Multi-Site Randomized Controlled Trial of a Child-Centered Physical Activity Program, a Parent-Centered Dietary-Modification Program, or Both in Overweight Children: The HIKCUPS Study

Okely, Anthony D.; Collins, Clare E.; Morgan, Philip J.; Jones, Rachel A.; Warren, Janet M.; Cliff, Dylan P.; Burrows, Tracy L.; Colyvas, Kim; Steele, Julie R.; Baur, Louise A.

doi:10.1016/j.jpeds.2010.03.028

« Previous Next »The Journal of Pediatrics
Volume 157, Issue 3 , Pages 388-394.e1, September 2010

Multi-Site Randomized Controlled Trial of a Child-Centered Physical Activity Program, a Parent-Centered Dietary-Modification Program, or Both in Overweight Children: The HIKCUPS Study

Anthony D. Okely, EdD
- Child Obesity Research Centre and Faculty of Education, University of Wollongong, Wollongong, Australia
- Reprint requests: Anthony D Okely, EdD, Faculty of Education, University of Wollongong, Wollongong NSW 2522 Australia.
Clare E. Collins, PhD
- School of Health Sciences, The University of Newcastle, Australia
Philip J. Morgan, PhD
- School of Education, The University of Newcastle, Australia
Rachel A. Jones, PhD
- Child Obesity Research Centre and Faculty of Education, University of Wollongong, Wollongong, Australia
Janet M. Warren, PhD
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, United Kingdom
Dylan P. Cliff, PhD
- Child Obesity Research Centre and Faculty of Education, University of Wollongong, Wollongong, Australia
Tracy L. Burrows, PhD
- School of Health Sciences, The University of Newcastle, Australia
Kim Colyvas, PhD
- School of Mathematical and Physical Sciences, The University of Newcastle, Australia
Julie R. Steele, PhD
- Biomechanics Research Laboratory, School of Health Sciences, University of Wollongong, Wollongong, Australia
Louise A. Baur, MBBS, PhD
- University of Sydney Discipline of Paediatrics & Child Health, Clinical School, The Children's Hospital at Westmead, Australia

Received 6 November 2009; received in revised form 18 February 2010; accepted 19 March 2010. published online 07 May 2010.

Objective

To evaluate whether a child-centered physical activity program, combined with a parent-centered dietary program, was more efficacious than each treatment alone, in preventing unhealthy weight-gain in overweight children.

Study design

An assessor-blinded randomized controlled trial involving 165 overweight/obese 5.5- to 9.9- year-old children. Participants were randomly assigned to 1 of 3 interventions: a parent-centered dietary program (Diet); a child-centered physical activity program (Activity); or a combination of both (Diet + Activity). All groups received 10 weekly face-to-face sessions followed by 3 monthly relapse-prevention phone calls. Analysis was by intention-to-treat. The primary outcome was change in body mass index z-score at 6 and 12 months (n = 114 and 106, respectively).

Results

Body mass index z-scores were reduced at 12-months in all groups, with the Diet (mean [95% confidence interval]) (−0.39 [−0.51 to 0.27]) and Diet + Activity (−0.32, [−0.36, −0.23]) groups showing a greater reduction than the Activity group (−0.17 [−0.28, −0.06]) (P = .02). Changes in other outcomes (waist circumference and metabolic profile) were not statistically significant among groups.

Conclusion

Relative body weight decreased at 6 months and was sustained at 12 months through treatment with a child-centered physical activity program, a parent-centered dietary program, or both. The greatest effect was achieved when a parent-centered dietary component was included.

BMI, Body mass index