Behavioral treatments helped obese children but had almost no effect on obese adolescents in a study in Sweden that suggests again that intervening as early as possible is one key to reducing a condition that can lead to many diseases in adulthood, researchers said.
“More and more evidence points to early childhood as a pivotal time for preventing in young children an
trajectory that is hard to alter by the time they enter middle school,” according to an editorial included with the study in the journal Archives of Pediatric and Adolescent Medicine published Monday. The editorial was written by Drs. Jennifer Woo Baidal and Elsie Taveras of Boston Children’s Hospital.
The Swedish study looked at 643 children at the National Childhood Obesity Center in Stockholm over three years. The children were divided into three age groups: 6 to 9 years, 10 to 13 years, and 14 to 16 years of age. And they were split into groups of moderately and severely obese.
The “age at the start of treatment appears to be of major importance,” the researchers, led by Pernilla Danielsson, said. They wanted to look at the differences based on the children’s ages and degree of obesity in the success of a program that includes learning more healthful eating habits, reducing sedentary time and improved physical activity.
In the accompanying editorial, the authors suggested several behavioral goals for young children and their families: avoiding sugar-sweetened drinks, reducing exposure to food marketing by reducing “screen time,” providing the chance for at least an hour a day of vigorous activity, replacing fried and sugary foods with more produce, and promoting sufficient sleep.
“Most children who were obese as adolescents were already obese by age 7 years” in the Swedish study, the editorial noted, “potentially representing a missed opportunity for effective intervention.”
More work is needed, they said, to identify young children at risk of obesity.
Having an obese mother mattered in the Swedish study.
The researchers said that among the moderately obese children, 54% of mothers and 53% of fathers were
or obese. Among the severely obese children, it was 64% of both parents. But the study found that only the mother’s status affected the children: Those with normal weight mothers showed a larger decrease in their
standard deviation scores than those with overweight mothers.
The adolescents ages 14 to 16 showed almost no change in that score after three years. Forty-four percent of the youngest children had a clinically significant 0.5 score reduction or greater. Among the children ages 10 to 13, 20% of moderately obese and 8% of severely obese showed at least that reduction.