Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study - a hospital/public health nurse combined treatment
Identifieur interne : 000303 ( Pmc/Curation ); précédent : 000302; suivant : 000304Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study - a hospital/public health nurse combined treatment
Auteurs : Magnhild L Pollestad Kolsgaard [Norvège] ; Geir Joner [Norvège] ; Cathrine Brunborg [Norvège] ; Sigmund A. Anderssen [Norvège] ; Serena Tonstad [Norvège] ; Lene Frost Andersen [Norvège]Source :
- BMC Pediatrics [ 1471-2431 ] ; 2011.
Abstract
Weight loss and increased physical fitness are established approaches to reduce cardiovascular risk factors. We studied the reduction in BMI z-score associated with improvement in cardiometabolic risk factors in overweight and obese children and adolescents treated with a combined hospital/public health nurse model. We also examined how aerobic fitness influenced the results.
From 2004-2007, 307 overweight and obese children and adolescents aged 7-17 years were referred to an outpatient hospital pediatrics clinic and evaluated by a multidisciplinary team. Together with family members, they were counseled regarding diet and physical activity at biannual clinic visits. Visits with the public health nurse at local schools or at maternal and child health centres were scheduled between the hospital consultations. Fasting blood samples were taken at baseline and after one year, and aerobic fitness (VO2peak) was measured. In the analyses, 230 subjects completing one year of follow-up by December 2008 were divided into four groups according to changes in BMI z-score: Group 1: decrease in BMI z-score≥0.23, Group 2: decrease in BMI z-score≥0.1-< 0.23, Group 3: decrease in/stable BMI z-score≥0.0-< 0.1, Group 4: increase in BMI z-score (>0.00-0.55).
230 participants were included in the analyses (75%). Mean (SD) BMI z-score was reduced from 2.18 (0.30) to 2.05 (0.39) (p < 0.001) in the group as a whole. After adjustment for BMI z-score, waist circumference and gender, the three groups with reduced BMI z-score had a significantly greater reduction in HOMA-IR, insulin, total cholesterol, LDL cholesterol and total/HDL cholesterol ratio than the group with increased BMI z-score. Adding change in aerobic fitness to the model had little influence on the results. Even a very small reduction in BMI z-score (group 3) was associated with significantly lower insulin, total cholesterol, LDL and total/HDL cholesterol ratio. The group with the largest reduction in BMI z-score had improvements in HOMA-IR and aerobic fitness as well. An increase in BMI z-score was associated with worsening of C-peptide and total/HDL cholesterol ratio.
Even a modest reduction in BMI z-score after one year of combined hospital/and public health nurse intervention was associated with improvement in several cardiovascular risk factors.
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DOI: 10.1186/1471-2431-11-47
PubMed: 21619652
PubMed Central: 3121603
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study - a hospital/public health nurse combined treatment </title><author><name sortKey="Kolsgaard, Magnhild L Pollestad" sort="Kolsgaard, Magnhild L Pollestad" uniqKey="Kolsgaard M" first="Magnhild L Pollestad" last="Kolsgaard">Magnhild L Pollestad Kolsgaard</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Joner, Geir" sort="Joner, Geir" uniqKey="Joner G" first="Geir" last="Joner">Geir Joner</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Brunborg, Cathrine" sort="Brunborg, Cathrine" uniqKey="Brunborg C" first="Cathrine" last="Brunborg">Cathrine Brunborg</name><affiliation wicri:level="1"><nlm:aff id="I3">Centre for Clinical Research, Unit of Epidemiology and Biostatistics, Oslo University Hospital, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Centre for Clinical Research, Unit of Epidemiology and Biostatistics, Oslo University Hospital, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Anderssen, Sigmund A" sort="Anderssen, Sigmund A" uniqKey="Anderssen S" first="Sigmund A" last="Anderssen">Sigmund A. Anderssen</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Tonstad, Serena" sort="Tonstad, Serena" uniqKey="Tonstad S" first="Serena" last="Tonstad">Serena Tonstad</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Preventive Cardiology, Oslo University Hospital, Oslo</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I6">Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Andersen, Lene Frost" sort="Andersen, Lene Frost" uniqKey="Andersen L" first="Lene Frost" last="Andersen">Lene Frost Andersen</name><affiliation wicri:level="1"><nlm:aff id="I6">Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21619652</idno><idno type="pmc">3121603</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121603</idno><idno type="RBID">PMC:3121603</idno><idno type="doi">10.1186/1471-2431-11-47</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000303</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000303</idno><idno type="wicri:Area/Pmc/Curation">000303</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000303</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study - a hospital/public health nurse combined treatment </title><author><name sortKey="Kolsgaard, Magnhild L Pollestad" sort="Kolsgaard, Magnhild L Pollestad" uniqKey="Kolsgaard M" first="Magnhild L Pollestad" last="Kolsgaard">Magnhild L Pollestad Kolsgaard</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Joner, Geir" sort="Joner, Geir" uniqKey="Joner G" first="Geir" last="Joner">Geir Joner</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Brunborg, Cathrine" sort="Brunborg, Cathrine" uniqKey="Brunborg C" first="Cathrine" last="Brunborg">Cathrine Brunborg</name><affiliation wicri:level="1"><nlm:aff id="I3">Centre for Clinical Research, Unit of Epidemiology and Biostatistics, Oslo University Hospital, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Centre for Clinical Research, Unit of Epidemiology and Biostatistics, Oslo University Hospital, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Anderssen, Sigmund A" sort="Anderssen, Sigmund A" uniqKey="Anderssen S" first="Sigmund A" last="Anderssen">Sigmund A. Anderssen</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Tonstad, Serena" sort="Tonstad, Serena" uniqKey="Tonstad S" first="Serena" last="Tonstad">Serena Tonstad</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Preventive Cardiology, Oslo University Hospital, Oslo</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I6">Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Andersen, Lene Frost" sort="Andersen, Lene Frost" uniqKey="Andersen L" first="Lene Frost" last="Andersen">Lene Frost Andersen</name><affiliation wicri:level="1"><nlm:aff id="I6">Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Pediatrics</title><idno type="eISSN">1471-2431</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Weight loss and increased physical fitness are established approaches to reduce cardiovascular risk factors. We studied the reduction in BMI z-score associated with improvement in cardiometabolic risk factors in overweight and obese children and adolescents treated with a combined hospital/public health nurse model. We also examined how aerobic fitness influenced the results.</p></sec><sec><title>Methods</title><p>From 2004-2007, 307 overweight and obese children and adolescents aged 7-17 years were referred to an outpatient hospital pediatrics clinic and evaluated by a multidisciplinary team. Together with family members, they were counseled regarding diet and physical activity at biannual clinic visits. Visits with the public health nurse at local schools or at maternal and child health centres were scheduled between the hospital consultations. Fasting blood samples were taken at baseline and after one year, and aerobic fitness (VO<sub>2peak</sub>) was measured. In the analyses, 230 subjects completing one year of follow-up by December 2008 were divided into four groups according to changes in BMI z-score: Group 1: decrease in BMI z-score≥0.23, Group 2: decrease in BMI z-score≥0.1-< 0.23, Group 3: decrease in/stable BMI z-score≥0.0-< 0.1, Group 4: increase in BMI z-score (>0.00-0.55).</p></sec><sec><title>Results</title><p>230 participants were included in the analyses (75%). Mean (SD) BMI z-score was reduced from 2.18 (0.30) to 2.05 (0.39) (p < 0.001) in the group as a whole. After adjustment for BMI z-score, waist circumference and gender, the three groups with reduced BMI z-score had a significantly greater reduction in HOMA-IR, insulin, total cholesterol, LDL cholesterol and total/HDL cholesterol ratio than the group with increased BMI z-score. Adding change in aerobic fitness to the model had little influence on the results. Even a very small reduction in BMI z-score (group 3) was associated with significantly lower insulin, total cholesterol, LDL and total/HDL cholesterol ratio. The group with the largest reduction in BMI z-score had improvements in HOMA-IR and aerobic fitness as well. An increase in BMI z-score was associated with worsening of C-peptide and total/HDL cholesterol ratio.</p></sec><sec><title>Conclusions</title><p>Even a modest reduction in BMI z-score after one year of combined hospital/and public health nurse intervention was associated with improvement in several cardiovascular risk factors.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ebbeling, Cb" uniqKey="Ebbeling C">CB Ebbeling</name></author><author><name sortKey="Pawlak, Db" uniqKey="Pawlak D">DB Pawlak</name></author><author><name sortKey="Ludwig, Ds" uniqKey="Ludwig D">DS Ludwig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vilimas, K" uniqKey="Vilimas K">K Vilimas</name></author><author><name sortKey="Glavin, K" uniqKey="Glavin K">K Glavin</name></author><author><name sortKey="Donovan, Ml" uniqKey="Donovan M">ML 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Pediatr</journal-id><journal-title-group><journal-title>BMC Pediatrics</journal-title></journal-title-group><issn pub-type="epub">1471-2431</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21619652</article-id><article-id pub-id-type="pmc">3121603</article-id><article-id pub-id-type="publisher-id">1471-2431-11-47</article-id><article-id pub-id-type="doi">10.1186/1471-2431-11-47</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study - a hospital/public health nurse combined treatment </article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Kolsgaard</surname><given-names>Magnhild L Pollestad</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>Magnhild.L.P.Kolsgaard@ous-hf.no</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Joner</surname><given-names>Geir</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I2">2</xref><email>geir.joner@medisin.uio.no</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Brunborg</surname><given-names>Cathrine</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>Cathrine.Brunborg@ous-hf.no</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Anderssen</surname><given-names>Sigmund A</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>Sigmund.Anderssen@nih.no</email></contrib><contrib contrib-type="author" id="A5"><name><surname>Tonstad</surname><given-names>Serena</given-names></name><xref ref-type="aff" rid="I5">5</xref><xref ref-type="aff" rid="I6">6</xref><email>Serena.Tonstad@ous-hf.no</email></contrib><contrib contrib-type="author" id="A6"><name><surname>Andersen</surname><given-names>Lene Frost</given-names></name><xref ref-type="aff" rid="I6">6</xref><email>l.f.andersen@medisin.uio.no</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Pediatrics, Oslo University Hospital, Ullevål, PB 4956 Nydalen, 0424 Oslo, Norway</aff><aff id="I2"><label>2</label>Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway</aff><aff id="I3"><label>3</label>Centre for Clinical Research, Unit of Epidemiology and Biostatistics, Oslo University Hospital, Oslo, Norway</aff><aff id="I4"><label>4</label>Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway</aff><aff id="I5"><label>5</label>Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway</aff><aff id="I6"><label>6</label>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</aff><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>27</day><month>5</month><year>2011</year></pub-date><volume>11</volume><fpage>47</fpage><lpage>47</lpage><history><date date-type="received"><day>22</day><month>12</month><year>2010</year></date><date date-type="accepted"><day>27</day><month>5</month><year>2011</year></date></history><permissions><copyright-statement>Copyright ©2011 Pollestad Kolsgaard et al; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2011</copyright-year><copyright-holder>Pollestad Kolsgaard et al; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.biomedcentral.com/1471-2431/11/47"></self-uri><abstract><sec><title>Background</title><p>Weight loss and increased physical fitness are established approaches to reduce cardiovascular risk factors. We studied the reduction in BMI z-score associated with improvement in cardiometabolic risk factors in overweight and obese children and adolescents treated with a combined hospital/public health nurse model. We also examined how aerobic fitness influenced the results.</p></sec><sec><title>Methods</title><p>From 2004-2007, 307 overweight and obese children and adolescents aged 7-17 years were referred to an outpatient hospital pediatrics clinic and evaluated by a multidisciplinary team. Together with family members, they were counseled regarding diet and physical activity at biannual clinic visits. Visits with the public health nurse at local schools or at maternal and child health centres were scheduled between the hospital consultations. Fasting blood samples were taken at baseline and after one year, and aerobic fitness (VO<sub>2peak</sub>) was measured. In the analyses, 230 subjects completing one year of follow-up by December 2008 were divided into four groups according to changes in BMI z-score: Group 1: decrease in BMI z-score≥0.23, Group 2: decrease in BMI z-score≥0.1-< 0.23, Group 3: decrease in/stable BMI z-score≥0.0-< 0.1, Group 4: increase in BMI z-score (>0.00-0.55).</p></sec><sec><title>Results</title><p>230 participants were included in the analyses (75%). Mean (SD) BMI z-score was reduced from 2.18 (0.30) to 2.05 (0.39) (p < 0.001) in the group as a whole. After adjustment for BMI z-score, waist circumference and gender, the three groups with reduced BMI z-score had a significantly greater reduction in HOMA-IR, insulin, total cholesterol, LDL cholesterol and total/HDL cholesterol ratio than the group with increased BMI z-score. Adding change in aerobic fitness to the model had little influence on the results. Even a very small reduction in BMI z-score (group 3) was associated with significantly lower insulin, total cholesterol, LDL and total/HDL cholesterol ratio. The group with the largest reduction in BMI z-score had improvements in HOMA-IR and aerobic fitness as well. An increase in BMI z-score was associated with worsening of C-peptide and total/HDL cholesterol ratio.</p></sec><sec><title>Conclusions</title><p>Even a modest reduction in BMI z-score after one year of combined hospital/and public health nurse intervention was associated with improvement in several cardiovascular risk factors.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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