RT Journal Article
SR Electronic
T1 Prevention of overweight and obesity in children and youth: a systematic review and meta-analysis
JF CMAJ Open
FD Canadian Medical Association
SP E23
OP E33
DO 10.9778/cmajo.20140053
VO 3
IS 1
A1 Leslea Peirson
A1 Donna Fitzpatrick-Lewis
A1 Katherine Morrison
A1 Donna Ciliska
A1 Meghan Kenny
A1 Muhammad Usman Ali
A1 Parminder Raina
YR 2015
UL http://www.cmajopen.ca/content/3/1/E23.abstract
AB Background One-third of Canadian children are overweight or obese. This problem carries considerable concern for negative impacts on current and future health. Promoting healthy growth and development is critical. This review synthesized evidence on the effectiveness of behavioural interventions for preventing overweight and obesity in children and adolescents. Methods We updated the search of a previous Cochrane review. Five databases were searched up to August 2013. Randomized trials of primary care–relevant behavioural (diet, exercise and lifestyle) interventions for preventing overweight and obesity in healthy normal- or mixed-weight children or youth aged 0–18 years were included if 12-week postbaseline data were provided for body mass index (BMI), BMI z-score, or prevalence of overweight or obesity. Any study reporting harms was included. Meta-analyses were performed if possible. Features of interventions showing significant benefits were examined. Results Ninety studies were included, all with mixed-weight populations. Compared with controls, interventions showed a small but significant effect on BMI and BMI z-score (standardized mean difference –0.07, 95% confidence interval [CI] –0.10 to –0.03, I2 = 74%), a reduction in BMI (mean difference –0.09 kg/m2, 95% CI –0.16 to –0.03, I2 = 76%) and a reduced prevalence of overweight and obesity (risk ratio [RR]; RRintervention – RRcontrol 0.94, 95% CI 0.89 to 0.99, I2 = 0%; number needed to treat 51, 95% CI 29 to 289). Little evidence was available on harms. There was variability across efficacious interventions, although many of the interventions were short-term, involved school-aged children and were delivered in educational settings. Interpretation Behavioural prevention interventions are associated with small improvements in weight outcomes in mixed-weight populations of children and adolescents. No intervention strategy consistently produced benefits. Registration: PROSPERO no. CRD42012002754