What childhood obesity prevention programmes work? A systematic review and meta‐analysis

Obesity Reviews - Tập 16 Số 7 - Trang 547-565 - 2015
Youfa Wang1,2,3,4, Li Cai5,4, Yang Wu2,4, Renée F Wilson6, Christine Weston6, Oluwakemi A Fawole6, Sara N. Bleich6, Lawrence J. Cheskin2, Nakiya Showell7, Brandyn Lau8, Dorothy T. Chiu4, Aijia Zhang6, Jodi B Segal6,3
1Department of Epidemiology and Environmental Health (formerly the Department of Social and Preventive Medicine), School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
2Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
3Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. USA
4Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
5Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
6Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
7Division of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
8Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Tóm tắt

Summary

Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high‐income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi‐experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2–18 in high‐income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta‐analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity‐related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity‐only interventions delivered in schools with home involvement or combined diet–physical activity interventions delivered in schools with both home and community components. SOE was moderate for school‐based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school‐based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics‐oriented interventions.

Từ khóa


Tài liệu tham khảo

10.1093/epirev/mxm007

Centers for Disease Control (CDC) Vital Signs: Obesity among low‐income preschool‐aged children – United States 2008–2011. URLhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6231a4.htm(accessed August 2013).

Centers for Disease Control (CDC).Childhood Overweight and Obesity. URLhttp://www.cdc.gov/obesity/childhood/index.html(accessed August 2013).

10.1001/jama.299.20.2401

10.3109/09540261.2012.688195

10.1006/pmed.1993.1014

10.1056/NEJM199709253371301

10.3928/00904481-20090301-07

10.1038/oby.2007.224

World Health Organization.Global Strategy on Diet Physical Activity and Health. URLhttp://www.who.int/dietphysicalactivity/childhood_what_can_be_done/en/index.html(accessed May 2012).

10.1016/j.jada.2004.11.023

Institute of Medicine, 2012, Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation

10.1016/j.puhe.2006.11.015

10.1210/jc.2006-2411

10.1038/oby.2008.29

10.1002/14651858.CD001871.pub3

WangY WuY WilsonRFet al.Childhood Obesity Prevention Programs: Comparative Effectiveness Review and Meta‐Analysis. URLhttp://www.effectivehealthcare.ahrq.gov/reports/final.cfm(accessed June 2013).

United Nations.Human Development Reports. Human Development Index. URLhttp://hdr.undp.org/en/statistics/hdi/(accessed May 2012).

10.1136/jech.52.6.377

10.1016/0197-2456(86)90046-2

10.1016/j.jclinepi.2009.03.009

10.1136/bmj.39342.571806.55

10.1136/bmj.38077.458438.EE

10.1006/pmed.1995.1003

10.1056/NEJMoa1203034

10.1038/sj.ijo.0803805

10.1111/j.1651-2227.2007.00426.x

10.1038/sj.ijo.0803738

10.1007/s00223-005-0096-6

10.1016/j.ypmed.2008.02.020

10.1016/j.ypmed.2009.07.022

10.1007/s00421-008-0932-2

10.1079/BJN2002672

10.1001/archpedi.153.4.409

Will JC, 2001, Reducing risk for cardiovascular disease in uninsured women: combined results from two WISEWOMAN projects, J Am Med Womens Assoc, 56, 161

10.1123/jpah.6.5.560

10.1093/heapro/dag402

10.1056/NEJMoa1001933

10.3390/ijerph9041355

10.1007/s00431-006-0153-9

Lubans DR, 2012, Preventing obesity among adolescent girls: one‐year outcomes of the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) cluster randomized controlled trial, Arch Pediatr Adolesc Med, 166, 821, 10.1001/archpediatrics.2012.41

10.1016/j.amepre.2012.09.055

10.1080/17477160801896457

10.1038/oby.2007.247

10.1093/her/cys049

10.1016/j.amepre.2010.07.017

10.1016/j.endonu.2012.03.002

10.1155/2011/358581

10.1111/j.2047-6310.2012.00050.x

10.1016/S0033-3506(86)80030-0

10.1136/bmj.c785

10.1001/jama.282.16.1561

10.1038/ijo.2008.99

10.1542/peds.2007-1365

10.1038/ijo.2009.38

10.1016/S0022-3476(98)70315-4

10.1186/1479-5868-7-90

10.1111/j.1600-0838.2011.01387.x

10.1038/oby.2012.89

10.1016/j.ypmed.2010.05.015

10.1017/S1368980009991625

10.1136/jech.2009.102319

10.1111/j.2047-6310.2012.00079.x

10.1159/000229783

10.1016/j.amepre.2007.11.018

10.1038/oby.2006.11

10.1186/1479-5868-8-74

10.1186/1741-7015-7-49

10.1001/archpedi.160.2.128

10.1542/peds.2008-2780C

10.1542/peds.2011-3088

10.1089/chi.2011.0060

10.1016/j.clnu.2009.01.001

10.1038/oby.2006.186

10.1136/bmj.d6195

Scheffler C, 2007, Does physical education modify the body composition? – results of a longitudinal study of pre‐school children, Anthropol Anz, 65, 193, 10.1127/anthranz/65/2007/193

10.2466/06.10.25.PMS.115.6.919-932

10.1001/archpediatrics.2009.2

10.1016/S0749-3797(02)00646-3

10.1038/oby.2009.431

10.1503/cmaj.080966

10.1161/CIRCULATIONAHA.113.005666

10.1111/obr.12227

10.1161/CIRCULATIONAHA.109.865808

10.1016/j.ypmed.2009.07.022

10.1007/s00421-008-0932-2

10.1016/j.ypmed.2008.02.020

10.1123/jpah.6.5.560

10.1111/j.1600-0838.2007.00682.x

10.1111/j.1749-6632.1993.tb18844.x

10.1007/s00431-011-1466-x

10.1111/j.1651-2227.2007.00426.x

10.1080/106402601753454886

10.1038/sj.ijo.0803738

10.1111/j.1600-0838.2010.01181.x

10.1038/sj.ijo.0803805

10.1007/s00223-005-0096-6

10.3109/01460862.2013.777818

10.1111/j.2047-6310.2011.00026.x

10.1177/1059840512438777

10.1006/pmed.1995.1003

10.1006/pmed.1995.1003

10.1016/j.amepre.2012.09.055

10.1056/NEJMoa1001933

10.3390/ijerph9041355

10.1007/s00431-006-0153-9

Lubans DR, 2012, Preventing obesity among adolescent girls: one‐year outcomes of the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) cluster randomized controlled trial, Arch Pediatr Adolesc Med, 166, 821, 10.1001/archpediatrics.2012.41

10.1080/17477160801896457

10.1038/oby.2007.247

10.1093/her/cys049

10.1111/j.2047-6310.2012.00050.x

10.1016/j.jadohealth.2012.07.008

10.1016/j.amepre.2010.07.017

10.1016/j.endonu.2012.03.002

10.1155/2011/358581

10.1079/BJN20051666

10.1006/pmed.1998.0388

10.1079/BJN2002672

10.1111/j.1600-0838.2007.00636.x

10.1080/02640410801930176

10.1038/oby.2006.98

10.1017/S136898000800428X

10.1177/0739986304272359

10.1038/sj.ejcn.1602216

10.1542/peds.2006-3003

10.1542/peds.2008-2186

10.4278/ajhp.08031224

Skybo TA, 2002, A school‐based intervention to teach third grade children about the prevention of heart disease, Pediatr Nurs, 28, 223

10.1093/oxfordjournals.aje.a114160

10.1136/bmj.323.7320.1029

10.1001/archpedi.153.4.409

10.1016/0738-3991(93)90060-A

10.1093/oxfordjournals.aje.a115158

10.1177/1403494811421059

10.1159/000333436

10.1186/1479-5868-9-80

10.1186/1471-2458-11-711

10.1186/1479-5868-9-27

10.1097/MPG.0b013e3182318b39

10.1016/j.jsams.2012.03.011

10.1017/S0007114511003151

10.1007/s10900-010-9323-9

10.1093/heapro/dag402

10.1111/j.1651-2227.2005.tb02131.x

10.1001/archpedi.158.9.911

10.1093/ajcn/78.5.1030

10.1016/j.appet.2011.01.024

10.1001/jama.282.16.1561

10.1093/her/13.4.593

10.1016/S0022-3476(98)70315-4

10.1186/1479-5868-7-90

Siegrist M, 2011, Effects of a physical education program on physical activity, fitness, and health in children: the JuvenTUM project, Scand J Med Sci Sports, 23, 2241

10.1038/oby.2012.89

10.1016/j.ypmed.2010.05.015

10.1017/S1368980009991625

10.1136/jech.2009.102319

10.1111/j.2047-6310.2012.00079.x

10.1186/1479-5868-9-145

10.1038/ijo.2012.126

10.1038/ejcn.2011.25

10.1111/j.1651-2227.2007.00165.x

10.1016/S0033-3506(86)80030-0

10.1136/bmj.c785

10.2105/AJPH.2009.165746

10.1038/oby.2009.430

10.1001/archpedi.153.7.695

10.1016/0091-7435(91)90064-B

10.1097/FCH.0b013e3181ab3c57

10.1038/ijo.2009.38

10.1159/000336255

10.1136/bmjopen-2011-000390

10.1038/oby.2012.60

10.1038/ijo.2008.99

10.1542/peds.2007-1365

10.1177/10598405070230060501

10.1080/02701367.2005.10599275

10.1001/archpedi.159.3.217

10.1093/eurpub/ckp004

10.1038/oby.2010.329

10.3109/17477166.2011.575151

10.1017/S1368980012000687

10.1016/j.ijnurstu.2012.09.004

10.1136/bjsm.2010.075531

10.1038/ijo.2008.79

10.1111/j.1467-789X.2011.00904.x

10.1093/fampra/cmr097

10.3402/ijch.v71i0.17999

10.1159/000229783

10.1016/j.amepre.2007.11.018

10.1007/s12160-011-9332-7

10.1006/pmed.1997.0241

10.1177/1367493509344823

10.1111/j.1467-789X.2011.00905.x

10.1038/oby.2006.11

10.1001/archpediatrics.2011.204

Schneider M, 2007, Impact of a school‐based physical activity intervention on fitness and bone in adolescent females, J Phys Act Health, 4, 17, 10.1123/jpah.4.1.17

10.1371/journal.pone.0032682

10.1016/j.jadohealth.2012.07.014

10.1038/oby.2001.18

10.1016/j.jada.2004.06.025

10.1038/oby.2010.328

10.1002/oby.20269

10.1001/archpediatrics.2010.196

10.1016/j.jpeds.2009.08.039

10.1001/archpediatrics.2009.2

10.1016/S0749-3797(02)00646-3

10.1038/oby.2009.431

10.1038/oby.2007.155

10.1001/archpediatrics.2010.197

10.3945/ajcn.2009.28826

10.1377/hlthaff.2009.0742

10.1007/s00038-013-0455-4

Thông tin
Thông tin xuất bản

Obesity Reviews

Tập 16 Số 7

547-565

Thông tin tác giả