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.