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Study to test primary-care-based weight-loss program
By LOIS BAKER
Contributing Editor
Children of obese parents are at risk of becoming obese early in life, and obese children are at risk of becoming obese as adults: This is well documented.
UB pediatric researchers have developed an approach to interrupting this cycle, involving parent, child and the family physician, which they tested successfully in a pilot study. The project continues a 20-year UB tradition in the treatment of obesity.
Now the researchers, headed by Teresa Quattrin, professor of pediatrics and a specialist in childhood endocrinology and diabetes, have received a $2.58 million grant from the National Institutes of Health to test their family-based, weight-control intervention in pre-school children in three large pediatric practices in Western New York. Quattrin is interim chair of the Department of Pediatrics in the UB School of Medicine and Biomedical Sciences and chief of service at Women & Children’s Hospital of Buffalo.
The study is the first of its kind in the U.S.
“We think this study is an important step toward translating effective family-based interventions to prevent and treat overweight in primary care,” said Quattrin. “Currently in Western New York, three out of 10 young children are close to being overweight or are already overweight.
“Fifty percent of children who are overweight between 3 and 5 years of age will remain overweight as adults and the risk of becoming an overweight adult increases to 83 percent if both parents are overweight,” Quattrin said. “And with obesity comes a myriad of other serious health conditions—hypertension, type 2 diabetes, heart disease, low self esteem—among others. It’s imperative that we find tools that can prevent and treat overweight in a clinical practice setting.”
The 24-month intervention, designed as a prospective randomized controlled trial, will involve 108 children ages 2-to-5 years with a BMI equal to or greater than the 85th percentile for age and sex (at risk for overweight or overweight), and a parent with a BMI equal to or greater than 30 (overweight).
The study is structured so that participating families will benefit from taking part in the program, irrespective of their assignment either to an “intervention” group or an “enhanced usual care” group. The study will test whether the program, implemented in the child’s primary-care setting, can promote weight maintenance or modest weight loss while the child grows in height, thus achieving a decreased percentage BMI overweight over time and gradually shifting the child’s trajectory for overweight to normal weight.
Changing eating and activity habits that result in weight loss will be the primary focus of the study. Education on behavioral-modification techniques to promote healthy habits will be part of the program. Healthy eating habits will concentrate on increasing the consumption of fruits and vegetables, and cutting out “energy-dense” food, such as snacks, cola and candy, to decrease the number of calories consumed. All families will be counseled on safe ways for both the child and parent to increase physical activity. The child’s pediatrician will be intimately involved with all aspects of the study, including following the child’s progress throughout the study.
Quattrin and co-investigators James Roemmich, associate professor of pediatrics and exercise and nutrition sciences and a specialist in behavioral medicine; and Leonard Epstein, UB Distinguished Professor of Pediatrics and head of the university’s Division of Behavioral Medicine, will work closely with the Pediatricians at Amherst, Sub-Urban and Hodge Pediatrics.