Interventions for the treatment of obesity among children and adolescents in Latin America: a systematic review

Abstract

Objective. The objective of this systematic literature review was to identify evidence-based strategies associated with effective healthcare interventions for prevention or treatment of childhood obesity in Latin America. Materials and methods. A systematic review of peer-reviewed, obesityrelated interventions implemented in the healthcare setting was conducted. Inclusion criteria included: implementation in Latin America, aimed at overweight or obese children and evaluation of at least one obesity-related outcome (e.g., body mass index (BMI), z-score, weight, and waist circumference, and body fat). Results. Five interventions in the healthcare setting targeting obese children in Latin America were identified. All five studies showed significant changes in BMI, and the majority produced sufficient to large effect sizes through emphasizing physical activity and health eating. Conclusion. Despite the limited number of intervention studies that treat obesity in the healthcare setting, there is evidence that interventions in this setting can be effective in creating positive anthropometric changes in overweight and obese children.Key words: overweight; quality of health care; child; adolescents; intervention studies; review Nagle BJ, Holub CK, Barquera S, Sánchez-Romero LM, Eisenberg CM, Rivera-Dommarco JA, Mehta SM, Lobelo F, Arredondo EM, Elder JP. Intervenciones para el tratamiento de la obesidad en niños y adolescentes en Latinoamérica: una revisión sistemática. Salud Publica Mex 2013;55 supl 3:S434-S440. ResumenObjetivo. El objetivo de esta revisión sistemática de la literatura fue identificar estrategias basadas en evidencia asociadas con intervenciones en salud efectivas para la prevención y el tratamiento de la obesidad infantil en Latinoamérica. Material y métodos. Se realizó una revisión sistemática por pares de intervenciones relacionadas con la obesidad, que fueron llevadas a cabo en clínicas de atención para la salud. Criterios de inclusión: implementadas en Latinoamérica, dirigidas a niños con obesidad y sobrepeso y evaluación de por lo menos un reultado relacionado con obesidad (ej. ín-dice de masa corporal (IMC), puntaje Z, peso, circunferencia de cintura o grasa corporal). Resultados. Se identificaron cinco intervenciones dirigidas a niños obesos en clínicas de salud en Latinoamérica. Todas las intervenciones mostraron cambios significativos en IMC y la mayoría obtuvo un tamaño del efecto grande a través de la promoción de actividad física y alimentación saludable. Conclusión. A pesar del número limitado de estudios de intervención para tratar la obesidad en clínicas de salud, existe evidencia que las intervenciones en estos lugares pueden ser efectivas en alcanzar cambios antropométricos positivos en los niños con obesidad y sobrepeso. In countries where prospective data are available increases in the prevalence of obesity have been found, especially in areas that are more developed.2,7 The increase in obesity prevalence is believed to be related to globalization and progression through the...

From Sea to Shining Sea and the Great Plains to Patagonia: A Review on Current Knowledge of Diabetes Mellitus in Hispanics/Latinos in the US and Latin America

“…While promising, there are few weight gain prevention interventions specifically focusing on Hispanics/Latinos in the US and Latin America ( 304 , 308 , 327 ). Reviews of childhood obesity interventions in Latin America and the Caribbean report encouraging trends in childhood obesity prevention and treatment programs in schools ( 328 ), healthcare ( 329 ), and settings such as home, summer camps and family clinics ( 330 ). However, these studies were mostly carried out in Mexico and Brazil, only three were randomized clinical trials (RCTs), and most did not include appropriate pediatric measures for BMI or participants’ ages ( 327 ).…”

The Effects of Physical Activity and Diet Interventions on Body Mass Index in Latin American Children and Adolescents: A Systematic Review and Meta-Analysis

“…Previous studies analyzed the effect of physical activity interventions versus interventions that combine physical activity plus diet on BMI, showing a higher effect in the physical activity plus diet interventions groups [27,28]. In Latin America, four previous systematic reviews on interventions aimed at increasing physical activity in children have been performed, some of which were combined with diet intervention [29][30][31][32]. These systematic reviews showed that when physical activity interventions are combined with a nutritional component, they are more effective in producing favourable changes in adiposity (i.e., body parameters, body composition, and BMI).…”

Tracing the Consequences of Child Poverty

“…The rise in overweight and obesity suggests a role for both market and regulatory reforms, and improvements in public understanding. Review evidence highlights the potential to use both health clinics (Nagle et al, 2013) and schools (Verstraeten et al, 2012) to promote healthy eating and exercise. One review argued that in schools multicomponent interventions (for example, promoting healthy eating and exercise through the curricula) were likely to be most effective, and highlighted how involving parents could improve effectiveness (Verstraeten et al, 2012).…”

“…One review argued that in schools multicomponent interventions (for example, promoting healthy eating and exercise through the curricula) were likely to be most effective, and highlighted how involving parents could improve effectiveness (Verstraeten et al, 2012). As with interventions to reduce undernutrition, it was also noted that the success of particular platforms is dependent on populations having good access to key services (Nagle et al, 2013).…”