Effectiveness of interventions on physical activity in overweight or obese children: a systematic review and meta‐analysis including studies with objectively measured outcomes

Abstract

There is no consensus on interventions to be recommended in order to promote physical activity among overweight or obese children. The objective of this review was to assess the effects on objectively measured physical activity, of interventions promoting physical activity among overweight or obese children or adolescents, compared to no intervention or to interventions without a physical activity component. Publications up to December 2015 were located through electronic searches for randomized controlled trials resulting in inclusion of 33 studies. Standardized mean differences from baseline to post-intervention and to long-term follow-up were determined for intervention and control groups and meta-analysed using random effects models. The meta-analysis showed that interventions had no effect on total physical activity of overweight and obese children, neither directly post-intervention (-0.02 [-0.15, 0.11]) nor at long-term follow-up (0.07 [-0.27, 0.40]). Separate analyses by typology of intervention (with or without physical fitness, behavioural or environmental components) showed similar results (no effect). In conclusion, there is no evidence that currently available interventions are able to increase physical activity among overweight or obese children. This questions the contribution of physical activity to the treatment of overweight and obesity in children in the studied interventions and calls for other treatment strategies.

Evaluation of Physical Activity and Lifestyle Interventions Focused on School Children with Obesity Using Accelerometry: A Systematic Review and Meta-Analysis

“…Our analysis was carried out on controlled and intervention groups based on mean differences among basal and post-intervention time using the variables BMI Z-score and MVPA time. Non-significant results, similar to those found by Nooijen et al [7], were reached. Therefore, thereafter, the effect of PA interventions on how to reduce these variables was examined, selecting only post-intervention data for school-age children.…”

“…However, there is no specific information about the effects these interventions have on children with obesity [3][4][5], for example, the length, intensity and frequency per week of the sessions, weekend sessions or exercise type. Some reviews [6][7][8][9][10][11] have considered individual studies which examined behavioral interventions regarding weight control, obesity prevention or treatment. These included PA, dietary patterns or a combination of both and concluded that there was only limited evidence about specific recommendations.…”

“…A particularly important group to target is that of school-aged children [8,9,22]. Under this premise, studies have been carried out on the effectiveness of interventions with a main component of PA measured objectively [7,23]. However, these interventions achieved small or negligible increases in PA for children and adolescents, as well as limited success in reducing BMI or body fat, or were carried out mainly in adolescents.…”

Evaluating Adolescents’ Reasons to Participate in Physical Activity: Alternative Approaches and Alternative Benefits

“…We also reconsidered the extensive use of BMI as a grouping variable when determining adolescents who are overweight and obese (Demetriou, 2017;Nooijen et al, 2017;Craeynest et al, 2005;Deforche et al, 2004;Ickes & Sharma, 2012;Kamtsios & Digelidis, 2008). Our alternative was based on Janiszewski's (2012) contention that BMI does not differentiate between the "Michelin Man and The Terminator" (Heading #1), and does not reflect lifestyle, as in the case of a high school football lineman who is highly active, but obese.…”

Differences in Physical Behaviour between Obese and Normal Weight Saudi Arabian Boys and Girls: What is Worth Noting?

“…However, one meta-analysis showed that PA interventions had no impact on the overall PA of obese children, neither directly post-intervention nor even follow up on a long-term basis (Nooijen et al 2017). Therefore, we can consider inadequate levels of PA as one of the leading reasons for rising children's obesity levels globally.…”