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Title: Achieving long-term weight maintenance in Mexican-American adolescents with a school-based intervention

Author
item JOHNSTON, CRAIG - Children'S Nutrition Research Center (CNRC)
item MORENO, JENNETTE - Children'S Nutrition Research Center (CNRC)
item GALLAGHER, MARTINA - University Of Texas Health Science Center
item WANG, JING - University Of Texas Health Science Center
item PAPAIOANNOU, MARIA - Children'S Nutrition Research Center (CNRC)
item TYLER, CHERMAINE - Children'S Nutrition Research Center (CNRC)
item FOREYT, JOHN - Baylor College Of Medicine

Submitted to: Journal of Adolescent Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/8/2013
Publication Date: 7/1/2013
Citation: Johnston, C.A., Moreno, J.P., Gallagher, M.R., Wang, J., Papaioannou, M.A., Tyler, C., Foreyt, J.P. 2013. Achieving long-term weight maintenance in Mexican-American adolescents with a school-based intervention. Adolescent Health. 53:335-341.

Interpretive Summary: The increasing rates of pediatric overweight and obesity are growing major health concerns in the US. In particular, ethnic minorities seem to be most at risk of becoming overweight and obese. Recent studies have found that Mexican American adolescents have been shown to have the highest rate of overweight and obesity. As one of the fastest growing ethnic groups in the United States, the health risks associated with obesity and its causes in Mexican American adolescents need to be addressed in order to prevent future health risks from evolving. In this study, adolescents from the Houston area participated in a school-based 6-month obesity prevention program. The program was divided into two groups: an instructor-led intervention (ILI) and the other a self-help group (SH). Both groups aimed at modifying eating and physical activity behaviors. However, the ILI group students participated in 12 weeks of daily instructor/trainer-led physical activity interventions or nutrition classes followed by 12 weeks of biweekly follow-up sessions. The SH group was only given a parent-guided manual for the prevention and treatment of childhood obesity. The results of this study showed adolescents participating in the ILI group significantly decreased their BMI compared to the adolescents in the SH group. This study showed that a school-based obesity prevention program improved weight outcomes in Mexican American adolescents and that these results were maintained over a 2-year period.

Technical Abstract: This study evaluated 24-month outcomes of a school-based intensive lifestyle weight management program targeting overweight Mexican American adolescents. A total of 71 adolescents (32 males, 45.1%) between the ages of 10 and 14 at or above the 85th percentile for body mass index (BMI) were recruited. Participants were randomized to a 6-month instructor-led intervention (ILI) or a self-help (SH) program. Both interventions were aimed at modifying eating and physical activity behaviors using behavior modification strategies. Changes in participants' standardized BMI (zBMI) and BMI percentile were assessed at baseline, and at 1 and 2 years. Repeated measures analyses showed that ILI participants showed significantly greater decreases in zBMI at 1 and 2 years (F = 8.58, p < 0.01, F = 9.27, p < 0.01, respectively) compared to SH controls. Similar results were found for changes in BMI and BMI percentile. At 2 years, the ILI condition decreased their average BMI percentile by 3.9 percentile points compared to an increase of 1.6 percentile points in the SH condition. A school-based intervention resulted in improved weight outcomes in overweight Mexican American adolescents, and results were maintained over 2 years.