title: Parent diet modification, child activity, or both in obese children: an RCT.
abstract: OBJECTIVE
  Outcomes of childhood obesity interventions are rarely reported beyond 1 year. We hypothesized that the impact on the BMI z score from a child-centered physical-activity program in combination with a parent-centered dietary-modification program would be greater than either program conducted alone at 24 months' after baseline.
  
  
  METHODS
  A total of 165 overweight prepubertal children (68 boys, aged 5.5-9.9 years, mean BMI z score: 2.8) were randomly assigned to either a child-centered physical-activity program, a parent-centered dietary-modification program, or both conducted together in an assessor-blinded 6-month intervention.
  
  
  RESULTS
  Using linear mixed models, all groups reduced their mean (95% confidence interval) BMI z score at 24 months from baseline (P < .001) (the activity and diet group: -0.24 [-0.35 to -0.13]; the diet-only group: -0.35 [-0.48 to -0.22]; activity-only group -0.19 [-0.30 to -0.07]). There was a significant group-by-time interaction (P = .04) with the activity + diet and the diet-only groups showing a greater reduction than the activity-only group. For waist z score and waist-to-height ratio, there was a significant time effect (P < .0001) at 24 months but no between-group differences (P > .05). Some metabolic outcomes improved at 24 months, although there were no between-group differences (P > .05).
  
  
  CONCLUSIONS
  A reduction in BMI z score was sustained at 24 months by treatment with either program combination. The greatest effects were achieved through inclusion of a parent-centered diet program, indicating the importance of targeting parents within treatment and the possibility of targeting them exclusively in treating obese prepubertal children.
authors: Department of Nutrition and Diet, School of Health Sciences, Faculty of Health, University of Newcastle, NSW, 2308, Australia. clare.collins@newcastle.edu.au
authors: Clare E
authors: CE
authors: Collins
authors: Anthony D
authors: AD
authors: Okely
authors: Philip J
authors: PJ
authors: Morgan
authors: Rachel A
authors: RA
authors: Jones
authors: Tracy L
authors: TL
authors: Burrows
authors: Dylan P
authors: DP
authors: Cliff
authors: Kim
authors: K
authors: Colyvas
authors: Janet M
authors: JM
authors: Warren
authors: Julie R
authors: JR
authors: Steele
authors: Louise A
authors: LA
authors: Baur
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D004493:Education; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009043:Motor Activity; D009517:New South Wales; D009765:Obesity / Q000178:diet therapy*; D055502:Secondary Prevention; D055105:Waist Circumference