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Effectiveness of Lifestyle Interventions in Child Obesity: Systematic Review With Meta-analysis

Ho, Mandy, Garnett, Sarah P., Baur, Louise, Burrows, Tracy, Stewart, Laura, Neve, Melinda, Collins, Clare·2012·Pediatrics

Abstract

BACKGROUND AND OBJECTIVES: The effects of lifestyle interventions on cardio-metabolic outcomes in overweight children have not been reviewed systematically. The objective of the study was to examine the impact of lifestyle interventions incorporating a dietary component on both weight change and cardio-metabolic risks in overweight/obese children. METHODS: English-language articles from 1975 to 2010, available from 7 databases, were used as data sources. Two independent reviewers assessed articles against the following eligibility criteria: randomized controlled trial, participants overweight/obese and ≤18 years, comparing lifestyle interventions to no treatment/wait-list control, usual care, or written education materials. Study quality was critically appraised by 2 reviewers using established criteria; Review Manager 5.1 was used for meta-analyses. RESULTS: Of 38 eligible studies, 33 had complete data for meta-analysis on weight change; 15 reported serum lipids, fasting insulin, or blood pressure. Lifestyle interventions produced significant weight loss compared with no-treatment control conditions: BMI (−1.25kg/m2, 95% confidence interval [CI] −2.18 to −0.32) and BMI z score (−0.10, 95% CI −0.18 to −0.02). Studies comparing lifestyle interventions to usual care also resulted in significant immediate (−1.30kg/m2, 95% CI −1.58 to −1.03) and posttreatment effects (−0.92 kg/m2, 95% CI −1.31 to −0.54) on BMI up to 1 year from baseline. Lifestyle interventions led to significant improvements in low-density lipoprotein cholesterol (−0.30 mmol/L, 95% CI −0.45 to −0.15), triglycerides (−0.15 mmol/L, 95% CI −0.24 to −0.07), fasting insulin (−55.1 pmol/L, 95% CI −71.2 to −39.1) and blood pressure up to 1 year from baseline. No differences were found for high-density lipoprotein cholesterol. CONCLUSIONS: Lifestyle interventions can lead to improvements in weight and cardio-metabolic outcomes. Further research is needed to determine the optimal length, intensity, and long-term effectiveness of lifestyle interventions.

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Metadata

Authors
Ho, M., Garnett, S. P., Baur, L., Burrows, T., Stewart, L., Neve, M., & Collins, C.
Venue
Pediatrics
Published
2012-12-01
Volume
130
Issue
6
Pages
e1647-e1671
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
OpenAlex
W2153105655
Cited by
509
References
4
FWCI
6.67
Type
journal article
Language
en
Open access
closed

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