A family-based weight management program developed by researchers at Yale School of Medicine was more effective at reducing weight, body fat, body mass index (BMI) and insulin sensitivity than traditional clinic-based weight counseling.
Mary Savoye-Desanti, research associate in Yale's Department of Pediatrics, will present the findings at a JAMA media briefing in New York on June 26 at 10 a.m. The study will be published in JAMA's June 27 theme issue on chronic diseases of children.
Savoye-Desanti, a registered dietician and certified diabetes educator, and her team conducted the one-year clinical trial of 209 overweight children between the ages of 8 and16 to address the increasing prevalence of childhood obesity, especially in the African American and Hispanic population. The childhood obesity epidemic has also sparked an increase of type 2 diabetes among adolescents.
Savoye-Desanti and colleagues measured the effectiveness of the weight management program Bright Bodies, in comparison to care provided at a pediatric obesity clinic. Bright Bodies was created 10 years ago by Savoye-Desanti and combines nutrition education, behavior modification and exercise tailored to the needs of inner-city children. The study sought to compare changes in BMI, body composition, insulin sensitivity, blood pressure and lipid profiles.
The 105 children randomly assigned to the Bright Bodies program participated in 50 minutes of exercise for two nights per week. The eight to 10-year-old group participated in several games such as relay races, obstacle courses and several other games including "Swim Fish Swim." The older group (11- to 16-year-olds) played flag football, basketball and other activities. Both groups played "Dance, Dance Revolution" by Konami.
The study revealed great differences in BMI, body weight, body fat and percent body fat between the control group and the weight management group. While the average body weight was essentially unchanged among the weight management group, BMI was reduced by 1.7 units and there was an improvement in overall cholesterol. The control group gained an average of 17 pounds and increased their BMI by 1.6 units. Percent and total body fat was reduced in the weight management group and increased in the control group.
Insulin sensitivity, which measures the risk of developing type 2 diabetes, was increased in the weight management group and decreased in the control group. Increased insulin sensitivity is linked to a reduced risk of developing type 2 diabetes.
"We have shown that a family-based program that uses nutrition education, behavior modification and supervised exercise can lower BMI, improve body composition and increase insulin sensitivity," said Savoye-Desanti, who stresses that the success of the Bright Bodies program relates to frequent contact between the families and staff members. "This is a family problem. The child can't do it alone."
Savoye-Desanti said that while the program was very successful in treating overweight children, the expense incurred in operating such a program is substantial. "We will focus future studies on cost-benefit analyses, as this would be helpful for pediatric clinicians or health management organizations that are considering offering similar services to overweight children and adolescents," said Savoye-Desanti.
The study was supported by grants from the National Institutes of Health and a gift from the McPhee Foundation of Bristol, Conn.
Other authors on the study include Melissa Shaw, James Dziura, William Tamborlane, M.D., Paulina Rose, Cindy Guandalini, Rachel Goldberg-Gell, Tania S. Brugert, M.D., Anna M.G. Cali, M.D., Ram Weiss, M.D. and Sonia Caprio, M.D.
Citation: JAMA, Vol. 297, No. 24: 2697-2704 (June 27, 2007)