Role of Carbohydrate Modification in Weight Management Among Obese Children

• The outcomes listed below will be obtained at baseline,3-month, [ Time Frame: 3 month ]
  
• 6-month,and 12-month assessments unless otherwise noted,body weight,
  
• height,body mass index,waist circumference,percent body fat,
  
• adipose mass,lean body mass,bone mineral density,fasting lipid profile,
  
• fasting insulin,fasting glucose,2-hour glucose (baseline and 3-month assessment),
  

• physical activity (3-day physical activity records and pedometer readings)
  
• compliance with behavioral intervention (frequency rewards were earned)
  
• attendance at group and individual sessions during initial 3-month intervention
  
• parent/guardian weight
  
• parent/guardian body mass index
  
• Sexual Maturity Rating
  
• Hunger/Satiety assessment (Three-Factor Eating Questionnaire)
  
• Parent/guardian perception of success for each diet assignment prior to their child being randomized to a diet group
  

The treatment of pediatric obesity supported by the medical community is a moderate restriction in calories by modifying intake of fat and simple sugars, along with an increase in energy expenditure through more physical activity. However, this approach is associated with only limited success. As a result, overweight children and adolescents are seeking alternative approaches to weight management, such as diets that modify the type and amount of carbohydrates. However, at this time there is limited data on the safety and efficacy of these diets, particularly with younger children. This study is a controlled clinical trial that compares the safety and efficacy of a low carbohydrate and reduced glycemic load diets to a more standard dietary intervention for the management of pediatric obesity (i.e. portion-controlled, moderate fat, high carbohydrate diet). This study will involve 150 overweight children (ages 7 to 12) who will be randomly assigned to one of the three diet groups for 12 months. The effects of each diet will be determined by measuring changes in anthropometric measures (body weight, height, body mass index, waist circumference, body composition), other cardiovascular risk factors (blood pressure, fasting lipid profile, fasting glucose and insulin, and inflammatory markers of cardiovascular disease), and measures of psychological well-being and mental status. The results of this study will provide needed information to the public in their quest for safe, effective, and health-promoting weight management strategies for obese children. Such information is vital if we are to address the obesity epidemic in the United States.