A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study - an intervention within the STOP project.


Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
15 Jul 2019
Historique:
received: 03 06 2019
accepted: 13 06 2019
entrez: 17 7 2019
pubmed: 17 7 2019
medline: 12 10 2019
Statut: epublish

Résumé

Childhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families. A two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n = 100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based on metabolic markers from urine and 24 h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline. This study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided. ClinicalTrials.gov NCT03800823; 11 Jan 2019.

Sections du résumé

BACKGROUND BACKGROUND
Childhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families.
METHODS/DESIGN METHODS
A two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n = 100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based on metabolic markers from urine and 24 h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline.
DISCUSSION CONCLUSIONS
This study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov NCT03800823; 11 Jan 2019.

Identifiants

pubmed: 31307412
doi: 10.1186/s12889-019-7161-y
pii: 10.1186/s12889-019-7161-y
pmc: PMC6631737
doi:

Banques de données

ClinicalTrials.gov
['NCT03800823']

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

945

Subventions

Organisme : European Union, Horizon 2020
ID : 774548
Organisme : Instituto de Salud Carlos III
ID : CIBEROBN (CB12/03/30038)
Organisme : Fernando Tarongí Bauzà Award
ID : 2018
Organisme : CIBERESP
ID : MPCUdG2016/69 and GDRCompetUdG2017

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Auteurs

Anna Ek (A)

Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. anna.ek@ki.se.

Christine Delisle Nyström (C)

Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.

Adela Chirita-Emandi (A)

Genetics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.
"Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara, Romania.

Josep A Tur (JA)

Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.
CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.

Karin Nordin (K)

Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Cristina Bouzas (C)

Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.
CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.

Emma Argelich (E)

Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.
CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.

J Alfredo Martínez (JA)

CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.
Department of Nutrition, Food Science, and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.
IMDEA Food Precision Nutrition, Madrid, Spain.

Gary Frost (G)

Section for Nutrition Research, Department of Medicine, Imperial College London, Hammersmith Campus, London, UK.

Isabel Garcia-Perez (I)

Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, South Kensington Campus, London, UK.

Marc Saez (M)

Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Campus de Montilivi, Girona, Spain.
CIBER of Epidemiology and Public Health (CIBERESP), Instituto Carlos III, Madrid, Spain.

Corina Paul (C)

Pediatrics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.
2nd Pediatrics Clinic, Clinical Emergency County Hospital Timisoara, Timisoara, Romania.

Marie Löf (M)

Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.

Paulina Nowicka (P)

Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden.

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