Multi-site randomized controlled trial of a child-centered physical activity program, a parent-centered dietary-modification program, or both in overweight children: the HIKCUPS study.
OBJECTIVE
To evaluate whether a child-centered physical activity program, combined with a parent-centered dietary program, was more efficacious than each treatment alone, in preventing unhealthy weight-gain in overweight children.


METHODS
An assessor-blinded randomized controlled trial involving 165 overweight/obese 5.5- to 9.9- year-old children. Participants were randomly assigned to 1 of 3 interventions: a parent-centered dietary program (Diet); a child-centered physical activity program (Activity); or a combination of both (Diet+Activity). All groups received 10 weekly face-to-face sessions followed by 3 monthly relapse-prevention phone calls. Analysis was by intention-to-treat. The primary outcome was change in body mass index z-score at 6 and 12 months (n=114 and 106, respectively).


RESULTS
Body mass index z-scores were reduced at 12-months in all groups, with the Diet (mean [95% confidence interval]) (-0.39 [-0.51 to 0.27]) and Diet + Activity (-0.32, [-0.36, -0.23]) groups showing a greater reduction than the Activity group (-0.17 [-0.28, -0.06]) (P=.02). Changes in other outcomes (waist circumference and metabolic profile) were not statistically significant among groups.


CONCLUSIONS
Relative body weight decreased at 6 months and was sustained at 12 months through treatment with a child-centered physical activity program, a parent-centered dietary program, or both. The greatest effect was achieved when a parent-centered dietary component was included.
Okely
Anthony D
AD
Child Obesity Research Centre and Faculty of Education, School of Health Sciences, University of Wollongong, Wollongong, Australia. tokely@uow.edu.au
Collins
Clare E
CE
Morgan
Philip J
PJ
Jones
Rachel A
RA
Warren
Janet M
JM
Cliff
Dylan P
DP
Burrows
Tracy L
TL
Colyvas
Kim
K
Steele
Julie R
JR
Baur
Louise A
LA
D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D050177:Overweight / Q000178:diet therapy / Q000628:therapy*; D010290:Parents; D016037:Single-Blind Method