Nutrition and Exercise Start Today (NEST)
This project is testing the hypothesis that exposure to a clinic-based, family-oriented obesity management strategy, Nutrition and Exercise Start Today (NEST), will prevent excess weight gain (> 3% weight change) among obese pediatric patients in a large rural pediatric practice in New Braunfels, Texas. Hispanic children aged 5-14 years (goal is n=200) who were overweight (body mass index [BMI] 85th-94th percentile for age and gender) or obese (BMI ≥ 95th percentile) and a parent (goal is n=200) were recruited from New Braunfels Pediatric Associates, P.A., a certified Center for Medicare and Medicaid Services rural health clinic in Texas. Medical record abstraction will be used to characterize children’s health status at diagnosis and to ascertain the effect of exposure to the NEST program. Participants were randomized to standard care, or an educational intervention based on the American Academy of Pediatrics “Prevention Plus” approach to weight management, which includes a healthy lifestyle prescription, health education session, follow-up counseling calls and bilingual newsletters sent to participants’ homes. Outcomes included weight maintenance, fasting insulin and serum glucose levels, and markers of cardiovascular risk like lipid profile. The study aims to determine what individual, clinical, and program factors predict weight maintenance among obese children.