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29-12-2011 | General practice | Article

Childhood obesity interventions largely effective


Free abstract

MedWire News: Childhood obesity interventions are effective at reducing adiposity in children aged 6 to 12 years, results of a systematic review indicate.

"Prevention research must now move towards identifying how effective intervention components can be embedded within health, education and care systems and achieve long term sustainable impacts," say Elizabeth Waters (The University of Melbourne, Victoria, Australia) and colleagues.

Obesity has been described as the foremost health problem affecting children in developed nations and is linked to serious physical, social, and psychological consequences.

There is strong evidence that once obesity is established, it is difficult to reverse through interventions and tracks through to adulthood, strengthening the case for primary prevention.

In this study, Waters et al searched the literature for research that evaluated interventions, policies, or programs aimed at tackling childhood obesity and lasted for 12 weeks or more. They searched the CENTRAL, MEDLINE, EMBASE, PsychINFO, and CINAHL databases and extracted information on cost equity and outcomes.

A wide spectrum of interventions were identified, say the researchers. These included a school curriculum focusing on healthy eating, physical activity, and body image; physical activity throughout the school week; improvements in nutritional quality of the food supply in schools; environments and cultural practices to support children eating healthier foods; support for teachers and other staff to implement promotion strategies; and parent support and home activities that encourage children to be more active, eat more nutritious foods, and spend less time in screen based activities.

A meta-analysis was conducted using body mass index (BMI) or standardized BMI (zBMI) score data with subgroup analysis by age (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings).

Drawing from 37 studies including 27,946 children, Waters et al found that interventions generally reduced adiposity, although not every strategy was effective and there was high heterogeneity.

Overall, children in the intervention group had a mean reduction in adiposity (measured as BMI or zBMI) of 0.15 kg/m2.

The mean adiposity reductions by age subgroups were 0.26 kg/m2 (0-5 years), 0.15 kg/m2 (6-12 years), and 0.09 kg/m2 (13-18 years).

Just eight studies reported adverse effects of the weight-loss interventions. These showed no evidence of phenomena such as unhealthy dieting practices, increased prevalence of underweight, or body image sensitivities.

Waters et al note that their review identified a broad range of promising policies and strategies for intervention. Regarding future studies the researchers advise that "study and evaluation designs need to be strengthened, and reporting extended to capture process and implementation factors, outcomes in relation to measures of equity, longer term outcomes, potential harms and costs."

The research is published in The Cochrane Database of Systematic Reviews.

By Andrew Czyzewski

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