Intervenção Multidisciplinar E Motivacional Para Tratamento De Adolescentes Obesos Brasileiros De Baixa Renda: Estudo Piloto

Abstract

Objective: To test a multidisciplinary and motivational intervention for the treatment of Brazilian obese and low-income adolescents (Z score>2 BMI-for-age) that used nutritional counseling without dietary control. Methods: An intervention protocol was developed including periodical nutritional education workshops, individual nutritional counseling guided by the stages of eating behavior of the Trans Theoretical Model of Behavior Change, physical exercise, psychological counseling, recreational activities, and clinical follow-up for 13 months in a sample of 21 adolescents (11-17 years old). Results: The rate of treatment withdrawal (9.5%) was lower than that seen in dietary control studies (30-60%). Initially, 70% of the sample was in the pre-contemplation behavior stage and, in the end, 100% of the remaining adolescents were in the stages of action or maintenance. There was a mean reduction in BMI-for-age (p=0.038) and visceral fat (M±SD=3.67±1.19 and 2.78±0.78 cm, p=0.02, initial and final, respectively). The percentage of fat mass decreased and that of lean mass increased (42±5 and 38±8, p=0.04, 58±6 and 61±8%, p=0.03, respectively).Conclusions: The intervention seems to be effective in generating a lifestyle change, accompanied by anthropometric profile and body composition improvement. The intervention protocol may offer easy adaptation and low-cost methodology for health services, with high adherence and low abandonment rates.

Transtheoretical model-based nutritional interventions in adolescents: a systematic review

“…Both of these articles were analyzed with the other studies on the same 6 intervention [25,27]. After the updated search, two more papers were included [29,30], totaling 15 articles and 12 interventions. All but one of the studies received funding, although this was not considered a potential added bias.…”

“…Four articles were classified as weak [16,18,24,30], five as moderate [17,21,23,26,29] and three as strong [19,24,27]. Most of the studies were rated as weak due to having a non-representative sample [16,18,24,30] and because blinding was not mentioned in the paper [16,24].…”

“…One study recruited adolescents from youth service agencies [19,20], another recruited adolescents in search of nutritional treatment [29] and a third recruited adolescents through digital media, radio and television [30]. The remaining studies recruited adolescents from schools [16,17,18,21,22,23,24,25,26].…”

“…The other studies included adolescents between twelve and nineteen years old. The majority of the studies targeted low-income populations [17,18,19,21,22,23,24,29], with three focusing on middle-income adolescents [16,25,26], one on African Americans [19] and two exclusively on girls [17,26]. Four studies focused on obese adolescents [21,26,29,30].…”

“…The sample sizes varied from 21 to 4158 participants. A total of seven randomized controlled trials [16,17,21,22,24,25,30] and five quasi-experimental studies [18,19,23,26,29] were included. All but four of the studies had two follow-up measurements, [16,21,25,29].…”