Can we Introduce an Effective Lifestyle Modification Intervention among Children at Risk of Overweight and Obesity in the Conditions of Family Practice?

Background: Diet and physical activity are crucial in management of pediatric overweight and obesity, however family involvement has not been adequately studied in primary care. Goal: Assessment of the effectiveness of lifestyle modification intervention among overweight and obese children, addressing parental adherence. Methods: During the period of the study (from October 2013 until June 2014) 588 children have visited the family practice involved in the study because of many different reasons. Each child of this group of 588 children was screened for the risk of abdominal obesity. 106 children have matched the criteria of the risk of abdominal obesity. An intervention - “3-color signaling diet and increased physical activity was implemented for 24 weeks in a group of 106 subjects, aged 2-17, with waist circumference (WC) ≥ 75 percentile (in industrial region of Poland). Anthropometric parameters (BM, BMI and WC), blood pressure, fasting lipid fractions (TG, HDL-C) and plasma glucose (FPG) levels were measured before and after the intervention, and parents were filling out the survey, assessing their adherence to the program. Results: After 24 weeks, in all the subjects, regardless of their age and gender, the mean values of BMI, WC, and BP were statistically significantly lower (p<0.01) than their baseline parameters, and the HDL-C levels were higher. The parental survey revealed that 77.3% were adherent to the dietary (20.7% for 24 weeks), and 55.7% – to the physical activity recommendations (25.5% continuously). Conclusions: Lifestyle modification intervention that targets overweight and obese children and adolescents and their families, reinforcing weight loss goals is helpful in improving anthropometric and HDL-C results. The whole family needs to accept and adhere to the recommended diet and physical activity changes for at least 6 months. A parental perspective of barriers to compliance needs to be considered in designing an effective weight management intervention in primary care.