title: Can a trial of motivational lifestyle counseling be effective for controlling childhood obesity and the associated cardiometabolic risk factors?
abstract: OBJECTIVE
  This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors.
  
  
  METHODS
  This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2-18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged.
  
  
  RESULTS
  Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14-18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement.
  
  
  CONCLUSIONS
  Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services.
authors.affiliation: Pediatric Preventive Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. kroya@aap.net
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Malekahmadi
authors.forename: Mahin
authors.initials: M
authors.lastname: Hashemipour
authors.forename: Mehrnaz
authors.initials: M
authors.lastname: Soghrati
authors.forename: Mojgan
authors.initials: M
authors.lastname: Soghrati
authors.forename: Parisa
authors.initials: P
authors.lastname: Mirmoghtadaee
authors.forename: Shohreh
authors.initials: S
authors.lastname: Ghatrehsamani
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.forename: Noushin
authors.initials: N
authors.lastname: Khavarian
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003376:Counseling; D005260:Female; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D009042:Motivation; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D008055:Lipids