Encouraging and counselling minority families in the United States to adopt
healthier household routines led to a small decrease in children's weight, in a
Researchers found that encouraging families to eat meals
together, limit TV time and get better sleep was linked to about half a kilo
drop in kids' weight, relative to children in homes that didn't receive the
encouragement and counselling.
"I can tell a family, 'You really need to get more
physical activity' and the conversation can end there," Dr Elsie Taveras,
the study's senior author from Massachusetts General Hospital for Children in
Boston, said. But, she added, "I think that the ability to go deeper and talk
about their routines is key." Previous research has found certain
household routines such as eating meals as a family and only spending a couple
of hours in front of a TV each day are linked to a reduced risk of children
It's also known that children in minority and low-income
families are more likely to be overweight and obese than white children from
wealthier families. For the new study, Taveras and her colleagues randomly
assigned 121 families with children between age two and five, who were
predominantly black and Latino, to receive usual care or the counselling programme.
The 62 families
assigned to the counselling group received four home visits and four phone calls
from health educators, educational materials mailed to the home and weekly text
messages about adopting healthy household routines. None of the counselling, however,
specifically mentioned obesity or reducing children's weight.
The 59 families randomised to the usual care group received
educational materials, such as colouring books, in the mail. The materials
didn't address the household routines, but focused on children reaching certain
After 6 months, the researchers found children in the
counselling group were sleeping almost an hour longer than children assigned to
the usual care group. Kids in the counselling group also reduced their TV
viewing by about one hour per day over weekends.
There was no change in the number of meals the children
shared with their families, but Taveras said many of the children were already
eating family meals at the beginning of the study.
The researchers did find that kids in the usual care group
had a small increase in body mass index (BMI) a measurement of weight in
relation to height and those in the counselling group had a slight decrease in
BMI. The difference was equivalent to about half a kilo. "Relative to the
control group it was a small decrease, but not insignificant in a six-month
period in growing children," Taveras said.
Feasible and successful
Despite the study's limitations – such as the small change
in BMI, uncertainty about whether the change will last and the small number of
families that participated – Indiana University School of Medicine's Dr Aaron
Carroll writes in an editorial accompanying it in JAMA Pediatrics that the
approach is feasible and successful.
"I'm encouraged anytime we find something that takes what
we know, shows it works and that it's feasible," Dr Shari Barkin, director
of paediatric obesity research at Vanderbilt University School of Medicine in
Nashville, told Reuters Health.
"It's not that
each of these things are new. What's different is trying to come up with the
intervention that reaches out to families in the context of the home,"
Barkin, who was not involved with the study, said.
Taveras told Reuters Health her team plans on looking at the
costs of the programme and hopes to develop a longer study in future. Barkin
said it is important to know whether the change in BMI among the counselling
group is sustainable over time.