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Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity.
Int J Obes (Lond) 2007; 31(4):630-6IJ

Abstract

OBJECTIVES

To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting.

DESIGN

Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey.

SETTING

Twenty nine general practices, Melbourne, Australia.

PARTICIPANTS

(1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control).

INTERVENTION

Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials.

MAIN OUTCOME MEASURES

Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth.

RESULTS

Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms.

CONCLUSIONS

This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level.

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    Authors+Show Affiliations

    McCallum Z
    Centre for Community Child Health, The University of Melbourne, Murdoch Childrens Research Institute, Parkville, Australia. zoe.mccallum@rch.org.au
    Wake M
    No affiliation info available
    Gerner B
    No affiliation info available
    Baur LA
    No affiliation info available
    Gibbons K
    No affiliation info available
    Gold L
    No affiliation info available
    Gunn J
    No affiliation info available
    Harris C
    No affiliation info available
    Naughton G
    No affiliation info available
    Riess C
    No affiliation info available
    Sanci L
    No affiliation info available
    Sheehan J
    No affiliation info available
    Ukoumunne OC
    No affiliation info available
    Waters E
    No affiliation info available

    MeSH

    Body ImageBody Mass IndexChildChild, PreschoolCross-Sectional StudiesDietExerciseFamily PracticeFemaleHealth Care CostsHealth StatusHumansLife StyleMaleNutritional StatusObesityOverweightSelf Concept

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    17160087

    Citation

    McCallum, Z, et al. "Outcome Data From the LEAP (Live, Eat and Play) Trial: a Randomized Controlled Trial of a Primary Care Intervention for Childhood Overweight/mild Obesity." International Journal of Obesity (2005), vol. 31, no. 4, 2007, pp. 630-6.
    McCallum Z, Wake M, Gerner B, et al. Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. Int J Obes (Lond). 2007;31(4):630-6.
    McCallum, Z., Wake, M., Gerner, B., Baur, L. A., Gibbons, K., Gold, L., ... Waters, E. (2007). Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. International Journal of Obesity (2005), 31(4), pp. 630-6.
    McCallum Z, et al. Outcome Data From the LEAP (Live, Eat and Play) Trial: a Randomized Controlled Trial of a Primary Care Intervention for Childhood Overweight/mild Obesity. Int J Obes (Lond). 2007;31(4):630-6. PubMed PMID: 17160087.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. AU - McCallum,Z, AU - Wake,M, AU - Gerner,B, AU - Baur,L A, AU - Gibbons,K, AU - Gold,L, AU - Gunn,J, AU - Harris,C, AU - Naughton,G, AU - Riess,C, AU - Sanci,L, AU - Sheehan,J, AU - Ukoumunne,O C, AU - Waters,E, Y1 - 2006/12/12/ PY - 2006/12/13/pubmed PY - 2007/11/14/medline PY - 2006/12/13/entrez SP - 630 EP - 6 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 31 IS - 4 N2 - OBJECTIVES: To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting. DESIGN: Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey. SETTING: Twenty nine general practices, Melbourne, Australia. PARTICIPANTS: (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control). INTERVENTION: Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials. MAIN OUTCOME MEASURES: Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth. RESULTS: Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms. CONCLUSIONS: This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level. SN - 0307-0565 UR - https://www.unboundmedicine.com/medline/citation/17160087/Outcome_data_from_the_LEAP__Live_Eat_and_Play__trial:_a_randomized_controlled_trial_of_a_primary_care_intervention_for_childhood_overweight/mild_obesity_ L2 - http://dx.doi.org/10.1038/sj.ijo.0803509 DB - PRIME DP - Unbound Medicine ER -