The effectiveness of a stage-based lifestyle modification intervention for obese children

Nor Baizura Md Yusop, Zalilah Mohd Shariff, Ting Tzer Hwu, Ruzita Abd Talib, Nicola Spurrier

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    Background: Interventions that encompass behavioural modifications of dietary intake and physical activity are essential for the management of obesity in children. This study assessed the effectiveness of a stage-based lifestyle modification intervention for obese children. 

    Methods: A total of 50 obese children (7-11 years old) were randomized to the intervention group (IG, n = 25) or the control group (CG, n = 25). Data were collected at baseline, at follow-up (every month) and at six months after the end of the intervention. IG received stage-based lifestyle modification intervention based on the Nutrition Practice Guideline for the Management of Childhood Obesity, while CG received standard treatment. Changes in body composition, physical activity and dietary intake were examined in both the intervention and control groups. 

    Results: Both groups had significant increases in weight (IG: 1.5 ± 0.5 kg; CG: 3.9 ± 0.6 kg) (p < 0.01) and waist circumference (IG: 0.1 ± 0.5 cm; CG: 2.2 ± 0.7 cm) (p < 0.05), but the increases were significantly higher in CG than IG. Body Mass Index (BMI)-for-age z scores decreased significantly in IG (- 0.2 ± 0.0, p < 0.01) but not in CG. The physical activity of the IG significantly increased (0.44 ± 0.13) compared with that of CG (- 0.28 ± 0.18), and the difference in mean change between groups was statistically significant (p < 0.05). Dietary intake was not significantly different between the two groups. However, calorie and carbohydrate intake decreased significantly in both groups. 

    Conclusions: A stage-based intervention that modified dietary and physical activity behaviour may be effective in weight management for obese children. 

    Trial registration: NCT03429699 retrospectively registered 9 February 2018.

    Original languageEnglish
    Article number299
    Number of pages10
    JournalBMC Public Health
    Publication statusPublished - 1 Mar 2018

    Bibliographical note

    Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


    • Body composition
    • Dietary intake
    • Lifestyle intervention
    • Obese children
    • Physical activity


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