The long-term effects of primary school-based obesity prevention interventions in children: A systematic review and meta-analysis

IF 2.7 3区医学 Q1 PEDIATRICS Pediatric Obesity Pub Date : 2022-12-21 DOI:10.1111/ijpo.12997

Michel S. Smit, Mirte Boelens, Famke J. M. M?lenberg, Hein Raat, Wilma Jansen

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Abstract

Introduction

This systematic review and meta-analysis investigate the long-term effects of primary school-based obesity prevention interventions on body-mass index (and z-scores), waist circumference (and z-scores) and weight status.

Methods

Four databases were searched for studies from date of inception until June 8th, 2021. We included randomized controlled trials (RCT) and non-RCTs investigating effects ≥12 months post-intervention of primary school-based interventions with intervention duration ≥6 months and containing a diet and/or physical activity component on outcomes of interest. Articles were assessed on risk of bias and methodological quality by RoB2 and ROBINS-I. Meta-analysis was performed and results were narratively summarized. Evidence quality was assessed with GRADE.

Results

Nineteen studies were included, 9 were pooled in a meta-analysis. No long-term effects were found on body-mass index (+0.06 kg/m²; CI95% = −0.38, 0.50; I² = 66%), body-mass index z-scores (−0.08; CI95% = −0.20, 0.04; I² = 36%), and waist circumference (+0.57 cm; CI95% = −0.62, 1.75; I² = 13%). Non-pooled studies reported mixed findings regarding long-term effects on body-mass index, body-mass index z-scores and weight status, and no effects on waist circumference and waist circumference z-scores. Evidence certainty was moderate to very low.

Discussion

No clear evidence regarding long-term effects of primary school-based interventions on obesity-related outcomes was found. Recommendations for further research and policy are discussed.

Prospero registration ID: CRD42021240446.

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以小学为基础的儿童肥胖预防干预的长期效果:系统回顾和荟萃分析

本系统综述和荟萃分析探讨了以小学为基础的肥胖预防干预措施对身体质量指数(和z分数)、腰围(和z分数)和体重状况的长期影响。方法检索4个数据库，检索自建立之日至2021年6月8日的研究。我们纳入了随机对照试验(RCT)和非随机对照试验，调查干预后≥12个月以小学为基础、干预持续时间≥6个月且包含饮食和/或体育活动成分的干预对结果的影响。采用RoB2和ROBINS-I对文章的偏倚风险和方法学质量进行评估。进行meta分析，并对结果进行叙述性总结。采用GRADE评价证据质量。结果共纳入19项研究，其中9项纳入meta分析。未发现对体重指数的长期影响(+0.06 kg/m2;Ci95% =−0.38,0.50;I2 = 66%)，身体质量指数z-分数(- 0.08;Ci95% =−0.20,0.04;I2 = 36%)，腰围(+0.57 cm;Ci95% =−0.62,1.75;i2 = 13%)。非合并研究报告了关于身体质量指数、身体质量指数z分数和体重状况的长期影响的混合结果，对腰围和腰围z分数没有影响。证据确定性为中等至极低。尚未发现以小学为基础的干预措施对肥胖相关结果的长期影响的明确证据。讨论了进一步研究和政策的建议。普洛斯彼罗注册ID: CRD42021240446。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.