Effect of intervention aimed at increasing physical activity, reducing sedentary behaviour, and increasing fruit and vegetable consumption in children: Active for Life Year 5 (AFLY5) school based cluster randomised controlled trial Recent advances in the treatment of childhood obesity. Salt Intake and the Association with Blood Pressure in Young Iranian Children: First Report From the Middle East and North Africa A school-based education programme to reduce salt intake in children and their families (School-EduSalt): protocol of a cluster randomised controlled trial School based education programme to reduce salt intake in children and their families (School-EduSalt): cluster randomised controlled trial A six month randomized school intervention and an 18-month follow-up intervention to prevent childhood obesity in Mexican elementary schools. Changes in BMI and blood pressure after a school based intervention: the CHILDREN study. Result of school-based intervention on cardiovascular risk factors Impact of a combined diet and progressive exercise intervention for overweight and obese children: the B.E. H.I.P. study. A school-based obesity control programme: Project Energize. Two-year outcomes. Eight-Year Follow-Up of School-Based Intervention on Childhood Overweight – the Kiel Obesity Prevention Study An effective lifestyle intervention in overweight children: one-year follow-up after the randomized controlled trial on "Obeldicks light". Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. [Evaluation of the training program "OBELDICKS" for obese children and adolescents]. Follow‐up results of different treatment programs for obese children An effective lifestyle intervention in overweight children: findings from a randomized controlled trial on "Obeldicks light".
Objective To investigate the effectiveness of a school based intervention to increase physical activity , reduce sedentary behaviour , and increase fruit and vegetable consumption in children . Design Cluster r and omised controlled trial . Setting 60 primary schools in the south west of Engl and . Participants Primary school children who were in school year 4 ( age 8 - 9 years ) at recruitment and baseline assessment , in year 5 during the intervention , and at the end of year 5 ( age 9 - 10 ) at follow-up assessment . Intervention The Active for Life Year 5 ( AFLY5 ) intervention consisted of teacher training , provision of lesson and child-parent interactive homework plans , all material s required for lessons and homework , and written material s for school newsletters and parents . The intervention was delivered when children were in school year 5 ( age 9 - 10 years ) . Schools allocated to control received st and ard teaching . Main outcome measures The pre-specified primary outcomes were accelerometer assessed minutes of moderate to vigorous physical activity per day , accelerometer assessed minutes of sedentary behaviour per day , and reported daily consumption of servings of fruit and vegetables . Results 60 schools with more than 2221 children were recruited ; valid data were available for fruit and vegetable consumption for 2121 children , for accelerometer assessed physical activity and sedentary behaviour for 1252 children , and for secondary outcomes for between 1825 and 2212 children for the main analyses . None of the three primary outcomes differed between children in schools allocated to the AFLY5 intervention and those allocated to the control group . The difference in means comparing the intervention group with the control group was –1.35 ( 95 % confidence interval –5.29 to 2.59 ) minutes per day for moderate to vigorous physical activity , –0.11 ( –9.71 to 9.49 ) minutes per day for sedentary behaviour , and 0.08 ( –0.12 to 0.28 ) servings per day for fruit and vegetable consumption . The intervention was effective for three out of nine of the secondary outcomes after multiple testing was taken into account : self reported time spent in screen viewing at the weekend ( –21 ( –37 to –4 ) minutes per day ) , self reported servings of snacks per day ( –0.22 ( –0.38 to –0.05 ) ) , and servings of high energy drinks per day ( –0.26 ( –0.43 to –0.10 ) ) were all reduced . Results from a series of sensitivity analyses testing different assumptions about missing data and from per protocol analyses produced similar results . Conclusion The findings suggest that the AFLY5 school based intervention is not effective at increasing levels of physical activity , decreasing sedentary behaviour , and increasing fruit and vegetable consumption in primary school children . Change in these activities may require more intensive behavioural interventions with children or upstream interventions at the family and societal level , as well as at the school environment level . These findings have relevance for research ers , policy makers , public health practitioners , and doctors who are involved in health promotion , policy making , and commissioning services . Trial registration Current Controlled Trials IS RCT N50133740 The rapid increase in the prevalence of obesity in the last decade indicates a need for effective treatment programs . We conducted a short-term , repeated- measures , clinical - outcome trial in three groups of children and adolescents in two different locations . Two cohorts ( n=34 ) were enrolled in a 36-wk multi-disciplinary weight-management program at the Children 's Hospital of New Orleans . One cohort ( n=16 ) was enrolled in a similar intervention at the General Clinical Research Center ( GCRC ) at the Medical Center of Louisiana for a 10-wk summer weight-loss program . Subjects were offered a protein-sparing modified fast ( PSMF ) diet ( 600 - 800 kcal/d ; 2 g protein/kg body weight ) , followed by a balanced hypocaloric diet , and they participated in behavior-modification sessions and a moderate-intensity ( 45 - 55 % volume of oxygen consumed at maximal effort [ VO(2)max ] ) , progressive exercise program . The following parameters were examined at baseline , 10 wk , and 36 wk ( cohort 1 only ) : Weight , height , percentage of ideal body weight ( % IBW ) , relative body fat ( % fat ) , fat free body ( FFB ) mass , estimated VO(2)max mL/kg min(BW ) [ adjusted for body weight ] ) , blood chemistries , lipid profiles ( total cholesterol [ TC ] , triglycerides [ TG ] , low-density lipoprotein [ LDL ] , high-density lipoprotein [ HDL ] , and insulin-like growth factor-1 [ IGF-1 ] ) . All three groups experienced significant decreases in weight , % IBW and % fat at 10 wk . The weight loss was maintained at 26 wk in cohorts 1 and 2 , and at 36 wk in cohort 1 . There were no significant decreases in height velocity during the study . In addition , measures of estimated VO(2)max mL/kg/min(BW ) and IGF-1 parameters were significantly greater at 10 wk compared to baseline . Measures of TC , TG , and LDL were significantly lower at 10 wk , with no significant changes noted in HDL . We conclude that a multi-disciplinary weight-management program , including PSMF , behavior modification , and exercise , provides an effective method of treatment for obesity in children and adolescents . Long-term , r and omized , and controlled clinical trials are needed to confirm the results of this preliminary , short-term observation Background : This study aim ed to assess the salt intake of Iranian children , and to assess the correlation of urinary electrolytes excretion with blood pressure . Methods : This cross-sectional study was conducted in 2011 - 2012 among 3 - 10-year-old children , selected by multi-stage cluster sampling from urban and rural areas of Isfahan , Iran . The sodium ( Na ) , potassium ( K ) , and creatinine ( Cr ) were measured in a r and om sample of the children 's first morning fasting urine . Three-day averages of dietary intakes were analyzed by the Nutritionist-4 software . Results : The mean ( SD ) of urinary Na was 177.17 ( 28.68 ) mEq/day without significant difference according to gender and living area . The mean ( SD ) dietary intakes of Na and K were 2017.76 ( 117.94 ) and 1119.06 ( 76.03 ) mg/day , respectively . Children of urban and rural areas consumed similar sources of salty foods ( bread , cheese , and snacks ) and had low intake of vegetables . No significant association was documented between urinary electrolytes excretions and blood pressure . Conclusions : This study , which to the best of our knowledge is the first of its kind in the Middle East and North Africa region , revealed that Iranian young children consume a large amount of sodium and small amount of potassium . The non-significant associations of electrolyte excretions with blood pressure may be because of the very young age group of participants . Given the development of preference to salt taste from early childhood , and the tracking of risk factors of chronic diseases from this age , reducing salt intake of young children should be emphasized Introduction The current salt intake is very high for children as well as adults in China . A reduction in salt intake is one of the most cost-effective measures to curb the rapidly growing disease burden attributed to blood pressure and cardiovascular disease in the Chinese population . A lower salt diet starting from childhood has the potential to prevent the development of such conditions . The School-EduSalt ( School-based Education Programme to Reduce Salt ) study aims to determine whether an education programme targeted at school children can lower salt intake in children and their families . Methods and analysis The study is design ed as a cluster r and omised controlled trial . The location is Changzhi , Shanxi province in northern China . The study population will consist of 28 primary schools with 280 children aged ≈11 years and 560 adult family members . Children in the intervention group will be educated on how to reduce salt intake . They will then be empowered to deliver the salt reduction message home to their families . In particular , children need to persuade the person who does the cooking to reduce the amount of salt used during food preparations . The duration of the intervention is one school term ( ≈4.5 months ) . The primary outcome is the difference between the intervention and the control group in the change in 24 h urinary sodium and the secondary outcome is the difference between the intervention and control group in the change of blood pressure . An economic evaluation will be undertaken to assess cost-effectiveness . Ethics and dissemination The study has been approved by The Queen Mary Research Ethics Committee ( QMREC2012/81 ) and Peking University Health Science Centre IRB ( IRB00001052 - 12072 ) . Study findings will be disseminated widely through conference presentations and peer- review ed publications . Protocol Registration Protocol Registered on Clinical Trials.gov NCT01821144 Objective To determine whether an education programme targeted at schoolchildren could lower salt intake in children and their families . Design Cluster r and omised controlled trial , with schools r and omly assigned to either the intervention or control group . Setting 28 primary schools in urban Changzhi , northern China . Participants 279 children in grade 5 of primary school , with mean age of 10.1 ; 553 adult family members ( mean age 43.8 ) . Intervention Children in the intervention group were educated on the harmful effects of salt and how to reduce salt intake within the schools ’ usual health education lessons . Children then delivered the salt reduction message to their families . The intervention lasted for one school term ( about 3.5 months ) . Main outcome measures The primary outcome was the difference between the groups in the change in salt intake ( as measured by 24 hour urinary sodium excretion ) from baseline to the end of the trial . The secondary outcome was the difference between the two groups in the change in blood pressure . Results At baseline , the mean salt intake in children was 7.3 ( SE 0.3 ) g/day in the intervention group and 6.8 ( SE 0.3 ) g/day in the control group . In adult family members the salt intakes were 12.6 ( SE 0.4 ) and 11.3 ( SE 0.4 ) g/day , respectively . During the study there was a reduction in salt intake in the intervention group , whereas in the control group salt intake increased . The mean effect on salt intake for intervention versus control group was −1.9 g/day ( 95 % confidence interval −2.6 to −1.3 g/day ; P<0.001 ) in children and −2.9 g/day ( −3.7 to −2.2 g/day ; P<0.001 ) in adults . The mean effect on systolic blood pressure was −0.8 mm Hg ( −3.0 to 1.5 mm Hg ; P=0.51 ) in children and −2.3 mm Hg ( −4.5 to −0.04 mm Hg ; P<0.05 ) in adults . Conclusions An education programme delivered to primary school children as part of the usual curriculum is effective in lowering salt intake in children and their families . This offers a novel and important approach to reducing salt intake in a population in which most of the salt in the diet is added by consumers . Trial registration Clinical Trials.gov NCT01821144 BACKGROUND The objective of this study , focused on parents and children to reduce sedentary behavior , consumption of soft drinks and high-fat and salt containing snacks , and increase the consumption of fruits and vegetables , was to assess the effect of a six month intervention and an 18 month follow-up intervention on the body mass index , food consumption and physical activity of 2nd and 3rd grade elementary school children . METHODS This was a r and omized cluster controlled trial . School children were selected from 2nd and 3rd ( n = 532 ) grade . MEASUREMENTS BMI z-score for age and sex was calculated and classified according to the WHO ( 2006 ) . Abdominal obesity was defined as WC > 90th of NHANES III . RESULTS At six months of the study differences were observed in BMI , -0.82 ( p = 0.0001 ) . At 24 months , results such as an increase of z-score BMI and waist circumference , a decrease in abdominal obesity , eighth per cent remission and an incidence of 18 % of overweight and obesity were observed . Additionally , an increase ( p = 0.007 ) in vegetable intake and physical activity ( p = 0.0001 ) was also reported , along with a decrease in sedentary activities and the consumption of snacks high in fat and salt . CONCLUSIONS The results of this study indicate that with a comprehensive intervention there is a positive response to lifestyle changes and a reduction of abdominal obesity BACKGROUND Identification of the behavioural , normative and control beliefs influencing children 's behaviour is an important prerequisite in design ing effective interventions . The current study aims to evaluate the effectiveness of an intervention program , based on the Theory of Planned Behaviour ( TPB ) , on  obesity indices and blood pressure ( BP ) in Ioannina , Greece . METHODS Participants were 646 fifth grade pupils ( 360 girls and 286 boys ) . The intervention group ( IG ) consisted of 321 children in 13 r and omly selected schools while the rest ( n = 325 children ) served as the  control group ( CG ) . Based on the outcome of the TPB question naire , the intervention focused on overcoming the barriers in accessing physical activity areas , increasing the availability of fruits and vegetables and increasing parental support . General linear mixed model and mediating variable analysis were used to evaluate the differences between the two groups and to test whether changes in certain dietary , physical activity and anthropometrical indices mediated the effect of the intervention on BP . RESULTS IG had higher consumption of fruits and lower consumption of fats/oils and sweets/beverages compared with the CG . Intervention 's effect on BMI could be explained by the changes in fruit and fats/oils intake whereas the reduction of systolic and diastolic BP could be explained by the reduction of BMI . CONCLUSIONS The findings indicate favourable changes in BP and obesity indices after the implementation of a 1-year school-based intervention program based on the TPB . These results highlight the importance of developing a social and physical environment that promotes balanced eating behaviours and extra-curricular access to physical activity venues Abstract Objective . To assess the effectiveness of a two-year school-based intervention , consisting of integrated and replicable physical activity and nutritional education on weight , fat percentage , cardiovascular risk factors , and blood pressure . Design and setting . Six elementary schools in Reykjavik were r and omly assigned to be either intervention ( n = 3 ) or control ( n = 3 ) schools . Seven-year-old children in the second grade in these schools were invited to participate ( n = 321 ) ; 268 ( 83 % ) underwent some or all of the measurements . These 286 children were followed up for two years . Intervention . Children in intervention schools participated in an integrated and replicable physical activity programme , increasing to approximately 60 minutes of physical activity during school in the second year of intervention . Furthermore , they received special information about nutrition , and parents , teachers , and school food service staff were all involved in the intervention . Subjects . 321seven-year-old schoolchildren . Main outcome measures . Blood pressure , obesity , percentage of body fat , lipid profile , fasting insulin . Results . Children in the intervention group had a 2.3 mmHg increase in systolic blood pressure ( SBP ) and a 2.9 mmHg increase in diastolic blood pressure ( DBP ) over the two-year intervention period , while children in the control group increased SBP by 6.7 mmHg and DPB by 8.4 mmHg . These changes were not statistically significant . Furthermore there were no significant changes in percentage body fat , lipid profile , or fasting insulin between the intervention and control schools . Conclusion . A two-year school-based intervention with increased physical activity and healthy diet did not have a significant effect on common cardiovascular risk factors The Biochemical Evaluation of a Health Intervention Programme ( B.E. H.I.P. ) investigated the impact of progressive exercise intensity in overweight and obese children . A 5-month prospect i ve r and omized crossover design ( X(A ) , immediate intervention ; O(B ) , control group ; X(B ) , delayed intervention , O(A ) , postintervention follow-up ) with a 10-week health intervention programme was employed . The intervention utilized a progressive increase in high-intensity exercise ( ≥ 75 % maximum heart rate ) and included 3 nutrition and 2 parent education sessions . Primary analysis was completed with ( i ) X(A ) versus O(B ) and ( ii ) all intervention participants ( collapsed X(A ) and X(B ) = X(A)X(B ) ) . Prepubertal overweight and obese male and female children ( n = 27 ) between 5 and 10 years of age were r and omly allocated to X(A ) ( n = 16 ; 11 females ; waist circumference = 80.0 ± 10.6 cm ) or O(B ) ( n = 11 ; 3 females ; waist circumference = 76.6 ± 7.5 cm ) . The primary variables were heart rate and percent fat mass . All variables , including body composition , habitual activity , and serum lipids , were repeatedly measured for up to a maximum of 7 time points . Energy expenditure was quantitatively measured throughout each exercise class ( n = 20 ) . A significantly longer time in the exercise sessions was spent in high-intensity ( 35.1%-60.0 % ) versus low- to moderate-intensity ( 64.9%-40.0 % ) exercise as the intervention progressed from the first to the last attended exercise class ( Fisher exact test , p < 0.0001 ) . The percent fat mass decreased in all intervention participants ( -2.2 % , p < 0.0001 ) . X(A ) had a greater slope decrease than O(B ) for percent fat mass ( p = 0.00051 ) and triglycerides ( p = 0.0467 ) . In conclusion , high-intensity exercise , within a comprehensive health programme that includes nutrition education , improved the lipid and physiological health profiles of obese children Through-school nutrition and physical activity interventions are design ed to help reduce excess weight gain and risk of chronic disease . From 2004 to 2006 , Project Energize was delivered in the Waikato Region of New Zeal and as a longitudinal r and omised controlled study of 124 schools ( year 1 - 6 ) , stratified by rurality and social deprivation , and r and omly assigned to intervention or control . Children ( 686 boys and 662 girls ) aged 5 ( 1926 ) and 10 ( 1426 ) years ( 692 interventions and 660 controls ) had height , weight , body fat ( by bioimpedance ) and resting blood pressure ( BP ) measured at baseline and 2 years later . Each intervention school was assigned an ' Energizer ' ; a trained physical activity and nutrition change agent , who worked with the school to achieve goals based on healthier eating and quality physical activity . After adjustment for baseline measures , rurality and social deprivation , the intervention was associated with a reduced accumulation of body fat in younger children and a reduced rate of rise in systolic BP in older children . There was some evidence that the pattern of change within an age group varied with rurality , ethnicity and sex . We conclude that the introduction of an ' Energizer led ' through-school programme may be associated with health benefits over 2 years , but the trajectory of this change needs to be measured over a longer period . Attention should also be paid to the differing response by ethnicity , sex , age group and the effect of rurality and social deprivation Objective : The aim of this study was to evaluate the 8-year outcome of school-based intervention on weight status , lifestyle and blood pressure ( BP ) as part of the Kiel Obesity Prevention Study ( KOPS ) . Methods : Within a quasi-r and omized controlled trial , 240 intervention ( I ) and 952 non-intervention ( NI ) students at age 6 and 14 years were assessed in schools .  Six nutrition units followed by 20-min running games were performed within the first year at school . Primary outcome was the 8-year change in body mass index st and ard deviation score ( BMI -SDS ) according to German references . Effective intervention was tested using multilevel linear regression analysis . Results : Eight-year changes in BMI SDS were + 0.18 and + 0.22 with increases in prevalence of overweight from 8.3 to 10.4 % and 7.0 to 11.2 % in I and NI students , respectively . Cumulative 8-year incidence of overweight was 5.9 % and 7.1 % in I and NI students , respectively . There was no overall effect of intervention , but a significant interaction was shown between the intervention and the socio-economic status ( SES ) , which demonstrated that in high SES , the 8-year change in BMI -SDS was in favour of I ( –0.17 in I and + 0.17 in NI ; p < 0.01 ) . Intervention had no measurable effects on lifestyle and BP . Conclusions : School-based health promotion has some favourable and sustained effects on 8-year changes in BMI -SDS , which are most pronounced in students of high SES families . The data argue in favour of further preventive measures BACKGROUND & AIMS Lifestyle interventions address primarily obese children , while interventions tailored to overweight but not obese children are scarce . The effectiveness of the lifestyle intervention " Obeldicks light " based on physical activity training , nutrition education , and behavior counseling for overweight children and their parents has been demonstrated by a r and omized controlled trial . Here , we present the 12 months follow-up analysis of these children after end of intervention . METHODS Degree of overweight ( BMI and SDS- BMI ) , waist circumference , skinfold thickness , bioimpedance analyses ( BIA ) , and blood pressure were determined in 76 overweight ( BMI > 90(th)≤97(th ) percentile ) children ( mean age 11.8 ± 1.8years , 67 % females , mean BMI 24.3 ± 1.9 kg/m(2 ) ) participating in the evaluation study of " Obeldicks light " at onset of intervention ( T0 ) , end of 6 months intervention ( T1 ) , 6 months after end of intervention ( T2 ) and 12 months after end of intervention ( T3 ) . Comparisons were performed on an intention-to-treat approach . RESULTS The drop-out rate  was 4 % in the intervention period and additional 3 % during follow-up . The children reduced significantly ( p < 0.001 ) their SDS- BMI in the intervention period between T0 and T1 ( -0.27 ± 0.23 ; p < 0.001 ) . This SDS- BMI reduction remained stable at T2 ( T0-T2:-0.26 ± 0.31 ; p < 0.001 ) and T3 ( T0-T3:-0.26 ± 0.39 ; p < 0.001 ) . SDS- BMI reductions were independent from age and gender . Body fat measured by skinfold thickness and BIA , waist circumference , and blood pressure decreased significantly in the intervention period and remained stable in the follow-up period as well . CONCLUSIONS The lifestyle intervention " Obeldicks light " was effective in reducing degree of overweight , fat mass , waist circumference , and blood pressure both at end of intervention and in a 12 months follow-up period OBJECTIVES The present study aim ed to assess the effect of a 6-month exercise program  in obese children on flow-mediated vasodilation ( FMD ) carotid intima-media thickness ( IMT ) and cardiovascular risk factors ( RF ) . BACKGROUND Childhood obesity contributes to adult obesity and subsequent cardiovascular disease . Physical inactivity is a major RF for obesity , endothelial dysfunction , and elevated carotid IMT , culminating in early atherosclerotic disease . METHODS Sixty-seven obese subjects ( age 14.7 + /- 2.2 years ) were r and omly assigned to 6 months ' exercise or non-exercise protocol . We examined the influence of exercises ( 1 h , 3 times/week ) on FMD , IMT , and cardiovascular risk profile . RESULTS Compared with lean control subjects , obese children demonstrated at baseline significantly impaired FMD ( 4.09 + /- 1.76 % vs. 10.65 + /- 1.95 % , p < 0.001 ) , increased IMT ( 0.48 + /- 0.08 mm vs. 0.37 + /- 0.05 mm , p < 0.001 ) , and a number of obesity-related cardiovascular RF . Significant improvements were observed in the exercise group for IMT ( 0.44 + /- 0.08 mm , p = 0.012 , -6.3 % ) and FMD ( 7.71 + /- 2.53 % , p < 0.001 , + 127 % ) . This improvement correlated with reduced RF , such as body mass index st and ard deviation scores , body fat mass , waist/hip ratio , ambulatory systolic blood pressure , fasting insulin , triglycerides , low-density lipoprotein/high-density lipoprotein ratio , and low-degree inflammation ( C-reactive protein , fibrinogen ) . CONCLUSIONS The present study documented increased IMT , impaired endothelial function , and various elevated cardiovascular RF in young obese subjects . Regular exercise over 6 months restores endothelial function and improves carotid IMT associated with an improved cardiovascular risk profile in obese children UNLABELLED The evaluation of treatment programs in obese children and adolescents is uncommon but necessary to prove effectiveness and to improve treatment modalities . We studied the effectiveness of the a one-year structured outpatient training programme " OBELDICKS " consisting of physical exercise , nutrition education and behaviour therapy in 132 participants based on the criterions developed by the Institute of Medicine and German Obesity Group ( degree of weight reduction , improvement of comorbidity and health behaviour , minimising of side effects ) . Furthermore , we analysed degree of overweight ( SDS- BMI ) two years after the end of the outpatient training ( n = 60 ) . - 74 % of participants reduced their overweight ( intention to treat ) . The mean reduction of SDS- BMI was 0.43 . 34 % of the participants was not obese any more at end of the training . The degree of overweight was significantly ( p < 0.001 ) lower two years after intervention compared to baseline . The comorbidity was improved ( significant reduction of the frequencies of hypertension , dyslipidaemia and hyperuricaemia ) . The nutrition , exercise and eating habits ( cognitive control and disinhibition of control ) were significantly improved . Side effects were not found . CONCLUSION The effectiveness based on the criterions of the Institute of Medicine and the German Obesity Group was proven for the outpatient training " OBELDICKS " .  Long-term weight reduction can be achieved in most of the obese participating children due to this long-term , specialised treatment Objective Many approaches have been tried in order to tackle the problem of obesity in children , but most of them have failed to achieve long‐term weight loss .  Cognitive behaviour therapy tends to predict good prospect s. So far , no studies have investigated the surplus value of introducing a “ healthy‐eating ” lifestyle program instead of a strict diet prescription , in combination with the principles of cognitive behaviour therapy . Therefore , a new program was design ed . The second aim of the study was to evaluate the impact of different forms of therapeutic contact . Subjects and methods : The obese group consisted of 205 children seeking treatment , and a control group of 54 obese school children . The effects of the program were evaluated by means of a pre‐test/post‐test design with a 1‐y follow‐up . Subjects were assigned to different therapeutic conditions : group therapy , individual therapy , summer camp or “ advice in one session ” . Results : A progressive and significant loss of weight for all therapeutic conditions was noticeable . The reduction continued at least 6 months after completing therapy . The control group , however , showed weight evolution in the opposite sense . Conclusions : A replication of the positive effect of CBT was found in a broad sample of clinical ly obese children , even without strict diet prescription . Our hypothesis that group approach will result in a better outcome is borne out BACKGROUND & AIMS R and omized controlled trials ( RCT ) have demonstrated the effectiveness of lifestyle interventions in obese children . However , the effectiveness of interventions for overweight , but no obese children has not been demonstrated yet by RCTs . METHODS A total of 66 overweight ( BMI > 90th < or = 97th percentile ) children ( mean age 11.5+/-1.6 years , 58 % females , mean BMI 23.4+/-1.5kg/m(2 ) ) were r and omized into a control group ( CG ) ( n=32 ; no intervention for a duration of 6 months ) or intervention group ( IG ) ( n=34 ; 6 months intervention " Obeldicks light " based on physical activity , nutrition education , and behaviour counselling ) . BMI , waist circumference , skinfold thickness , bioimpedance analyses , blood pressure , physical activity based on question naires , and three-day-weighed dietary records  were determined at baseline ( T0 ) and 6 months ( T1 ) later . Degree of overweight was calculated as BMI -SDS . Comparisons were performed on an intention-to-treat approach . RESULTS The  drop-out rate was 3 % in IG and 16 % in CG . At T1 , 94 % of the children in IG decreased their BMI -SDS and 24 % of them were normal weight . The changes between T0 and T1 in BMI -SDS differed significantly ( p<0.001 ) between IG and CG ( CG : + 0.05+/-0.19 BMI -SDS ; IG : -0.26+/-0.22 BMI -SDS ) . Similar findings were observed for blood pressure , waist circumference , skinfold thickness , and fat mass based on bioimpedance analyses . In the IG , energy , fat and sugar intake decreased significantly between T0 and T1 , while no significant changes were observed in the CG . CONCLUSIONS The lifestyle intervention was associated with an improvement of dietary patterns and was effective in reducing degree of overweight , fat mass , waist circumference , and blood pressure
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