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Primary prevention of overweight in children and adolescents: a meta-analysis of the effectiveness of interventions aiming to decrease sedentary behaviour
Open accessAbstract
The objectives of this meta-analysis were to provide an overview of the evidence regarding the effects of interventions, implemented in the school- and general population setting, aiming to prevent excessive sedentary behaviour in children and adolescents on (1) the amount of sedentary behaviour and (2) BMI. Differences in effects on sedentary behaviour and BMI between single health behaviour interventions (sedentary behaviour only) and multiple health behaviour interventions were explored. A literature search was conducted in PubMed, EMBASE, Web of Science, PsycINFO and Cochrane Database of Systematic Reviews. Thirty-four (R)CT studies evaluating 33 general population interventions, published between 1990 and April 2011, aiming to decrease sedentary behaviour in normal weight children or adolescents (0-18 years) were included. Intervention duration ranged from 7 days to 4 years. Mean change in sedentary behaviour and BMI from baseline to post-intervention was calculated using a random effects model. Results showed significant decreases for the amount of sedentary behaviour and BMI. For sedentary behaviour the post-intervention mean difference was -17.95 min/day (95%CI:-26.61;-9.28); the change-from-baseline mean difference was -20.44 min/day (95%CI:-30.69;-10.20). For BMI the post-intervention mean difference was -0.25 kg/m² (95%CI:-0.40;-0.09); the change-from-baseline mean difference was -0.14 kg/m² (95%CI:-0.23;-0.05). No differences were found between single and multiple health behaviour interventions. Interventions in the school- and general population setting aiming to reduce only sedentary behaviour and interventions targeting multiple health behaviours can result in significant decreases in sedentary behaviour. Studies need to increase follow-up time to estimate the sustainability of the intervention effects found.
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“Few systematic reviews have considered SB interventions within a school setting.17, 18, 35”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [35]
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“Within the school setting single or multi-component interventions that address dietary intake, and/or physical activity or sedentary behavior have shown limited effectiveness in reducing sedentary behavior and BMI [8–10].”
From Barriers, facilitators and capacities for childhood obesity prevention in 12 European nations: results of a policy-maker survey (2018) · cites this paper as [8]
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“Across all settings, strategies targeting sedentary behaviour emerged as the most consistently successful (57,65,104,110), with ES ranging from 0.”
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“A recent meta-analysis quantitatively compared the results of 34 studies evaluating sedentary behavior change interventions in children and adolescents (van Grieken et al., 2012).”
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“Results from intervention studies suggest that preventing excessive sedentary behaviour may be an effective approach in improving healthy weight among children [66].”
Rapid review to update evidence for Healthy Child Programme 0-5
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“A growing number of studies have documented excessive ST (≥2 hours per day) among preschool-age children (aged 2 to 5 years) [4-11], and some studies have linked excessive ST to an increased risk of overweight and obesity among children [4,12,13].”
InfluentialStraker, L. M., Howie, E. K., Cliff, D. P., Davern, M. T., Engelen, L., Gomersall, S. R., Ziviani, J. M., Schranz, N. K., Olds, T., & Tomkinson, G. R. (2015) · Journal of Physical Activity and Health · doi:10.1123/jpah.2015-0026 · Cited by 29
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Seral-Cortés, M., Sabroso‐Lasa, S., Bailo-Aysa, A., González‐Gross, M., Molnár, D., Censi, L., Molina‐Hidalgo, C., Gottrand, F., Henauw, S. D., Μanios, Y., et al. (2021) · Nutrients · doi:10.3390/nu13020474 · Cited by 27
“In previous childhood obesity prevention programs, the greatest changes were observed in sedentary time [59].”
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Ribeiro, E. H. C., Guerra, P. H., de Oliveira, A. C., da Silva, K. S., dos Santos, P. C., Santos, R., Okely, A. D., & Florindo, A. A. (2020) · Revista de Saúde Pública · doi:10.11606/s1518-8787.2020054001977 · Cited by 23
“We found that effective interventions targeted changes in multiple health behaviors, corroborating Grieken et al. (2012)39, which reported no difference in the positive effects of interventions of single or multiple health behavior on SB.”
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Lawlor, D. A., Howe, L. D., Anderson, E. L., Kipping, R., Campbell, R. M., Wells, S. L., Chittleborough, C., Peters, T. J., & Jago, R. (2015) · BMC Public Health · doi:10.1186/s12889-016-2734-5 · Cited by 22
The German recommendations for physical activity promotion
Abu‐Omar, K., Rütten, A., Messing, S., Pfeifer, K., Ungerer-Röhrich, U., Goodwin, L., Burlacu, I., & Gediga, G. (2018) · Journal of Public Health · doi:10.1007/s10389-018-0986-5 · Cited by 20
“…those 39, 3 were reviews of reviews (Heath et al. 2012; Kriemler et al. 2011; Steenbock et al. 2014); 33 were systematic reviews, with 6 having conducted a meta-analysis (Beets et al. 2009; Cushing et al. 2014; Kamath et al. 2008; Lonsdale et al. 2013; van Grieken et al. 2012; Waters et al. 2014).”
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“Interventions targeting diet and physical activity have shown positive effects on BMI in children and adolescents [4], and a recent meta-analysis show that reducing time spent on screen behaviours as a part of multiple behaviour interventions can affect BMI in young people [5].”
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Effects of the 3-year Sigue la Huella intervention on sedentary time in secondary school students
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Physical Activity and Public Health: Four Decades of Progress
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“Only nine of these studies reported that random allocation was adequately concealed, and only eight reported blinding of the outcome assessment; sedentary behaviour was assessed by self-/parent-report in all studies.(16) Two recent systematic reviews of school-based interventions to increase fruit and vegetable consum…”
BackgroundMethodSitzendes Verhalten als Risikofaktor im Kindes- und Jugendalter
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“In addition, the activities carried out in leisure time are usually those that consume less body energy.(2) Adolescence is a great period to the development of healthy habits, which may resonate into adulthood.”
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“[30] Another 12‐month school‐based intervention on overweight adolescents at risk for diabetes found no effects on BMI or PA but results in higher self‐efficacy for PA and better food choices.[31] Thus, it is possible that these students were more self‐motivated than before intervention.”
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“…fat mass, P Diet intake (FV, fatty food, sugar sweetened beverages, totalE ), PA (MVA, TV watching time, active commuting to school, accelerometer) von Grieken et al. (2012)15) 34 (1999-2010) Meta Mod/24 1.9-18.2 SB, PA, N, Ed 7 d-4 y S, H, Pc, Cm, nursery SB BMI, BMI Z-score, %BF, SFT, WC,…”
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The Role of Physical Activity and Exercise in Managing Obesity and Achieving Weight Loss
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Sedentary Behaviour and Adiposity
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Community actions to prevent obesity in children and adolescents
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LITERATURE REVIEW: PERUBAHAN GAYA HIDUP SEBAGAI UPAYA MANAJEMEN SINDROMA METABOLIK PADA REMAJA
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Effects of a cluster-randomized exercise intervention on cardiovascular health in preschoolers
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“When energy intake exceeds expenditure, increased lipid accumulation occurs, promoting obesity development (Heinonen, 2024; Hills et al., 2007; van Grieken et al., 2012).”
Reduzierung von Sitzzeiten bei Kindern – ein systematisches Review
Alfes, J., Bucksch, J., Aue, K., & Demetriou, Y. (2016) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-016-2452-2 · Cited by 2
“nismen des Zusammenhangs zwischen sitzendem Verhalten und Übergewicht noch nicht abschließend geklärt sind [7], weisen randomisiert kontrollierte Interventionsstudien zur Reduzierung von Sitzzeiten gleichzeitig eineAbnahme des Gewichts nach [8].”
BackgroundMiguel‐Etayo, P. D., Flores‐Rojas, K., Vázquez‐Cobela, R., Jurado‐Castro, J. M., Larruy‐García, A., Picáns‐Leis, R., Castro-Collado, C., Pastor‐Villaescusa, B., Llorente‐Cantarero, F. J., Aguilera, C. M., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-24351-2 · Cited by 1
“Both, for PA [43] and sedentary behavior [44], systematic reviews have shown that intervention studies generally succeed modifying both positively [45].”
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Screen time and physical activity in schoolchildren
Feu, S., García-Ceberino, J. M., la Cruz, M. L.-D., & López-Pérez, M. (2026) · Cogent Education · doi:10.1080/2331186x.2026.2682595
Metadata
- Authors
- van Grieken, A., Ezendam, N. P., Paulis, W. D., van der Wouden, J. C., & Raat, H.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Raat, Hein
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2012-05-28
- Volume
- 9
- Issue
- 1
- Pages
- 61-61
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC3462110
- OpenAlex
- W2118742552
- Cited by
- 111
- References
- 66
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 16 · 2019: 6 · 2018: 9 · 2017: 7 · 2016: 19 · 2015: 11 · 2014: 14 · 2013: 9
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- ZonMw (121020027)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Keywords
- sedentary behavior, overweight prevention, children, adolescents, body mass index, health behavior interventions, school-based intervention, intervention effectiveness
- MeSH terms
- Adolescent, Child, Humans, Health Knowledge, Attitudes, Practice, Primary Prevention, Health Behavior, Internet, Overweight, Sedentary Behavior
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