- Email: [email protected]
Influence of school holidays on weight of children participating in a tertiary hospital weight management programme
Oral Abstracts
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achieving short-term, with additional sustained post-program long-term reductions in BMI z in obese youth. In younger children, higher initial BMI z is associated with greater reduction in obesity. This suggests that greater impact may be achieved by targeting intervention at preadolescents with severe obesity. Conflict of interest: None. doi:10.1016/j.orcp.2011.08.097 O20
doi:10.1016/j.orcp.2011.08.098
The beginnings of CAFAP—–A family centred, multi-disciplinary program for overweight and obese adolescents, and their families Smith 1,∗ ,
serves pre 1.2 (0.6—1.7), post 1.4 (0.7—2.1) and 3 months 1.4 (0.2—2.7)). Daily intake of ‘extra’ foods (e.g. junk foods) were reduced at follow up (extras pre 4.0 (1.8—6.1), post 3.1 (2.2—3.8), 3 months 3.4 (1.6—5.1). Conclusions: Positive behaviour changes were observed in adolescent participants in CAFAP. The current research is now focussing on whether these positive behaviours can be maintained. Conflict of interest: None.
Straker 1 ,
Kerr 2 ,
K. L. D. Fielding 4 , E. Ward 1 , A. McManus 5
M.
Davis 3 ,
A.
1 School
of Physiotherapy, Perth, Australia 2 School of Public Health, Perth, Australia 3 School of Psychology and Speech Pathology, Perth, Australia 4 School of Occupational Therapy and Social Work, Perth, Australia 5 Curtin Health Innovation Research Institute, Curtin University, Perth, Australia Aim: Although 25% of Australian teenagers are overweight or obese, there is limited good research into effective interventions for this target group. The aim of this study was to develop and evaluate a multi-disciplinary, family centred intervention targeting activity, food and attitudes in overweight/obese adolescents. Methods: 30 adolescents completed Curtin University’s Activity Food and Attitudes Program (CAFAP) in 2009 and 2010. Adolescents, and their parent/carer, attended twice weekly 2-hour sessions for eight weeks. During each session, adolescents participated in one hour of gym-based exercise followed by an hour long education/skill building session related to food, activity or attitudes. Parent sessions provided education and support to assist them to make changes in family lifestyle. Sessions were facilitated by physiotherapy, dietetics, psychology and social work professionals and undergraduate/postgraduate students. The goal of the program was sustainable lifestyle change rather than weight loss. Results: Activity levels were increased immediately after the program (pre daily accelerometer count mean 856 (95% confidence interval 619—1093); post 916 (577—1255)) but were reduced from base-line levels at 3 month follow up (720 (603—838) n = 7). Daily intake of vegetables and fruits were greater at follow up (e.g. vegetable
O21 Influence of school holidays on weight of children participating in a tertiary hospital weight management programme S.J.V. Rao ∗ , S.A. Alexander Weight Management Services, The Children’s Hospital at Westmead, Westmead, Australia Background: Weight gain during holiday periods is a recognised phenomenon, with summer being a particularly vulnerable period for children in northern hemisphere. Outcomes regarding summer holiday weight gain in children in southern hemisphere are unknown. Objective: To determine the pattern of weight change during summer school holidays (Christmas break — CB) in a population of overweight/obese children attending a tertiary hospital weight management programme. Methods: The study was conducted as a retrospective review using anthropometric measurements (height, weight, BMI and BMI z scores) at four different time points: (1) Baseline — 2 months before CB; (2) At commencement of CB; (3) At conclusion of CB; (4) 2 months after CB. Changes in anthropometry over three time periods (preholiday, holiday, and post-holiday) were calculated and analysed. Weight change was standardised to an interval of 60 days. Results: 50 patients (mean age 8.3 years) were included in the study with 61 data points. 63.9% of children lost weight preholiday compared to 13.1% during the holiday and 34.1% post-holiday. Mean weight change pre-holiday was 0.01 kg (95% CI −0.40 to +0.42), during holiday was 1.6 kg (95% CI 1.21—2.02) and post-holiday was +0.80 kg (95% CI 0.31—1.28). There was a statistically significant difference in the weight change during holiday period compared to pre-holiday period (p < 0.05) and postholiday period (p < 0.05). Conclusions: This study demonstrates that, for children with overweight/obesity, Christmas sum-
S24 mer school holidays, is an especially vulnerable period. Thus, holiday specific planning with focus on strategies to reduce or prevent weight gain is needed. Conflict of interest: None. doi:10.1016/j.orcp.2011.08.099 O22 Tertiary level management of overweight and obese children and adolescents—–Does intensive dietetic intervention using a moderate protein intake have a positive impact on weight control in children? K.W. Chisholm ∗ , S. Alexander The Children’s Hospital at Westmead, Westmead, Australia Aims: To review weight loss outcomes (change in BMI z score) in a tertiary (dietetic) clinical practice, to determine if number of appointments or time between appointments is associated with outcome, to determine gender or age differences in outcome, to determine correlation between level of obesity and attrition rate and to review clinical practice dependent upon outcome. Methods: A retrospective audit with analysis of patient data collected June 2005—September 2009. Data included: Anthropometry, biochemistry, comorbidities and referral source on 210 patients (52% females). Patients attended for assessment and education on a structured moderate-protein diet. Reviews are scheduled monthly for up to 5 visits. Results: Significant reduction in BMI z score for boys at all appointments (p < 0.001). Significant reduction in BMI z score for girls by the fifth appointment (p = 0.036). Significant reduction in pre-adolescent BMI z scores at all appointments (p < 0.001). High attrition rate (50%) after the first appointment but 20% still returning for the fifth appointment. Changes in BMI z score ranging from −0.28 to −0.13. No correlation between changes in BMI z score and duration or number of clinic appointments. Conclusions: Tertiary level dietary treatment of childhood obesity using a structured moderate protein intake and regular reviews has a positive influence on childhood obesity. These findings will assist in service improvement and development of best practice guidelines for treatment of childhood obesity in a tertiary clinic setting. Funding source: None. doi:10.1016/j.orcp.2011.08.100
Oral Abstracts O23 RCT of intragastric balloons in adolescents: Preliminary data J.A. Curran 1,4,∗ , R.J. Kalic 1,3 , C.S. Sherrington 2 , M. Ravikumara 2 , D. Messina 1 , J. Doust 1 , C.F. Tremayne 1 , D.A. Forbes 2,4 , E.A. Mews 2 , A. 1,4 Davis 1 Department
of Endocrinology, Princess Margaret Hospital for Children, Perth, Australia 2 Department of Gastroenterology, Princess Margaret Hospital for Children, Perth, Australia 3 Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia 4 School of Paediatrics and Child Health, University of Western Australia, Perth, Australia Aim: A RCT to determine if the intragastric balloon (balloon) has a role in obesity management in obese adolescents receiving lifestyle modification. Methods: A total of 12 obese adolescents with co-morbidities were randomly allocated to 2 groups: A 10-week intensive lifestyle program and maintenance phase follow-up (Control, M:F 1:5, age 13.9 ± 1.19 years, weight 100.7 ± 5.1 kg, mean BMI z-score 2.45 ± 0.05) or the program and the balloon (M:F 5:1, age 13.66 ± 1.15 years, weight 123.1 ± 20.9 kg, BMI z-score 2.7 ± 0.12). The intervention group was admitted for insertion and removal of the balloon under general anaesthetic; the balloon remained in situ for 6 months. Results: On completion of the intensive phase of the program both the control group and intervention group had significant weight loss (2.58 ± 2.4 kg p = 0.047 vs. 5.47 ± 4.95 kg p = 0.042 [mean ± SD] respectively). The intervention group had a reduction in BMI z-score (−0.13 ± 0.12 p = 0.048). The groups did not differ in percentage weight change or percentage change in BMI z-score. Neither group showed significant weight loss at 6 months, only the intervention group (n = 5) had significant reduction in mean BMI z-score (−0.17 ± 0.13 p = 0.043). The groups did not differ in weight loss or BMI zscore. No adverse events occurred during insertion, whilst in situ, or removal of the balloon. No detrimental effects on nutrition, fitness, emotional and behavioural wellbeing, or family functioning were observed. Conclusions: At 10 weeks lifestyle and balloon and lifestyle alone improve BMI z-score in obese adolescents. The balloon maintained the BMI z-score reduction at 6 months. The preliminary
S23
achieving short-term, with additional sustained post-program long-term reductions in BMI z in obese youth. In younger children, higher initial BMI z is associated with greater reduction in obesity. This suggests that greater impact may be achieved by targeting intervention at preadolescents with severe obesity. Conflict of interest: None. doi:10.1016/j.orcp.2011.08.097 O20
doi:10.1016/j.orcp.2011.08.098
The beginnings of CAFAP—–A family centred, multi-disciplinary program for overweight and obese adolescents, and their families Smith 1,∗ ,
serves pre 1.2 (0.6—1.7), post 1.4 (0.7—2.1) and 3 months 1.4 (0.2—2.7)). Daily intake of ‘extra’ foods (e.g. junk foods) were reduced at follow up (extras pre 4.0 (1.8—6.1), post 3.1 (2.2—3.8), 3 months 3.4 (1.6—5.1). Conclusions: Positive behaviour changes were observed in adolescent participants in CAFAP. The current research is now focussing on whether these positive behaviours can be maintained. Conflict of interest: None.
Straker 1 ,
Kerr 2 ,
K. L. D. Fielding 4 , E. Ward 1 , A. McManus 5
M.
Davis 3 ,
A.
1 School
of Physiotherapy, Perth, Australia 2 School of Public Health, Perth, Australia 3 School of Psychology and Speech Pathology, Perth, Australia 4 School of Occupational Therapy and Social Work, Perth, Australia 5 Curtin Health Innovation Research Institute, Curtin University, Perth, Australia Aim: Although 25% of Australian teenagers are overweight or obese, there is limited good research into effective interventions for this target group. The aim of this study was to develop and evaluate a multi-disciplinary, family centred intervention targeting activity, food and attitudes in overweight/obese adolescents. Methods: 30 adolescents completed Curtin University’s Activity Food and Attitudes Program (CAFAP) in 2009 and 2010. Adolescents, and their parent/carer, attended twice weekly 2-hour sessions for eight weeks. During each session, adolescents participated in one hour of gym-based exercise followed by an hour long education/skill building session related to food, activity or attitudes. Parent sessions provided education and support to assist them to make changes in family lifestyle. Sessions were facilitated by physiotherapy, dietetics, psychology and social work professionals and undergraduate/postgraduate students. The goal of the program was sustainable lifestyle change rather than weight loss. Results: Activity levels were increased immediately after the program (pre daily accelerometer count mean 856 (95% confidence interval 619—1093); post 916 (577—1255)) but were reduced from base-line levels at 3 month follow up (720 (603—838) n = 7). Daily intake of vegetables and fruits were greater at follow up (e.g. vegetable
O21 Influence of school holidays on weight of children participating in a tertiary hospital weight management programme S.J.V. Rao ∗ , S.A. Alexander Weight Management Services, The Children’s Hospital at Westmead, Westmead, Australia Background: Weight gain during holiday periods is a recognised phenomenon, with summer being a particularly vulnerable period for children in northern hemisphere. Outcomes regarding summer holiday weight gain in children in southern hemisphere are unknown. Objective: To determine the pattern of weight change during summer school holidays (Christmas break — CB) in a population of overweight/obese children attending a tertiary hospital weight management programme. Methods: The study was conducted as a retrospective review using anthropometric measurements (height, weight, BMI and BMI z scores) at four different time points: (1) Baseline — 2 months before CB; (2) At commencement of CB; (3) At conclusion of CB; (4) 2 months after CB. Changes in anthropometry over three time periods (preholiday, holiday, and post-holiday) were calculated and analysed. Weight change was standardised to an interval of 60 days. Results: 50 patients (mean age 8.3 years) were included in the study with 61 data points. 63.9% of children lost weight preholiday compared to 13.1% during the holiday and 34.1% post-holiday. Mean weight change pre-holiday was 0.01 kg (95% CI −0.40 to +0.42), during holiday was 1.6 kg (95% CI 1.21—2.02) and post-holiday was +0.80 kg (95% CI 0.31—1.28). There was a statistically significant difference in the weight change during holiday period compared to pre-holiday period (p < 0.05) and postholiday period (p < 0.05). Conclusions: This study demonstrates that, for children with overweight/obesity, Christmas sum-
S24 mer school holidays, is an especially vulnerable period. Thus, holiday specific planning with focus on strategies to reduce or prevent weight gain is needed. Conflict of interest: None. doi:10.1016/j.orcp.2011.08.099 O22 Tertiary level management of overweight and obese children and adolescents—–Does intensive dietetic intervention using a moderate protein intake have a positive impact on weight control in children? K.W. Chisholm ∗ , S. Alexander The Children’s Hospital at Westmead, Westmead, Australia Aims: To review weight loss outcomes (change in BMI z score) in a tertiary (dietetic) clinical practice, to determine if number of appointments or time between appointments is associated with outcome, to determine gender or age differences in outcome, to determine correlation between level of obesity and attrition rate and to review clinical practice dependent upon outcome. Methods: A retrospective audit with analysis of patient data collected June 2005—September 2009. Data included: Anthropometry, biochemistry, comorbidities and referral source on 210 patients (52% females). Patients attended for assessment and education on a structured moderate-protein diet. Reviews are scheduled monthly for up to 5 visits. Results: Significant reduction in BMI z score for boys at all appointments (p < 0.001). Significant reduction in BMI z score for girls by the fifth appointment (p = 0.036). Significant reduction in pre-adolescent BMI z scores at all appointments (p < 0.001). High attrition rate (50%) after the first appointment but 20% still returning for the fifth appointment. Changes in BMI z score ranging from −0.28 to −0.13. No correlation between changes in BMI z score and duration or number of clinic appointments. Conclusions: Tertiary level dietary treatment of childhood obesity using a structured moderate protein intake and regular reviews has a positive influence on childhood obesity. These findings will assist in service improvement and development of best practice guidelines for treatment of childhood obesity in a tertiary clinic setting. Funding source: None. doi:10.1016/j.orcp.2011.08.100
Oral Abstracts O23 RCT of intragastric balloons in adolescents: Preliminary data J.A. Curran 1,4,∗ , R.J. Kalic 1,3 , C.S. Sherrington 2 , M. Ravikumara 2 , D. Messina 1 , J. Doust 1 , C.F. Tremayne 1 , D.A. Forbes 2,4 , E.A. Mews 2 , A. 1,4 Davis 1 Department
of Endocrinology, Princess Margaret Hospital for Children, Perth, Australia 2 Department of Gastroenterology, Princess Margaret Hospital for Children, Perth, Australia 3 Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia 4 School of Paediatrics and Child Health, University of Western Australia, Perth, Australia Aim: A RCT to determine if the intragastric balloon (balloon) has a role in obesity management in obese adolescents receiving lifestyle modification. Methods: A total of 12 obese adolescents with co-morbidities were randomly allocated to 2 groups: A 10-week intensive lifestyle program and maintenance phase follow-up (Control, M:F 1:5, age 13.9 ± 1.19 years, weight 100.7 ± 5.1 kg, mean BMI z-score 2.45 ± 0.05) or the program and the balloon (M:F 5:1, age 13.66 ± 1.15 years, weight 123.1 ± 20.9 kg, BMI z-score 2.7 ± 0.12). The intervention group was admitted for insertion and removal of the balloon under general anaesthetic; the balloon remained in situ for 6 months. Results: On completion of the intensive phase of the program both the control group and intervention group had significant weight loss (2.58 ± 2.4 kg p = 0.047 vs. 5.47 ± 4.95 kg p = 0.042 [mean ± SD] respectively). The intervention group had a reduction in BMI z-score (−0.13 ± 0.12 p = 0.048). The groups did not differ in percentage weight change or percentage change in BMI z-score. Neither group showed significant weight loss at 6 months, only the intervention group (n = 5) had significant reduction in mean BMI z-score (−0.17 ± 0.13 p = 0.043). The groups did not differ in weight loss or BMI zscore. No adverse events occurred during insertion, whilst in situ, or removal of the balloon. No detrimental effects on nutrition, fitness, emotional and behavioural wellbeing, or family functioning were observed. Conclusions: At 10 weeks lifestyle and balloon and lifestyle alone improve BMI z-score in obese adolescents. The balloon maintained the BMI z-score reduction at 6 months. The preliminary