1. Childhood Obesity Pauline Williams, PhD, RD

2. Preventing and Treating Overweight Obesity

3. Lifestyle Guideline: Standard Comparison Nutrition ActivityBehavior

4. Nutrition Continued  Food associated with overweight  Fruits and vegetables ↓ overweight  Dairy and calcium maybe ↓ overweight  Skipping Breakfast ↑ overweight  Total Energy ↑ overweight  Fruit juice ↑ overweight  Sugar Sweetened beverages ↑ overweight

5. Physical Activity  Regular physical activity ↓ overweight  Sports participation ↓ overweight  Excessive TV viewing ↑ overweight  Excessive video games ↑ overweight

6. Environment  Parental restriction of highly palatable foods ↑ overweight  Consumption of food away from home ↑ overweight  Increased portion size ↑ overweight  Parent’s dietary disinhibition and restraint ↑ overweight  Lack of parental support or over-possessiveness ↑ overweight  Extra concern for overweight ↑ overweight  Family cohesion ↓overweight  Family expressiveness ↓ overweight  Parental support ↓ overweight  Cognitive stimulation at home ↓ overweight

7. Anthropometric Measure CompliantNon-Compliant Average Change n=36 Average Change in n=24 BMI z-score -0.19 ± 0.05 (p=.0004) -0.05 ± 0.06 (p=.4129) BMI (kg/m 2 ) 0.20 ± 0.35 (p=.5655) 1.02 ± 0.43 (p=.0212) BMI %tile -2.02 ± 0.87 (p=.0235) -0.09 ± 1.07 (p=.9283)

8. Anthropometric Measure CompliantNon-Compliant Average Change n=36 Average Change in n=24 Weight (kg) 4.14 ± 0.8 (p=<.0001) 6.58 ± 0.99 (p=<.0001) Weight percentile -1.69 ± 0.93 (p=.0754) -0.05 ± 1.14 (p=.9627) Height (cm) 4.72 ± 0.38 (p=<.0001) 5.72 ± 0.47 (p=<.0001) Height percentile -0.82 ± 1.87 (p=.6616) 0.19 ± 2.29 (p=.9330)

9. P robabi lity Meeting Nutrition Guideline Lifestyle guideline CompliantNon- Compliant p-value PrePostPrePost Timeinterve ntion Vegetable Intake 0.31%55.67%12.69%13.19% <.0001 Fruit Intake 72.41%97.14%82.32%91.35% =.0015=.0913 Juice Intake 95.69%93.02%82.57%86.12% =.8281=.3901 Dairy Intake 15.59%13.09%34.44%16.85% =.2040=.3666 Sugar Sweetened Beverage Consumption 62.24%82.34%57.59%82.39% =.0337=.8522

10. Probability Meeting Activity Guideline Lifestyle guideline CompliantNon- Compliant p-value PrePostPrePost timeinterve ntion Physical Activity13.58%56.58%39.80%25.46%=.1093=.0032 Screen Time48.61%69.39%44.27%57.92%=.0951=.6995 Physical activity – males more likely to meet guideline (p=.0007)

11. Probability Meeting Behavior Guideline Lifestyle guideline CompliantNon- Compliant p-value PrePostPrePost Timeinterv ention Breakfast Frequency88.25%93.46%75.02%78.67%=.3307=.6146 Family Meals76.44%83.87%86.20%58.93%=.2100=.5754 Sleep Time47.15%54.80%45.74%54.73%=.4370=.9499