UVM Theses and Dissertations
Format:
Print
Author:
Revette, Dania M.
Dept./Program:
Nutritional and Food Sciences
Year:
2011
Degree:
MS
Abstract:
Pediatric obesity has become a serious health epidemic with the National Health Institute reporting the percentage of obese children tripling to over 17%. Pediatric obesity can Iead to a wide variety of co-morbidities including hyperlipidemia, non-alcoholic liver disease, orthopedic problems, hypertension, insulin resistance, Type 2 diabetes, sleep apnea, and asthma, as well as psychological and emotional issues. Despite numerous and diverse interventions, there has been little progress in reducing or halting the prevalence ofthis health crisis. Pediatric obesity programs were first developed over 25 years ago but there remains limited outcome data from these interventions, especially those in clinical settings. Most studies of this kind do not evaluate the programs used once the results are produced.
The purpose of this study was to evaluate the Fletcher Allen Health Care Healthy Living Clinic (HLC). This was done by determining its ability to help participants achieve 1) changes in body mass index 2) changes in lab values and 3) changes in behaviors. Data were collected from charts of 188 patients attending the HLC. Baseline and three month follow-up data were compared for body mass index (BMI), cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose, and glycated hemoglobin (HbA1c) using paired Hests and for excessive calorie intake, consumption of calorie containing beverages, large or extra portions, excessive snacking, high calorically dense foods, poor food choices, limited calcium intake, excessive calcium intake, limited fruit/vegetable intake, limited fiber intake, skipped meals, limited physical activity, excessive screen time, low family motivation, low child motivation, low family receptiveness, and low child receptiveness using McNemar's test. There was no change in BMI or laboratory values except for ALT.
However, there were changes in behaviors. Consumption of calorie containing beverages, large or extra portions, excessive calcium intake, limited fiber intake, limited physical activity, and excessive screen time were significantly improved between initial and follow-up visits. An additional two behaviors, excessive calorie intake and excessive snacking, showed a trend toward change between the initial and follow-up visits. Long term use of these positive behaviors has been shown to reduce BMI and improve laboratory values. Although the HLC has shown some success, improvements that could be made. in the program given the confines oftime, space, and team members include instructing parents on positive reinforcement technique, setting time outlined goals, encouraging parental modeling, and the use of incentives.
The purpose of this study was to evaluate the Fletcher Allen Health Care Healthy Living Clinic (HLC). This was done by determining its ability to help participants achieve 1) changes in body mass index 2) changes in lab values and 3) changes in behaviors. Data were collected from charts of 188 patients attending the HLC. Baseline and three month follow-up data were compared for body mass index (BMI), cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose, and glycated hemoglobin (HbA1c) using paired Hests and for excessive calorie intake, consumption of calorie containing beverages, large or extra portions, excessive snacking, high calorically dense foods, poor food choices, limited calcium intake, excessive calcium intake, limited fruit/vegetable intake, limited fiber intake, skipped meals, limited physical activity, excessive screen time, low family motivation, low child motivation, low family receptiveness, and low child receptiveness using McNemar's test. There was no change in BMI or laboratory values except for ALT.
However, there were changes in behaviors. Consumption of calorie containing beverages, large or extra portions, excessive calcium intake, limited fiber intake, limited physical activity, and excessive screen time were significantly improved between initial and follow-up visits. An additional two behaviors, excessive calorie intake and excessive snacking, showed a trend toward change between the initial and follow-up visits. Long term use of these positive behaviors has been shown to reduce BMI and improve laboratory values. Although the HLC has shown some success, improvements that could be made. in the program given the confines oftime, space, and team members include instructing parents on positive reinforcement technique, setting time outlined goals, encouraging parental modeling, and the use of incentives.