The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study

doi:10.1186/s12887-014-0296-1

. 2014 Dec 5:14:296.

doi: 10.1186/s12887-014-0296-1.

The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study

Dirk E Bock^{1

2}, Tracy Robinson³, Jamie A Seabrook^{4

5

6}, Meghan Rombeek⁷, Kambiz Norozi^{8

9

10

11}, Guido Filler^{12

13

14}, Ralf Rauch^{15

16}, Cheril L Clarson^{17

18

19}

Affiliations

¹ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. dirk.bock@lhsc.on.ca.
² Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. dirk.bock@lhsc.on.ca.
³ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Tracy.Robinson@lhsc.on.ca.
⁴ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Jamie.Seabrook@lhsc.on.ca.
⁵ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Jamie.Seabrook@lhsc.on.ca.
⁶ Division of Food & Nutritional Sciences, Brescia University College, Western University, 1285 Western Rd, London, ON, N6G 1H2, Canada. Jamie.Seabrook@lhsc.on.ca.
⁷ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Meghan.Rombeek@lhsc.on.ca.
⁸ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Kambiz.Norozi@lhsc.on.cas.
⁹ Division of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Kambiz.Norozi@lhsc.on.cas.
¹⁰ Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Kambiz.Norozi@lhsc.on.cas.
¹¹ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Kambiz.Norozi@lhsc.on.cas.
¹² Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Guido.Filler@lhsc.on.ca.
¹³ Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Guido.Filler@lhsc.on.ca.
¹⁴ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Guido.Filler@lhsc.on.ca.
¹⁵ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. rrauch@khrmk.de.
¹⁶ Rems Murr Kliniken, Department of Pediatrics, Winnender Str. 45, 71334, Waiblingen, Germany. rrauch@khrmk.de.
¹⁷ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Cheril.Clarson@lhsc.on.ca.
¹⁸ Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Cheril.Clarson@lhsc.on.ca.
¹⁹ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Cheril.Clarson@lhsc.on.ca.

PMID: 25475951
PMCID: PMC4263062
DOI: 10.1186/s12887-014-0296-1

The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study

Dirk E Bock et al. BMC Pediatr. 2014.

. 2014 Dec 5:14:296.

doi: 10.1186/s12887-014-0296-1.

Authors

Dirk E Bock^{1

2}, Tracy Robinson³, Jamie A Seabrook^{4

5

6}, Meghan Rombeek⁷, Kambiz Norozi^{8

9

10

11}, Guido Filler^{12

13

14}, Ralf Rauch^{15

16}, Cheril L Clarson^{17

18

19}

Affiliations

¹ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. dirk.bock@lhsc.on.ca.
² Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. dirk.bock@lhsc.on.ca.
³ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Tracy.Robinson@lhsc.on.ca.
⁴ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Jamie.Seabrook@lhsc.on.ca.
⁵ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Jamie.Seabrook@lhsc.on.ca.
⁶ Division of Food & Nutritional Sciences, Brescia University College, Western University, 1285 Western Rd, London, ON, N6G 1H2, Canada. Jamie.Seabrook@lhsc.on.ca.
⁷ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Meghan.Rombeek@lhsc.on.ca.
⁸ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Kambiz.Norozi@lhsc.on.cas.
⁹ Division of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Kambiz.Norozi@lhsc.on.cas.
¹⁰ Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Kambiz.Norozi@lhsc.on.cas.
¹¹ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Kambiz.Norozi@lhsc.on.cas.
¹² Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Guido.Filler@lhsc.on.ca.
¹³ Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Guido.Filler@lhsc.on.ca.
¹⁴ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Guido.Filler@lhsc.on.ca.
¹⁵ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. rrauch@khrmk.de.
¹⁶ Rems Murr Kliniken, Department of Pediatrics, Winnender Str. 45, 71334, Waiblingen, Germany. rrauch@khrmk.de.
¹⁷ Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Cheril.Clarson@lhsc.on.ca.
¹⁸ Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Cheril.Clarson@lhsc.on.ca.
¹⁹ Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Cheril.Clarson@lhsc.on.ca.

PMID: 25475951
PMCID: PMC4263062
DOI: 10.1186/s12887-014-0296-1

Abstract

Background: Though recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL). The aim of this study was to determine if a 1-year multidisciplinary, family-centered outpatient intervention based on social cognitive theory would be effective in (i) preventing further increases in BMI and BMI z-score, and (ii) improving QoL in obese children and adolescents.

Methods: Obese children and adolescents 8-17 years of age and their families participated in this 1-year longitudinal pilot intervention study. The intervention consisted of fifteen 90-minute educational sessions led by a dietitian, exercise specialist, and social worker. Anthropometric measures, body composition, and QoL (Pediatric Quality of Life Inventory 4.0), were assessed at baseline, 3 months, and 12 months. Laboratory values were measured at baseline and 12 months. The primary outcome measures were change in BMI and BMI z-score, secondary outcome measures included change in QoL and body composition. A paired sample t-test was used to assess within-group differences and 95% confidence intervals were reported for the mean differences.

Results: 42 obese children and adolescents (21 girls) completed the 1-year intervention (mean age 12.8 ± 3.14 years). Mean baseline BMI was 31.96 ± 5.94 kg/m(2) and BMI z-score was +2.19 ± 0.34. Baseline QoL (self-assessments and parental assessments) was impaired: mean baseline scores were 74.5 ± 16.5 and 63.7 ± 19.4 for physical functioning and 69.0 ± 14.9 and 64.0 ± 18.3 for emotional functioning, respectively. At 12 months, BMI z-score had decreased (-0.07 ± 0.11, 95% CI: -0.11 to -0.04). BMI (0.80 ± 1.57 kg/m(2), 95% CI 0.31 to 1.29) and fat-free mass (4.02 ± 6.27 kg, 95% CI 1.90 to 6.14) increased, but % body fat and waist circumference did not. Both the parent-reported physical (11.3 ± 19.2, 95% CI 4.7 to 17.9) and emotional (7.7 ± 15.7, 95% CI 2.3 to 13.0) functioning QoL scores and the children's self-reported physical (5.3 ± 17.1, 95% CI 0.5 to 11.1) and emotional (7.9 ± 14.3, 95% CI 3.2 to 12.7) functioning scores significantly improved.

Conclusions: Following a 1-year intervention, the participants' BMI z-scores and QoL improved, while other adiposity-related measures of body composition remained unchanged.

Trial registration: UMIN Clinical Trials Registry UMIN000015622 .

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Figures

**Figure 1**
**Flow of subject progress from point of referral until the end of the 12-month intervention.**

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References

1. Roberts KC, Shields M, De Groh M, Aziz A, Gilbert JA. Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2011;2012(23):37–41. - PubMed
1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–490. doi: 10.1001/jama.2012.40. - DOI - PMC - PubMed
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[1] Roberts KC, Shields M, De Groh M, Aziz A, Gilbert JA. Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2011;2012(23):37–41. - PubMed

[2] Roberts KC, Shields M, De Groh M, Aziz A, Gilbert JA. Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2011;2012(23):37–41. - PubMed

[3] Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–490. doi: 10.1001/jama.2012.40. - DOI - PMC - PubMed

[4] Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–490. doi: 10.1001/jama.2012.40. - DOI - PMC - PubMed

[5] Abrams P, Levitt Katz LE. Metabolic effects of obesity causing disease in childhood. Curr Opin Endocrinol Diabetes Obes. 2011;18:23–27. doi: 10.1097/MED.0b013e3283424b37. - DOI - PubMed

[6] Abrams P, Levitt Katz LE. Metabolic effects of obesity causing disease in childhood. Curr Opin Endocrinol Diabetes Obes. 2011;18:23–27. doi: 10.1097/MED.0b013e3283424b37. - DOI - PubMed

[7] Weiss R, Caprio S. The metabolic consequences of childhood obesity. Best Pract Res Clin Endocrinol Metab. 2005;19:405–419. doi: 10.1016/j.beem.2005.04.009. - DOI - PubMed

[8] Weiss R, Caprio S. The metabolic consequences of childhood obesity. Best Pract Res Clin Endocrinol Metab. 2005;19:405–419. doi: 10.1016/j.beem.2005.04.009. - DOI - PubMed

[9] Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, Zitman FG. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–229. doi: 10.1001/archgenpsychiatry.2010.2. - DOI - PubMed

[10] Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, Zitman FG. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–229. doi: 10.1001/archgenpsychiatry.2010.2. - DOI - PubMed

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The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study

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The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study

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