OBJECTIVE: To determine if beneficial effects of a weight-management program could be sustained for up to 24 months in a randomized trial in an ethnically diverse obese population. PATIENTS AND METHODS: There were 209 obese children (BMI > 95th percentile), ages 8 to 16 of mixed ethnic backgrounds randomly assigned to the intensive lifestyle intervention or clinic control group. The control group received counseling every 6 months, and the intervention group received a family-based program, which included exercise, nutrition, and behavior modification. Lifestyle intervention sessions occurred twice weekly for the first 6 months, then twice monthly for the second 6 months; for the last 12 months there was no active intervention. There were 174 children who completed the 12 months of the randomized trial. Follow-up data were available for 76 of these children at 24 months. There were no statistical differences in dropout rates among ethnic groups or in any other aspects. RESULTS: Treatment effect was sustained at 24 months in the intervention versus control group for BMI z score (-0.16 [95% confidence interval: -0.23 to -0.09]), BMI (-2.8 kg/m(2) [95% confidence interval: -4.0-1.6 kg/m(2)]), percent body fat (-4.2% [95% confidence interval: -6.4% to -2.0%]), total body fat mass (-5.8 kg [95% confidence interval: -9.1 kg to -2.6 kg]), total cholesterol (-13.0 mg/dL [95% confidence interval: -21.7 mg/dL to -4.2 mg/dL]), low-density lipoprotein cholesterol (-10.4 mg/dL [95% confidence interval: -18.3 mg/dL to -2.4 mg/dL]), and homeostasis model assessment of insulin resistance (-2.05 [95% confidence interval: -2.48 to -1.75]). CONCLUSIONS: This study, unprecedented because of the high degree of obesity and ethnically diverse backgrounds of children, reveals that benefits of an intensive lifestyle program can be sustained 12 months after completing the active intervention phase.
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机译：目的：确定一项体重控制计划的有益效果是否可以在针对不同种族的肥胖人群的一项随机试验中持续长达24个月。患者与方法：209名肥胖儿童（BMI> 95％），混合种族背景的8至16岁年龄段，被随机分配到强化生活方式干预或临床对照组。对照组每6个月接受一次咨询，干预组接受一项基于家庭的计划，其中包括运动，营养和行为改变。在最初的6个月中，每周两次进行生活方式干预会议，然后在接下来的6个月中，每月两次。在过去的12个月中，没有进行积极的干预。有174名儿童完成了为期12个月的随机试验。在24个月时有76名儿童的随访数据。各族裔之间或其他任何方面的辍学率均无统计学差异。结果：干预组与对照组的BMI z评分（-0.16 [95％置信区间：-0.23至-0.09]），BMI（-2.8 kg / m（2）[95％可信度]在治疗24个月时均保持治疗效果间隔：-4.0-1.6 kg / m（2）]），体脂百分比（-4.2％[95％置信区间：-6.4％至-2.0％]），总体脂质量（-5.8 kg [95％置信度]间隔：-9.1 kg至-2.6 kg]，总胆固醇（-13.0 mg / dL [95％置信区间：-21.7 mg / dL至-4.2 mg / dL]），低密度脂蛋白胆固醇（-10.4 mg / d dL [95％置信区间：-18.3 mg / dL至-2.4 mg / dL]）和胰岛素抵抗稳态模型评估（-2.05 [95％置信区间：-2.48至-1.75]）。结论：由于肥胖程度高和儿童种族背景不同，这项研究是空前的。该研究表明，密集的生活方式计划的好处可以在完成积极干预阶段后的12个月内得以维持。
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