About this trial
Childhood obesity in Singapore is rising with a record prevalence of 13% in 2017 (1). Given that 70% of overweight children remain so into adulthood (2), this will further increase the public health epidemic of diabetes among Singaporeans. Early intervention is thus critical to improve the weight trajectory of overweight children and foster life long healthy lifestyle habits. Family-based interventions combining dietary, physical activity and behavioural interventions are currently recommended as the best practice in the management of childhood obesity in children younger than 12 years old (3-7). Our pilot study on family-based intervention in the tertiary setting demonstrated feasibility and short-term effectiveness. However, its outreach and sustainable results are limited. Currently, school-based screening, weight management clinics and community recreational facilities are operating in silos with limited effectiveness. Here, the investigators will integrate our family-based intervention into a school, clinic and community partnership to achieve an impactful and sustainable outcome for families with overweight children.
The community Lifestyle InTervention for Everyone (LITE) program is a structured, group family-based multicomponent lifestyle intervention. Community LITE program will introduce various exercise programs within the family based online sessions to reduce perceived barrier and promote self-efficacy of community sports facilities to increase physical activity. Children have minimal control over their food and physical activity choices especially in current obesogenic environment (8). Parents are the most important influencers(9) to impose interventions for childhood obesity through parental practices and parenting style(10). Therefore, they are the main focus of the community-based intervention program.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Overweight as defined by BMI percentile of above 90th percentile
Age 6- 12 years old
Ability to provide informed consent
Disqualifiers
Patients with secondary causes of obesity especially genetic syndromes e.g. Trisomy 21, Prader-Willi, and those who are taking medications that can affect weight status.
Intellectual disability, poor level of spoken English (including their parent/carer)
Significant medical illness that precludes physical activity and significant psychiatric illness
Sibling who is already participating in the study
Trial design
Crossover
Treatments tested in this trial
Usual Care
BehavioralParticipants will be offered standard care which consists of the following: * Clinic consultation with physician and dietician, * pamphlets on weight management principles.
Online community LITE programme
BehavioralParticipants will be invited to participate in the online community LITE programme. Participants will also receive basic sports equipment for the online programme. The online community LITE programme will consist of 2 sessions a week for 4-5 months. Each session is 1 hour long. The programme will deliver 3 domains: physical activity, nutrition and behaviour. It consists of relatively unstructured sessions comprising of cooking and nutrition classes, games and sports and peer support.
Treatment groups
Trial outcomes
Primary outcomes
Change in Body Mass Index (BMI)
Measure the change in BMI at baseline, 6 months and 12 months. Body mass index (BMI) will be calculated as kg/m2
Secondary outcomes
Change in waist circumference
Measure change in waist circumference at baseline, 6 months and 12 months. Waist circumference is measured at the narrowest point between the lower costal (rib) border and the iliac crest using a non-extensible steel tape.
Change in blood pressure
Measure change in blood pressure at baseline, 6 months and 12 months. Blood pressure will be measured in mmHg via an electronic sphygmomanometer. Both systolic and diastolic blood pressure will be measured.
Change in servings of fruits and vegetables
Measure change in number of servings of fruits and vegetables using food frequency questionnaire at baseline, 6 months and 12 months .
Change in physical activity
Measure change in physical activity using results from accelerometer to assess time spent on sedentary and moderate to vigorous physical activity at baseline, 6 months and 12 months.
Sponsors and contacts
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KK Women's and Children's Hospital
Lead sponsor
Duke University
Collaborator
Sport Singapore
Collaborator
Health Promotion Board, Singapore
Collaborator
Duke-NUS Graduate Medical School
Collaborator