Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta‐analysis

Abstract

Summary Aim We aimed to assess the effects of childhood obesity prevention programs on blood lipids in high-income countries. Methods We searched MEDLINE®, Embase, PsychInfo, CINAHL®, clinicaltrials.gov, and the Cochrane Library up to April 22, 2013 for relevant randomized controlled trials, quasi-experimental studies, and natural experiments published in English. Studies were included if they implemented diet and/or physical activity intervention(s) with ≥ one year follow up (or ≥ six months for school-based intervention studies) in 2 to 18 years old, and were excluded if they targeted only overweight/obese children, or those with a pre-existing medical condition. Results Seventeen studies were finally included. For total cholesterol, the pooled intervention effect was −0.97 mg/dL (95% CI: −3.26, 1.32; P=0.408); for low density lipoprotein-cholesterol (LDL-C), −6.06 mg/dL (95% CI: −11.09, −1.02; P=0.018); for high density lipoprotein-cholesterol (HDL-C), 1.87 mg/dL (95% CI: 0.39, 3.34; P=0.013); and for triglycerides, −1.95 mg/dL (95% CI: −4.94, 1.04; P=0.202). Most interventions (70%) showed similar significant or no effects on adiposity- and lipids outcomes: 15% interventions improved both adiposity- and lipids outcomes; 55% had no significant effects on either. Conclusions Childhood obesity prevention programs had a significant desirable effect on LDL-C and HDL-C. Two-thirds of interventions showed similar significant or no effects in adiposity- and lipids outcomes. Assessing lipids outcomes provide additional useful information on obesity prevention program benefits.

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

“…The significant improvement of the blood lipid profile has also been reported in previous intervention studies [8,9,31,32]. Two recent systematic review and meta-analysis showed that fewer than half of the included studies reported the improvements of HDL and FPG [9,32]. Likewise, in the present study, the nutrition education and physical activity intervention posed a significant improvement in HDL and a decrease in FPG among schoolchildren with obesity.…”

“…Despite numerous studies having explored the effectiveness of school-based childhood obesity interventions, results on the cardiovascular risk profile have been inconsistent [8,9]. A meta-analysis showed differential intervention effects on anthropometric and blood lipids outcomes, with more than half of 17 studies showing no significant effect on either, while three of interventions demonstrated beneficial changes on both [9].…”

“…Despite numerous studies having explored the effectiveness of school-based childhood obesity interventions, results on the cardiovascular risk profile have been inconsistent [8,9]. A meta-analysis showed differential intervention effects on anthropometric and blood lipids outcomes, with more than half of 17 studies showing no significant effect on either, while three of interventions demonstrated beneficial changes on both [9]. In addition, most of the previous studies were lifestyle interventions to prevent the incidence of obesity in the general population rather than to study the treatment effect on children with obesity [10,11].…”

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

“…However, the evidence on the effectiveness of interventions implemented in other settings is generally insufficient. Other analyses and findings from this systematic review on other outcomes such as on blood pressure and blood lipids can be found and were reported recently elsewhere .…”

30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015

“…9, 10, 11 The stabilization of child obesity rates is positive for public health, but there is strong evidence that child obesity remains unequally distributed across subgroup populations, 12, 13 and that in some countries obesity trends among children from socially disadvantaged backgrounds and certain ethnicities are not stabilizing. 14, 15, 16 The evidence suggests that some child obesity interventions are effective; 17, 18, 19, 20 however, changing obesogenic factors is not a linear process, rather, change is time dependent and complex, and involves interactions between biology, environment and behavior. These interactions may differ across population groups, which may explain why the current interventions are not having the desired impacts in socially disadvantaged communities.…”