Korean J Health Promot.  2016 Dec;16(4):231-250. 10.15384/kjhp.2016.16.4.231.

Evidence of Interventions for Preventing Obesity of Children and Adolescents Using Existing Systematic Reviews and Meta-Analyses

• Kim S
• Sung E
• Yoo S

• KMID: 2367356
• DOI: http://doi.org/10.15384/kjhp.2016.16.4.231

Abstract

BACKGROUND
Pediatric obesity is an important global issue in public health. However, previous efforts for childhood obesity prevention have sporadically been implemented in Korea, neither evidence-based nor with proper evaluation. We aimed to investigate the characteristics of an effective intervention for prevention of pediatric obesity by reviewing previous systematic reviews and Meta-analyses.
METHODS
PubMed was searched for articles published frombetween January 2005 to November 2015. Inclusion criteria were as follows: (1) articles published in English; (2) child and/or adolescents (between 2 and 18 years of age) as subjects; and (3) systematic reviews or meta-analyses concerning the preventive intervention of pediatric/adolescent obesity. Each study was evaluated via the Assessment of Multiple Systematic Reviews for quality assessment. We conducted a quantitative analysis to evaluate the implications, strengths, and limitations of each study.
RESULTS
Our final analysis included 35 articles, of which 15 were systematic reviews and 20 were meta-analyses. Among these, 24 studies (69%) advocated the efficacy of preventive intervention for pediatric obesity. Multidimensional approach including diet, exercise, and environmental factors conducted in schools with a parent and community involvement wasis more effective at preventing obesity. The efficacy of intervention varied depending on the age, sex, region, and socioeconomic characteristics of participantssubjects.
CONCLUSIONS
Preventive intervention of pediatric obesity demonstrated smallminor improvements in body mass index and had positive effects on behavioral and clinical variables, which are associated with obesity. For the efficient prevention of pediatric obesity, it is necessary to consider efforts for developing various intervention programs, with active as well as the participation of school, family, and social community groups.

Keyword

Obesity; Prevention and control; Review; Child; Adolescent

MeSH Terms

Adolescent*
Body Mass Index
Child*
Diet
Humans
Korea
Obesity*
Parents
Pediatric Obesity
Public Health

Figure

• 

  Figure 1. Flow-chart of literature search.

Reference

References

1. World Health Organization. Population-based prevention strategies for childhood obesity: report of a WHO forum and technical meeting, Geneva, 15–17 December 2009 [Internet]. Geneva: World Health Organization;2010. [Accessed Dec 21, 2016]. Available from:. http://apps.who.int/iris/bitstream/10665/44312/1/9789241599344_eng.pdf.

2. Kim HR, Kang YH, Kwak NS, Kang EJ, Kim EJN. Trends in obesity and comprehensive policy strategy to prevent obesity in Korea [Internet]. Sejong: Korea Institute for Health and Social Affairs;2009. [Accessed Dec 21, 2016]. Available from:. http://repository.kihasa.re.kr. 8080/bitstream/201002/803/1/%ec% 97%b0%ea%b5%ac_2009–07.pdf.

3. Lee HY. Effectiveness of Obesity management programs: systematic review and metaanalysis. Korean J Health Educ Promot. 2007; 24(4):131–46.

4. Sung KS, Yoon YM, Kim EJ. Meta-analysis of the effects of obesity management program for children. Child Health Nurs Res. 2013; 19(4):262–9.

5. Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009; 62(10):1013–20.

6. Kim SY, Park JE, Seo HJ, Seo HS, Shon HJ, Shin CM, et al. NECA's guidance for undertaking systematic reviews and metaanalyses for intervention. Sejong: Korea Institute for Health and Social Affairs;2011.

7. Liberati A, Altman DG, Tetzlaff J, Mulrow C, G⊘tzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339:b2700.

8. Budd GM, Volpe SL. School-based obesity prevention: research, challenges, and recommendations. J Sch Health. 2006; 76(10):485–95.

9. Cook-Cottone C, Casey CM, Feeley TH, Baran J. A meta-analytic review of obesity prevention in the schools: 1997–2008. Psychol Sch. 2009; 46(8):695–719.

10. Katz DL, O'Connell M, Njike VY, Yeh MC, Nawaz H. Strategies for the prevention and control of obesity in the school setting: systematic review and metaanalysis. Int J Obes (Lond). 2008; 32(12):1780–9.

11. Lavelle HV, Mackay DF, Pell JP. Systematic review and metaanalysis of school-based interventions to reduce body mass index. J Public Health (Oxf). 2012; 34(3):360–9.

12. Luckner H, Moss JR, Gericke CA. Effectiveness of interventions to promote healthy weight in general populations of children and adults: a metaanalysis. Eur J Public Health. 2012; 22(4):491–7.

13. Marsh S, Foley LS, Wilks DC, Maddison R. Family-based interventions for reducing sedentary time in youth: a systematic review of randomized controlled trials. Obes Rev. 2014; 15(2):117–33.

14. Stice E, Shaw H, Marti CN. A meta-analytic review of obesity prevention programs for children and adolescents: the skinny on interventions that work. Psychol Bull. 2006; 132(5):667–91.

15. van Grieken A, Ezendam NP, Paulis WD, van der Wouden JC, Raat H. Primary prevention of overweight in children and adolescents: a metaanalysis of the effectiveness of interventions aiming to decrease sedentary behaviour. Int J Behav Nutr Phys Act. 2012; 9:61.

16. Wahi G, Parkin PC, Beyene J, Uleryk EM, Birken CS. Effectiveness of interventions aimed at reducing screen time in children: a systematic review and metaanalysis of randomized controlled trials. Arch Pediatr Adolesc Med. 2011; 165(11):979–86.

17. Chen JL, Wilkosz ME. Efficacy of technology-based interventions for obesity prevention in adolescents: a systematic review. Adolesc Health Med Ther. 2014; 5:159–70.

18. Williams AJ, Henley WE, Williams CA, Hurst AJ, Logan S, Wyatt KM. Systematic review and metaanalysis of the association between childhood overweight and obesity and primary school diet and physical activity policies. Int J Behav Nutr Phys Act. 2013; 10:101.

19. Osei-Assibey G, Dick S, Macdiarmid J, Semple S, Reilly JJ, Ellaway A, et al. The influence of the food environment on overweight and obesity in young children: a systematic review. BMJ Open. 2012; 2(6):): e001538.

20. Brown T, Summerbell C. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: an update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obes Rev. 2009; 10(1):110–41.

21. Branscum P, Sharma M. After-school based obesity prevention interventions: a comprehensive review of the literature. Int J Environ Res Public Health. 2012; 9(4):1438–57.

22. Connelly JB, Duaso MJ, Butler G. A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: a realistic synthesis of the evidence. Public Health. 2007; 121(7):510–7.

23. Doak CM, Visscher TL, Renders CM, Seidell JC. The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obes Rev. 2006; 7(1):111–36.

24. Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V. School-based interventions on childhood obesity: a metaanalysis. Am J Prev Med. 2009; 37(5):418–27.

25. Harris KC, Kuramoto LK, Schulzer M, Retallack JE. Effect of school-based physical activity interventions on body mass index in children: a metaanalysis. CMAJ. 2009; 180(7):719–26.

26. Kamath CC, Vickers KS, Ehrlich A, McGovern L, Johnson J, Singhal V, et al. Clinical review: behavioral interventions to prevent childhood obesity: a systematic review and metaanalyses of randomized trials. J Clin Endocrinol Metab. 2008; 93(12):4606–15.

27. Kropski JA, Keckley PH, Jensen GL. School-based obesity prevention programs: an evidencebased review. Obesity (Silver Spring). 2008; 16(5):1009–18.

28. Lissau I. Prevention of overweight in the school arena. Acta Paediatr. 2007; 96(454):12–8.

29. Niemeier BS, Hektner JM, Enger KB. Parent participation in weight-related health interventions for children and adolescents: a systematic review and metaanalysis. Prev Med. 2012; 55(1):3–13.

30. Peirson L, Fitzpatrick-Lewis D, Morrison K, Ciliska D, Kenny M, Usman Ali M, et al. Prevention of overweight and obesity in children and youth: a systematic review and metaanalysis. CMAJ Open. 2015; 3(1):E23–33.

31. Sbruzzi G, Eibel B, Barbiero SM, Petkowicz RO, Ribeiro RA, Cesa CC, et al. Educational interventions in childhood obesity: a systematic review with metaanalysis of randomized clinical trials. Prev Med. 2013; 56(5):254–64.

32. Silveira JA, Taddei JA, Guerra PH, Nobre MR. The effect of participation in school-based nutrition education interventions on body mass index: a metaanalysis of randomized controlled community trials. Prev Med. 2013; 56(3–4):237–43.

33. Sobol-Goldberg S, Rabinowitz J, Gross R. School-based obesity prevention programs: a metaanalysis of randomized controlled trials. Obesity (Silver Spring). 2013; 21(12):2422–8.

34. Vasques C, Magalhães P, Cortinhas A, Mota P, Leitão J, Lopes VP. Effects of intervention programs on child and adolescent BMI: a metaanalysis study. J Phys Act Health. 2014; 11(2):426–44.

35. Wang Y, Cai L, Wu Y, Wilson RF, Weston C, Fawole O, et al. What childhood obesity prevention programmes work? A systematic review and metaanalysis. Obes Rev. 2015; 16(7):547–65.

36. Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011; 12:CD001871.

37. Zenzen W, Kridli S. Integrative review of school-based childhood obesity prevention programs. J Pediatr Health Care. 2009; 23(4):242–58.

38. Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, et al. The WHO health promoting school framework for improving the health and wellbeing of students and their academic achievement. Cochrane Database Syst Rev. 2014; 4:CD008958.

39. Bleich SN, Segal J, Wu Y, Wilson R, Wang Y. Systematic review of community-based childhood obesity prevention studies. Pediatrics. 2013; 132(1):e201–10.

40. Showell NN, Fawole O, Segal J, Wilson RF, Cheskin LJ, Bleich SN, et al. A systematic review of home-based childhood obesity prevention studies. Pediatrics. 2013; 132(1):e193–200.

41. Li M, Li S, Baur LA, Huxley RR. A systematic review of school-based intervention studies for the prevention or reduction of excess weight among Chinese children and adolescents. Obes Rev. 2008; 9(6):548–59.

42. Friedrich RR, Schuch I, Wagner MB. Effect of interventions on the body mass index of school-age students. Rev Saude Publica. 2012; 46(3):551–60.

43. Brown HE, Atkin AJ, Panter J, Corder K, Wong G, Chinapaw MJ, et al. Family-based interventions to increase physical activity in children: a metaanalysis and realist synthesis protocol. BMJ Open. 2014; 4(8):): e005439.

44. Swinburn B, Gill T, Kumanyika S. Obesity prevention: a proposed framework for translating evidence into action. Obes Rev. 2005; 6(1):23–33.

45. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014; 348:g1687.

46. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015; 350:h1258.