Abstract
Factors associated with change in percent body fat (%BF) of children in pediatric weight management (PWM) care may differ from those associated with change in weight status. Objective: To describe %BF and weight status at initial visits to 14 PWM sites, identify differences by sex, and evaluate factors associated with change over 6 months. Methods: Initial visits of 2496 males and 2821 females aged 5–18 years were evaluated. %BF was measured using bioelectrical impedance analysis. Results: Sex-specific logistic regressions [806 males (32.3%), 837 females (29.7%)] identified associations with primary outcomes: lower %BF and metabolically impactful ‡5-point drop in percent of the 95th BMI percentile (%BMIp95) over 6 months. At the initial visit, males had lower %BF and higher %BMIp95 than females. Over 6 months, males had significantly (p < 0.001) greater median drop in %BF (-1.4% vs. -0.4%) and %BMIp95 (-3.0% vs. -1.9%) and a higher frequency of decreased %BF (68.9% vs. 57.8%), but similar percentage with ‡5-point %BMIp95 drop (36.5% vs. 32.4%; p = 0.080). For males, factors significantly associated with decreased %BF (older age, ‡6 visits, lack of developmental or depression/anxiety concerns) were not related to having a ‡5-point %BMIp95 drop. For females, lack of depression/anxiety concern was significantly associated with decreased %BF but was not associated with ‡5-point %BMIp95 drop. Conclusions: There are differences by sex in initial visit %BF and %BMIp95 and in characteristics associated with changes in these measures. PWM interventions should consider evaluating body composition and sex-stratifying outcomes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 50-64 |
| Number of pages | 15 |
| Journal | Childhood Obesity |
| Volume | 21 |
| Issue number | 1 |
| DOIs | |
| State | Accepted/In press - 2024 |
Funding
The authors are grateful to the many patients and family members who participate in POWER and for the many care providers who have contributed data to POWER. Abraham-Pratt I., Fals A. Florida Hospital for Children (Orlando, FL); Armstrong S. Duke Children\u2019s Hospital and Health Center (Durham, NC); Binns H., Ariza A. Ann & Robert H. Lurie Children\u2019s Hospital of Chicago (Chicago, IL); Christison A. University of Illinois College of Medicine (Peoria, IL); Cuda S., Children\u2019s Hospital of San Antonio (San Antonio, TX); de Heer D. Fit Kids of Arizona at Northern Arizona Healthcare (Flagstaff, AZ); de la Torre A., Cook Children\u2019s Medical Center (Fort Worth, TX); Fox C, Kelly A. University of Minnesota Masonic Children\u2019s Hospital (Minneapolis, MN); Gaddis M., Mutchie J., Peterson S. St. Luke\u2019s Children\u2019s Hospital (Boise, ID); Gordan C., Dedekian M. Barbara Bush Children\u2019s Hospital at Maine Medical Center (Portland, ME); Hendrix S., Ward W. Arkansas Children\u2019s Hospital (Little Rock, AR); Herring W. University of Mississippi Medical Center (Jackson, MS); Hes D. Gramercy Pediatrics (New York City, NY); Iqbal A. Marshfield Clinic Health Systems (Marshfield, WI); Jenkins L. Dell Children\u2019s Medical Center (Austin, TX); Joseph M. University of Florida Health at Wolfson Children\u2019s Hospital (Jacksonville, FL); Kim R. Cleveland Clinic Children\u2019s (Cleveland, OH); Kirk S. Cincinnati Children\u2019s Hospital Medical Center (Cincinnati, OH); Kumar S. Mayo Clinic Rochester (Rochester, MN); Lamiaa A, Hendrix A. University of Oklahoma, Early Lifestyle Intervention Clinic (Tulsa, OK); Liu L., Grow M. Seattle Children\u2019s Hospital (Seattle, WA); McClure A., Hofley M. Children\u2019s Hospital at Dartmouth-Hitchcock (Lebanon, NH); Naramore S. Riley Hospital for Children at UI Health (Indianapolis, IN); Negrete S, Dalen J. University of New Mexico Children\u2019s Hospital (Albuquerque, NM); Novick M., Williams R. Penn State Children\u2019s Hospital (Hershey, PA); Oden J., Kim R., Gupta O. Children\u2019s Medical Center\u2014UT Southwestern Medical Center (Dallas, TX); Ohara V. Eastern Maine Medical Center (Bangor, ME); Radulescu A. Kentucky Children\u2019s Hospital, UK Health Care (Lexington, KY); Safder S., Ross M. Arnold Palmer Hospital Center for Digestive Health and Nutrition (Orlando, FL); Santos M., Trapp C., Boyle K. Connecticut Children\u2019s Medical Center (Hartford, CT); Stoll J.M. St. Louis Children\u2019s Hospital (St. Louis, MO); Stratbucker W., Tucker J. Helen DeVos Children\u2019s Hospital (Grand Rapids, MI); Sweeney B. Children\u2019s Mercy Kansas City (Kansas City, MO); Tester J. Children\u2019s Hospital Oakland (Oakland, CA); Turner L. Children\u2019s Hospital and Medical Center, Omaha (Omaha, NE); Vidmar A., Borzutzky C., Fink C.\u2014Children\u2019s Hospital of Los Angeles (Los Angeles, CA); Wallace S. UAB Pediatrics/Children\u2019s of Alabama (Birmingham, AL); Walsh S. Children\u2019s Hospital of Atlanta (Atlanta, GA); Weedn A. University of Oklahoma Health Sciences Center (Oklahoma City, OK); Wittcopp C. Baystate Children\u2019s Hospital (Springfield, MA); Woolford S. C.S. Mott Children\u2019s Hospital (Ann Arbor, MI); and Yee J., Perez De La Garza G., Grace B. Harbor UCLA Medical Center (Torrance, CA).
Keywords
- bioelectrical impedance
- body composition
- body mass index
- children
- fat mass
- fat-free mass
- obesity treatment
- youth
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Endocrinology, Diabetes and Metabolism
- Nutrition and Dietetics
