Getting in the Game Boosts Health of Overweight Children, Stanford/Packard Study Shows
For Release: March 03, 2008STANFORD, Calif -- After-school sports can be a fun and rewarding way for a child to work off steam following a day behind a desk. But children who stand to benefit the most from the increased exercise - those who are struggling with their weight - often avoid organized teams.
Now researchers and physicians at Lucile Packard Children's Hospital and the Stanford University School of Medicine have found that creating teams composed exclusively of overweight children can slow their weight gain. The teams can also foster a newfound love of sports and physical activity that may launch them into a life of regular exercise.
"Obesity is a challenging problem in this country," said lead researcher and Packard Children's pediatrician Dana Weintraub, MD. "Just telling these kids they need to exercise more isn't enough. They need positive, supportive opportunities to do so."
Given an inch, the kids take - or is that run? - a mile. Weintraub and her colleagues found that many of the children who participated in a six-month, "overweight only" soccer program went on to join other "regular" school teams, from boxing to tennis to flag football and, of course, soccer. That's a marked turnaround considering the reluctance of some participants to take that first step out onto the field.
"Many of the kids who agreed to participate were hoping to be placed in the 'health-education' arm of the trial, either because they were unfamiliar with organized sports or they had had a negative experience on a team in the past," said Weintraub, a clinical instructor in pediatrics at the medical school. "We had to explain to them that the trial was randomized, and we couldn't control which group they would end up in."
The small pilot study was the first to investigate whether "overweight only" teams are a viable way to reduce weight gain. The trial pitted traditional classroom-based learning about nutrition and exercise - heavy on sitting and light on sweating - against active team participation that focused on building skills and positive reinforcement. The results will be published in the March 3 issue of the Archives of Pediatric and Adolescent Medicine.
The researchers devised the Stanford Sports to Prevent Obesity Randomized Trial, or SPORT, after becoming frustrated with the increasing numbers of obese, physically inactive children they were seeing in their clinics. Although the children and their families clearly realized that exercise is an important way to control or slow weight gain, they were unable to incorporate it into their daily lives.
Beginning in April 2005, Weintraub recruited 21 overweight fourth- and fifth-graders at Cesar Chavez Elementary School in East Palo Alto - a low-income community comprising mostly racial and ethnic minorities - to participate in the six-month study. The children all had body-mass indexes at or above the 85th percentile for their gender and age. Fourteen of the students had never before been on a sports team. They were randomly assigned to either a co-ed soccer team that met three days a week, or to a weekly health-education group that taught the importance of healthy nutrition and exercise.
Parents of the nine participants assigned to the soccer team reported that their children felt more confident, comfortable and safe when playing with children of similar weight. The kids reported having fun, making friends and - a first for many - enjoying the camaraderie of a team. All nine of the soccer players also reduced their age- and gender-adjusted body-mass index after six months on the team, but only five of the 12 health-education participants had done so. The soccer players were also significantly more physically active than the education-only group.
The results of the study suggest that after-school sports teams comprised of overweight children may be a relatively easy way to teach new habits, control weight gain and encourage a lifelong interest in sports participation. Weintraub and her colleagues are now conducting a larger SPORT trial of nearly 100 children in Bay Area schools. Soccer is particularly well-suited for a variety of reasons: it doesn't require a lot of equipment, it's easy to learn, it's very active even for beginners and it's extremely popular in diverse communities. Providing the team sports at schools is also important.
"SPORT allows us to help kids where they are: at school," said Weintraub. She emphasized that weight-control programs at hospitals or clinics can be difficult for low-income families without a car or flexible work schedules. "It keeps them occupied during a time of day when many students are snacking in front of the television or computer, and it instills confidence and a love of team sports. Every kid should have this opportunity."
Other Stanford co-authors include Evelyn Tirumalai, MPH, project coordinator and a social science research assistant; database manager and software developer Farish Haydel; data analyst Michelle Fujimoto, and Thomas Robinson, MD, director of Packard Children's Center for Healthy Weight and the Irving Schulman, MD, Endowed Professor in Child Health at the School of Medicine.
The study was supported under a cooperative agreement from the U.S. Centers for Disease Control and Prevention through the Association of American Medical Colleges.
Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.
Ranked as one of the nation's top 10 pediatric hospitals by U.S. News & World Report, Lucile Packard Children's Hospital at Stanford is a 272-bed hospital devoted to the care of children and expectant mothers. Providing pediatric and obstetric medical and surgical services and associated with the Stanford University School of Medicine, Packard Children's offers patients locally, regionally and nationally the full range of health care programs and services, from preventive and routine care to the diagnosis and treatment of serious illness and injury. For more information, visit http://www.lpch.org.
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