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The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial
Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands.
Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK ; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.ORCID iD: 0000-0002-3203-792X
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2019 (English)In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 14, no 11, article id e12556Article in journal (Refereed) Published
Abstract [en]

Background: Few studies have explored the influence of preschoolers' behavioural problems on obesity treatment.

Objectives: To assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status.

Method: The study included 77 children (4‐6 years old, 53% girls, mean body mass index [BMI] z‐score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z‐score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions.

Results: Child emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z‐scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z‐scores.

Conclusions: Child behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 14, no 11, article id e12556
Keywords [en]
ADHD, CBCL, CBCL/1.5‐5, Child Behavior Checklist, depression, family, parents
National Category
Nutrition and Dietetics Pediatrics
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-389360DOI: 10.1111/ijpo.12556ISI: 000494800900002OAI: oai:DiVA.org:uu-389360DiVA, id: diva2:1336725
Funder
Swedish Research Council, K2015-99X-22717-01-3Vinnova, 2011‐3443Sven Jerring FoundationSwedish Society of MedicineFredrik och Ingrid Thurings StiftelseMagnus Bergvall FoundationHelge Ax:son Johnsons stiftelse Available from: 2019-07-10 Created: 2019-07-10 Last updated: 2019-11-27Bibliographically approved

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Sandvik, PernillaSomaraki, MariaNowicka, Paulina

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