Behavioral Interventions to Prevent Childhood Obesity: A Systematic Review and Metaanalyses of Randomized Trials

Kamath, Celia C.; Vickers, Kristin S.; Ehrlich, Angela; McGovern, Lauren; Johnson, Jonathan N.; Singhal, Vibha; Paulo, Remberto; Hettinger, Allison; Erwin, Patricia J.; Montori, Víctor M.

doi:10.1210/jc.2006-2411

Cited by 359 publications

(345 citation statements)

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“…However, they may be important because they imply that the recent rise in childhood obesity could have an uncomplicated explanation, and they might explain why behavioural intervention at the level of the child has little impact on BMI. 25 The lack of gestational effect on the offspring's weight, dominant influence of the same-sex parent and evidence for an 'epidemic' confined selectively to the children of overweight/obese parents suggest that childhood obesity may be less a 'feed-forward' effect of parental genes and gestational programming, as has been suggested in the past, 26,27 and more a 'feed-backward' effect of parental behaviour. Childhood obesity in the 21st century may owe more to obese parents than to obesity genes.…”

Section: Discussionmentioning

confidence: 99%

Assortative weight gain in mother–daughter and father–son pairs: an emerging source of childhood obesity. Longitudinal study of trios (EarlyBird 43)

et al. 2009

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Objective: To look for same-sex (gender assortative) association of body mass index (BMI) in healthy trios (mother, father and child) from a contemporary birth cohort, which might imply shared environment rather than shared genes because selective mother-daughter and father-son gene transmission is not a common Mendelian trait. Design: Prospective (longitudinal) cohort study with four annual time points, from 5 to 8 years. Subjects: 226 healthy trios from a 1995 to 1996 birth cohort randomly selected in the city of Plymouth, UK. Measurements: Average BMI of the two parents and maternal/paternal BMI separately related to the BMI-SDS (standard deviation score) of all offspring and to the BMI-SDS of the sons and the daughters separately. Results: There were big differences in BMI-SDS among the daughters grouped according to mothers' category of BMI (effect size 1.37 SDS), but not their sons (effect size 0.16 SDS, gender interaction Po0.004), and among the sons grouped according to their fathers' BMI (effect size 1.28 SDS), but not their daughters (effect size 0.17, gender interaction P ¼ 0.02). Children whose same-sex parents were of normal weight, weighed either close to (girls þ 0.20 BMI-SDS) or less than (boys,À0.34 BMI-SDS) children of 20 years ago, and did not change from 5 to 8 years. In contrast, the risks of obesity at 8 years were 10-fold greater (girls 41%, Po0.001) or sixfold greater (boys 18%, Po0.05) if the same-sex parent was obese. Longitudinal linear mixed effects (multilevel) modelling showed a marked influence of maternal and paternal BMI on the rate of weight gain, which was unaffected by birth weight of the child. We report perhaps the largest effect sizes so far recorded in childhood obesity. Conclusions: Childhood obesity today seems to be largely confined to those whose same-sex parents are obese, and the link does not seem to be genetic. Parental obesity, like smoking, might be targeted in the interests of the child.

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Section: Discussionmentioning

confidence: 99%

Assortative weight gain in mother–daughter and father–son pairs: an emerging source of childhood obesity. Longitudinal study of trios (EarlyBird 43)

et al. 2009

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“…[13][14][15][16] Although school programs have increased PA in youth, reviews suggest that their effects are modest. [17][18][19][20] The Alberta Project Promoting Active Living and Healthy Eating in Schools (APPLE Schools) builds on and extends previous school-based health promotion interventions by offering the placement of a full-time staff member dedicated to facilitating healthy living programming and curricula. 21,22 A key objective of CSH is to foster positive health behaviors beyond the school environment.…”

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confidence: 99%

School-Based Health Promotion and Physical Activity During and After School Hours

et al. 2014

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OBJECTIVES: Comprehensive school health (CSH) is a multifaceted approach to health promotion. A key objective of CSH is to foster positive health behaviors outside of school. This study examined the 2-year change in physical activity during and after school among students participating in a CSH intervention in Edmonton, Alberta, Canada. METHODS: This was a quasi-experimental, pre–post trial with a parallel, nonequivalent control group. Intervention schools had to be located in socioeconomically disadvantaged neighborhoods. In the spring of 2009 and 2011, pedometer recordings (7 full days) and demographic data were collected from cross-sectional samples of fifth grade students from 10 intervention schools and 20 comparison schools. A total of 1157 students participated in the study. Analyses were adjusted for potential confounders and the clustered design. RESULTS: Relative to 2009, children in 2011 were more active on schools days (1172 steps per day; P < .001) and on weekends (1450 steps per day; P < .001). However, the increase in mean steps between 2009 and 2011 was greater in CSH intervention schools than in comparison schools (school days: 1221 steps per day; P = .009; weekends: 2001 steps per day; P = .005). These increases remained significant after adjusting for gender and overweight status. CONCLUSIONS: These findings provide evidence of the effectiveness of CSH to affect children’s physical activity during and outside of school. Results of this study justify broader implementation of effective CSH interventions for physical activity promotion and obesity prevention in the long term.

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“…Dessa forma, é complexo afirmar, pelos resultados dos programas aqui apresentados, a influência do período da intervenção sobre os componentes relacionados à saúde dos escolares, visto que a efetividade das intervenções foi independente da duração dos programas. No entanto, a literatura recomenda que programas de promoção com mudanças sustentáveis no estilo de vida de crianças e adolescentes tenham duração prolongada, propiciando aos participantes maiores benefícios com o programa 34,35 .…”

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Atividade física e alimentação saudável em escolares brasileiros: revisão de programas de intervenção

et al. 2011

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IntroduçãoA infância e a adolescência são períodos extremamente importantes para o desenvolvimento de um estilo de vida saudável, uma vez que os comportamentos adquiridos nesta fase tendem a ser perpetuados por toda a vida 1 . Durante a adolescência também ocorrem o aumento da independência e ganho de autonomia na tomada de decisões sobre práticas e comportamentos de vida 2 . Essa situação pode ser preocupante pelo fato de que os adolescentes passam a ficar mais expostos a comportamentos de risco como etilismo, tabagismo, sedentarismo e alimentação inadequada.Estudos nacionais e internacionais sobre fatores de risco e de proteção comportamentais relacionados à saúde em adolescentes, como o Global School-based Student Health Survey, o Youth Health Risk Beahaviour Surveillance System, o Health Behaviour in School-aged Children Study 2 e a Pesquisa Nacional de Saúde do Escolar 3 , mostram que o estilo de vida adotado por crianças e adolescentes não é saudável, incluindo baixo consumo de frutas, inatividade física, inabilidade de manter um peso corporal saudável e consumo de bebidas alcoólicas e tabaco. Esses comportamentos de risco à saúde estão cada vez mais presentes na sociedade contemporânea e estão associados ao desenvolvimento das doenças crô-nicas não transmissíveis (DCNT). As DCNT estão aumentando no público jovem, lideram as cau-REVISÃO REVIEW

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Behavioral Interventions to Prevent Childhood Obesity: A Systematic Review and Metaanalyses of Randomized Trials

Abstract: Pediatric obesity prevention programs caused small changes in target behaviors and no significant effect on BMI compared with control. Trials evaluating promising interventions applied over a long period, using responsive outcomes, with longer measurement timeframes are urgently needed.

Cited by 359 publications

References 38 publications

Assortative weight gain in mother–daughter and father–son pairs: an emerging source of childhood obesity. Longitudinal study of trios (EarlyBird 43)

Assortative weight gain in mother–daughter and father–son pairs: an emerging source of childhood obesity. Longitudinal study of trios (EarlyBird 43)

School-Based Health Promotion and Physical Activity During and After School Hours

Atividade física e alimentação saudável em escolares brasileiros: revisão de programas de intervenção

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