Interventions to prevent global childhood overweight and obesity: a systematic review

Bleich, Sara N.; Vercammen, Kelsey A.; Zatz, Laura Y.; Frelier, Johannah M.; Ebbeling, Cara B.; Peeters, Anna

doi:10.1016/s2213-8587(17)30358-3

Cited by 319 publications

(334 citation statements)

References 90 publications

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“…In a systematic review of interventions to prevent global childhood overweight and obesity, the authors concluded that their findings support recommendations that schools should be the focal point of child obesity prevention efforts, and school‐based interventions should include diet, physical activity, and home components . The home component may be particularly relevant for younger children because parents report feeling more responsibility for feeding their younger children than their older children .…”

Section: Discussionmentioning

confidence: 93%

Diet quality of children in the United States by body mass index and sociodemographic characteristics

Thomson

Landry

Tussing‐Humphreys

et al. 2019

Obesity Science & Practice

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Summary Objective The primary objective was to use the Healthy Eating Index‐2015 (HEI‐2015) to describe diet quality by categories of body mass index (BMI) and by sociodemographic characteristics within categories of BMI using a nationally representative sample of US children. Methods Dietary datasets from three cycles of the National Health and Nutrition Examination Survey (2009‐2014) were analysed for children 2 to 18 years of age (N = 8894). Using the population ratio method, mean and 95% confidence intervals for HEI‐2015 total and component scores were computed by BMI (underweight, normal weight, overweight, and obese) and by age (2‐5, 6‐11, and 12‐18 y), gender, race/ethnicity (non‐Hispanic black, non‐Hispanic white, Mexican American, other Hispanic, and other race), and family poverty to income ratio (below and at/above poverty threshold). Results HEI‐2015 mean total scores were 50.4, 55.2, 55.1, and 54.0 out of 100 points for children with underweight, normal weight, overweight, and obesity, respectively, and were not significantly different. Within BMI categories, significant differences in total and mean component scores were present for age and race/ethnicity groups. Conclusions Total and most components of diet quality did not significantly differ among child populations classified by BMI status. Within BMI categories, significant diet quality differences were found for age and race/ethnicity groups, although scores were low for all child groups. Researchers may need to address or target specific dietary components with low quality in various child populations to have the greatest effect on improving nutrition nationwide.

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Section: Discussionmentioning

confidence: 93%

Diet quality of children in the United States by body mass index and sociodemographic characteristics

Thomson

Landry

Tussing‐Humphreys

et al. 2019

Obesity Science & Practice

View full text Add to dashboard Cite

show abstract

“…These findings highlight the paucity of high-quality, theory based interventions to mitigate the effects of overweight and obesity, and energy-related behaviours among African children. A considerable body of evidence suggests that multicomponent school-based interventions that target PA, dietary behaviours, sedentary behaviours, and the environments are more likely to be effective in children and adolescents compared with single component interventions [15][16][17][18]34]. Given the multi-faceted nature of overweight and obesity, it is not surprising that programmes that target individual behaviours and the obesogenic environments simultaneously are promising.…”

Section: Discussionmentioning

confidence: 99%

“…The school setting has been identified as ideal for health promotion interventions, since children spend a significant amount of time in schools and are exposed to supportive environments such as school health policies, nutrition education and support, physical education, and physical activity (PA) during school hours. Despite these, the evidence from systematic reviews and meta-analyses on the effectiveness of school-based programmes have been mixed [14][15][16][17][18][19]. Moreover, the evidence is mostly from high-to middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

School-Based Interventions Targeting Nutrition and Physical Activity, and Body Weight Status of African Children: A Systematic Review

et al. 2019

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Background: Overweight/obesity is an emerging health concern among African children. The aim of this study was to summarise available evidence from school-based interventions that focused on improving nutrition and physical activity knowledge, attitude, and behaviours, and weight status of children aged 6-15 years in the African context. Methods: Multiple databases were searched for studies evaluating school-based interventions of African origin that involved diet alone, physical activity alone, or multicomponent interventions, for at least 12 weeks in duration, reporting changes in either diet, physical activity, or body composition, and published between 1 January 2000 and 31 December 2018. No language restrictions were applied. Relevant data from eligible studies were extracted. Narrative synthesis was used to analyse and describe the data. Results: This systematic review included nine interventions comprising 10 studies. Studies were conducted among 9957 children and adolescents in two African countries, namely South Africa and Tunisia, and were generally of low methodological quality. The sample size at baseline ranged from 28 to 4003 participants. Two interventions reported enrolling children from both urban and rural areas. The majority of the study participants were elementary or primary school children and adolescents in grades 4 to 6. Participants were between the ages of 12.4 and 13.5 years. All but one intervention targeted children of both sexes. Four studies were described as randomised control trials, while five were pre-and post-test quasi-experiments. Except for one study that involved the community as a secondary setting, all were primarily school-based studies. The duration of the interventions ranged from four months to three years. The interventions focused largely on weight-related behaviours, while a few targeted weight status. The results of the effectiveness of these interventions were inconsistent: three of five studies that evaluated weight status (body mass index (BMI), BMI z-score, overweight/obesity prevalence), three of six studies that reported physical activity outcomes (number of sports activities, and physical activity duration ≥ 30 min for at least six days/week), and four of six reporting on nutrition-related outcomes (number meeting fruit and vegetable intake ≥ 5 times/day) found beneficial effects of the interventions. Conclusion: Given the dearth of studies and the inconsistent results, definite conclusions about the overall effectiveness and evidence could not be made. Nonetheless, this study has identified research gaps in the childhood obesity literature in Africa and strengthened the need for further studies, the findings of which would contribute valuable data and inform policy.

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“…The applicability of these interventions in LMIC settings, where overnutrition and undernutrition coexist, is yet to be established. These mostly U.S. interventions have shown some effect on behaviours but no effect on weight‐related outcomes (Showell et al, ), including in older children (Bleich et al, ). Culturally appropriate home‐based obesity prevention interventions targeting preschool children that have been implemented by community‐based workers have shown promising findings with regard to feasibility and changes in obesity‐related behaviours (Haines et al, ; Sosa, Parra‐Medina, He, Trummer, & Yin, ; Taverno Ross, Barone Gibbs, Documet, & Pate, ; Yun et al, ), with some significant improvements in weight‐related outcomes in overweight and obese children (Taverno Ross et al, ).…”

Section: Introductionmentioning

confidence: 99%

Feasibility and acceptability of a home‐based intervention to promote nurturing interactions and healthy behaviours in early childhood: The Amagugu Asakhula pilot study

Draper

Howard

Rochat

2019

Child

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Background The aim of this study was to assess the feasibility and acceptability of a home‐based intervention—Amagugu Asakhula—to promote nurturing interactions and healthy behaviours with the caregivers of preschool children. Amagugu Asakhula means “treasures that are still growing” and focuses on children's cognitive development, physical activity, screen time, diet and sleep while also promoting the caregiver–child relationship. Methods This study took place in a low‐income setting in Cape Town, South Africa. The 6‐week intervention was implemented by community health workers (CHWs) with 20 caregivers of preschool children. CHWs provided written feedback on intervention sessions, and two focus groups were conducted, one with the CHWs involved (n = 4) and another with caregivers (n = 6), to obtain their feedback on the intervention and its implementation. Data were collated according to themes relating to implementation. In this pilot study, training and recruitment proved feasible and were facilitated by partnership with a community‐based organization. Results The intervention was generally implemented as intended, in terms of dose and delivery. Family support and active engagement of caregivers' preschool children in intervention activities were reported by CHWs and caregivers, and CHWs also reported mostly positive interactions with caregivers. CHWs and caregivers perceived the intervention to have benefits relating to the following: caregivers' awareness and knowledge of health behaviours, awareness of their role, changes in behaviours, and connection between the caregiver and child. The only change to the intervention suggested was the inclusion of some group sessions to promote support amongst intervention participants and sustain engagement in the intervention. Conclusions The findings of this pilot study indicate that Amagugu Asakhula was both feasible and acceptable with caregivers of preschool children in a low‐income urban setting. Further research is needed to assess the extent to which this intervention has an objective and measurable effect on intended outcomes.

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Interventions to prevent global childhood overweight and obesity: a systematic review

Cited by 319 publications

References 90 publications

Diet quality of children in the United States by body mass index and sociodemographic characteristics

Diet quality of children in the United States by body mass index and sociodemographic characteristics

School-Based Interventions Targeting Nutrition and Physical Activity, and Body Weight Status of African Children: A Systematic Review

Feasibility and acceptability of a home‐based intervention to promote nurturing interactions and healthy behaviours in early childhood: The Amagugu Asakhula pilot study

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