Die effek van 'n fisieke-aktiwiteits-, dieet en gedragsveranderingsintervensie op obesiteit by 9-12 jarige kinders
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Various research studies have indicated that the prevalence of overweight and obesity among children and adolescents has increased worldwide and has, therefore, become a serious health problem. Besides the various health implications of childhood obesity, it can also have psychological consequences for these children and they have a greater risk than a normal weight child to suffer from poor self perception. The effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure, physical activity levels and self perception of 9 to 12 year old overweight and obese children is, however, not clear. The aim of the study was firstly to determine the effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure and physical activity levels of 9 to 12 year old overweight and obese children. Secondly, to determine the effect of such an intervention on the self perception, and more specifically athletic and physical self perception of these children. An availability sample of 20 overweight and obese subjects (13 girls and 7 boys) between the ages of 9 and 12 years with a mean age of 11 years, participated in a 13 week (3 times/week) multidisciplinary intervention programme. Actical® monitors were used to monitor energy expenditure as well as physical activity levels during 2 weekdays and 1 weekend day before and after the intervention programme. From the results, analyzed by means of t-testing and linear regression, it is apparent that the total energy expenditure of the group, when adjusted for the effect of the intervention, showed a significant increase (p < 0.05) and body fat percentage as well as waist and upper arm circumferences decreased significantly. Although not significant, a decrease of 2,9 kg in body mass and 2,00 kg.rh" in body mass index were also indicated. However, the moderate and high intensity physical activity levels of the groups decreased significantly after the intervention programme. A possible reason for this decrease can be ascribed to the fact that the post-test took place during the school holidays. Further analysis of the data also indicated that the group slept longer hours, which increased their hours spent in the sedentary activity zone. The group also spent more time during the day watching television which also contributed to a decrease in the percentage of time spent in the moderate intensity zone. It is, however, concluded that increased total energy expenditure alone could not bring about effective weight loss and must, therefore, be accompanied by activity in the moderate and high intensity zones. For the purpose of the second aim, twenty children (13 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, participated in a 13 week multidisciplinary intervention programme (3 times per week). Eighteen children (11 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, served as a control group. Self perception, which consisted of 6 subcomponents, was determined by using the Harter Scale for Self Perception (Harter, 1985). It is clear from the results of the t-test (p < 0.05) that all subcomponents of self perception of the experimental group, especially physical, athletic and global self perception, increased significantly in relation to the control group which remained the same in all the subcomponents (p > 0.05), while a decrease in their social self perception was noted (p < 0.05). The experimental and control group did not differ significantly before the intervention programme, therefore the significant differences with regard to the subcomponents during the post-test, confirm the effect of the programme. On the basis of the abovementioned results the assumption can be made that a multidisciplinary intervention programme holds various benefits for overweight and obese children and is, therefore, another strategy in the prevention of overweight and obesity in children in South Africa. A multidisciplinary intervention programme, as used in this programme, is not only advantageous for weight loss in overweight and obese children, but also significantly improves their self perception.
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