“Sacbe”, a Comprehensive Intervention to Decrease Body Mass Index in Children with Adiposity: A Pilot Study

Abstract

Interventions in children with adiposity decrease less than 0.2 the body mass index (BMI) z-score less than 0.2 and only in 21–23% of cases. Experts recommend focusing on the habits of a healthy lifestyle (HLS) but considering the sociocultural context of children and their parents. Our objective was to achieve a higher percentage of success in lowering the BMI z-score in children with adiposity and their parents through a pilot program “Sacbe” based on HLS, sensitive to the sociocultural context previously explored and with the active participation of parents. This is a pilot study in children aged 8 to 18 years with adiposity according to the BMI z-score. The program consisted of two workshops on HLS and nutrition given by the pediatric endocrinologist in group sessions with 3–5 families and reinforcements in each visit by registered dietitians. We recorded lifestyle habits and anthropometric characteristics of children and their parents at the baseline visit and every month for 3–4 months. Forty-nine families, 55 children and 64 parents participated, 60% of the children were female, the average age was 13.95 ± 3.3 years, 72.7% and 86.7% lowered the z score of the BMI due to intention to treat and protocol analysis (p < 0.001), respectively; BMI z-score decreased by 0.22 ± 0.21, from 2.13 ± 0.57 to 1.91 ± 0.58 (p < 0.001). In total, 83% of the parents involved were mothers, the average age was 45.8 ± 9.4 years, 77% lost weight and body fat (p < 0.001), the frequency of unhealthy habits decreased. The results of “Sacbe” exceeded expectations by combining the active participation of parents, sessions in groups, and the education on various components of an HLS inside sociocultural context. The main challenge will be to standardize and reproduce this type of complex interventions, as well as to assure long-term success.

Nutritional Management in Childhood Obesity

“…Most of the studies showed decreased BMI z-scores of obese children and adolescents after 6 weeks to 6 months for each of the intervention studies. Theme-based nutritional sessions, involving portion size and food groups,51 feelings of hunger and satisfaction,52 nutrition counseling and phone calls,53 nutrition education group sessions and leaflets for caregivers,54 healthful and balanced diet with fruits and vegetables,55 and healthy beverage intake and increased consumption of fruits, nuts, legumes, vegetables, fish, and dairy products50 were implemented in childhood obesity intervention studies (data not shown).…”

Interventions to Prevent Obesity in Mexican Children and Adolescents: Systematic Review

“…All the studies targeted and included both males and female participants. Most of the studies (89.6%) were delivered in school settings, two (Martínez-Andrade et al, 2014;Rodriguez-Ventura et al, 2018) in public clinics, and one (Zacarías et al, 2019) in a community setting. One study (Martinez-Andrade et al, 2014) was delivered among a preschool population, 22 studies among a school-age population (6-12 years), and six among adolescents (13-18 years).…”

“…Overall, significant improvements in dietary lifestyles were reported in these studies. Rodriguez-Ventura et al (2018) reported that the frequency of unhealthy dietary patterns decreased, but only some (e.g., eating more fruits and vegetables and breakfast consumption) were significant (p < 0.05). Elizondo-Montemayor et al…”

“…2 Map from the origin of the included interventions Carrete, 2018;Cruz-Bello et al, 2019;Elizondo-Montemayor et al, 2014;Perichart-Perera et al, 2008;Polo-Oteyza et al, 2017;Vazquez et al, 2017). But some studies (5/13) reported significant reductions in BMI (Rodriguez-Ventura et al, 2018;Saucedo-Molina et al, 2018;Zacarias et al, 2019) or obesity prevalence (Balas-Nakash et al, 2010;Rios-Cortazar et al, 2013). Caballero-Garcia et al (2017) was the only multi-site study (carried out in four different states of Mexico) and found that anthropometric changes varied depending on the site.…”

What to Do about Childhood Obesity?

“…The authors’ approach may serve as a model for further research efforts in health promotion in complex systems. Rodriguez-Ventura et al studied a pilot program focusing on healthy lifestyle which considered the socio-cultural context of the participants and their parents [22]. The program involved group sessions and active parent participation.…”