The Effect of Motivational Interviewing and Healthy Diet on Anthropometric Indices and Blood Pressure in Overweight and Obese School Children

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Health Science in Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Counseling, School of Education and Psychology, University of Isfahan, Isfahan, Iran

4 Instructor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The prevalence of children obesity is increasing all over the world. Healthy diet is one of the interventions for obesity treatment. Behavioral therapy approaches can affect child’s food behaviors. One of these approaches is motivational interviewing.Methods: This study was a paralleled randomized clinical trial. 96 children were randomly allocated to 3 groups: first group, diet and motivational interview, second group, diet, and the third one, control. Participants were under intervention for 8 weeks. Anthropometric indecies and blood pressure were measured at baseline and at the end of the intervention. To make sure about the maintenance of intervention effects, participates were assessed 3 month later again. Adherence to diet was assessed by measuring healthy eating index.Findings: The mean body mass index (BMI) and waist circumference (WC) in first (P < 0.001) and second (P = 0.001) groups decreased after intervention, but this difference were not significant in control group. In first group, this reduction was more than the second group. The mean blood pressure had no significant difference between the 3 groups. The mean healthy eating index was higher in first group than the second group. There was an inverse relation between healthy eating index with body mass index and waist circumference (P = 0.001).Conclusion: Healthy diet can reduce mean body mass index and waist circumference in overweight and obese children. Using diet therapy with motivational interview increases this effect and also the adherence to diet.

Keywords


  1. Simsek E, Akpinar S, Bahcebasi T, Senses DA, Kocabay K. The prevalence of overweight and obese children aged 6-17 years in the West Black Sea region of Turkey. Int J Clin Pract 2008; 62(7): 1033-8.
  2. Taheri F, Kazemi T, Sadeghi H. Prevalence of Overweight and obesity among primary school children in Iran from 2001-2013: A systematic review. Mod Care J 2015; 12(3): 139-45.
  3. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007; 29: 62-76.
  4. Hurley KM, Cross MB, Hughes SO. A systematic review of responsive feeding and child obesity in high-income countries. J Nutr 2011; 141(3): 495-501.
  5. Flegal KM, Wei R, Ogden C. Weight-for-stature compared with body mass index-for-age growth charts for the United States from the Centers for Disease Control and Prevention. Am J Clin Nutr 2002; 75(4): 761-6.
  6. Jouret B, Ahluwalia N, Cristini C, Dupuy M, Negre-Pages L, Grandjean H, et al. Factors associated with overweight in preschool-age children in southwestern France. Am J Clin Nutr 2007; 85(6): 1643-9.
  7. Willett WC. Is dietary fat a major determinant of body fat? Am J Clin Nutr 1998; 67(3 Suppl): 556S-62S.
  8. James PT, Leach R, Kalamara E, Shayeghi M. The worldwide obesity epidemic. Obes Res 2001; 9(S11): 228S-33S.
  9. de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92(5): 1257-64.
  10. Newby PK, Muller D, Hallfrisch J, Qiao N, Andres R, Tucker KL. Dietary patterns and changes in body mass index and waist circumference in adults. Am J Clin Nutr 2003; 77(6): 1417-25.
  11. Dehghan M, Akhtar-Danesh N, Merchant AT. Childhood obesity, prevalence and prevention. Nutr J 2005; 4: 24.
  12. He L, Ren X, Chen Y, Jin Y, Pan R, Wei N, et al. Prevalence of overweight and obesity among primary school children aged 5 to 14 years in Wannan area, China. Nutr Hosp 2014; 30(4): 776-81.
  13. Mirmohammadi SJ, Hafezi R, Mehrparvar AH, Rezaeian B, Akbari H. Prevalence of overweight and obesity among Iranian school children in different ethnicities. Iran J Pediatr 2011; 21(4): 514-20.
  14. Luo JS, Chen SK, Fan X, Tang Q, Feng Y. Prevalence of hypertension and relationship between hypertension and obesity in children and adolescents in Nanning of Guangxi Province. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16(10): 1040-4. [In Chinese].
  15. Addo OY, Himes JH. Reference curves for triceps and subscapular skinfold thicknesses in US children and adolescents. Am J Clin Nutr 2010; 91(3): 635-42.
  16. Himes JH, Dietz WH. Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. Am J Clin Nutr 1994; 59(2): 307-16.
  17. McGuire S. U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, January 2011. Adv Nutr 2011; 2(3): 293-4.
  18. Wing RR. Behavioral treatment of severe obesity. Am J Clin Nutr 1992; 55(2 Suppl): 545S-51S.
  19. Navidian A, Abedi M, Baghban I, Fatehizadeh M, Poursharifi H, Hashemi Dehkordi M. Effects of motivational interviewing on weight loss of individuals suffering . Iran J Nutr Sci Food Technol 2010; 5(2): 45-52. [In Persian].
  20. Britt E, Hudson SM, Blampied NM. Motivational interviewing in health settings: a review. Patient Educ Couns 2004; 53(2): 147-55.
  21. Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 1982; 36(5): 936-42.
  22. Guenther PM, Casavale KO, Reedy J, Kirkpatrick SI, Hiza HA, Kuczynski KJ, et al. Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet 2013; 113(4): 569-80.
  23. Tande DL, Magel R, Strand BN. Healthy Eating Index and abdominal obesity. Public Health Nutr 2010; 13(2): 208-14.
  24. Guo X, Warden BA, Paeratakul S, Bray GA. Healthy Eating Index and obesity. Eur J Clin Nutr 2004; 58(12): 1580-6.
  25. Gao SK, Beresford SA, Frank LL, Schreiner PJ, Burke GL, Fitzpatrick AL. Modifications to the Healthy Eating Index and its ability to predict obesity: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr 2008; 88(1): 64-9.
  26. Dong J, Guo XL, Lu ZL, Cai XN, Wang HC, Zhang JY, et al. Prevalence of overweight and obesity and their associations with blood pressure among children and adolescents in Shandong, China. BMC Public Health 2014; 14: 1080.
  27. Kolpa M, Jankowicz-Szymanska A, Jurkiewicz B. High-normal arterial blood pressure in children with excess body weight. Iran J Pediatr 2016; 26(4): e4677.
  28. Ataei N, Hosseini M, Fayaz M, Navidi I, Taghiloo A, Kalantari K, et al. Blood pressure percentiles by age and height for children and adolescents in Tehran, Iran. J Hum Hypertens 2016; 30(4): 268-77.
  29. Woollard J, Beilin L, Lord T, Puddey I, MacAdam D, Rouse I. A controlled trial of nurse counselling on lifestyle change for hypertensives treated in general practice: preliminary results. Clin Exp Pharmacol Physiol 1995; 22(6-7): 466-8.
  30. Carels RA, Darby L, Cacciapaglia HM, Konrad K, Coit C, Harper J, et al. Using motivational interviewing as a supplement to obesity treatment: a stepped-care approach. Health Psychol 2007; 26(3): 369-74.
  31. DiMarco ID, Klein DA, Clark VL, Wilson GT. The use of motivational interviewing techniques to enhance the efficacy of guided self-help behavioral weight loss treatment. Eat Behav 2009; 10(2): 134-6.
  32. Hardcastle SJ, Taylor AH, Bailey MP, Harley RA, Hagger MS. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up. Int J Behav Nutr Phys Act 2013; 10: 40.
  33. Davoli AM, Broccoli S, Bonvicini L, Fabbri A, Ferrari E, D'Angelo S, et al. Pediatrician-led motivational interviewing to treat overweight children: an RCT. Pediatrics 2013; 132(5): e1236-e1246.
  34. Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ, Campbell TS, Hemmelgarn BR. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. Obes Rev 2011; 12(9): 709-23.
  35. Schwartz RP, Hamre R, Dietz WH, Wasserman RC, Slora EJ, Myers EF, et al. Office-based motivational interviewing to prevent childhood obesity: a feasibility study. Arch Pediatr Adolesc Med 2007; 161(5): 495-501.
  36. Walpole B, Dettmer E, Morrongiello BA, McCrindle BW, Hamilton J. Motivational interviewing to enhance self-efficacy and promote weight loss in overweight and obese adolescents: a randomized controlled trial. J Pediatr Psychol 2013; 38(9): 944-53.
  37. Tripp SB, Perry JT, Romney S, Blood-Siegfried J. Providers as weight coaches: using practice guides and motivational interview to treat obesity in the pediatric office. J Pediatr Nurs 2011; 26(5): 474-9.