Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight

Poll, Fabiana A.; Miraglia, Fernanda; D'avila, Helen F.; Reuter, Cézane P.; Mello, Elza D.

doi:10.1016/j.jped.2019.05.007

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Original articles • J. Pediatr. (Rio J.) 96 (5) • Sep-Oct 2020 • https://doi.org/10.1016/j.jped.2019.05.007 copy

Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight^☆ ☆ Please cite this article as: Poll FA, Miraglia F, D'avila HF, Reuter CP, Mello ED. Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight. J Pediatr (Rio J). 2020;96:621-9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate the impact of a nutritional intervention on nutritional status, ultra-processed food consumption, and quality of life of adolescents with excess weight.

Methods:

Experimental study with adolescent students with excess weight, divided into two groups, an intervention group and a control group. The nutritional intervention lasted six months, with an educational and motivational approach. Nutritional status (waist circumference and body mass index), quality of life, and ultra-processed food consumption were evaluated before and after the period.

Results:

Sixty-two adolescents with overweight or obesity participated in the study, 37 in the intervention group and 25 in the control group, aged 13.2 ± 1.5 years in intervention group, and 13.0 ± 1.8 years in control group, both of which had a higher female participation. There were changes in the body mass index (intervention group Δ: −0.81 ± 2.28, control group Δ: −0.64 ± 1.28) and in the waist circumference for intervention group (Δ:−3.31 ± 5.47). For the pre- and post-ultra-processed food consumption, there was a significant reduction in the consumption of soft drinks in the intervention group (Δ: −0.07 [−0.27 to 0.00]), instant noodles (Δ: −0.03 [−0.07 to 0.00]), and sandwich cookies (Δ: −0.06 [−0.26 to 0.00]). The quality of life increased in the intervention group and decreased in the control group, with no intra- (p = 0.162) or intergroup statistical relevance in the pre- (p = 0.426) and post- (0.249) intervention period, with a reduction in the emotional domain score, with a significant variation in the intervention group (pre and post; Δ: −19.0 ± 40.6).

Conclusion:

There was a decrease in body mass index and waist circumference (central obesity being more often related to insulin resistance), reduction of ultra-processed food consumption (soft drinks, sandwich cookies, and instant noodles), and a tendency toward quality of life improvement (however, there was a decrease in the domains of emotional and school quality of life).

KEYWORDS
Adolescents; Clinical trial; Quality of life; Food consumption

Variables	Intervention group	Control group	p
Age (years)	13.2 ± 1.5	13.0 ± 1.8	0.607^a a Student's t -test or Mann-Whitney U -test.

Gender			1.000^b b Chi-squared or Fisher's exact test.
Male	17 (45.9)	11 (44.0)
Female	20 (54.1)	14 (56.0)

Pubertal stage			0.616^b b Chi-squared or Fisher's exact test.
Prepubertal	3 (11.1)	1 (4.2)
Pubertal	20 (74.1)	20 (83.3)
Postpubertal	4 (14.8)	3 (12.5)

BMI (kg/m²)
Pre-	29.3 ± 6.7	27.4 ± 4.5	0.213^a a Student's t -test or Mann-Whitney U -test.
Post-	28.5 ± 6.4	26.8 ± 5.1	0.260^a a Student's t -test or Mann-Whitney U -test.
Range	-0.81 ± 2.28^c c There was a significant reduction from pre- to post-intervention, with a significance of 5%.	-0.64 ± 1.28^c c There was a significant reduction from pre- to post-intervention, with a significance of 5%.	0.693^a a Student's t -test or Mann-Whitney U -test.

WC (cm)
Pre-	87.0 ± 10.9	81.3 ± 10.2	0.044^a a Student's t -test or Mann-Whitney U -test.
Post-	83.7 ± 11.2	80.5 ± 11.6	0.276^a a Student's t -test or Mann-Whitney U -test.
Range	-3.31 ± 5.47^c c There was a significant reduction from pre- to post-intervention, with a significance of 5%.	-0.88 ± 6.99	0.129^a a Student's t -test or Mann-Whitney U -test.

Food consumption	Intervention group (n = 37)	Control group (n = 25)	p ^b b Comparison between groups: Student's t -test or Mann-Whitney- U test.
	Median (25th to 75th percentile)^a a Intragroup comparison: paired t -test or Wilcoxon paired test.	Median (25th to 75th percentile)^a a Intragroup comparison: paired t -test or Wilcoxon paired test.
Instant noodles
Pre	0.06 (0.03-0.13)	0.06 (0.00-0.26)	0.448
Post	0.00 (0.00-0.06)	0.06 (0.00-0.73)	0.049
Range	-0.03 (-0.07-0.00)^c c Showed a significant reduction from pre- to post-intervention, with a significance of 5%.	0.00 (-0.07-0.00)	0.232

Frankfurters/sausages
Pre	0.06 (0.06-0.13)	0.13 (0.13-0.40)	0.009
Post	0.06 (0.00-0.13)	0.13 (0.06-0.40)	0.004
Range	-0.06 (-0.13-0.00)	0.00 (-0.28-0.11)	0.633

Snacks
Pre	0.06 (0.06-0.13)	0.13 (0.06-0.26)	0.307
Post	0.06 (0.00-0.13)	0.13 (0.06-0.13)	0.002
Range	-0.06 (-0.13-0.04)	0.00 (-0.06-0.13)	0.149

Industrialized fruit juice
Pre	0.13 (0.03-1.00)	0.40 (0.13-1.37)	0.051
Post	0.06 (0.00-0.73)	0.73 (0.06-1.00)	0.035
Range	0.00 (-0.23-0.00)	-0.10 (-0.38-0.85)	0.910

Soft drinks
Pre	0.13 (0.13-0.40)	0.13 (0.06-0.26)	0.177
Post	0.13 (0.00-0.40)	0.13 (0.06-0.73)	0.021
Range	-0.07 (-0.27-0.00)^c c Showed a significant reduction from pre- to post-intervention, with a significance of 5%.	0.00 (0.00-0.27)	0.011

Cold cuts/bologna
Pre	0.73 (0.13-1.00)	0.40 (0.13-1.00)	0.259
Post	0.73 (0.07-1.00)	0.40 (0.13-1.00)	0.912
Range	0.00 (-0.27-0.00)	0.00 (-0.06-0.27)	0.245

Sandwich cookies
Pre	0.13 (0.06-0.40)	0.13 (0.13-0.56)	0.154
Post	0.06 (0.00-0.13)	0.13 (0.06-0.73)	0.008
Range	-0.06 (-0.26-0.00)^c c Showed a significant reduction from pre- to post-intervention, with a significance of 5%.	0.00 (-0.13-0.07)	0.199

Plain cookies
Pre	0.06 (0.06-0.40)	0.13 (0.13-1.00)	0.003
Post	0.06 (0.00-0.13)	0.40 (0.13-0.73)	0.003
Range	0.00 (-0.10-0.07)	0.00 (-0.60-0.27)	0.586

Sugar
Pre	0.13 (0.00-0.56)	0.73 (0.13-2.50)	0.022
Post	0.13 (0.00-1.00)	0.13 (0.06-1.00)	0.487
Range	0.00 (-0.13-0.47)	0.00 (-0.87-0.00)^c c Showed a significant reduction from pre- to post-intervention, with a significance of 5%.	0.064

Chocolate milk
Pre	0.13 (0.06-0.56)	0.40 (0.00-1.00)	0.348
Post	0.06 (0.00-0.13)	0.40 (0.06-1.00)	0.011
Range	0.00 (-0.13-0.06)	0.00 (-0.06-0.60)	0.186

Quality of life domains	Intervention group (n = 37)	Control group (n = 25)	p ^a a Intragroup comparison: paired Student's t -test or paired Wilcoxon test.
	Mean ± SD	Mean ± SD
Physical
Pre-	81.2 ± 17.6	82.5 ± 12.2	0.762
Post-	84.5 ± 13.5	78.9 ± 21.6	0.202
Range^b b Comparison between groups: Student's t -test or Mann-Whitney U -test.	2.85 ± 11.8	-3.62 ± 22.3	0.154

Emotional
Pre-	67.7 ± 25.5	60.6 ± 22.1	0.264
Post-	51.9 ± 40.0	54.0 ± 30.2	0.814
Range^b b Comparison between groups: Student's t -test or Mann-Whitney U -test.	-19.0 ± 40.6^c c Showed a significant reduction from pre- to post-intervention, with a significance of 5%.	-6.6 ± 34.4	0.223

Social
Pre-	87.3 ± 15.8	81.6 ± 15.4	0.168
Post-	89.4 ± 17.2	77.4 ± 26.3	0.051
Range^b b Comparison between groups: Student's t -test or Mann-Whitney U -test.	1.91 ± 14.8	-4.20 ± 24.9	0.244

School
Pre-	79.8 ± 14.8	79.0 ± 12.0	0.816
Post-	76.6 ± 17.6	73.0 ± 23.2	0.493
Range^b b Comparison between groups: Student's t -test or Mann-Whitney U -test.	-3.82 ± 13.7	-5.97 ± 24.8	0.699

Psychosocial
Pre-	71.9 ± 25.9	73.7 ± 13.1	0.728
Post-	72.7 ± 20.1	68.1 ± 17.0	0.352
Range^b b Comparison between groups: Student's t -test or Mann-Whitney U -test.	0.76 ± 30.0	-5.60 ± 17.9	0.345

Total
Pre-	72.9 ± 25.8	76.7 ± 11.4	0.426
Post-	76.9 ± 16.5	71.9 ± 16.7	0.249
Range^b b Comparison between groups: Student's t -test or Mann-Whitney U -test.	3.96 ± 28.0	-4.91 ± 17.0	0.162

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[1] * Corresponding author. E-mail: Corresponding author. helen14davila@hotmail.com (H.F. D'avila).