Modest caloric and exercise changes improve weight control

Small lifestyle changes can make a major difference in childhood weight gain. Adding as few as 2,000 steps to daily activity and reducing daily food intake by 100 calories through a family intervention program can significantly reduce body mass index in children and limit weight gain.

"These are very small changes that seem almost insignificant, but they produce a major impact on children's health status," said lead author Susan Rodearmel, EdD, Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver. "What we have shown is that the whole family can make some minor changes in activity and nutrition and have a significant impact on children's weight. Pediatricians can have a real impact in getting that message across to families. You don't have to run marathons or go on serious diets to affect weight gain, you can do a couple of little things and see positive results in a short period."

The single-blind study assigned 216 families with at least one overweight child based on body mass index to one of two groups. The intervention group created a family plan, based on existing America on the Move programs, designed to increase physical activity by 2,000 steps daily. Families also targeted a reduction of 100 calories per day, primarily by substituting artificial sweetener for dietary sugar. Control families maintained their normal activity level and diet.

Both groups used step counters to monitor physical activity and detailed food diaries to assess caloric intake.

After six months, over half the children in both groups showed a statistically significant decrease in mean body mass index. But the intervention group showed significantly better progress, with children in 67.4% of families maintaining or losing weight compared to 52.7% in the control group. The intervention group also had a lower proportion of children gaining weight, 32.6%, compared to 47.2% in the control group.

The study used SPLENDA brand artificial sweetener and was funded by in part by McNeil Nutritionals. Any 100-calorie reduction in daily intake would be equally beneficial, Dr. Rodearmel said. An artificial sweetener may be particularly useful because it allows children to continue a familiar diet without eliminating sweet foods to which they have become accustomed.

"It is vital to intervene early," she said. "A full 33%, 34% of our kids are already classed as overweight. They are mimicking the trends in the adult world. If we don't correct this early, they are setting themselves up for even worse problems as adults."