Poster Presentation Australian & New Zealand Obesity Society 2014 Annual Scientific Meeting

Multidisciplinary obesity management program improvements dietary outcomes at 10 weeks & 12 months in obese children and adolescents.  (#279)

Deanna Messina 1 , Rachelle Kalic 2 , Lyndsey Price 1 , Luise Russell 1 , Anna Tremayne 1 , Sarah Johnson 1 , Justine Doust 1 , Sarah Carbon 1 , Joanna Norfolk 1 , Jacqueline Curran 1 , Lana Bell 1 , Elizabeth Ann Davis 1
  1. Department of Diabetes and Endocrinology, Child and Adolescent Health Service, Princess Margaret Hospital for Children, Perth, WA, Australia
  2. Diabetes and Obesity Research Group , Telethon Kids Institute, The University Of Western Australia, Perth, WA, Australia

The Department of Diabetes and Endocrinology at Princess Margaret Hospital for Children, in keeping with NHMRC guidelines 1, provides a 12-month family-based, multidisciplinary program (CLASP) for children and adolescents with impaired glucose tolerance and/or obesity ±co-morbidities. We aimed to assess the impact of the intensive nutrition component of this program.

The validated Children’s Dietary Questionnaire2 was used to assess key dietary patterns (fruit and vegetable intake [target-14], sweetened beverages [target-1], non-core-foods [target-2] and fat from dairy [target-0]). Anthropometric measurements and metabolic markers were measured at baseline, week-10 and 12-months. ANOVA determined changes between time-points and a single-sided t-test determined if dietary markers were meeting targets for dietary intake.

105 group participants (aged 7-16years) that attended the group programme between 2011 and April 2014 were available for baseline analysis; 90 were available for week-10 assessments with 35 assessed at 12-months.

BMI z-score improved between baseline and 12-months (+2.47±0.02 to +2.33±0.04, p=<0.004). Waist circumference, fasting insulin, total cholesterol and HDL were reduced at 12 months but did not reach significance.

At baseline no dietary targets were being met. At week-10, Fruit-Veg achieved the target score of 14 (p=0.418). Sweetened-Beverages and Non-core-foods exceeded recommended targets of below 1 and 2 (0.5±0.1, p<0.001; 0.9±0.1, p=<0.001, respectively).

Between baseline and week 10, improvements occurred in consumption of Fruit-Veg (12.2±0.5 vs 13.6±0.5, p=0.044), sweetened beverages (0.9±0.1 vs 0.5±0.1, p=0.021) and non-core-foods (1.6±0.1, 0.9±0.1, p<0.001). Improvements were maintained at 12 months for fat from dairy (1.6±0.2 vs 0.8±0.2, p=0.005), sweetened-beverages (0.9±0.1 vs 0.4±0.1, p=0.044) and non-core-foods (1.6±0.1 vs 1.0±0.1, p=0.004) but not for fruit-veg (12.2±0.5 vs 10.9±1.2, p=0.226).

At week-10, Fruit-Veg intake was significantly higher for those who achieved ≥5% BMI z-score loss vs those who maintained or gained ≤5% BMI z-score (15.5±0.7 vs 12.7±0.6, p=0.009).

The multidisciplinary obesity program is successful at improving dietary patterns and BMI z-scores at 10-weeks, with continued benefits extending through to 12 months.

  1. National Health and Medical Research Council 2013, Clinical Practice Guidelines for the Management of Overweight and Obesity in Children and Adolescents, Department of Health and Ageing, Australia.
  2. A Magarey, R Golley, N Spurrier, E Goodwin & F Ong. Reliability and Validity of the Children's Dietary Questionnaire; A new tool to measure childrens dietary patterns.