Slimmer future for heavy kids who get help early

NEW YORK Mon Oct 29, 2012 8:13pm GMT

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NEW YORK (Reuters Health) - Weight-loss programs can help even very young children slim down, and it appears that acting early may improve the odds of success, according to a pair of new studies.

"What they are showing is a pretty consistent trend that if we were to intervene early, we could really have an effect on changing the trajectory of weight gain in children," said Dr. Elsie Taveras, a pediatrician at Harvard Medical School and Boston Children's Hospital, who co-wrote an editorial on the findings.

In one study, Dutch scientists found that heavy three- to five-year-olds saw continued benefits from a weight-loss intervention at least several months after it ended.

And a report from Sweden shows overweight and obese children under 10 were much more likely to slow their weight gain than were adolescents getting similar behavioral treatments.

The two studies were released Monday in the Archives of Pediatrics & Adolescent Medicine.

Excessive pounds in childhood often stay on into adulthood, where they have been linked to heart disease, diabetes and other health problems.

Taveras said there is mounting evidence that paying attention to young kids may be a promising way to stem the global obesity epidemic. In 2008, more than a third of U.S. youths were either overweight or obese, according to the Centers for Disease Control and Prevention.

The numbers have also been on the rise in Europe, although they are still lower than in the U.S.

The Dutch researchers, led by Dr. Gianni Bocca of Beatrix Children's Hospital in Groningen, studied 75 heavy children who had been randomly assigned to get either usual care or an intensive weight-loss program. The program lasted four months and involved 25 sessions with dietary advice, exercise and, for the parents only, behavioral counseling.

A year after the study began, kids in the intervention group had gained 4.2 pounds on average, and those who got usual care had added another 6.8 pounds.

While that difference could have been due to chance, there was a statistically reliable difference in body mass index, or BMI, a measure of height in relation to weight.

Children in the intervention group went one unit down in BMI, while the others saw no change. In adults, a healthy BMI is between 18.5 and 25.

"The magnitude of the effect, especially initially after the intervention, wasn't very large, but what needs to be taken into account was that these children were growing," Taveras told Reuters Health.

"What these interventions are showing is that you can have an effect, and hopefully these interventions are changing the trajectory the children were headed towards."

PARTICULARLY TOUGH CASES?

She also cautioned that the Swedish findings, led by Pernilla Danielsson of Karolinska Institutet in Stockholm, were based on observations instead of an experiment.

That means it's possible that the youngsters between 14 and 16, who saw no or little effect of the behavioral treatment, could have been particularly tough cases.

Still, Taveras said, there is good evidence that heavy kids who start weight-loss programs early have an easier time slimming down.

Weight-loss programs for kids are available from healthcare providers across the country and are often covered by insurance, she said, adding that interested families could ask their pediatrician or check with local public health departments.

The government is also funding research that takes a more comprehensive approach to keeping children's weight healthy. The Childhood Obesity Research Demonstration, for example, includes sites in three states and attacks the problem at various levels. At the Massachusetts site, Taveras said primary care doctors, child care centers and schools are all involved in the efforts.

"I hope that in a few years there will be more examples of programs that aren't just clinical that we can send families to," she said.

SOURCE: bit.ly/PogxGc Archives of Pediatrics & Adolescent Medicine, online October 29, 2012.

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