title: Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity.
abstract: OBJECTIVE
  To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting.
  
  
  METHODS
  Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey.
  
  
  METHODS
  Twenty nine general practices, Melbourne, Australia.
  
  
  METHODS
  (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control).
  
  
  METHODS
  Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials.
  
  
  METHODS
  Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth.
  
  
  RESULTS
  Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms.
  
  
  CONCLUSIONS
  This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level.
authors.affiliation: Centre for Community Child Health, The University of Melbourne, Murdoch Childrens Research Institute, Parkville, Australia. zoe.mccallum@rch.org.au
authors.forename: Z
authors.initials: Z
authors.lastname: McCallum
authors.forename: M
authors.initials: M
authors.lastname: Wake
authors.forename: B
authors.initials: B
authors.lastname: Gerner
authors.forename: L A
authors.initials: LA
authors.lastname: Baur
authors.forename: K
authors.initials: K
authors.lastname: Gibbons
authors.forename: L
authors.initials: L
authors.lastname: Gold
authors.forename: J
authors.initials: J
authors.lastname: Gunn
authors.forename: C
authors.initials: C
authors.lastname: Harris
authors.forename: G
authors.initials: G
authors.lastname: Naughton
authors.forename: C
authors.initials: C
authors.lastname: Riess
authors.forename: L
authors.initials: L
authors.lastname: Sanci
authors.forename: J
authors.initials: J
authors.lastname: Sheehan
authors.forename: O C
authors.initials: OC
authors.lastname: Ukoumunne
authors.forename: E
authors.initials: E
authors.lastname: Waters
mesh_terms: D001828:Body Image; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise / Q000502:physiology; D005194:Family Practice / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000523:psychology / Q000628:therapy; D050177:Overweight; D012649:Self Concept