Interventions for the prevention of overweight and obesity in preschool children: a systematic review of randomized controlled trials

Monasta, Lorenzo; Batty, G. David; Macaluso, Anna; Ronfani, Luca; Lutje, Vittoria; Bavcar, Alessandro; Lenthe, Frank J. van; Brug, Johannes; Cattaneo, Adriano

doi:10.1111/j.1467-789x.2010.00774.x

Cited by 118 publications

(110 citation statements)

References 37 publications

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“…Accordingly, short-term in-patient interventions over 2-8 weeks are very unlikely to offer long-term success (20,(45)(46)(47) . The successful interventions required periods of 6-12 months (26,41,42) . However, there are no studies analysing the relationship between the duration of interventions and long-term outcomes.…”

Section: Duration Of Interventionmentioning

confidence: 99%

Effectiveness of lifestyle intervention in overweight children

Reinehr

2011

Proc. Nutr. Soc.

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Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.

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Section: Duration Of Interventionmentioning

confidence: 99%

Effectiveness of lifestyle intervention in overweight children

Reinehr

2011

Proc. Nutr. Soc.

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“…32 Other trials assessing children in preschoolenvironmentsfailedtodemonstrate improvements in growth patterns. 9,33 We suspect that the success of our trial was attributable to the inclusion of parent-child dyads instead of preschoolaged children alone. Similarly, a recently published small trial by Stark et al 34 of 17 families with obese preschool-aged children reported reductions in BMI after an in-home family-centered intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Of 7 published randomized controlled trials with this age group, most were school based. 9 In their review of these studies, Monasta et al 9 concluded that none of the interventions altered weight gain or BMI. Reasons suggested for the failure of these interventions included faulty study designs, inadequate parental engagement, or failure to account for macro-environments (eg, neighborhoods, community, society).…”

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confidence: 99%

Culturally Tailored, Family-Centered, Behavioral Obesity Intervention for Latino-American Preschool-aged Children

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Childhood obesity is already prevalent by preschool age, particularly among Latinos. Parents have tremendous influence on factors that contribute to childhood obesity (eg, diet, physical activity); thus, family plays a crucial role in pediatric obesity prevention. WHAT THIS STUDY ADDS:This randomized controlled trial examined the effect of a behavioral intervention involving LatinoAmerican parent-preschool-aged child dyads. The intervention resulted in reductions in absolute BMI across the 3-month study period, with patterns suggesting the largest effect for obese children.abstract OBJECTIVE: To test the effect of a culturally tailored, family-centered, short-term behavioral intervention on BMI in Latino-American preschool-aged children. METHODS:In a randomized controlled trial, 54 parent-child dyads were allocated to the intervention and 52 dyads were allocated to an alternative school-readiness program as the control condition. Parent-child dyads were eligible if the parent self-defined Latino, was at least 18 years old, had a 2-to 6-year-old child not currently enrolled in another healthy lifestyle program, had a valid telephone number, and planned on remaining in the city for the next 6 months. The Salud Con La Familia (Health with the Family) program consisted of 12 weekly 90-minute skills-building sessions designed to improve family nutritional habits and increase physical activity. Both programs were conducted in a community recreation center serving an urban neighborhood of mostly Spanish-speaking residents.RESULTS: Forty-two percent of participating preschool-aged children were overweight or obese. Controlling for child age, gender, and baseline BMI, the effect of the treatment condition on postintervention absolute BMI was B = -0.59 (P , .001). The intervention effect seemed to be strongest for obese children.CONCLUSIONS: A skills-building, culturally tailored intervention involving parent-child dyads changed short-term early growth patterns in these Latino-American preschool-aged children. Examining long-term effects would be a prudent next step.

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“…However, all RCTs have focused on obese children so far and even less is known about intervention effects in overweight children (Monasta et al 2010;Oude et al 2009). …”

Section: Introductionmentioning

confidence: 99%

“…Guidelines recommend long-term outpatient training programs consisting of a combination of physical exercise, nutrition education, and behaviour counselling for obese children and adolescents, but only few programs have run and have been evaluated in the past (Oude et al 2009;Monasta et al 2010). A recent Cochrane review (Oude et al 2009) concerning treatment in already obese children including 64 randomized controlled trials (RCTs) with 5,230 participants identified lifestyle interventions for obese children focused on physical activity and sedentary behavior in 12 studies, diet in 6 studies, and 36 concentrated on behaviorally orientated treatment programs.…”

Section: Introductionmentioning

confidence: 99%