P160 Management of Obesity in Children with Asthma Using Nutrition Video Counseling

BackgroundAsthma and obesity in children are major public health concerns. Asthma makes obesity worse and obesity makes asthma worse. We report a pilot program integrating nutrition video counseling with routine office visits.ObjectiveTo determine if routine office visits plus nutrition video counseling improve body mass index (BMI), asthma, and obesity quality of life scores.Study Design, Setting, ParticipantsObese children ages 7-18 years old with persistent asthma were enrolled into a 6-month program that included 3 visits with a pediatric pulmonologist and a registered dietitian and 4 additional monthly free nutrition video visits using FaceTime, WhatsApp, or Skype. Motivational interviewing guided discussions about why and how to change behaviors such as skipping meals, binge eating, excessive screen time and physical inactivity. Identifying whole foods, nutrition label reading, mindfulness and goal setting skills were taught. At each office visit, subjects underwent evaluation of anthropometric measures, respiratory and nutritional status, and validated quality-of-life measures for asthma (PAQOL) and obesity (Sizing Me Up [SMU] for 7 to 13 years; IWQOL-Kids for 14 to 18 years).Measurable Outcome/AnalysisParticipants were assessed for BMI, asthma control, and quality of life measures pre-, mid-, and post-intervention.ResultsTwenty-one subjects were enrolled; 14 (67%) completed all visits and procedures. Twelve of the 14 (86%) reported improvement in obesity quality of life scores. Median SMU score improved from 61 (IQR 56, 76) to 76 (IQR 72, 77), P = .03. Median IWQOL-Kids score was 95 at baseline, 97 at completion, P = .20. Seven of the 14 (50%) had a decrease in BMI; mean BMI decreased from 33.0 to 31.3, which was not significant. There were no significant changes in pulmonary function or PAQOL.ConclusionsIn this small pilot study, the addition of video nutrition counseling to enhance office visits showed promising results and allows for deep discussions on the complexities of behavior change. However, future studies should be longer, combined with other multidisciplinary approaches, and have larger sample sizes. Asthma and obesity in children are major public health concerns. Asthma makes obesity worse and obesity makes asthma worse. We report a pilot program integrating nutrition video counseling with routine office visits. To determine if routine office visits plus nutrition video counseling improve body mass index (BMI), asthma, and obesity quality of life scores. Obese children ages 7-18 years old with persistent asthma were enrolled into a 6-month program that included 3 visits with a pediatric pulmonologist and a registered dietitian and 4 additional monthly free nutrition video visits using FaceTime, WhatsApp, or Skype. Motivational interviewing guided discussions about why and how to change behaviors such as skipping meals, binge eating, excessive screen time and physical inactivity. Identifying whole foods, nutrition label reading, mindfulness and goal setting skills were taught. At each office visit, subjects underwent evaluation of anthropometric measures, respiratory and nutritional status, and validated quality-of-life measures for asthma (PAQOL) and obesity (Sizing Me Up [SMU] for 7 to 13 years; IWQOL-Kids for 14 to 18 years). Participants were assessed for BMI, asthma control, and quality of life measures pre-, mid-, and post-intervention. Twenty-one subjects were enrolled; 14 (67%) completed all visits and procedures. Twelve of the 14 (86%) reported improvement in obesity quality of life scores. Median SMU score improved from 61 (IQR 56, 76) to 76 (IQR 72, 77), P = .03. Median IWQOL-Kids score was 95 at baseline, 97 at completion, P = .20. Seven of the 14 (50%) had a decrease in BMI; mean BMI decreased from 33.0 to 31.3, which was not significant. There were no significant changes in pulmonary function or PAQOL. In this small pilot study, the addition of video nutrition counseling to enhance office visits showed promising results and allows for deep discussions on the complexities of behavior change. However, future studies should be longer, combined with other multidisciplinary approaches, and have larger sample sizes.