A meta-analysis of school-based obesity prevention programs demonstrates limited efficacy of decreasing childhood obesity

Hung, Ling-Shen; Tidwell, D.K.; Hall, Michael E.; Lee, Michelle L.; Briley, Chiquita; Hunt, Barry

doi:10.1016/j.nutres.2015.01.002

Cited by 87 publications

(93 citation statements)

References 56 publications

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“…Those that have, provide indication that it is not weight status that drives academic achievement, but that both academic achievement and body weight status are a result of long-term lifestyle behaviors [17, 18]. This study complements this important work and indicates that promoting healthy lifestyles and values, rather than focusing on obesity prevention and reduction, is most effective in supporting optimal health, holistic wellness and academic achievement [23, 58–60]. …”

Section: Discussionmentioning

confidence: 79%

The combined impact of diet, physical activity, sleep and screen time on academic achievement: a prospective study of elementary school students in Nova Scotia, Canada

Faught

Ekwaru

Gleddie

et al. 2017

Int J Behav Nutr Phys Act

105

101

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BackgroundFew studies have investigated the independent associations of lifestyle behaviors (diet, physical activity, sleep, and screen time) and body weight status with academic achievement. Even fewer have investigated the combined effect of these behaviors on academic achievement. We hypothesize that the combined effect of these behaviors will have a higher impact on academic achievement than any behavior alone, or that of body weight status.MethodsIn 2011, 4253 grade 5 (10–11 years old) students and their parents were surveyed about the child’s diet, physical activity, screen time and sleep. Students’ heights and weights were measured by research assistants. Academic achievement was measured using provincial standardized exams in mathematics, reading and writing, and was expressed as ‘meeting’ or ‘not meeting’ expectations as per standardized criterion. Exams were written 1 year following the measurement of lifestyle behaviors. Lifestyle behaviors were measured with self- and parental proxy reports and expressed as meeting recommendations (yes/no) for each behavior. Mixed effects logistic regression models adjusting for demographic confounders and caloric intake were used to determine the independent and combined associations.ResultsMeeting dietary recommendations was associated with increased likelihood of meeting academic expectations for each of math, reading and writing. Meeting recommendations for screen time and sleep was associated with meeting expectations for writing. For all three subjects, meeting additional lifestyle behavior recommendations was associated with higher likelihood of meeting expectations. Children who met 7–9 lifestyle behavior recommendations had greater than three-times the odds of meeting expectations for reading compared to those who met 0–3 recommendations (OR: 3.07, 95% CI: 2.09, 4.51), and 1.47 and 2.77 times the odds of meeting expectations in mathematics and writing, respectively. Body weight status was not associated with academic achievement.ConclusionsWe found that lifestyle behaviors, not body weight status, are strongly associated with student academic performance. Promoting compliance with established healthy lifestyle recommendations could improve both the health and educational outcomes of school-aged children. School-based health promotion initiatives that target multiple lifestyle behaviors may have a greater effect on academic achievement than those that focus on a single behavior.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0476-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 79%

The combined impact of diet, physical activity, sleep and screen time on academic achievement: a prospective study of elementary school students in Nova Scotia, Canada

Faught

Ekwaru

Gleddie

et al. 2017

Int J Behav Nutr Phys Act

105

101

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“…In addition, meta-analyses using other physical measures (i.e. body weight and skinfold thickness) showed no substantially different results (29,31,58,73). their cooperation.…”

Section: Limitations and Strengthsmentioning

confidence: 94%

“…Moderator analyses might explain why some interventions are more effective than others and could increase the effectiveness of future interventions. In this respect, a broad framework for moderator analyses (28) that has been adopted often (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) and includes participant features (i.e. participant age, gender, ethnicity and overweight/obesity risk) and intervention features (e.g.…”

mentioning

confidence: 99%

Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis

Kobes¹,

Kretschmer²,

Timmerman³

et al. 2018

Preprint

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The prevalence of childhood and adolescent obesity has been a major worldwide problem for decades. To stop the number of children and adolescents with overweight or obesity from increasing, numerous interventions focusing on improving children’s weight status have been designed and implemented. This vastly growing body of research on weight-related interventions for children and adolescents has been summarized by several meta-analyses that aim to provide an overview of the effectiveness of these interventions. Yet, the number of meta-analyses is expanding so quickly and overall results differ, making a comprehensive synopsis of the literature difficult. To tackle this problem, a meta- synthesis was conducted to draw informed conclusions about the state of the effectiveness of interventions targeting child and adolescent overweight. The results of the quantitative synthesis of 26 meta-analyses resulted in a standardized mean difference of -0.12 (95%CI: -0.16;-0.08). Several moderator analyses (e.g., gender, age, duration of the intervention, parental involvement) showed that participant and intervention characteristics had little impact on the overall effect size. Overall, the results of this meta-synthesis suggest that interventions result in statistically significant effects albeit of relatively little clinical relevance.

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“…In addition, more recent evidence on effective children’s obesity interventions [10, 33–36] and on behaviour change techniques that are effective in influencing obesity-related behaviours in children [37] have been identified. The research evidence and guidelines will be considered throughout the adaptation process to ensure that the developed programme incorporates approaches that have been acknowledged to be effective and that the structure, content and delivery is consistent with current guidance.…”

Section: Methodsmentioning

confidence: 99%

Cultural adaptation of a children’s weight management programme for Bangladeshi and Pakistani families in the UK: a cluster-randomised feasibility study protocol

Pallan

Griffin

Lancashire

et al. 2016

Pilot Feasibility Stud

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BackgroundGroup-based children’s weight management programmes are widely available in the UK and evidence shows that these are effective in the short-term. No programmes have been specifically developed to meet the cultural requirements of UK minority ethnic communities. South Asian children are a high-risk group for obesity and its consequences; therefore, the study aim is to adapt an existing weight management programme for children aged 4-11 years and their families to ensure cultural relevance to Pakistani and Bangladeshi communities, and undertake a feasibility study of the adapted programme.Methods/designPakistani and Bangladeshi families of overweight children who have been offered the existing children’s weight management programme in Birmingham, UK, will be invited to interviews and focus groups to explore their experiences and views of the programme. These data, together with existing literature and service provider information, will inform adaptation of the programme to be more culturally relevant to these families. The feasibility study will employ a cluster-randomised design, and will assess success of programme adaptation and feasibility of programme delivery. Planned programmes will be randomised to be delivered as the adapted programme (intervention) or the standard programme (comparator) with a 2:1 ratio. The primary outcome will be the proportion of Pakistani and Bangladeshi families completing the adapted programme. To assess recruitment, retention and data collection methods to inform a future trial, we aim to recruit 80 participants. A range of assessments will be undertaken with participants pre-, post- and 6-months post-intervention.DiscussionThis study addresses the identified need to provide children’s weight management programmes that are suitable for minority ethnic communities. Whilst the focus of the intervention adaptation is on Pakistani and Bangladeshi communities, the programme will be developed to be flexibly delivered to meet the cultural needs of communities of all ethnic compositions. The feasibility study will directly compare the adapted and existing weight management programmes, and will enable a comprehensive evaluation of the success of the adaptation. Essential information will also be gathered to inform the design and sample size calculation of a future trial to evaluate intervention effectiveness.Trial registration ISRCTN81798055, registered: 13/05/2014.

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A meta-analysis of school-based obesity prevention programs demonstrates limited efficacy of decreasing childhood obesity

Cited by 87 publications

References 56 publications

The combined impact of diet, physical activity, sleep and screen time on academic achievement: a prospective study of elementary school students in Nova Scotia, Canada

The combined impact of diet, physical activity, sleep and screen time on academic achievement: a prospective study of elementary school students in Nova Scotia, Canada

Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis

Cultural adaptation of a children’s weight management programme for Bangladeshi and Pakistani families in the UK: a cluster-randomised feasibility study protocol

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