title: Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth.
abstract: Intervention studies in youth with obesity that can be translated into primary care are limited. We compared a lifestyle intervention to a brief intervention applied by primary care physicians (control group) for treating pediatric obesity in the primary care setting. Seventy-six youth with obesity (body mass index [BMI] >95th percentile or >90th percentile plus waist circumference >90th percentile, aged 9 to 17 years) participated in a 12-month, randomized, controlled trial, conducted at a primary care unit in Northern México from June 2006 through October 2007. Participants randomized to lifestyle intervention attended a family-centered program consisting of 12 sessions of behavioral curriculum, dietary advice from a registered dietitian (weekly for the first 3 months and monthly thereafter), and monthly consultations with a primary care physician. Control group participants attended monthly consultations with a primary care physician who received a brief training on obesity. Forty-three (57%) participants completed the 12 months of study. After 12 months, mean changes (95% confidence interval) in body weight for the lifestyle group and the control group were -0.8 kg (-3.2, 1.5) vs +5.6 kg (3, 8.2; P<0.001) and mean changes in BMI were -1.8 (-2.6, -0.9) vs +0.4 (-0.5, 1.3; P<0.001), respectively. Intention-to-treat analysis at 12 months confirmed significant differences in primary outcomes (weight -3.5 kg, P=0.02; BMI -1.2, P=0.03) in favor of the lifestyle group. This study provides preliminary evidence that primary care physicians supported by a registered dietitian and a behavioral curriculum can be a successful strategy for treating pediatric obesity in the primary care setting.
authors.affiliation: Department of Human Nutrition, Centro de Investigación en Alimentación y Desarrollo, Sonora, México.
authors.forename: Rolando G
authors.initials: RG
authors.lastname: Díaz
authors.forename: Julián
authors.initials: J
authors.lastname: Esparza-Romero
authors.forename: Silvia Y
authors.initials: SY
authors.lastname: Moya-Camarena
authors.forename: Alma E
authors.initials: AE
authors.lastname: Robles-Sardín
authors.forename: Mauro E
authors.initials: ME
authors.lastname: Valencia
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology; D004046:Dietetics; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008800:Mexico; D009765:Obesity / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D016896:Treatment Outcome