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Intervention improved weight loss, maintenance in adolescents
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At long-term follow-up, a higher percentage of children in the Motivating Adolescents with Technology to Choose Health, or MATCH, intervention demonstrated weight reduction from overweight to a healthy weight or maintained weight loss vs. those in an age-matched comparison group.
East Carolina University researchers compared participants in MATCH — a single-site, pre- and post-intervention cohort study — with a representative cohort of children of similar age.
The MATCH intervention, which was conducted at a rural middle school with high obesity rates, was designed to merge health, nutrition, exercise and technology curriculum with the North Carolina Standard Course of Study for seventh-grade students.
The current study evaluated 4- and 5-year data on 106 participants in MATCH (54% retention rate from 195 baseline participants; 82% still at the school). This cohort was compared with data gleaned from 600 participants in the 2006 Child Survey and 2010 Child and Young Adult Surveys obtained from the National Longitudinal Survey of Youth 1979.
Children in the MATCH intervention group participated in daily physical activity measured with pedometers, self-monitoring of daily activity, food intake chronicling and analysis, self-evaluation of health behaviors, incentives for achieving goals, peer accountability contracts and more. The comparison group was a representative sample of weight changes without MATCH intervention.
The study’s outcome measures were defined as pre- and post-intervention changes in weight category, BMI, BMI z score, BMI percentile for sex and age, and BMI rates of change per month.
The researchers found that, at follow-up, there was a significant difference in percent overweight change between groups, with the MATCH group showing a percent decrease (from 20% to 12%) and the comparison group reflecting a percent increase (from 17% to 19%) In general, the MATCH group showed significantly greater decrease rates in BMI z scores (P=.002) and BMI percentiles (P=.001) than the comparison group. Moreover, of the adolescents determined to have a healthy baseline weight, 2% from the MATCH group became overweight at 5-year follow-up, whereas 13% of the comparison group became overweight or obese (P=.02) at 4-year follow-up.
The researchers said the MATCH intervention has now been expanded to 13 schools in North Carolina and four in South Carolina.
“Using a school-based model such as MATCH holds promise because once core educational elements and activities are identified, if adopted, they have the potential to reach substantial numbers of youth and prevent development of obesity,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Caroline M. Apovian, MD
Very few interventions in childhood have seen dramatic results in terms of decreasing BMI or certainly intervened enough to turn an overweight child into a child of normal weight for height. This study suffers from a few methodological issues such as low retention rate of 54% and small sample size starting with 195 children at baseline. However, an intervention that was school-based requiring no extra staffing for a low-income neighborhood school in rural North Carolina showed that in a high risk for obesity setting, a significant long-term change in BMI z score was seen in the intervention group. The intervention was a 14-week lesson-based program (MATCH) imbedded in standard curricula with daily physical activity and some self-evaluations of physical activity and diet plus some tools such as pedometers given to the seventh-graders. Summarizing the intervention and outcome, a 55 contact-hour low-cost program given over 14 to 16 weeks to reach rural underprivileged minority youth resulted in a positive decrease in those with overweight compared with control group at long-term follow-up. Whereas the percent overweight in the intervention group decreased from 20% to 12%, in the comparison group it increased from 17% to 19%. A program such as MATCH — due to its low cost and sustainability — has the potential to be a model for other communities and schools in high-risk areas of the country to prevent the development of obesity in children.
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