Exploring the association between individual, family, and program characteristics and change in health outcomes 12 months after enrollment into the CANadian Pediatric Weight management Registry (CANPWR)

Patrick G McPhee; Geoff D C Ball; Annick Buchholz; Jill K Hamilton; Josephine Ho; Ian Zenlea; Lehana Thabane; Katherine M Morrison; CANPWR Consortium

doi:10.1038/s41366-024-01631-2

Exploring the association between individual, family, and program characteristics and change in health outcomes 12 months after enrollment into the CANadian Pediatric Weight management Registry (CANPWR)

Int J Obes (Lond). 2024 Sep 16. doi: 10.1038/s41366-024-01631-2. Online ahead of print.

Authors

Patrick G McPhee^{1

2}, Geoff D C Ball³, Annick Buchholz⁴, Jill K Hamilton⁵, Josephine Ho⁶, Ian Zenlea⁷, Lehana Thabane^{8

9

10}, Katherine M Morrison^{11

12

13}; CANPWR Consortium

Collaborators

CANPWR Consortium:
Catherine Birken, Jean-Pierre Chanoine, Stasia Hadjiyannakis, Anne-Marie Laberge, Laurent Legault, Mark S Tremblay

Affiliations

¹ Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
² Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, ON, Canada.
³ Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
⁴ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
⁵ Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
⁶ Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
⁷ Trillium Health Partners, Mississauga, ON, Canada.
⁸ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
⁹ Biostatistics Unit, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
¹⁰ Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.
¹¹ Department of Pediatrics, McMaster University, Hamilton, ON, Canada. [email protected].
¹² Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, ON, Canada. [email protected].
¹³ Population Health Research Institute, Hamilton, ON, Canada. [email protected].

PMID: 39285212
DOI: 10.1038/s41366-024-01631-2

Abstract

Objectives: To examine individual, family, and program characteristics associated with changes in anthropometric and cardiometabolic health indicators in children with overweight or obesity after participating in multidisciplinary obesity management for 12 months.

Methods: Participants included children 2-17 years old with overweight or obesity enrolled in the CANadian Pediatric Weight Management Registry (CANPWR). Multiple linear regression analyses were conducted to investigate the associations between individual, family, and program characteristics and changes in anthropometry (WHO BMI z-score) and cardiometabolic health indicators (systolic and diastolic blood pressure; fasting and 2-h glucose post-oral glucose tolerance test (OGTT); high density lipoprotein- (HDL) and non-HDL cholesterol and fasting triglycerides).

Results: BMI z-score data were available from 1065/1286 (82.8%) at 6-months post-baseline and 893/1286 (69.4%) at 12-months post-baseline. At 6-months, BMI z-score decreased relative to baseline (mean difference (MD) [95% confidence interval (CI)] = -0.08 [-0.10 to -0.06]; p < 0.001). BMI z-score (MD [95% CI] = -0.08 [-0.13 to -0.04); p = 0.001) and fasting triglycerides (MD [95% CI] = -0.07 [-0.13 to -0.02); p = 0.011) decreased at 12 months from baseline. Older age at baseline (estimated β = 0.025; 95% CI [0.006, 0.042], p = 0.007) and female sex (estimated β = 0.241; 95% CI [0.108, 0.329], p < 0.001) were associated with a worsened Δ BMI z-score at 12 months, while total hours with mental health provider (estimated β = -0.015; 95% CI [-0.030, -0.001], p = 0.049) was associated with an improved Δ BMI z-score at 12 months. Hours with an exercise counselor (estimated β = 0.023; 95% CI [0.008, 0.039], p = 0.003) were associated with improved HDL, while hours with a registered dietitian (estimated β = -0.026; 95% CI [-0.051, -0.001], p = 0.044) were associated with improved non-HDL cholesterol.

Conclusions: Male sex and hours spent with a mental health provider, exercise counselor, and registered dietitian were related to significant improvements in several anthropometric and cardiometabolic health indicators at 12 months post-baseline.