DIETITIANS MAKE A DIFFERENCE WHEN TREATING OBESITY
In an April 2015 study published in the Journal of Childhood Obesity, Kirk worked with Robert Siegel, MD, Medical Director of the Center for Better Health and Nutrition to examine the impact of visits with registered dieticians on the BMI outcomes of obese children as part of their intervention program.
They found that each additional dietitian visit was associated with a 28 percent increased chance of successfully reducing BMI. Overall, the probability of success exceeded 78 percent with monthly dietician visits, compared to 43 percent success rates with minimal exposure.
One big and frustrating challenge: “In some cases insurance coverage for a registered dietitian is limited to three 30-minute visits a year,” Kirk says.
Still, the study was important because it helped set some precedents, Kirk and Siegel say.
“The biggest lesson is that success correlated with the number of dietitian visits,” Siegel says. “Dietitians are very, very important. Exercise physiologists are very, very important. When the family does not meet with a dietitian and an exercise physiologist, the results are generally not good.”
EARLY INTERVENTION MATTERS FOR WEIGHT CONTROL
In another paper, published in October 2015 in Childhood Obesity, Kirk and researchers from 13 of the institutions in POWER analyzed data on 6,737 obese patients ages 2-17.
The team studied laboratory tests, blood pressure and demographics. They also examined the relationships between BMI status and co-morbidities.
Their finding: By the time most obese youths enter weight management programs, it is too late to avoid significant co-morbidities. Yet convincing families to enroll kids earlier, at lower weights, has been an uphill battle, Kirk says.
POWER’S FUTURE, ONCE UNCERTAIN, TAKES FLIGHT
Creating the POWER registry was long overdue, Kirk and Siegel say, but the effort has demonstrated that dozens of pediatric hospitals can team up to collect a valuable, uniform set of data.
“We’re here to stay,” Kirk says. “Nobody knew we even had a future when we started. But Cincinnati Children’s, including the Heart Institute, has been there the whole way.”
The next step is to secure additional sources of funding. So far, the POWER project has been primarily funding by enrollment fees covering each two-year cycle ($5,000 for 2014-2016; $6,000 for 2016-2018) from each participating institution. However, additional funding provided by the Heart Institute to cover needed administrative and faculty support during the first cycle was key to the project’s success.
Kirk has been invited to speak about patient outcomes based on POWER at a September workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases. The audience will include scientists with expertise in a range of specialties relevant to obesity, including genetics, endocrinology, epidemiology, psychology, behavioral medicine, and bariatric surgery.
She can’t wait.
“We don’t have National Institutes of Health funding now,” she says, “but this meeting provides an opportunity to showcase the work of POWER and make important connections that can help secure future funding. We know that pediatric obesity research is important to NIH and we believe POWER offers a needed resource to address this important health issue. That’s the vision we have for POWER going forward.”
—By Tom O’Neill
(This article originally appeared in the Summer 2017 issue of Research Horizons)