An activity-based intervention for obese and physically inactive children organized in primary care: feasibility and impact on fitness and BMI

Abstract

Objective. To investigate the feasibility and impact on BMI and physical fitness of an intervention for obese and inactive children, based on physical activity and carried out in primary health care. Design. A prospective, longitudinal one-year follow-up study. Setting. The community of Kristiansand, Norway (80 000 inhabitants). Intervention. A 40-week structured intervention based on physical training with some lifestyle advice for the obese child and one parent. Subjects. A total of 62 physically inactive children aged 6–14 years with iso-BMI ≥ 30 kg/m². Main outcome measures. Body mass index (BMI), maximum oxygen uptake, and physical fitness in tests of running, jumping, throwing, and climbing assessed at baseline and after six and 12 months as well as number of dropouts and predicting factors. Results. A total of 49 out of 62 children completed the first six months and 37 children completed 12 months. Dropout rate was higher when parents reported being physically inactive at baseline or avoided physical participation in the intervention. The children's maximum oxygen uptake increased significantly after 12 months from 27.0 to 32.0 ml/kg/min (means), as did physical fitness (endurance, speed, agility, coordination, balance, strength) and BMI was significantly reduced. Conclusion/implications. This one-year activity-based intervention for obese and inactive children performed in primary health care succeeded by increasing cardiovascular capacity and physical fitness combined with reduced BMI in those who completed. Dropout was substantial and depended on the attendance and compliance with physical activity by the parents.

Key Words::

• BMI
• childhood obesity
• dropouts
• family practice
• fitness
• parental participation
• physical activity
• primary care

Acknowledgements

The authors are grateful to the children and their parents for their willingness to contribute and to the educated trainers, testers, and coordinators: Trine Fjeld Syvertsen, Ken Hetlelid and Kari Aas Hansen. They would like to thank Professor Knut Øymar, University of Bergen, Ingunn Fjørtoft, Telemark University College, Prof. Emeritus Christian Borchgrevink and General Practitioner Gunnar Mouland in the “Primary health-care research group Arendal”, for their guidance on this paper.

Funding

The local council and the local hospital contributed to financing the project. The leaders of the project were paid by their employers. The first author received grants from the research fund for primary health care in Norway.

Conflicts of interest

The first two authors have received an unrestricted grant of NOK 30000 from the ‘Norwegian Association for the Study of Obesity’ in 2005.