The effect of a multidisciplinary lifestyle modification program for obese and overweight children.

BACKGROUND/PURPOSE: The increasing prevalence of overweight and obese children and adolescents has been recognized as a public health threat worldwide. This study aimed to assess the effect of a stepwise lifestyle intervention in children and adolescents. METHODS: We developed a multidisciplinary clinic aimed at providing lifestyle interventions for obese children and adolescents. The program comprised three stages with stepwise goals: knowledge building (the first 4 weeks), habit consolidation (5-12 weeks), and self-monitoring (13-20 weeks). RESULTS: Of the 63 participants (age 11.6 ± 3.2 years) who entered the first stage of the program, 48, 22, and 15 completed the first, second and third stages (4, 12, and 20 weeks), respectively. In the first stage, significant improvement was noted in body weight, body mass index (BMI), BMI z-score, and waist circumference. Improvements in physical fitness performance were observed at 4 weeks in 3/5 items and at 12 weeks in 4/5 items. The decreases in body weight, BMI and BMI z-score were most prominent in the first two stages. In the third stage, participants maintained a stable body weight. In the 15 subjects who completed the whole program, BMI decreased from 29.3 ± 6.9 to 27.8 ± 6.1 (P = 0.001), and BMI z-score decreased from 3.06 ± 0.96 to 2.69 ± 0.91(P = 0.001). CONCLUSION: We developed a feasible multidisciplinary program based on knowledge education and individualized training. BMI and physical fitness scores can be used as early indicators of lifestyle change for obese children and adolescents.

Dietary intake and growth deficits in Rett syndrome-A cross-section study.

Growth deficit is a common comorbidity and one of the supportive criteria in Rett syndrome (RTT). This study aimed to investigate the impact of dystonia, dietary intakes, and clinical severities on growth patterns in a Taiwanese cohort of RTT. We recruited 44 RTT patients with MECP2 mutation for analysis. For individuals ≤18 years of age, in comparison to the RTT-specific growth chart which comprised American RTT cohort, the body height was right-shifted to a higher percentile, whereas the body weight was left-shifted to a lower percentile. Furthermore, the body mass index was significantly decreased when compared to RTT-specific growth chart (p = 0.01). Higher degree of overall disease severity (odd ratio = 1.159; 95% CI = 1.063-1.264; p = 0.001) and hand use impairment (odd ratio = 2.017; 95% CI = 1.037, 3.921; p = 0.039) were associated with more severe growth patterns. All individuals had dystonia at certain variable degrees. The dystonia worsened with age (p < 0.001) but did not have significant impact on growth deficit. Most of our cohort had adequate protein (97.37%) and energy (58.97%) intakes. The fiber intakes were generally low, with about 38 (97.4%) individuals did not meet the daily reference intakes of fiber. The protein intake was significantly lower in individuals with severe growth deficit (p = 0.04). Our study shows that ethnicity should be considered when comparing RTT individuals' growth pattern to the RTT-specific growth chart. Further, disease severity, genotypes, and nutrition exert important impacts on RTT-growth pattern. LAY SUMMARY: Growth impairment is an important issue in Rett syndrome and the underlying patho-mechanism is multifactorial. Higher degree of overall disease severity and hand use impairment were associated with more severe growth pattern deficits. Although all individuals had dystonia at certain variable degrees and the dystonia worsened with age, but it did not have significant impact on growth deficit. Nutritional intakes may partially affect growth. Furthermore, ethnicity should be considered when comparing RTT individuals' growth pattern to the RTT-specific growth chart.