Obesity Program for Obese Children And Adoscelents in New York City
Live Light...Live Right

ACHIEVEMENTS

Awards and Funding

Outcomes

Every year over 250 new patients are evaluated through the multidisciplinary Obesity program and referred to the Live Light .. Live Light program. We have evaluated over 2000 children over the past 5 years.

Expected outcomes we evaluate among program participants:

The outcomes are very positive:

For 1290 patients we have the following available data : Mean follow up period is 18 months ( range 1 month to 10 years)

Live Light...Live Right Program Outcomes

Metabolic Risk Factors by BMI Z Scores in 3-12 Yrs (Brookdale Data)

Metabolic Risk Factors by BMI Z Scores in >12 yrs (Brookdale Data)

Changes in Anthropometric Measures

Improvement in Risk Factors (%age of children showing improvement of individual risk factors)

%age of patients showing improvement in Risk Factors in Patients with Decrease in BMI Z (Mean 0.19)

Table 1: Risk factor improvement in patients with increase and decrease in BMI Z scores

Table 2: Mean changes in risk factors for all patients followed in the program at the last data analysis done on 12.31.06

The data so far shows maintenance or decreased rate of weight gain in 2/3rd of the children followed with nearly 50% risk factor reduction in most children. There is a significant mean change in risk factor reduction in most variables as shown in Table 2.

Even in those with weight gain, ( Increase in BMI Z scores ) lifestyle modification lead to risk factor reduction in a substantial number of children ( Table 1) especially for the lipid values and insulin levels which really are the cardiovascular risk factor. This is the most positive outcome of our program .

Other Achievements

Exercise Programs: Currently over 100 children are enrolled in our free or subsidized exercise program on an ongoing basis and the numbers are growing every week. They are given incentives in the form of pedometers, metro cards, free YMCA admissions, and certificates of achievement at the end of the year.

Nutritional program: Our nutritional program involves one on one counseling by both the physicians and reinforcement with behavior modification by the nutritionist. Children and their families undergo a complete assessment through verbal food recalls for food eaten on a regular basis on weekdays and weekends and a follow up evaluation to assess changes in nutritional choices is completed by the nutritionist at the 3 month intervals.

Community acceptance: Excellent community acceptance has been demonstrated by many factors. Our team has been invited several times to give workshops in the local School Districts, recreational centers, health fairs, PTA meetings. Community pediatricians are referring patients regularly to the obesity program as a result of community education. There is over a 3 month waiting period to get an appointment in this clinic. Most importantly, there has been a steady increase in patient self-referral, showing a community awareness of the problem and the knowledge of where to find help. Some of the patients who have lost weight and benefited from the program are now volunteering and motivating other children.

Seminars & Workshops

Over 200 seminars & workshops held
Attended by 5000 members of the community
Attended by 600 physicians
Distribution of brochures & nutritional handouts, as well as posters available

Seminar Attendees:

Pre- and Post-Test Evaluations

Pre and post test questionnaires confirm a significant improvement in level of awareness regarding food choices and a genuine desire to implement lifestyle changes on the part of the attendees.

Seminar Outcomes: Pre & Post Questionnaires

Q. Did you gain any new knowledge about childhood obesity from the seminar?
All attendees answered yes.

Q. What worked for you?
A. Inspired me to change my own life style before preaching to others.

Ongoing Projects

Metabolic Risk factors in Childhood obesity: Focus on metabolic syndrome

1.	Beverage and fruit juice intake as a source of calories in obese children.
2.	Insulin resistance and associated cardiovascular risk factors in childhood obesity.
3.	Cardiovascular risk reduction in obese children attending a community based intervention program.
4.	Assessment of endothelial function using Endo Pat 2000 a non invasive device in obese vs. non obese children Endothelial dysfunction is a well recognized marker of sub-clinical atherosclerosis and a predictor of cardiovascular events Endothelial function studies have now been incorporated into numerous cardiovascular risk assessment and prevention studies PAT (Peripheral Arterial Tone) is a physiological signal that reflects changes in the autonomic nervous activity and endothelial function through the precise measurement of arterial pulsatile volume changes in the fingertip PAT (Peripheral Arterial Tone) The PAT probe is applied to the index fingers of both armsA reactive hyperemia procedure is performed by occluding the brachial artery of one arm for 5 minutesPAT data is quickly analyzed by the proprietary software package The final result is displayed on the PC or laptop screen. Normal vs. Abnormal Signal
5.	Correlation of inflammatory markers with endothelial function in overweight children with and without metabolic syndrome.
6.	Echocardiographic assessment of systolic and diastolic function in childhood obesity.
7.	Sleep related disorders and the association of obesity , metabolic syndrome and cardiovascular dysfunction.

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