Interventions for preventing obesity in children.

Cochrane Database Syst Rev. 2005 Jul 20;(3):CD001871. Update of:Cochrane Database Syst Rev. 2002;(2):CD001871.
Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ.School of Health and Social Care, University of Teesside, Parkside West,Middlesbrough, Teesside, UK, TS1 3BA.
BACKGROUND: Obesity prevention is an international public health priority. Theprevalence of obesity and overweight is increasing in child populationsthroughout the world, impacting on short and long-term health. Obesityprevention strategies for children can change behaviour but efficacy in terms ofpreventing obesity remains poorly understood.
OBJECTIVES: To assess theeffectiveness of interventions designed to prevent obesity in childhood throughdiet, physical activity and/or lifestyle and social support.
SEARCH STRATEGY:MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 toFebruary 2005. Non-English language papers were included and experts contacted.
SELECTION CRITERIA: Randomised controlled trials and controlled clinical trialswith minimum duration twelve weeks.
DATA COLLECTION AND ANALYSIS: Two reviewersindependently extracted data and assessed study quality.
MAIN RESULTS:Twenty-two studies were included; ten long-term (at least 12 months) and twelveshort-term (12 weeks to 12 months). Nineteen were school/preschool-basedinterventions, one was a community-based intervention targeting low-incomefamilies, and two were family-based interventions targeting non-obese childrenof obese or overweight parents.Six of the ten long-term studies combined dietaryeducation and physical activity interventions; five resulted in no difference inoverweight status between groups and one resulted in improvements for girlsreceiving the intervention, but not boys. Two studies focused on physicalactivity alone. Of these, a multi-media approach appeared to be effective inpreventing obesity. Two studies focused on nutrition education alone, butneither were effective in preventing obesity.Four of the twelve short-termstudies focused on interventions to increase physical activity levels, and twoof these studies resulted in minor reductions in overweight status in favour ofthe intervention. The other eight studies combined advice on diet and physicalactivity, but none had a significant impact.The studies were heterogeneous interms of study design, quality, target population, theoretical underpinning, andoutcome measures, making it impossible to combine study findings usingstatistical methods. There was an absence of cost-effectiveness data.
AUTHORS'CONCLUSIONS: The majority of studies were short-term. Studies that focused oncombining dietary and physical activity approaches did not significantly improveBMI, but some studies that focused on dietary or physical activity approachesshowed a small but positive impact on BMI status. Nearly all studies includedresulted in some improvement in diet or physical activity. Appropriateness ofdevelopment, design, duration and intensity of interventions to prevent obesityin childhood needs to be reconsidered alongside comprehensive reporting of theintervention scope and process.
Publication Types: Meta-Analysis, Review