Physical activity interventions in early life aimed at reducing later risk of obesity and related non‐communicable diseases: A rapid review of systematic reviews

Abstract

To identify useful components of interventions aimed at prevention of childhood obesity and related non-communicable diseases (NCDs), which included physical activity and which targeted any or all of four life-course stages: peri-conception; pregnancy; infancy and toddlerhood (0 to 23 months); and early childhood (24 to 59 months). In May 2016, WHO Geneva searched the Cochrane Library and PubMed for systematic reviews of interventions including physical activity to prevent childhood obesity or risk factors for obesity-related NCDs. Using a narrative synthesis, the efficacy of randomized controlled trials (RCTs) to alter energy balance outcomes (measures of weight status or body fatness) was characterized by life-course stage, study characteristics, intervention functions (as defined in the behaviour change wheel), and level of the socio-ecological model (SEM) targeted. The quality of included systematic reviews was assessed. We retrieved 82 reviews from the World Health Organization (WHO) search, of which 23 were eligible for the present synthesis. The number of eligible studies by life-course stage was: 0 (peri-conception); 0 (pregnancy); 8 (infancy and toddlerhood, age 0 to 23 months; seven RCTs; age); and 37 (early childhood, age 24 to 59 months; 30 RCTs;). Thus, there was a lack of evidence for physical activity interventions during peri-conception and pregnancy.Almost all relevant studies in the 0-to 23-and 24-to 59-month life-course stages were multicomponent interventions (ie, targeted physical activity, dietary, and/or sedentary behaviours). Interventions with evidence of efficacy tended to target multiple levels of the SEM, with emphasis on parents, and extend over long periods.Effective intervention elements for early life obesity prevention included classes on parenting skills, alteration of the kindergarten playground, and financial incentives.Evidence from low-and middle-income countries was scarce, and evidence for ---

Family-based prevention of overweight and obesity in children aged 2–6 years: a systematic review and narrative analysis of randomized controlled trials

“…From the results in this review, it is not possible to conclude which parts of the multicomponent interventions that had effect. However, trials with interventions showing a significant difference between intervention and control groups had interventions with a minimum of 12 weeks, with each session lasting a minimum of 45 minutes, including more than one lifestyle behaviour, in line with Reilly et al (2019) and Brown et al (2019). Of the four trials showing effects on child BMI, two targeted both parents and children (Berry et al 2011;Barkin et al 2012) while two targeted the parents directly and the children indirectly (Slusser et al 2012;Smith et al 2015).…”

“…Interventions aimed to change children's habits require parental involvement (Reilly et al 2019). Such interventions have been shown to have effect only at short time follow-up, specifically if the intervention has many components (Yavuz et al 2015).…”

“…A review by Ling et al (2016) examined the effects of prevention and management interventions on overweight/obesity among children aged 2-5 years and concluded that management interventions showed greater effects in weight loss as compared to prevention interventions. Further, a recent systematic review on prevention of obesity (Reilly et al 2019) reported results for children aged 2-4 years old separately. In this review, including physical activity as intervention, 11 of 16 studies reported no effect on BMI.…”

Effectiveness of a Physical Education Program on the Motor and Pre-literacy Skills of Preschoolers From the Training-To-Health Project: A Focus on Weight Status

“…Furthermore, the assumption of harmful behaviors (e.g., eating unhealthy foods) during the time spent in a sedentary lifestyle has been shown to exacerbate the capacity to maintain an adequate body weight in children by creating a vicious cycle (Pagani et al, 2010;Eichinger et al, 2017). As reported by several researches, both physical inactivity and sedentary/unhealthy behaviors increase the risk of being overweight and obesity in childhood (Tucker, 2008;Han et al, 2010;Hills et al, 2011;Reilly et al, 2019). For this reason, the role of diet and physical activity in children has been investigated in previous studies (Obradovic Salcin et al, 2019;Tabacchi et al, 2020a).…”

Report on advances for pediatricians in 2018: allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery

“…To reduce the risk of noncommunicable diseases several healthy advices during the first years of life have been shown significant, such as breastfeeding, using lower protein formulas for formula-fed infants, increasing fruit and vegetables and reducing junk foods and sugar-sweetened drinks [156]. With as much importance, physical activity interventions since peri-conception and pregnancy period to childhood are efficacious to reduce the risk of non-communicable diseases in childhood [157].…”