Super Obese Children, Weight & Diet
The objective of this study was to examine
whether a protein-sparing modified fast diet and a hypocaloric balanced
diet are effective in a clinic-based dietary intervention implemented
in a school setting high-risk weight loss program for super obese (>
or = 140 percent of their ideal body weight for height [IBW] children.
A group of children from two suburban public schools in New Orleans, Louisiana
were randomized to either dietary-intervention group and control group.
Children were followed for 6 months. In the dietary-intervention-group,
12 of 44 super obese children [ages 8.8 to 13.4 years, weight 144 percent
to 212 percent of IBW] volunteered to participate. In the control group,
7 of 19 super obese children [ages 9.4 to 12.9 years, weight 140 percent
to 195 percent of IBW] volunteered to participate. During the first 9
weeks, 12 super obese children were placed on a 2520 to 3360 J (600 to
800 Cal) protein-sparing modified fast diet. Subsequently, the diets of
all children were increased in a 3-month period 420 J (100 Cal) every
2 weeks until a 5040 J (1200 Cal) per day balanced diet was attained.
In both groups, height and weight were obtained at baseline, 10 weeks,
and 6 months; and biochemical measurements were performed at baseline
and 6 months. At 6 months the 12 super obese children on protein-sparing
modified fast diet had a significant weight loss from baseline; a significant
decrease in percentage IBW; and had positive growth velocity Z-score.
Six children were not super obese at 6 months. At 6 months eight of 12
children were active participants and 11 of 12 children were followed.
Decrease in blood pressure, as well as, downward trends in serum lipids
were observed at 6 months. No clinical complications were observed. At
6 months, the 7 control super obese children, when compared with baseline
had gained weight (2.8kg); but had no significant change in percentage
IBW; and had no changes in growth velocity Z-score. These children did
not have any change in blood pressure and an upward trend in serum lipids
were observed at 6 months. Protein-sparing modified fast diet and a hypocaloric
balanced diet appear to be effective in a group of super-obese-school-age
children in a medically supervised clinic-based program implemented in
a school setting over a 6-month period. The efforts of committed clinic
staffs, school officials, peers, and family involvement were crucial to
the success of this intervention program in promoting and maintaining
weight loss over a 6-month period. Further research with a specific comparison
of the hypocaloric diets with longer follow-up periods in the school setting
is necessary. In the meantime, these diets should be used only with close
medical supervision.
Source: Figueroa-Colon R, Franklin FA,
Lee JY, von Almen TK, Suskind RM. Department of Pediatrics, University
of Alabama at Birmingham, Children's Hospital of Alabama 35233, USA. 1996
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