This umbrella review analysed the relationships between family variables and child/adolescent body weight, diet and physical activity. In line with theories of health behaviour change, it was assumed that behaviour-specific family variables (i.e. beliefs, perceptions and practices referring to food intake or physical activity) would have stronger support than more general family variables (i.e. socio-economic status or general parental practices). Data obtained from 18 systematic reviews (examining 375 quantitative studies) were analysed. Reviews of experimental trials generally supported the effectiveness of reward/positive reinforcement parental strategies, parental involvement in treatment or prevention programmes, and cognitive-behavioural treatment in reducing child/adolescent body mass and/or obesity. Results across reviews of correlational studies indicated that healthy nutrition of children/adolescents was related to only one parental practice (parental monitoring), but was associated with several behaviour-specific family variables (e.g. a lack of restrictive control over food choices, high intake of healthy foods and low intake of unhealthy foods by parents and siblings, low pressure to consume foods). With regard to adolescent physical activity, stronger support was also found for behaviour-specific variables (e.g. physical activity of siblings), and for certain socio-economic variables (e.g. parental education). Child and adolescent obesity prevention programmes should account for behaviour-specific family variables.
This umbrella review analyzed the effectiveness of school-based interventions, applying body weight or behavioral outcomes. Twelve systematic reviews and five meta-analyses (examining 196 trials) were included. Results indicated that the effectiveness was usually referred to body weight or BMI change, with 1/3 of trials (per review) indicating significant changes in BMI or obesity prevalence. Meta-analyses yielded mixed effects (three showed significant changes in weight, BMI, or obesity). Interventions were more effective if they aimed at a reduction of sedentary behaviors, incorporated moderate-to-vigorous physical activity, and parental involvement. The inclusion of a nutrition component moderated the long-term effects of interventions. More efficient interventions lasted at least 3 months, did not aim solely at environmental changes, and were implemented in general population. Female and younger participants may benefit more from the interventions. The role of psychological theories and behavioral or cognitive mediators was rarely investigated.
Objective: To investigate associations of self-perceived eating-related peer norms (called 'subjective peer norms') with adolescents' healthy eating intentions and intake of healthy and unhealthy food. Design: Cross-sectional data were collected in a large international survey. Setting: Two types of subjective peer norms were assessed: perceived peer encouragement of healthy eating and perceived peer discouragement of unhealthy eating. Outcome variables were healthy eating intentions, intake of healthy food (fruits and vegetables) and intake of unhealthy food (snacks and soft drinks). Subjects: Over 2500 European (pre-)adolescents aged between 10 and 17 years participated. Results: Subjective peer norms were associated with all three outcome variables. While both perceived encouragement of healthy eating and perceived discouragement of unhealthy eating were related to intentions, only peer encouragement of healthy eating was related to intakes of both healthy and unhealthy food. Conclusions: Subjective peer norms play a role in adolescent eating behaviour and as such are an important target for health promotion. Addressing norms that encourage healthy eating may be more promising in changing behaviour than norms that discourage unhealthy eating.
This umbrella review analyzed the relationships between social and physical micro-environmental (neighborhood, school) characteristics as predictors of child and adolescent diet, physical activity, and body weight. Eight systematic reviews, discussing 132 original studies (97% correlational, 3% experimental) yielded 98 social, physical, and socio-economic characteristics, as categorized in the original reviews. Among micro-environmental predictors stronger support (i.e., replicated results) was obtained for 12 out of 98 original micro-environmental variables, with physical activity as the outcome in 10 out of 12 cases. In particular, replicated significant relationships were found for several physical activity-specific neighborhood and school characteristics (e.g., community opportunities to exercise, lower costs of physical activity facilities, physical activity build environment) and adolescent physical activity. Among more general (i.e., not behavior-specific) micro-environmental characteristics, stronger support was found for low crime level, school type, and child/adolescent physical activity.
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