Regular readers may recall a previous post calling for treating the parents to tackle childhood obesity. Indeed, there is little evidence that trying to address childhood obesity without involving the whole family is likely to have any success.
Thus, it may not be all that surprising that Clare Collins and colleagues from the University of Newcastle, NSW, Australia, in a randomised controlled study just published in PEDIATRICS, find that targeting the parents’ diets appears far more likely to affect the weight of their overweight offspring than trying to getting the kids to be more active.
This study included 165 overweight prepubertal children (68 boys, aged 5.5-9.9 years) who were randomised to either a child-centered physical-activity program to either a child-centered physical-activity program, a parent-centered dietary-modification program, or both in an assessor-blinded 6-month intervention.
All group interventions weekly 2-hour face-to-face session for 10 weeks that included homework activities followed by a relapse-prevention program that reviewed short- to medium-term goals set by parents, by telephone, monthly for 3 months.
The diet program, which was delivered exclusively to the parents, focused on goal setting, problem solving, role modeling, and positive reinforcement.
The activity program, consisted of weekly face-to-face sessions aimed to improve child fundamental movement-skill proficiency, with parents participating in the first session and being encouraged to complete the homework activities weekly with their child.
The combined intervention consisted of both the dietary intervention for the parents and the activity intervention for the kids.
At 24 months after the start of the intervention, BMI z scores showed the greatest reduction in the parent-centred diet-modification group (-0.35), followed by the activity and diet group: -0.24, and the activity-only group -0.19.
Thus, the greatest effects were achieved through inclusion of a parent-centered diet program, indicating the importance of targeting parents within treatment. In fact the authors even suggest the possibility that exclusively targeting parents diet may be a viable option for treating obese prepubertal children.
“The implication for health service providers, and parents who seek effective treatment options, is that parental involvement is essential for program effectiveness. In addition, parents can participate in intervention programs that will benefit their child without their child being required to participate.”
In any case, it is probably safe to say that (perhaps contrary to popular belief) programs that exclusively focus on trying to address childhood obesity by getting kids to be more active are probably the least effective strategies.
In contrast, leaving the kids alone and focussing on the parents, may be best, unless of course one has the resources and capacity to do both.
Collins CE, Okely AD, Morgan PJ, Jones RA, Burrows TL, Cliff DP, Colyvas K, Warren JM, Steele JR, & Baur LA (2011). Parent Diet Modification, Child Activity, or Both in Obese Children: An RCT. Pediatrics PMID: 21444600