Objective: The aim of the study was to compare the efficacy of group treatment stressing a health-promoting lifestyle with routine counseling in the treatment of childhood obesity. Design and subjects: Seventy obese children (weight for height 115-182%) aged 7-9 years were randomized either to routine counseling (two appointments for children) or to family-based group treatment (15 separate sessions for parents and children). These sessions included nutrition education, physical activity education and behavioral therapy. Outcome measures: Children's weights and heights were measured at baseline, after the 6-month intervention and after the 6-month follow-up. The change of weight for height based on Finnish growth charts was used as the primary, and changes in body mass index (BMI) and BMI standard deviation scores (BMI-SDS) as secondary outcome measures. Results: Children attending the group treatment lost more weight for height (6.8%) than children receiving routine counseling (1.8%) (P ¼ 0.001). The difference was significant when the data were analyzed in four groups by the cut-off limits of 0, À5 and À10% for the change in weight for height. The respective decreases in BMI were 0.8 vs 0.0 (P ¼ 0.003) and in BMI-SDS 0.3 vs 0.2 (P ¼ 0.022). The results remained similar in adjusted analyses. Both group and routine programs were feasible with a high, 87-99%, participation rate in sessions and appointments and very low, 3% or less, attrition rate from the programs. Six months after the intervention, beneficial effects were partly lost, but for changes in weight for height and BMI, the differences between the two treatment programs still were significant, and for BMI-SDS, there was a trend. Conclusions: Family-based group treatment that stresses a health-promoting lifestyle and is given separately for parents and children, offers an effective mode of therapy to treat obese school-aged children.

Family-based group treatment is more costly compared with individual routine counseling. Salaries form most of the total costs.

Objective: We investigated the long-term efficacy of two childhood obesity treatment programs, routine counselling (two appointments for children) and group treatment (15 sessions separately for children and parents) in a randomised controlled trial. As published earlier, group treatment was more effective than routine counselling in the treatment of 7-9 year-old obese children in the short term. Design: The children's heights and weights were measured 2 and 3 years after the beginning of the intervention and changes in weight for height, body mass index (BMI) and BMI standard deviation scores were used as outcome measures. Results: There were no significant differences between the treatment arms in the changes of outcome measures from baseline to 2-or 3-years follow-up visits. Conclusion: In conclusion, novel efforts are needed for the improvement of the long-term results of childhood obesity treatment programs.

Obesity-related metabolic risk factors reduced in prepubertal children if BMI-SDS decreased substantially. This result was not dependent on which intervention, family-oriented group program or routine counselling, was used.

Viikari, J., h e r b l o m , H. K., Rasiinen, L., Kalavainen, M. and Pietarinen, 0. ). Cardiovascular risk of Young Finns. Exoeriences from the Finnish multicentre -study regarding the prevention of coronary heart disease. Acta Paediatr Scand Suppl365: 13, 1990.A large multicentre study of coronary heart disease risk factors and their determinants in children and adolescents was planned in the late 1970s. The main cross-sectional study with 3596 subjects was made in 1980, and two follow-up studies have been carried out, in 1983 and 1986, respectively. In addition, a study with 630 newborns was carried out in 1981, and a series of children aged 1 to 36 months was collected in 1981-1982. Cord blood, serum cholesterol was about 1.5 mmoVI, which is no different from the level found in other studies. The diet of mothers had no effect on the cholesterol values of the newborns. The cholesterol level of infants and small children was correlated with the amount and quality of fat eaten. The dietary habits of the family were correlated with the family's standard of education, which calls for intervention measures already in early childhood. Serum cholesterol levels have decreased in Finnish children during the 1980s by about 1 % per year, which should be reflected in coronary heart disease morbidity and mortality in the future.