Objective: To evaluate whether a child-centered physical activity program, combined with a parent-centered dietary program, was more efficacious than each treatment alone, in preventing unhealthy weight-gain in overweight children. Study design: An assessor-blinded randomized controlled trial involving 165 overweight/obese 5.5- to 9.9- year-old children. Participants were randomly assigned to 1 of 3 interventions: a parent-centered dietary program (Diet); a child-centered physical activity program (Activity); or a combination of both (Diet + Activity). All groups received 10 weekly face-to-face sessions followed by 3 monthly relapse-prevention phone calls. Analysis was by intention-to-treat. The primary outcome was change in body mass index z-score at 6 and 12 months (n = 114 and 106, respectively). Results: Body mass index z-scores were reduced at 12-months in all groups, with the Diet (mean [95% confidence interval]) (−0.39 [−0.51 to 0.27]) and Diet + Activity (−0.32, [−0.36, −0.23]) groups showing a greater reduction than the Activity group (−0.17 [−0.28, −0.06]) (P = .02). Changes in other outcomes (waist circumference and metabolic profile) were not statistically significant among groups. Conclusion: Relative body weight decreased at 6 months and was sustained at 12 months through treatment with a child-centered physical activity program, a parent-centered dietary program, or both. The greatest effect was achieved when a parent-centered dietary component was included.
Journal of Pediatrics Vol. 157, Issue 3, p. 388-394