The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

Abstract

Background Childhood obesity persists as a serious public health problem. In the current meta-analysis, we summarized the results of controlled trials that evaluated the effect of obesity prevention policies in children and adolescents. Methods Three databases (SCOPUS, PubMed and Embase) were searched for studies published before the 6th April 2020, by reported outcome measures of body mass index (BMI) and BMI-Zscore. Forty-seven studies reported BMI, while 45 studies reported BMI-Zscore as final outcome. Results The results showed that the obesity-prevention policies had significant effect in reducing BMI (WMD: − 0.127; CI − 0.198, − 0.056; P < 0.001). These changes were not significant for BMI-Zscore (WMD: − 0.020; CI − 0.061, 0.021; P = 0.340). In dose–response meta-analysis, a non-linear association was reported between the duration of intervention and BMI (Pnonlinearity < 0.001) as well as BMI-Zscore (Pnonlinearity = 0.023). In subgroup analysis, the more favorite results were observed for 5–10 years old, with combination of physical activity and diet as intervention materials. Conclusion In conclusion, the obesity prevention policies in short-term periods of less than 2 years, in rather early age of school with approaches of change in both of diet and physical activity, could be more effective in prevention of childhood obesity. Trial registration PROSPERO registration number: CRD42019138359

Feasibility and Efficacy of the “FUNPALs Playgroup” Intervention to Improve Toddler Dietary and Activity Behaviors: A Pilot Randomized Controlled Trial

“…Parental BMI has been found associated with children's health behavior development [59]. Further, age of children and received intervention dose can influence success of family-based childhood obesity prevention programs [60,61]. Therefore, nearest neighbors were determined by computing the distance between the recipient (missing case) and all other subjects (candidate donors) based on the three variables mentioned above.…”

“…Results of repeated measure ANOVA analyses examining changes in parenting behaviors and child health behaviors within and between the study arms from baseline to post-intervention (n = 50). 4 (−3 60. to −1.04) p = 0.207 0.6 (−1.00 to 2.16) p = 0.458 −0.4 (−1.71 to 0.90); p = 0.536 G × T; p = 0.137 FV intake (FFQ) 1.2 (−2.06 to 4.37) p = 0.466 −1.8 (−5.06 to 1.46) p = 0.266 −0.3 (−2.56 to 1.91); p = 0.772 G × T; p = 0.190 SSB intake ** −0.7 (−1.35 to −0.14) 72 to 3.04); p = 0.220 G × T; p = 0.663 Home Environment Mediators Home Environment Composite Score−3.7 (−8.01 to 0.66) p = 0.093 0.6 (−3.82 to 5.08) p = 0.773 −1.5 (−4.56 to 1.51); p = 0.319 G × T; p = 0.161 T, treatment group; C, control group; CI, confidence interval; FV, fruits and vegetables; SSB, sugar-sweetened beverage; SCS, skin carotenoid scores; SF, structure feeding; G × T, interaction effect between group and time.…”

Stakeholders perspectives of barriers and facilitators of childhood obesity prevention policies in Iran: A Delphi method study

“…Using the themes and the results of our previous systematic review [ 13 ], a preliminary list of barriers and facilitators of childhood and adolescent obesity prevention policies was obtained, and its validity was confirmed by five experts. The acceptable proposed barriers and facilitators had a strong and provable retrospective effect.…”

Childhood obesity prevention policies in Iran: a policy analysis of agenda-setting using Kingdon’s multiple streams

“…WHO, advise governments to implement population-based strategies to combat obesity [9]. Review studies show that different CAOP policies were adopted in each society based on their structure [10], however, in 2015, WHO, in collaboration with 100 member countries, launched a program called Ending Childhood Obesity (ECHO), and persuaded member countries to implement the program to prevent and treat CAO [11]. Based on this, we decided to examine how and when the CAO prevention policies were on the agenda, before and after the ECHO program.…”