Anti-obesity program doesn't help teen girls: study
By Genevra Pittmann
NEW YORK (Reuters Health) May 09 - An intensive obesity-prevention program for Australian girls didn't lead to any improvements in their diet, physical activity or body weight a year later, according to a new report.
Findings from the school-based intervention, which involved exercise sessions and nutrition workshops for lower-income girls, are the latest disappointment in a slew of research attempting to head-off adult obesity -- and the disease risks that come with it.
Especially during the middle- and high-school years, girls' physical activity declines dramatically, according to lead researcher Dr. David Lubans, from the University of Newcastle in New South Wales, Australia.
"We were fighting against a range of psychological, sociological, environmental and biological barriers," he told Reuters Health in an email.
In the future, he added, "we need to make the programs more appealing and exciting and present information in a way that is meaningful to adolescent girls."
Dr. Lubans and his colleagues conducted their study in 12 schools in low-income areas of New South Wales. All in all, they randomly assigned 357 eighth-grade girls either to an intensive program at school or to a control group.
At the start of the study, girls in both groups weighed an average of close to 130 pounds, with about 40% considered overweight or obese.
Adolescents in the intervention group were given pedometers to encourage walking and running and invited to nutrition workshops and regular exercise sessions during the school day and at lunchtime.
Participation in some of those activities was less than ideal. For example, the girls went to only one-quarter of optional lunchtime exercise sessions, and less than one in ten completed at-home physical activity or nutrition challenges, the researchers reported May 7th in Archives of Pediatrics & Adolescent Medicine.
At the end of the year, girls in both groups had gained a similar amount of weight and there was no difference in their average body fat -- about 33%.
The participants also gave similar answers on surveys of how much exercise they got and how much they ate, as well as on measures of self-esteem.
Only "screen time" was significantly lower in the intervention group after a year -- by about half an hour per day.
Preventive medicine researcher Dr. Robert Klesges, from the University of Tennessee Health Science Center in Memphis, said that although some anti-obesity programs have helped adults lose weight, the teen population has consistently been a source of frustration for researchers.
"The common belief is: nothing works," he said. "And we've got to get beyond that."
Dr. Klesges and his colleagues also found "bupkis" (i.e., nothing) when they tested group behavioral counseling covering physical activity and healthy eating in hopes of preventing obesity in younger African American girls.
"We need to think outside the box," Dr. Klesges, who wasn't involved in the new study, told Reuters Health.
That could include learning from what has worked in adult studies, such as giving meal replacement drinks or prepared foods to teens who have trouble making changes to their diet.
Or, it could mean using a "step-care" approach where young people who are still having trouble eating better and losing weight after a few months are given more intensive help -- rather than researchers or their doctor telling them to keep doing the same thing, Dr. Klesges said.
SOURCE: Preventing Obesity Among Adolescent Girls
One-Year Outcomes of the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) Cluster Randomized Controlled Trial
David R. Lubans, PhD; Philip J. Morgan, PhD; Anthony D. Okely, EdD; Deborah Dewar, BEd; Clare E. Collins, PhD; Marijka Batterham, PhD; Robin Callister, PhD; Ronald C. Plotnikoff, PhD
Arch Pediatr Adolesc Med. Published online May 7, 2012. doi:10.1001/archpediatrics.2012.41
Objective To evaluate the impact of a 12-month multicomponent school-based obesity prevention program, Nutrition and Enjoyable Activity for Teen Girls among adolescent girls.
Design Group randomized controlled trial with 12-month follow-up.
Setting Twelve secondary schools in low-income communities in the Hunter and Central Coast regions of New South Wales, Australia.
Participants Three hundred fifty-seven adolescent girls aged 12 to 14 years.
Intervention A multicomponent school-based intervention program tailored for adolescent girls. The intervention was based on social cognitive theory and included teacher professional development, enhanced school sport sessions, interactive seminars, nutrition workshops, lunch-time physical activity sessions, handbooks and pedometers for self-monitoring, parent newsletters, and text messaging for social support.
Main Outcome Measures Body mass index (BMI, calculated as weight in kilograms divided by height in meters squared), BMI z score, body fat percentage, physical activity, screen time, dietary intake, and self-esteem.
Results After 12 months, changes in BMI (adjusted mean difference, –0.19; 95% CI, –0.70 to 0.33), BMI z score (mean, –0.08; 95% CI, –0.20 to 0.04), and body fat percentage (mean, –1.09; 95% CI, –2.88 to 0.70) were in favor of the intervention, but they were not statistically different from those in the control group. Changes in screen time were statistically significant (mean, –30.67 min/d; 95% CI, –62.43 to –1.06), but there were no group by time effects for physical activity, dietary behavior, or self-esteem.
Conclusions A school-based intervention tailored for adolescent girls from schools located in low-income communities did not significantly reduce BMI gain. However, changes in body composition were of a magnitude similar to previous studies and may be associated with clinically important health outcomes.
Trial Registration anzctr.org.au Identifier: 12610000330044
Author Affiliations: Schools of Education (Drs Lubans, Morgan, and Plotnikoff and Mrs Dewar), Health Sciences (Dr Collins), and Biomedical Sciences and Pharmacy (Dr Callister), Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle; and Interdisciplinary Educational Research Institute (Dr Okely), and Centre for Statistical and Survey Methodology, (Dr Batterham), University of Wollongong, Wollongong, Australia.