Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity.
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.
McCallum
Z
Z
Centre for Community Child Health, The University of Melbourne, Murdoch Childrens Research Institute, Parkville, Australia. zoe.mccallum@rch.org.au
Wake
M
M
Gerner
B
B
Baur
L A
LA
Gibbons
K
K
Gold
L
L
Gunn
J
J
Harris
C
C
Naughton
G
G
Riess
C
C
Sanci
L
L
Sheehan
J
J
Ukoumunne
O C
OC
Waters
E
E
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