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P228 „the importance of the family physician in the treatment of childhood obesity’
  1. Carmen-Adriana Dogaru
  1. Assistant professor at the department of family medicine – University of Medicine and Pharmacy (UMF) Craiova, Romania
  2. Abstract thematic category: Clinical research

Abstract

Background and aims Childhood obesity is a chronic nutrition disorder, pandemic and with multiple short-term implications and more severe long-term consequences on the health, quality of life and life expectancy of the future adult. The aim of the research was to demonstrate that, if family physicians apply a protocol adapted to the patient‘s needs upon the obese children in their record, they will obtain significant results in the future adult.

Methods In the course of the clinical research undergone at my clinic, I used the single-blind technique with longitudinal design, in a controlled clinical trial, and I analysed a single dependent variable: the body mass index (BMI). The independent variable is represented by the intervention at an educational level, referring to the items employed in the changing of the hygienic-dietary behaviour and lifestyle optimisation.

The study was conducted in 3 stages:

  • 1. a retrospecive part;

  • 2. the moment of introspection according to protocol;

  • 3. a prospective part.

The protocol applied, according to WHO:

  • limit energy intake from total fats and sugars;

  • increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts;

  • engage in regular physical activity (60 min a day for children).

Results

  • The impact of the educational activity was very important, all the children in the test group having lost weight significantly.

  • The children that did not benefit from the intervention have modified their weight negatively during the course of the study.

ResultsCarrying out Fisher’s exact test, which verifies the dependency of two factors, I obtained a value of p≈0, much smaller than the<0001 threshold which indicates a high statistic significance in the dependency relation of the analysed variables, in this case the application of the WHO protocol and the reduction of the body mass index (BMI).

This fact is supported by the Odds ratio (OR), 62.23, chiefly by the OR’s confidence interval (13.358–318.721) which does not contain the value 1, showing their connexion, by the value of the Relative risk (RR) 7.023, and by the confidence interval of the RR (1.438–34.307), which, once more, does not contain the value 1 (the value 1 shows the independence of the two factors, hence the lack of a connexion). I objectified the BMI modifications that occurred after the intervention by comparing the procentual BMI reductions recorded between the initial and the final visits of the subjects in the test group and the witness group. For this, I calculated the difference between the final BMI and the initial BMI, referencing the results to the initial BMI. Comparing the means of the BMI modifications for the two groups, I identified a highly significant statistical difference, p=2,19x10-24≈0, hence<0001.

ConclutionS 1. The intervention activity, following the stages of the protocol established by the World Health Organisation, which has the goal of modifying the unhealthy lifestyle and the maintenance of this change, applied at the level of the Family Physician’s clinic, has significant results, leading to a weight normalisation inthe case of the children to which it is applied.

2. It is necessary that the intervention activity is dedicated more time and a greater importance, since important results can be achieved at minimum expense.

3. Family physicians, who are the first link in indentifying childhood obesity, can play an important role in the management of this disorder, provided that they are encouraged to do so.

BIBLIOGRAPHY 1. WHO:http://www.who.int/mediacentre/factsheets/fs311/en/

2. Cygan, H.R., Baldwin K., et.alt., Six to Success: Improving Primary Care Management of paediatric Overweight and Obesity, Journal of paediatric Health Care.2014;28(5):429-437;

3. Tanda, R., Salsberry, P., The Impact of the 2007 Expert Committee Recommendations on Childhood Obesity Preventive Care in Primary Care Settings in the United States, Journal of Paediatric Health Care. 2014;28(3):241-250;

4. Popa, I., Brega1, D. – Obezitatea la copil śi adolescent - Revista medicală română – vol. LVI, nr. 3, an 2009, pag.197-20119. Moreno LA, Pigeot I, Ahrens W, eds. Epidemiology of obesity in children and adolescents – prevalence and aetiology. New York, USA: Springer Publisher, 2011;

5. De Henauw S, Verbestel V, Marild S, et al., on behalf of the IDEFICS consortium. The IDEFICS Community-Oriented Intervention Program. A new model for childhood obesity prevention in Europe? Int J Obes (Lond)2011; 35(Suppl. 1): pag. 16-23.

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