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Routine changes tied to kids' weight loss: study

By Andrew M. Seaman

NEW YORK (Reuters Health) - Encouraging and counseling minority families to adopt healthier household routines led to a small decrease in children's weight, in a new study.

Researchers found encouraging families to eat meals together, limit TV time and get better sleep was linked to about a one-pound drop in kids' weight relative to children in homes that didn't receive the encouragement and counseling.

"I can tell a family, ‘You really need to get more physical activity' and the conversation can end there," Dr. Elsie Taveras, the study's senior author from Massachusetts General Hospital for Children in Boston, said.

But, she added, "I think that ability to go deeper and talk about their routines is key."

Previous research has found certain household routines - such as eating meals as a family and only spending a couple of hours in front of a TV each day - are linked to a reduced risk of children being obese.

It's also known that children in minority and low-income families are more likely to be overweight and obese than white children from wealthier families.

For the new study, Taveras and her colleagues randomly assigned 121 families with children between age two and five, who were predominantly black and Latino, to receive usual care or the counseling program.

The 62 families assigned to the counseling group received four home visits and four phone calls from health educators, educational materials mailed to the home and weekly text messages about adopting healthy household routines. None of the counseling, however, specifically mentioned obesity or reducing children's weight.

The 59 families randomized to the usual care group received educational materials, such as coloring books, in the mail. The materials didn't address the household routines, but focused on children reaching certain developmental milestones.

After six months, the researchers found children in the counseling group were sleeping almost an hour longer than children assigned to the usual care group. Kids in the counseling group also reduced their TV viewing by about one hour per day during the weekend.

There was no change in the number of meals the children shared with their families, but Taveras said many of the children were already eating family meals at the beginning of the study.

The researchers did find that kids in the usual care group had a small increase in body mass index (BMI) - a measurement of weight in relation to height - and those in the counseling group had a slight decrease in BMI. The difference was equivalent to about one pound.

"Relative to the control group it was a small decrease, but not insignificant in a six-month period in growing children," Taveras said.

Despite the study's limitations - such as the small change in BMI, uncertainty about whether the change will last and the small number of families that participated - Indiana University School of Medicine's Dr. Aaron Carroll writes in an editorial accompanying it in JAMA Pediatrics that the approach is feasible and successful.

"I'm encouraged anytime we find something that takes what we know, shows it works and that it's feasible," Dr. Shari Barkin, director of pediatric obesity research at Vanderbilt University School of Medicine in Nashville, told Reuters Health.

"It's not that each of these things are new. What's different is trying to come up with the intervention that reaches out to families in the context of the home," Barkin, who was not involved with the study, said.

Taveras told Reuters Health her team plans on looking at the costs of the program and hopes to develop a longer study in the future.

Barkin said it is important to know whether the change in BMI among the counseling group is sustainable over time.

SOURCE: http://bit.ly/Ms92Cy JAMA Pediatrics, online September 9, 2013.

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