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Location: Children's Nutrition Research Center

Title: Effects of a school-based weight maintenance program for Mexican-American children: results at 2 years

item Johnston, Craig
item Tyler, Chermaine
item Mcfarlin, Brian
item Poston, Walker S
item Haddock, C
item Reeves, Rebecca
item Foreyt, John

Submitted to: Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/20/2009
Publication Date: 3/1/2010
Citation: Johnston, C.A., Tyler, C., McFarlin, B.K., Poston, W.S.C., Haddock, C.K, Reeves, R.S., Foreyt, J.P. 2010. Effects of a school-based weight maintenance program for Mexican-American children: results at 2 years. Obesity. 18(3):542-547.

Interpretive Summary: The purpose of this study was to examine the long term effectiveness of an instructor-led weight maintenance intervention in comparison to a self help program for overweight Mexican-American children. Results indicate that both weight loss and cardiovascular improvements were maintained over 2 years in children participating in the instructor-led intervention. Children in the intervention showed significantly greater decreases in weight in comparison to children in the self-help program at 1 and 2 years. Children in the intervention also showed greater improvements in body composition, total cholesterol, and triglycerides than participants of the self-help program. The findings of this study suggest that school-based weight loss programs can effectively improve weight and clinical outcomes, and result in the long term maintenance of these outcomes for Mexican-American children. Further research is necessary to determine the components (e.g. diet, physical activity, self-monitoring, social support strategies) of the program most responsible for the favorable outcomes. Future studies may also assess the cost-effectiveness of school-based programs in order to establish generalizable methods for addressing overweight in children.

Technical Abstract: The prevalence of childhood overweight has increased significantly, with the highest rates noted among Mexican Americans. Many negative health outcomes are associated with overweight; thus, there is a need for effective weight-loss interventions tailored to this group. This study evaluated 24-month outcomes of a randomized, controlled trial involving an intensive lifestyle-based weight maintenance program targeting overweight Mexican-American children at a charter school in Houston, Texas. A total of 60 children (33 males, 55%) between the ages of 10 and 14 at or >85th percentile for BMI were recruited. Participants were randomized to an instructor-led intervention (ILI) or a self-help (SH) program, both aimed at modifying eating and physical activity behaviors using behavior modification strategies. Changes in participants' standardized BMI (zBMI) were assessed at baseline, 1, and 2 years. Tricep skinfold, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and calculated low-density lipoprotein were assessed at baseline and 1 year. ILI participants showed significantly greater decreases in zBMI at 1 and 2 years (F = 26.8, P < 0.001, F = 4.1, P < 0.05, respectively) compared to SH controls. ILI participants showed greater improvements in body composition, as measured by tricep skinfold (F = 9.75, P < 0.01). Children in the ILI condition experienced benefits with respect to total cholesterol (F = 7.19, P < 0.05) and triglycerides (F = 4.35, P < 0.05) compared to children in the SH condition. Overall, the school-based intervention resulted in improved weight and clinical outcomes in overweight Mexican-American children, and zBMI was maintained over 2 years.