The effectiveness of a health promotion and stress-management intervention program in a sample of obese children and adolescents.
OBJECTIVE
Our study aimed to evaluate the effectiveness of an 8-week stress management intervention program that included progressive muscle relaxation, diaphragmatic breathing, guided imagery, and cognitive restructuring in obese Greek children and adolescents.


DESIGN
Thirty-six patients were prospectively recruited to participate in this randomized controlled study. Of these, 16 participants formed the intervention group and 20 participants the control group. Anthropometric measurements and salivary cortisol, determined serially 3 times a day, were assessed at the beginning and at the end of the study. Participants also completed the state-trait anxiety in children questionnaire (STAIC), the stress in children questionnaire (SiC), and the child behavior checklist (CBCL).


RESULTS
The intervention resulted in a significant reduction of waist-hip ratio (p = 0.008) in the intervention group compared with the control group. Moreover, school performance was improved in the intervention group (p = 0.025), while both the intervention and the control group adopted healthier daily habits (p = 0.020 and 0.011, respectively). However, there was no statistically significant difference between body mass index (BMI) z-score, stress, anxiety, and diurnal patterns in salivary cortisol.


CONCLUSIONS
The present study supports the effectiveness of stress management intervention programs on waist-hip ratio reduction. Further research is required to investigate biomarkers able to predict and evaluate the effectiveness of stress management intervention programs.
['Emmanouil|Chrysoula-Christina|CC|', 'Pervanidou|Panagiota|P|', 'Charmandari|Evangelia|E|', 'Darviri|Christina|C|', 'Chrousos|George P|GP|']
D000293:Adolescent D001945:Breathing Exercises D002648:Child D015928:Cognitive Behavioral Therapy D005260:Female D006293:Health Promotion D006801:Humans D019018:Imagery, Psychotherapy D008297:Male D009126:Muscle Relaxation D017063:Outcome Assessment, Health Care D063766:Pediatric Obesity D015397:Program Evaluation D012064:Relaxation Therapy D013315:Stress, Psychological
Obesity Children Adolescents Stress Cortisol Anxiety