Dietary Interventions to Prevent Childhood Obesity: A Literature Review

Abstract

Several dietary interventions have been conducted to prevent/reduce childhood obesity, but most of them are known to have failed in tackling the obesity epidemic. This study aimed to review the existing literature on dietary interventions for the prevention of childhood obesity and their effectiveness. A literature search was conducted using PubMed Central®. Only articles published between 2009 and 2021, written in English, conducted in humans, and including children and/or adolescents (<18 years old) were considered. The majority of studies were school-based interventions, with some addressing the whole community, and including some interventions in the food sector (e.g., taxation of high fat/sugar foods, front-of-pack labelling) and through mass media (e.g., restrictions on food advertising for children) that directly or indirectly could help to manage childhood obesity. Most of the programs/interventions conducted focus mainly on person-based educational approaches, such as nutrition/diet education sessions, allied to the promotion of physical activity and lifestyles to students, parents, and school staff, and less on environmental changes to offer healthier food choices. Only a few trials have focused on capacity building and macro-policy changes, such as the adaptation of the built environment of the school, serving smaller portion sizes, and increasing the availability and accessibility of healthy foods and water in schools, and restricting the access to vending machines, for example. Overall, most of the intervention studies showed no consistent effects on changing the body mass index of children; they have only reported small weight reductions, clinically irrelevant, or no effects at all. Little is known about the sustainability of interventions over time.

Lower Circulating Leptin Levels Are Related to Non-Alcoholic Fatty Liver Disease in Children With Obesity

“…All interventions described an improvement in liver outcomes in conjunction with weight loss ( 4 ). It is known that it is very difficult to achieve clinically relevant and lasting body weight reduction in children and adolescents with obesity or extreme obesity by lifestyle intervention ( 5 , 6 ). Since the effective treatment of NAFLD by lifestyle modification has no sustainable effect, the search for pharmacological agents is of high relevance.…”

“…A recently published review demonstrated, that the positive effects of a lifestyle intervention on liver-associated parameters are weak and are strongly associated with body weight loss ( 4 ). Since lifestyle interventions are largely unsuccessful in achieving and maintaining clinically meaningful weight loss ( 5 , 6 ), the search for new pharmacological interventions in adults and children with NAFLD is on focus. One possible approach would be to further investigate the role of the adipokine leptin in relation to the development of NAFLD ( 7 , 8 ).…”

Effectiveness of the “Planning Health in School” Programme on Children’s Nutritional Status

“…An analysis of seven school-based nutrition programmes seeking to increase F&V consumption has shown weaker results [ 46 ] than those of this study. Ultimately, a recent literature review to report the effectiveness of dietary interventions in childhood obesity published between 2009 and 2021, discloses that a large number of studies, mainly based on school interventions, did not show any results or did not obtain effective results [ 47 ].…”

Overweight and Obesity in Childhood and Adolescence in Bangladesh and Its Consequences and Challenges.

“…Obesity and overweight are often blatantly ignored and delay early intervention, which inevitably increases the risk of significant health hazards 78 . In addition to behavioral and dietary recommendations, changes in the community-based interventions are crucial measures 79,80 .…”