| NEW YORK
NEW YORK (Reuters Health) - Two large initiatives designed to prevent African-American girls from becoming obese are not very successful at it, according to two new studies.
The two-year programs consisted of either practical advice and goals for staying fit and healthy, or regular dance classes along with an intervention to reduce the amount of time girls spent playing video games, watching TV, or on the computer.
However, over the course of two years, 8- to 10-year-old girls who were enrolled in either program were just as likely to gain weight as girls who did not participate in the interventions.
It's not clear why the programs had so little impact, lead author of one of the studies, Dr. Robert Klesges at the University of Tennessee Health Science Center, told Reuters Health. However, "the environmental factors that promote sedentary behavior" - such as TV and video games - and preferences for high-calorie foods "probably overwhelmed" the effects of the program, he suggested.
Obesity has become an epidemic among American children, and African-American girls are particularly at risk - a recent nationwide health survey found that approximately one-quarter of black girls are obese.
To see whether targeted programs help prevent young girls from becoming obese teens, Klesges and his colleagues followed 303 girls in the Memphis area for two years. They randomly assigned half to a program designed to prevent them from becoming obese by giving them goals for healthy eating and exercise while teaching their parents about providing healthy foods, and the other half to an alternative program that did not focus on diet and exercise, but just self-esteem in general.
They found that girls who completed the obesity program tended to consume more water and vegetables, and fewer sweet drinks, than girls in the other program. But both groups were just as likely to gain weight, and both decreased their amount of physical activity over the two years.
"For those girls who changed these eating patterns and didn't see weight gain prevention, they probably just replaced these calories with other foods," Klesges noted. The next step, he suggested, could be to encourage girls to reduce their overall calories, not just shift the calories they'd get from soda and fatty foods into other food types.
And younger girls appeared to benefit more from the program, Klesges noted, suggesting it is worth continuing this program in that age group. "We didn't do a cost analysis but the intervention is definitely portable and could be implemented for very low cost," he said in an e-mail.
In the other study, also published in the November issue of the Archives of Pediatrics & Adolescent Medicine, researchers randomly assigned 261 black girls in Oakland, California, to either participate in an intervention to reduce their "screen" time along with regular dance classes that included African, hip-hop, and step dancing; or receive newsletters about health issues for young girls and attend occasional family health lectures.
Here, too, girls in both groups were equally likely to gain weight during the study period, but those in the dance program showed improvements in some other aspects of health, such as lower cholesterol and insulin levels and fewer symptoms of depression. "I felt really good about (those findings)," study author Dr. Thomas Robinson at Stanford University School of Medicine told Reuters Health.
He added that the program experienced a few unexpected challenges that may have affected the findings - for example, transportation for the girls fell through early in the program, which likely lowered attendance. Implementing a similar program at a school would cut down on costs considerably, Robinson added, so the only expense would be paying the dance teacher, who might be willing to volunteer. "We haven't given up on the concept," he noted.
Furthermore, girls who were at higher risk of weight gain - those who watched more TV overall and were being raised by unmarried adults - appeared to benefit more from the program than other girls, Robinson said. "They have more room to go, and are more likely to benefit," he suggested. "Our intervention definitely helped a lot of girls."
The next step, Klesges suggested, is to ensure children have regular access to physical activity that they enjoy, and find ways to encourage people not to opt for fast foods. "While we have a long way to go, promoting healthy diets from the time a child is very small is needed," he said. "If more people wanted healthy alternatives, (fast food restaurants) would sell them."
SOURCE: link.reuters.com/peg53q and link.reuters.com/meg53q Archives of Pediatrics & Adolescent Medicine, November 2010.