{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:16:57Z","timestamp":1788239817467,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Introduction<\/jats:title>\n Continuous energy restriction may be associated with poor adherence and a risk of muscle mass loss in pediatric obesity management. This study evaluated the effects of a structured \u201c5\u202f+\u202f2\u201d dietary management model\u2014cycling 5 weekdays of calorie-restricted diet with 2 weekend days of high-protein diet\u2014supported by standardized supplements and professional supervision.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this prospective, non-randomized controlled trial conducted in Shenzhen, China, 84 children with persistent obesity (median age 11.1\u202fyears) were enrolled. The intervention group (\n N<\/jats:italic>\n \u202f=\u202f31) followed an 8-week \u201c5\u202f+\u202f2\u201d protocol with dietitian-led behavioral guidance and satiety-enhancing supplements, followed by a 12-week follow-up period. Controls (\n N<\/jats:italic>\n \u202f=\u202f53) received conventional weight-loss advice. Propensity score matching was employed to balance baseline cohorts (\n N<\/jats:italic>\n \u202f=\u202f74; 30 intervention, 44 control). Changes in weight, body composition, metabolic parameters, and behavior were assessed at weeks 8 and 20.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At week 8, the intervention group achieved significantly greater weight loss (\u22121.42\u202f\u00b1\u202f1.73\u202fkg vs. \u22120.44\u202f\u00b1\u202f1.54\u202fkg,\n p<\/jats:italic>\n \u202f=\u202f0.015) and body mass index (BMI) standard deviation score (SDS) reduction (\u22120.21\u202f\u00b1\u202f0.14 vs. -0.11\u202f\u00b1\u202f0.14,\n p<\/jats:italic>\n \u202f=\u202f0.005) compared to controls. The median behavior score in the intervention group improved significantly from 66.0 to 82.0 (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), with marked increases in self-weighing frequency and physical activity. At the 20-week follow-up (post-summer break), the intervention group maintained greater reductions in body fat mass (\u22121.42\u202f\u00b1\u202f3.41 vs. +1.84\u202f\u00b1\u202f3.67\u202fkg,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and greater skeletal muscle gain (3.90\u202f\u00b1\u202f3.46 vs. 2.21\u202f\u00b1\u202f2.36\u202fkg,\n p<\/jats:italic>\n \u202f=\u202f0.031) than the control group, with significantly lower fat mass index (FMI)\n Z<\/jats:italic>\n -scores and higher muscle mass index (MMI)\n Z<\/jats:italic>\n -scores. Linear regression identified boys (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.758,\n p<\/jats:italic>\n \u202f=\u202f0.015), older children (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.240,\n p<\/jats:italic>\n \u202f=\u202f0.003) and children with higher baseline adherence (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.356,\n p<\/jats:italic>\n \u202f=\u202f0.004) as key predictors for BMI SDS reduction.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The \u201c5\u202f+\u202f2\u201d dietary management model was associated with favorable changes in body composition and health-related behaviors in children with obesity and may represent a practical dietary management strategy.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1907795","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:26:55Z","timestamp":1788236815000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of a \u201c5\u202f+\u202f2\u201d dietary management model on body composition and behavioral modification in Chinese children with obesity: a prospective, non-randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Huiping","family":"Su","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongfei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chushan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingfan","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Chronic Disease Prevention and Control, Shenzhen Center for Chronic Disease Control","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minlu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Chronic Disease Prevention and Control, Longgang District Chronic Disease Prevention and Control Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen Children\u2019s Hospital","place":["Shenzhen, 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