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      Remote Lifestyle Counseling Influences Cardiovascular Health Outcomes in Youth with Overweight or Obesity and Congenital Heart Disease

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          Abstract

          Background

          Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD.

          Methods

          We examined the effect of bi-weekly nutrition and fitness counseling delivered via smartphone over 12 months. Thirty-four youth, previously diagnosed with CHD and with overweight or obesity, participated in the intervention. They were divided into two groups depending on whether the heart disease required surgical correction (operated, n = 19) or not (non-operated, n = 15). Anthropometry, body composition cardiorespiratory exercise capacity, and cardio-metabolic risk factors were assessed at baseline, 6 months, and 12 months.

          Results

          Statistically significant decreases in waist circumference (WC), body mass index z-score, WC z-score, and waist to height ratio z-score were observed at 6 and 12 months in the operated group. A significant linear increase in lean body mass was observed in both groups. The study also had a high retention rate and a low attrition rate.

          Conclusion

          The observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as perception of condition and self-efficacy, may influence lifestyle behaviors. The results from this pilot study clearly demonstrate the feasibility to perform a larger controlled study on remote lifestyle intervention in children with congenital heart defects and overweight or obesity.

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          Most cited references25

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          A comparison of indirect versus direct measures for assessing physical activity in the pediatric population: a systematic review.

          Kristi Adamo, Mark S. Tremblay, Stephanie A Prince … (2008)
          Accurate assessment of physical activity (PA) in children and adolescents is required to establish PA levels, monitor changes and inform public healthy policy. This study systematically reviews the literature to determine the extent of agreement between indirect (e.g., questionnaire) and direct (e.g., accelerometry) assessments of PA in pediatric populations (
          Article 0 comments Cited 134 times – based on 0 reviews     Review now
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            Construction of LMS parameters for the Centers for Disease Control and Prevention 2000 growth charts.

            Stewart T. Cole, Katherine Flegal (2013)
            In 2000, the Centers for Disease Control and Prevention (CDC) released a new set of childhood growth charts for the United States. These charts included a set of smoothed percentiles along with LMS (lambda-mu-sigma) parameters to allow the calculation of other percentiles or standard deviation scores. These parameters resemble the LMS parameters derived using Cole's LMS method. Similarities in the terminology mask differences in the methods used. This brief commentary is intended to clarify these differences. The background for the creation of standard deviation scores (z scores) for growth charts is discussed, and the method used to create the CDC LMS parameters is compared with Cole's LMS method. Using an approach similar to that used by CDC, LMS parameters could be calculated for any set of fitted percentile curves, regardless of the smoothing methods employed to create the curves. However, this is not equivalent to using the LMS method.
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              Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American Heart Association.

              Patricia Longmuir, Julie A Brothers, Sarah de Ferranti … (2013)
              Article 0 comments Cited 65 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Pediatr
                Journal ID (iso-abbrev): Front Pediatr
                Journal ID (publisher-id): Front. Pediatr.
                Title: Frontiers in Pediatrics
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2360
                Publication date (Electronic): 18 December 2017
                Publication date Collection: 2017
                Volume: 5
                Electronic Location Identifier: 269
                Affiliations
                [1] 1Department of Paediatrics, Western University , London, ON, Canada
                [2] 2Paediatric Cardiopulmonary Research Laboratory, London Health Science Centre , London, ON, Canada
                [3] 3Children’s Health Research Institute , London, ON, Canada
                [4] 4School of Kinesiology, Western University , London, ON, Canada
                [5] 5Translational Research Centre , London, ON, Canada
                [6] 6Lawson Health Research Institute , London, ON, Canada
                [7] 7Department of Paediatric Cardiology and Intensive Care Medicine, Medical School Hannover , Hannover, Germany
                [8] 8Department of Paediatric Cardiology and Intensive Care Medicine, University of Goettingen , Goettingen, Germany
                Author notes

                Edited by: Utpal S. Bhalala, Baylor College of Medicine, United States

                Reviewed by: Madhusudan Ganigara, Mt SInai Medical Centre, United States; Meena Nathan, Boston Children’s Hospital, Harvard University, United States

                *Correspondence: Kambiz Norozi, kambiz.norozi@ 123456lhsc.on.ca

                Specialty section: This article was submitted to Pediatric Cardiology, a section of the journal Frontiers in Pediatrics

                Article
                DOI: 10.3389/fped.2017.00269
                PMC ID: 5741592
                SO-VID: 721a6efc-9d7b-4de5-b790-bf7bea4d2256
                Copyright © Copyright © 2017 Altamirano-Diaz, Rombeek, De Jesus, Welisch, Prapavessis, Dempsey, Fraser, Miller and Norozi.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 12 October 2017
                Date accepted : 01 December 2017
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 33, Pages: 9, Words: 6892
                Funding
                Funded by: Academic Medical Organization of Southwestern Ontario 10.13039/100010564
                Award ID: INN 12-003
                Categories
                Subject: Pediatrics
                Subject: Original Research

                Keywords: smartphone,congenital heart disease,remote counseling,obesity,children,lifestyle intervention
                Data availability:
                Keywords: smartphone, congenital heart disease, remote counseling, obesity, children, lifestyle intervention

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