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Articles in Professional JournalsKidShape Data Reported in Peer-Reviewed Journals
In the past ten years, Dr. Naomi Neufeld, Christiane Wert Rivard, MPH, RD, and others from KidShape have published six articles in peer-reviewed journals (Pediatric Research, Journal of the American Dietetic Association, and Endocrine Practice). The data reported in these articles demonstrates that participation in KidShape helps youth improve their health, eating habits, physical activity habits, self-esteem and their body mass index (BMI). Participation in KidShape also helps parents improve their health and their parenting skills. Abstracts of these articles follows this summary. KidShape is a nine-week program. Each class is 2-1/4 hours long and conducted by a Registered Dietitian, a Licensed Mental Health Professional, a Physical Activity Instructor, and a Site Coordinator. Each child at KidShape must be accompanied by a parent or guardian and the classes have separate tracks for both students and adults. KidShape has graduated more than 12,000 students and their families and has been called “the gold standard” and “the best program of its kind in the country for dealing with the problem of childhood obesity.” SummaryTwo studies published in Pediatric Research in 1999 showed that the KidShape program effected statistically significant health improvement and helped in the development of good parenting skills. Abstracts1. Reversing Hyperinsulinemia (HI) and Associated Sequelae of Childhood Obesity (CO) through Medical Nutrition Therapy (MNT)[The American Pediatric Society and The Society for Pediatric Research 1999 Abstracts]Pediatric Research, 45(4) Part 2 of 2:95A, April, 1999 Neufeld, Naomi D; Wert, Christiane Center for Human Nutrition, UCLA, Los Angeles, CA Abstract 548 Nutritional Issues in Underserved Populations Platform, Monday, 5/3 Childhood obesity (CO) is the most prevalent nutritional disease in the U.S., and affects minority populations (African-American AA and Mexican-American MA) disproportionately. In addition, obese minority children develop Type 2 Diabetes Mellitus (T-2DM) at much younger ages that previously thought. Hyperinsulinemia (HI) is a common finding that underlies T-2 DM as well as several morbidities of obesity. We studied the effect of medical nutrition therapy (MNT), consisting of 8 weeks of nutrition education, physical activity, parent support and child psychological support on serum insulin as well as on several clinical variables: BMI, diastolic blood pressure (BP) and serum triglyceride (TG) levels. Our study population included 27 children, (14F/13M), of whom 10 were white, 7 AA and 10 MA, and whose mean age was 13.1+3.84 yrs. At initial evaluation none had hyperglycemia.
Summary: Participation in a structured nutrition and exercise program resulted in a significant change in BMI, and was associated with a marked fall in serum insulin. This was accompanied by correction of serum TG and lowered diastolic BP. Conclusions: CO is associated with significant medical complications, including hypertension, dyslipidemia and T-2DM, which comprise the "deadly triad" known as syndrome X. Such findings respond to aggressive MNT, which if begun early enough, may prevent the development of T-2 DM in this at risk population.
2. Relationship between Parenting Practices and Outcomes in the Treatment of Childhood Obesity (CO)[The American Pediatric Society and The Society for Pediatric Research 1999 Abstracts]
Abstract 699 Childhood obesity (CO) is the most prevalent nutritional disorder in the United States, affecting one out of three children, and is associated with significant short-term and long-term sequelae. While prevention of CO is necessary, effective methods of treatment for this problem must be also developed. Parenting style is an important factor in the etiology of CO. Three distinct parenting styles have been proposed: authoritarian: parents making most decisions for families with little input from children; authoritative: parents make most decisions, but in a more democratic setting, where input from children is considered, and permissive: parents do not set many ground rules or follow through with punishments. We examined 20 children and their primary caregivers before and after they participated in KidShape, a pediatric weight loss program with three primary components: a) nutritional counseling, b) exercise and wellness, and C) cognitive-behavioral therapy. The objectives of the program were to teach children coping skills, to teach them to exercise self-control and to promote healthier lifestyles. Eighteen of the adults were biological mothers, seven of whom were single parents, one was a grandmother, and one a great-grandmother. 11 children were male and 9 were female. Average age was 11.8 yr. During the four-week program, there was a significant change in the child's weight, shown by a reduction in body mass index (BMI). (Pre-Rx BMI = 33.1±5.6 vs Post-Rx BMI =32.5±5.6 kg/m2, p <0.001. Both children and adults were examined before and after the 4-week class using the Parenting Practices Questionnaire. Adult responses to the Parenting Practices Questionnaire showed significant increases in authoritative parenting and a reduction in permissive parenting.
Summary: 1. Family based behavioral intervention is effective in reducing weight in obese children, as shown by a significant reduction in Body Mass Index (BMI) 2. Participation in KidShape for four weeks resulted in significant move towards an authoritative parenting style 3. Furthermore, authoritative parenting was correlated with effectiveness of this weight loss program. We conclude that parenting styles are an important aspect of children’s weight loss, which must be considered in the design of programs treating CO. 3. Successful Weight Management Program for Overweight Children and Their Families[Journal of the American Dietetic Association, Volume 104, Issue 8, Page 31 (August, 2004)]AUTHORS: C.W. Rivard, MPH, RD; K.A. Graves, MPH, RD; N.D. Neufeld, MD, FACELEARNING OUTCOME: To increase awareness of successful strategies for weight management in overweight children. TEXT: Being overweight is the number one health problem affecting children today. KidShape, a family-based pediatric weight management program, developed in 1987 by Dr. Naomi Neufeld and a team of Registered Dietitians, mental health professionals, and exercise experts, successfully treats socio-economically and ethnically diverse overweight children ages 6-14 and their families. KidShape incorporates individual and group medical nutrition therapy, group behavior modification, and on-site physical activity to empower families to adopt healthier eating and physical activity habits and promote positive self-esteem. In 2003, 406 overweight children (214 females/193 males) and their families completed a series of eight weekly KidShape classes in 13 community-based sites throughout Southern California. At lease one parent or guardian was required to attend with the enrolled child. Families participated in unique activities and discussion groups, developed over the past seventeen years. As measured by pre- and post-food and activity questionnaires, families reported increased fruit and vegetable consumption, decreased added fat and sweet consumption, increased time spent being physically active, and decreased time watching television and/or playing video games upon completion of KidShape. Students reported feeling better about themselves as measured by the Rosenberg Self-Esteem Scale. Students’ heights and weights were taken at the beginning and end of the eight-week program. The students’ average body mass index before KidShape was 30.9 kg/m2 and decreased to 30.5 kg/m2, which is statistically significant with a p-value of 0.006 (analyzed by a paired student t-test). KidShape’s involvement of families and multi-discipline format successfully improves overweight children’s nutrition habits and improves growth parameters. FUNDING DISCLOSURE: Partial funding sources: Grant from Orange County Health Care Agency, Grant from Santa Clarita School Food Service Agency, Grant from Santa Monica-Malibu Unified School District, SKETCH Foundation, Ventura County Health Communities Grant, Grant from West Covina Unified School District. 4. A Comprehensive Outcome Analysis of a Multi-Site, Multi-State Family-Based Pediatric Weight Management Program[Journal of the American Dietetic Association, Volume 107, Issue 8, Page A11 (August, 2007)]AUTHORS: C. Wert Rivard, N Neufeld LEARNING OUTCOME: To understand the program components, including evaluation methods, of a comprehensive multi-site family-based pediatric weight management program and state why these particular strategies are successful for treatment of overweight children and their families. TEXT: Childhood obesity, affecting one out of three children, is a family-based problem that requires a family-based solution. KidShape, a comprehensive family-based pediatric weight management program implemented in over 40 different sites in 4 different states, was developed in southern California in 1987 by a board certified pediatric endocrinologist with a team of Registered Dietitians, mental health professionals, and exercise physiologists for families who were both ethnically and socio-economically diverse. KidShape’s curriculum has been updated every year since its inception as the result of current evidence-based nutrition and physical activity information as well as feedback from KidShape instructors and participating families. This updating ensures that the program is relevant to the diverse families it serves. KidShape works with entire families in a nine-week group setting to improve eating habits, physical activity habits, and self esteem, incorporating individual and group medical nutrition therapy, cognitive behavior modification and unique pedagogical tools to make the program fun and engaging. Food records, activity records, program questionnaires, and body mass index (BMI) were collected from 1022 participating families at the beginning and the conclusion of the program from 24 community-based and hospital-based sites in Pennsylvania and California from 2004 through 2006. Outcome analyses demonstrated statistically significant comparable improvements in BMI, eating and physical habits, and self-esteem across the multiple sites indicating that the program strategies are effective for childhood obesity treatment. The outcome analysis also demonstrated that KidShape can be successfully replicated and maintain relevancy to families from diverse geographic areas and diverse ethnic and socio-economic backgrounds. FUNDING DISCLOSURE: None 5. A Long-Term Comprehensive Evaluation of a Family-Based Pediatric Weight Management Program Implemented in Multiple Community-Based and Hospital-Based Sites[Journal of the American Dietetic Association, Volume 108, Issue 9, Page A94 (September, 2008)]AUTHORS: C. Wert Rivard, N. Neufeld; KidShape Foundation, Los Angeles, California LEARNING OUTCOME: To understand how and why a family-based and cognitive behavioral-based pediatric weight management program provides effective short-term and long-term outcomes in multiple community-based and hospital-based program locations. TEXT: Childhood obesity is the most significant health problem facing our children today. The KidShape program was developed by a team of health care professionals, including Registered Dietitians, to provide a comprehensive effective family-based solution to directly combat childhood obesity. The program is taught by an interdisciplinary team, including a Registered Dietitian, a mental health professional, a health educator and a fitness expert, for families with overweight children, ages 6-14. KidShape incorporates hands-on interactive learning experiences and cognitive behavior modification techniques focused on eating healthy, moving more and feeling good into nine weekly two hour group classes. Outcome analysis has previously demonstrated that children who participate in KidShape lose weight, eat more fruits and vegetables, eat less added fats and sweets, are more physically active, watch less screen time, and enjoy improved self-esteem at the end of the program. In a convenience sample to evaluate the long-term efficacy, height, weight and body mass index (BMI) data was collected from 86 children at three months, 88 children at six months, 30 children at twelve months and 15 children at 18 to 24 months after of the KidShape program to determine if children maintain their weight loss from 20 KidShape sites in California and Pennsylvania. KidShape graduates did maintain a significant decrease in their BMI up to 24 months after KidShape and reported continued improved eating and physical activity habits. This study demonstrates the value of effective family-based, cognitive behavior-based pediatric weight management programs in fighting the childhood obesity crisis. FUNDING DISCLOSURE: None |
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Articles in Professional Journals
Studies on the effectiveness of KidShape have been published in peer-reviewed journals. 87% of our 12,000 graduates have lost weight and 80% of those who lost weight kept it off at least two years.
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