Long-term effects of a family-centered comprehensive lifestyle intervention on body composition and cardiometabolic indicators in school-aged obese children aged 6–12 years

Abstract

Childhood obesity increases risks for metabolic and cardiovascular disease, yet long-term effectiveness of family-centered interventions remains unclear. This retrospective study evaluated associations between a family-centered comprehensive lifestyle intervention and changes in body composition and cardiometabolic indicators in school-aged children with obesity. Children aged 6–12 years diagnosed with obesity at Qingdao Chengyang District People’s Hospital from March 2021 to March 2024 were included. A total of 289 participants were categorized into the Family-Centered Intervention Group ( n = 162) receiving a 12-month multidisciplinary program or the Routine Guidance Group ( n = 127) receiving standard health education. Anthropometric measurements, body composition, blood pressure (BP), lipid profiles, glucose metabolism indices, inflammatory markers, liver function, uric acid, cardiovascular structure, and health-related quality of life were assessed at baseline and at the 12-month follow-up. At the 12-month mark, the intervention group demonstrated markedly greater associations with enhancements in body mass index (BMI, adjusted mean difference: -1.23, 95% CI: -1.80 to -0.66, adjusted p < 0.001), waist circumference (adjusted mean difference: -4.13, 95% CI: -5.68 to -2.58, adjusted p < 0.001), body fat percentage (adjusted mean difference: -2.61, 95% CI: -3.60 to -1.62, adjusted p < 0.001), systolic BP (adjusted mean difference: -4.23, 95% CI: -6.12 to -2.34, adjusted p < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR, adjusted mean difference: -0.46, 95% CI: -0.77 to -0.15, adjusted p = 0.004), high-sensitivity C-reactive protein (hs-CRP, adjusted mean difference: -0.57, 95% CI: -0.82 to -0.32, adjusted p < 0.001), and total Pediatric Quality of Life Inventory (PedsQL) score (adjusted mean difference: 4.73, 95% CI: 1.82 to 7.64, adjusted p = 0.002), along with more favorable lipid profiles, lower uric acid, improved cardiac structure, and reduced carotid intima-media thickness (all p < 0.05). In this retrospective cohort of school-aged children affected by obesity, a family-centered comprehensive lifestyle intervention was associated with favorable body composition, cardiometabolic profiles, and overall quality of life related to health over 12 months. Given the retrospective and non-randomized design, these findings should be interpreted as hypothesis-generating associations rather than causal effects.