Nutrición Hospitalaria (Jun 2006)
Influencia de la educación nutricional en el tratamiento de la obesidad infanto-juvenil Influence of nutritional education on management of infantile-juvenile obesity
Abstract
Objetivo: Analizar la respuesta terapéutica de un grupo de pacientes obesos a un programa de tratamiento basado en la educación nutricional, autocontrol y seguimiento intensivo. Material y métodos: Se han revisado 60 historias clínicas de pacientes con obesidad exógena (42 mujeres y 18 varones) sometidos a un programa de tratamiento y seguimiento intensivo (controles trimestrales) durante un periodo continuado de 24 meses. Se registraron las siguientes variables: sexo, edad cronológica (EC), edad ósea (EO) e índice de masa corporal porcentual (IMC%) en la primera visita; el IMC% en cada uno de los controles y la respuesta terapéutica (abandonos, mejorías y fracasos) a los 12 y 24 meses de seguimiento. Resultados: Los valores medios de la edad y del cociente EO/EC eran de 9,7 años (varones: 9,4 y mujeres: 9,7) y 1,12 (varones: 1,1 y mujeres: 1,12), respectivamente. El valor medio del IMC% basal era de 144,7 (IC del 95%: 4,4), siendo significativamente superior (p Objective: To analyze the therapeutic response in a group of obese patients to a therapy program based on nutritional education, auto-management, and intensive follow-up. Material and methods: Sixty clinical charts have been reviewed of patients with exogenous obesity (42 female and 18 male patients) submitted to management program and intensive follow-up (every three months controls) for continuous period of 24 months. The following variables were registered: sex, chronological age (CA), bone age (BA), and percent body mass index (%BMI) in he first visit; %BMI in each control day, and therapeutic response (drop-outs, improvements, and failures) at 12 and 24 months of follow-up. Results: Mean values for age and CA/BA ratio were 9.7 years (males: 9.7; and females: 9.7), and 1.12 (males: 1.1; and females: 1.12), respectively. Average basal %BMI was 144.7 (95% CI: 4.4), being significantly higher in male patients. There was a progressive decrease from basal %BMI that was statistically significant from 18 months of follow-up in female patients (p < 0.05). At 12 and 24 months of follow-up, 20% and 30% had mild improvement, although 58.3% and 60% had a decreased basal %BMI, respectively. At 24 months of follow-up, the rate failure was significantly higher (p < 0.05) in males (83.3% vs 42.8%), where the success rate was higher among females (40.5% vs 5.5%), the total dropout rate being 15%. Growth was kept normal independently of gender and/or therapeutic response. Conclusions: Individualized information and intensive follow-up favor good acceptance and/or adhesion to the therapeutic program, and it allows for instilling health education to patients and/or relatives that, particularly in motivated patients, conditions a series of behavioral rules essential for controlling obesity.
