Effects of a 12‐Week Lifestyle Intervention in a Mixed Sample of Rural Youth With Obesity
Authors: Johnson Kelsey , Nicoara Daniel , Sorrells Robert , Yi‐Frazier Joyce P. , Early Kathaleen Briggs 
Published: November 2023

Background

Youth nutrition intervention research is lacking in rural and medically underserved regions. Actively Changing Together (ACT) is an evidence based obesity intervention program designed for overweight and obese youth and their families. Yakima, WA was used as a model for a medically underserved, rural population with high rates of obesity. The objective of this work was to examine the short and long term changes in nutritional habits, BMI and waist circumference following the ACT lifestyle intervention program.

Methods

Youth (n=68) 8–14 years old with BMI‐for‐age ≥85th%tile were referred to the program by local primary care providers. The intervention was designed for both English or Spanish speakers, and delivered over 12 weeks. Small‐groups of 10–15 youth and their parents met for 90‐min. weekly sessions at the local YMCA. The sessions addressed nutrition, physical exercise, and problem solving. Anthropometrics (weight (WT), height (HT), waist circumference (WC), Body Mass Index (BMI), and body fat (BF) percentage) and nutrition intake were measured (via Block Food Screener) at baseline and immediately following the intervention (3M), and again at 6‐ (6M) and 12‐months (12M) after the intervention concluded. SPSS 24.0 was used for descriptive and comparative analyses.

Results

Sixty‐eight participants (54.4% male, 45.6% female; 10.8 years [±1.67]) were recruited. Baseline data revealed mean weight 149.8 lbs (±34.6); WC: 37.4 inches (±4.85); BMI: 29.4 kg/m2 (±5.32); and BF: 27.5 percent (±9.89). Complete data were available from n=21 (30%) participants to 12 months after the end of intervention. Participants significantly increased in WT from baseline to 6M: 151.1 (±35.8), p<0.000; and 12M: (±5.32), p<0.00. Significant differences were noted in WC from baseline to 12M: 39.2 inches (±5.71), p=0.001 and from 3M: 37.0 inches (±4.63) to 6M: 38.4 inches (±5.14), p=0.003 and 12M, p=0.003, respectively. Significant differences were noted in BMI from baseline to 12M: 29.4 kg/m2 (±5.32), p=0.04 and from 3M: 29.05 kg/m2 (±5.4) to 12M, p=0.001 and 6M: 29.3 kg/m2 (±5.32) to 12M, p=0.008, respectively. No significant differences were noted in BF from baseline to 3M, 6M, and 12M, respectively. There was a significant (p=0.038) strong negative (r=−0.836) correlation in soda consumption and WT at 12M. No significant correlations were revealed between fruit and vegetable consumption and WT.

Conclusions

In this sample of rural youth with obesity, this 12‐week lifestyle intervention resulted in reductions in soda consumption up to 1 year after the intervention concluded. The reduction in soda consumption is an encouraging indication that ACT produces long‐term modifications in nutrition choices. Body weight and BMI increased during the follow up period, most likely due to the expected growth of both male and female youth enrolled during this high‐growth time of life, but waist circumference significantly declined. It is also encouraging that body fat did not increase despite the increase in body weight. Further work will be done to determine if specific types of eating patterns were predictive of anthropometric changes.

Support or Funding Information

The Safeway Foundation