Randomized, controlled trial of a best-practice individualized behavioral program for treatment of childhood overweight: Scottish childhood overweight treatment trial (SCOTT)

Hughes, A., Stewart, L., Chapple, J., McColl, J.H. , Donaldson, M.D., Kelnar, C., Zabihollah, M., Ahmed, S.F. and Reilly, J. (2008) Randomized, controlled trial of a best-practice individualized behavioral program for treatment of childhood overweight: Scottish childhood overweight treatment trial (SCOTT). Pediatrics, 121(3), E539-E546. (doi: 10.1542/peds.2007-1786)

Abstract

<p>OBJECTIVE. The objective of this study was to determine whether a generalizable best-practice individualized behavioral intervention reduced BMI z score relative to standard dietetic care among overweight children.</p> <p>METHODS. The design consisted of an assessor-blinded, randomized, controlled trial involving 134 overweight children (59 boys, 75 girls; BMI ≥ 98th centile relative to United Kingdom 1990 reference data for children aged 5–11 years) who were randomly assigned to a best-practice behavioral program (intervention) or standard care (control). The intervention used family-centered counseling and behavioral strategies to modify diet, physical activity, and sedentary behavior. BMI z score, weight, objectively measured physical activity and sedentary behavior, fat distribution, quality of life, and height z score were recorded at baseline and at 6 and 12 months.</p> <p>RESULTS. The intervention had no significant effect relative to standard care on BMI z score from baseline to 6 months and 12 months. BMI z score decreased significantly in both groups from baseline to 6 and 12 months. For those who complied with treatment, there was a significantly smaller weight increase in those in the intervention group compared with control subjects from baseline to 6 months. There were significant between-group differences in favor of the intervention for changes in total physical activity, percentage of time spent in sedentary behavior, and light-intensity physical activity.</p> <p>CONCLUSIONS. A generalizable, best-practice individualized behavioral intervention had modest benefits on objectively measured physical activity and sedentary behavior but no significant effect on BMI z score compared with standard care among overweight children. The modest magnitude of the benefits observed perhaps argues for a longer-term and more intense intervention, although such treatments may not be realistic for many health care systems.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McColl, Professor John and Ahmed, Professor Syed Faisal and Donaldson, Dr Malcolm and Reilly, Prof John
• Authors: Hughes, A., Stewart, L., Chapple, J., McColl, J.H., Donaldson, M.D., Kelnar, C., Zabihollah, M., Ahmed, S.F., and Reilly, J.
• Subjects: R Medicine > R Medicine (General); R Medicine > RJ Pediatrics
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: Pediatrics
• Publisher: American Academy of Pediatrics
• ISSN: 0031-4005
• ISSN (Online): 1098-4275
• Published Online: 29 February 2008