A Multicomponent Family Treatment of Childhood Obesity Based on the Planetary Healthy Diet: A Randomized Controlled Trial

Joana Maia Brandão, Diana Barbosa Cunha (), Magno Conceição Garcia, Cinthia Guimarães Assemany, Marina Campos Araújo, Valéria Troncoso Baltar and Rosely Sichieri
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Joana Maia Brandão: Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 7017B, Maracanã, Rio de Janeiro 20550-900, RJ, Brazil
Diana Barbosa Cunha: Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 7017B, Maracanã, Rio de Janeiro 20550-900, RJ, Brazil
Magno Conceição Garcia: Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 7017B, Maracanã, Rio de Janeiro 20550-900, RJ, Brazil
Cinthia Guimarães Assemany: Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 7017B, Maracanã, Rio de Janeiro 20550-900, RJ, Brazil
Marina Campos Araújo: Department of Epidemiology and Quantitative Methods in Health, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 20911-300, RJ, Brazil
Valéria Troncoso Baltar: Department of Epidemiology and Biostatistics, Institute of Collective Health, Fluminense Federal University, Niterói 24030-210, RJ, Brazil
Rosely Sichieri: Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 7017B, Maracanã, Rio de Janeiro 20550-900, RJ, Brazil

IJERPH, 2025, vol. 22, issue 11, 1-16

Abstract: The Planetary Health Diet (PHD), recognized as a healthy and environmentally sustainable dietary pattern, has been promoted globally; however, its role in supporting weight change among children within structured weight management interventions remains unclear. A four-month randomized multicomponent family-based trial was conducted with 120 dyads of children with obesity (7–12 years) and their guardians. The intervention group (IG) received counseling on the PHD, portion size reduction, and strategies to increase moderate-to-vigorous physical activity, while the control group (CG) received general guidance based on the Dietary and Physical Activity Guidelines for the Brazilian Population, emphasizing the avoidance of ultra-processed foods. Dietary intake was assessed using a food frequency questionnaire, and anthropometric measurements were taken by trained professionals at baseline and during each consultation. Mixed-effects models were used to estimate BMI change in children and guardians. Most guardians were mothers with low-to-middle income. Attrition was around 40% in both groups, but most participants were followed up for four visits. No significant difference in BMI variation was observed between allocation groups; however, both groups of children reduced BMI (IG = −0.2 and CG = −0.4; p = 0.002), with no change among guardians. PHD adherence scores changed minimally overall, but consumption of nuts and fruits increased in both groups. Although the intervention did not outperform the control in reducing BMI, the overall BMI reduction among children in both groups suggests that participation in a lifestyle-focused trial, regardless of specific content, may promote weight management in children with obesity.

Keywords: obesity; food consumption; environmental health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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