go back to reference Varni JW, Seid M, Kurtin PS: PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001, 39: 800-812. 10.1097/00005650-200108000-00006.CrossRefPubMed Varni JW, Seid M, Kurtin PS: PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001, 39: 800-812. 10.1097/00005650-200108000-00006.CrossRefPubMed
20.
go back to reference Kowalski KC, Crocker PR, Kowalski NP: Convergent validity of the physical activity questionnaire for adolescents. Pediatr Exerc Sci. 1997, 9: 342-352. Kowalski KC, Crocker PR, Kowalski NP: Convergent validity of the physical activity questionnaire for adolescents. Pediatr Exerc Sci. 1997, 9: 342-352.
21.
go back to reference Kowalski KC, Crocker PR, Faulkner RA: Validation of the physical activity questionnaire for older children. Pediatr Exerc Sci. 1997, 9: 174-186. Kowalski KC, Crocker PR, Faulkner RA: Validation of the physical activity questionnaire for older children. Pediatr Exerc Sci. 1997, 9: 174-186.
23.
go back to reference Sbruzzi G, Eibel B, Barbiero SM, Petkowicz RO, Ribeiro RA, Cesa CC, Martins CC, Marobin R, Schaan CW, Souza WB, Schaan BD, Pellanda LC: Educational interventions in childhood obesity: a systematic review with meta-analysis of randomized clinical trials. Prev Med. 2013, 56: 254-264. 10.1016/j.ypmed.2013.02.024.CrossRefPubMed Sbruzzi G, Eibel B, Barbiero SM, Petkowicz RO, Ribeiro RA, Cesa CC, Martins CC, Marobin R, Schaan CW, Souza WB, Schaan BD, Pellanda LC: Educational interventions in childhood obesity: a systematic review with meta-analysis of randomized clinical trials. Prev Med. 2013, 56: 254-264. 10.1016/j.ypmed.2013.02.024.CrossRefPubMed
24.
go back to reference Ho M, Garnett SP, Baur L, Burrows T, Stewart L, Neve M, Collins C: Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics. 2012, 130: e1647-e1671. 10.1542/peds.2012-1176.CrossRefPubMed Ho M, Garnett SP, Baur L, Burrows T, Stewart L, Neve M, Collins C: Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics. 2012, 130: e1647-e1671. 10.1542/peds.2012-1176.CrossRefPubMed
25.
go back to reference Madowitz J, Knatz S, Maginot T, Crow SJ, Boutelle KN: Teasing, depression and unhealthy weight control behaviour in obese children. Pediatr Obes. 2012, 7: 446-452. 10.1111/j.2047-6310.2012.00078.x.CrossRefPubMedPubMedCentral Madowitz J, Knatz S, Maginot T, Crow SJ, Boutelle KN: Teasing, depression and unhealthy weight control behaviour in obese children. Pediatr Obes. 2012, 7: 446-452. 10.1111/j.2047-6310.2012.00078.x.CrossRefPubMedPubMedCentral
26.
go back to reference Schwimmer JB, Burwinkle TM, Varni JW: Health-related quality of life of severely obese children and adolescents. JAMA. 2003, 289: 1813-1819. 10.1001/jama.289.14.1813.CrossRefPubMed Schwimmer JB, Burwinkle TM, Varni JW: Health-related quality of life of severely obese children and adolescents. JAMA. 2003, 289: 1813-1819. 10.1001/jama.289.14.1813.CrossRefPubMed
27.
go back to reference Ravens-Sieberer U, Redegeld M, Bullinger M: Quality of life after in-patient rehabilitation in children with obesity. Int J Obes Relat Metab Disord. 2001, 25 (Suppl 1): S63-S65. 10.1038/sj.ijo.0801702.CrossRefPubMed Ravens-Sieberer U, Redegeld M, Bullinger M: Quality of life after in-patient rehabilitation in children with obesity. Int J Obes Relat Metab Disord. 2001, 25 (Suppl 1): S63-S65. 10.1038/sj.ijo.0801702.CrossRefPubMed
28.
go back to reference Barnow S, Stopsack M, Bernheim D, Schröder C, Fusch C, Lauffer H, Freyberger HJ, Grabe HJ, Spitzer C: Results of an outpatient intervention for obese children and adolescents. Psychother Psychosom Med Psychol. 2007, 57: 353-358. 10.1055/s-2007-970929.CrossRefPubMed Barnow S, Stopsack M, Bernheim D, Schröder C, Fusch C, Lauffer H, Freyberger HJ, Grabe HJ, Spitzer C: Results of an outpatient intervention for obese children and adolescents. Psychother Psychosom Med Psychol. 2007, 57: 353-358. 10.1055/s-2007-970929.CrossRefPubMed
29.
go back to reference LeBlanc AG, Janssen I: Dose–response relationship between physical activity and dyslipidemia in youth. Can J Cardiol. 2010, 26: 201-205. 10.1016/S0828-282X(10)70400-1.CrossRefPubMed LeBlanc AG, Janssen I: Dose–response relationship between physical activity and dyslipidemia in youth. Can J Cardiol. 2010, 26: 201-205. 10.1016/S0828-282X(10)70400-1.CrossRefPubMed
30.
go back to reference Ludwig DS, Peterson KE, Gortmaker SL: Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet. 2001, 357: 505-508. 10.1016/S0140-6736(00)04041-1.CrossRefPubMed Ludwig DS, Peterson KE, Gortmaker SL: Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet. 2001, 357: 505-508. 10.1016/S0140-6736(00)04041-1.CrossRefPubMed
31.
go back to reference Nowicka P, Flodmark C-E: Family in pediatric obesity management: a literature review. Int J Pediatr Obes. 2008, 3: 44-50. 10.1080/17477160801896994.CrossRefPubMed Nowicka P, Flodmark C-E: Family in pediatric obesity management: a literature review. Int J Pediatr Obes. 2008, 3: 44-50. 10.1080/17477160801896994.CrossRefPubMed
32.
go back to reference Hampl S, Paves H, Laubscher K, Eneli I: Patient engagement and attrition in pediatric obesity clinics and programs: results and recommendations. Pediatrics. 2011, 128 (Suppl 2): S59-S64. 10.1542/peds.2011-0480E.CrossRefPubMedPubMedCentral Hampl S, Paves H, Laubscher K, Eneli I: Patient engagement and attrition in pediatric obesity clinics and programs: results and recommendations. Pediatrics. 2011, 128 (Suppl 2): S59-S64. 10.1542/peds.2011-0480E.CrossRefPubMedPubMedCentral
33.
go back to reference Knöpfli BH, Radtke T, Lehmann M, Schätzle B, Eisenblätter J, Gachnang A, Wiederkehr P, Hammer J, Brooks-Wildhaber J: Effects of a multidisciplinary inpatient intervention on body composition, aerobic fitness, and quality of life in severely obese girls and boys. J Adolesc Health. 2008, 42: 119-127. 10.1016/j.jadohealth.2007.08.015.CrossRefPubMed Knöpfli BH, Radtke T, Lehmann M, Schätzle B, Eisenblätter J, Gachnang A, Wiederkehr P, Hammer J, Brooks-Wildhaber J: Effects of a multidisciplinary inpatient intervention on body composition, aerobic fitness, and quality of life in severely obese girls and boys. J Adolesc Health. 2008, 42: 119-127. 10.1016/j.jadohealth.2007.08.015.CrossRefPubMed
Metadata
Title
The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents - a longitudinal pilot intervention study
Authors
Dirk E Bock
Tracy Robinson
Jamie A Seabrook
Meghan Rombeek
Kambiz Norozi
Guido Filler
Ralf Rauch
Cheril L Clarson
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2014
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-014-0296-1

Other articles of this Issue 1/2014

BMC Pediatrics 1/2014 Go to the issue