This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.More than 1 in 7 children in the U.S. is overweight. Clinic-based family-oriented pediatric behavioral weight control intervention has demonstrated short- and long-term efficacy, although efficacy has not necessarily been evaluated on all important indices of the health risk incurred by overweight children. For instance, among adults the pattern of body fat distribution may be more important for health risk than total body fat, with intra-abdominal or visceral fat accumulation considered among the most detrimental to long-term health. Few studies, either observational or interventional, have examined changes in children's visceral fat accumulation. Evidence from our observational Child Health and Natural Growth Evaluation Study (CHANGES; CCHMC #02-1-17) among overweight children suggests that physical activity is a strong determinant of children's visceral fat accumulation (more physical activity, less visceral fat), independent of the relation between physical activity and total body fat. This observational study was part of a K23 career development award from NIH/NIDDK. The current study is the second study that is part of this award. We propose a pilot 4-month behavioral pediatric obesity intervention trial that examines the impact on children's visceral fat of standard care intervention consisting of diet and physical activity modification (standard care intervention; SCI) versus standard care intervention with greater physical activity and enhanced strategies to increase physical activity (standard care plus physical activity; SCP). Both intervention conditions will include 1) weekly group and individual family sessions focused on behavioral strategies for dietary and activity change and 2) dietary prescriptions targeting caloric reduction, increasing healthy foods, and decreasing unhealthy foods. The activity prescription for the SCI participants will be set at 60+ minutes of physical activity each day, the current recommendation for children. The SCP participants will set goals for reaching 90+ minutes of physical activity each day and utilize various behavioral strategies to meet this elevated activity goal. Forty child-parent pairs (n=34 following expected attrition), in which both the child and parent are overweight, will participate and be randomly assigned to one of the intervention conditions. The primary outcomes will include pre-intervention to post-intervention change in child visceral fat, after adjusting for changes in total body fat. Secondary outcomes will include child weight, body fat, height, physical activity, diet, and behavioral skill adherence, as well as parent body fat and weight. This pilot study has the goals of 1) evaluating whether the SCP intervention can increase children's physical activity to desired levels and 2) estimating the initial efficacy and effect size (to inform future larger clinical trials) of visceral fat change for children provided similar dietary interventions but dissimilar physical activity interventions.
Showing the most recent 10 out of 502 publications
