Nutrition‐related interventions targeting childhood overweight and obesity: A narrative review

Abstract

Systematic reviews of nutritional interventions indicate limited efficacy in reducing childhood obesity, but their blanket conclusions could obscure promising components.This narrative review sought more detail on effective components within nutritionrelated interventions involving children aged 2 to 11 years. In May 2016, the World Health Organization (WHO) searched the Cochrane Library and PubMed for relevant reviews. From 36 reviews, we screened 182 nutrition-related randomized trials for inclusion. We then reviewed those that reported at least 1 statistically significant (P < 0.05) treatment benefit on body weight and/or composition outcomes at their longest follow-up assessment. Fourteen trials met inclusion criteria (median n = 554; mean intervention duration = 10.8 mo; follow-up = 4.4 mo). "Effective" approaches included environmental changes such as school water fountain installations and cafeteria menu changes and possibly less sustainable strategies such as health education lessons.However, effect sizes even of these selected significant treatment benefits were modest-significant body mass index z-score effects range from −0.1 to −0.2. Each trial was associated with very small improvements in body composition. Because this is a "bestcase" scenario (reflecting our design), trialists should rigorously test these strategies alone and possibly together; be open to novel strategies; and ensure that each strategy is culturally relevant and self-sustainable.

Childhood obesity prevention: what can be achieved?

“…They were able to identify components that proved effective, which included adaptations to the school environment. However, even in this selection of trials, effects were rather small [54]. Accordingly, Brown et al.…”

“…They were able to identify components that proved effective, which included adaptations to the school environment. However, even in this selection of trials, effects were rather small [54]. Accordingly, Brown et al [52 && ], within their Cochrane review meta-analysis, found high-certainty evidence from 15 RCTs that isolated dietary interventions had no effect on BMI or zBMI.…”

Racial Disparities in Obesity Treatment Among Children and Adolescents

“…Nutrition-based interventions include increasing access to fruits and vegetables, limiting intake of sugar-sweetened beverages, minimizing fat content in meals, adjusting nutrition standards in schools, and educating families about healthy nutrition practices [67][68][69]. Thus far, the efficacy of such treatments has been limited, showing only modest success in reducing BMI and other obesity related factors [67,68,70]. Multi-component interventions demonstrate similar results, although research suggests programs with environmental components have the potential to produce larger, long-term changes [68,[71][72][73].…”

“…Thus far, the efficacy of such treatments has been limited, showing only modest success in reducing BMI and other obesity related factors [67,68,70]. Multi-component interventions demonstrate similar results, although research suggests programs with environmental components have the potential to produce larger, long-term changes [68,[71][72][73]. This evidence emphasizes the need for additional research to determine if nutrition-related treatment options could provide longer-lasting positive health outcomes in children and adolescents with obesity.…”

Protocol for the development of Core Outcome Sets for Early intervention trials to Prevent Obesity in CHildren (COS-EPOCH)

“…Open access reported from obesity prevention intervention studies in children aged from birth to 5 years. [5][6][7] There are also a wide range of methods currently used for measuring relevant outcomes, which limits consistency and comparability of findings between studies and can lead to research waste. 8 Variation also makes evidence synthesis via retrospective meta-analysis very difficult, if not impossible, due to limitations in combining data that has been collected, measured or reported using different methods.…”