Educational interventions in childhood obesity: A systematic review with meta-analysis of randomized clinical trials

Sbruzzi, Graciele; Eibel, Bruna; Barbiero, Sandra Mari; Petkowicz, Rosemary de Oliveira; Ribeiro, Rodrigo Antonini; Cesa, Cláudia Ciceri; Martins, Carla Corrêa; Marobin, Roberta; Schaan, Camila Wohlgemuth; Souza, Willian B.; Schaan, Beatriz D’Agord; Pellanda, Lúcia Campos

doi:10.1016/j.ypmed.2013.02.024

Cited by 92 publications

(100 citation statements)

References 45 publications

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“…4,5 Two other metaanalyses have reported larger intervention differences of 0.31 and 0.47. 4,6 However, Ho et al 4 showed that study duration was important with much larger effects in shorter studies than those lasting .6 months (0.31 vs 0.09 BMI z score units, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Janicke et al 6 included studies in adolescents and showed that age was a significant moderator, with greater effects in older children. 6 Direct comparisons are also complicated given that each metaanalysis was examining related but subtly different types of interventions, from educational approaches 5 to comprehensive lifestyle interventions. 6 Alternatively, the relatively small intervention effect we observed may have arisen because our children were recruited through screening rather than families seeking treatment.…”

Section: Discussionmentioning

confidence: 99%

“…3 Although individual studies report mixed success, 2 meta-analyses indicate that BMI is ∼1 unit lower in intervention children compared with control children. [4][5][6] However, virtually all interventions are only 6 to 12 months in duration, [4][5][6] with few exceptions. 7,8 Whether long-term changes to weight and the behavioral practices underpinning them are sustained has rarely been examined, 9,10 but this is important given that shorter studies report greater BMI differences than longer studies.…”

Section: What This Study Addsmentioning

confidence: 99%

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A Tailored Family-Based Obesity Intervention: A Randomized Trial

Taylor¹,

Cox

Knight

et al. 2015

Pediatrics

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OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care.METHODS: Two hundred and six overweight and obese (BMI $85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months.RESULTS: BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed.CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

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A Tailored Family-Based Obesity Intervention: A Randomized Trial

Taylor¹,

Cox

Knight

et al. 2015

Pediatrics

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“…Distintos programas de manejo de la obesidad en población infantil se han desarrollado en diferentes centros. Revisiones sistemáticas de intervenciones educativas en niños de 6 a 12 años han demostrado que éstas son efectivas en el tratamiento de la obesidad, no así en su prevención 5,6,7 . El Programa Bright Bodies de la Universidad de Yale consiste en una intervención sobre el estilo de vida, considerando aspectos nutricionales, de actividad física, con énfasis en la modificación conductual y el apoyo familiar.…”

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Impacto del Programa de manejo de la obesidad Bright Bodies aplicado a niños y adolescentes chilenos

et al. 2015

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“…However, some evidence also suggests that schoolbased interventions are more effective at treating obesity compared to preventing it [17]. Furthermore, studies suggest that school-based interventions can have broader influences on home environments when they include components aimed to change parents' knowledge, attitudes, and practices regarding children's nutrition [18,19].…”

mentioning

confidence: 99%

RE-AIM analysis of a randomized school-based nutrition intervention among fourth-grade classrooms in California

Larsen

Robertson²,

Dunton

2015

Behav. Med. Pract. Policy Res.

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Childhood overweight and obesity are major health problems. School-based programs enable intervening with large groups of children, but program overall health impact is rarely completely assessed. A RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis tested the overall public health impact of the fourthgrade BNutrition Pathfinders^school-based nutritioneducation program. A randomized controlled trial in 47 fourth-grade California classrooms (1713 students) tested program efficacy, and a secondary analysis of archival data tested program dissemination. Desired effects were seen in child nutrition knowledge, attitudes, consumption of low-nutrient high-density foods, sugar-sweetened beverages, proteins, grains, and parent willingness to serve new foods. The program was disseminated to ∼25 % of public school fourth-grade classrooms in California and cost about $1.00 per student to implement. The Nutrition Pathfinders program demonstrates potential for moderate to high public health impact due to its wide dissemination, effectiveness in altering attitudes and behaviors, and its relatively inexpensive cost of implementation.

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Educational interventions in childhood obesity: A systematic review with meta-analysis of randomized clinical trials

Cited by 92 publications

References 45 publications

A Tailored Family-Based Obesity Intervention: A Randomized Trial

A Tailored Family-Based Obesity Intervention: A Randomized Trial

Impacto del Programa de manejo de la obesidad Bright Bodies aplicado a niños y adolescentes chilenos

RE-AIM analysis of a randomized school-based nutrition intervention among fourth-grade classrooms in California

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