CoChat
Sign Up
Cited by 91Obesity, Physical Activity, DietPhysical Activity and HealthDiabetes, Cardiovascular Risks, and Lipoproteins

Diet and Physical Activity Interventions to Prevent or Treat Obesity in South Asian Children and Adults: A Systematic Review and Meta-Analysis

Open access
Brown, Tamara, Smith, Sarah, Bhopal, Raj, Kasim, Adetayo, Summerbell, Carolyn·2015·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph120100566PMC PMC4306880
Open this paper in CoChat — free accountOpen PDF

Abstract

Background and Aims: The metabolic risks associated with obesity are greater for South Asian populations compared with White or other ethnic groups, and levels of obesity in childhood are known to track into adulthood. Tackling obesity in South Asians is therefore a high priority. The rationale for this systematic review is the suggestion that there may be differential effectiveness in diet and physical activity interventions in South Asian populations compared with other ethnicities. The research territory of the present review is an emergent, rather than mature, field of enquiry, but is urgently needed. Thus the aim of this systematic review and meta-analysis was to assess the effectiveness of diet and physical activity interventions to prevent or treat obesity in South Asians living in or outside of South Asia and to describe the characteristics of effective interventions. Methods: Systematic review of any type of lifestyle intervention, of any length of follow-up that reported any anthropometric measure for children or adults of South Asian ethnicity. There was no restriction on the type of comparator; randomised controlled trials, controlled clinical trials, and before-after studies were included. A comprehensive search strategy was implemented in five electronic databases: ASSIA, Cochrane Controlled Trials Register, Embase, Medline and Social Sciences Citation Index. The search was limited to English language abstracts published between January 2006 and January 2014. References were screened; data extraction and quality assessment were carried out by two reviewers. Results are presented in narrative synthesis and meta-analysis. Results: Twenty-nine studies were included, seven children, 21 adult and one mixed age. No studies in children under six were identified. Sixteen studies were conducted in South Asia, ten in Europe and three in USA. Effective or promising trials include physical activity interventions in South Asian men in Norway and South Asian school-children in the UK. A home-based, family-orientated diet and physical activity intervention improved obesity outcomes in South Asian adults in the UK, when adjusted for baseline differences. Meta-analyses of interventions in children showed no significant difference between intervention and control for body mass index or waist circumference. Meta-analyses of adult interventions showed significant improvement in weight in data from two trials adjusted for baseline differences (mean difference −1.82 kgs, 95% confidence interval −2.48 to −1.16) and in unadjusted data from three trials following sensitivity analysis (mean difference −1.20 kgs, 95% confidence interval −2.23 to −0.17). Meta-analyses showed no significant differences in body mass index and waist circumference for adults. Twenty of 24 intervention groups showed improvements in adult body mass index from baseline to follow-up; average change in high quality studies (n = 7) ranged from 0.31 to −0.8 kg/m2. There was no evidence that interventions were more or less effective according to whether the intervention was set in South Asia or not, or by socio-economic status. Conclusions: Meta-analysis of a limited number of controlled trials found an unclear picture of the effects of interventions on body mass index for South Asian children. Meta-analyses of a limited number of controlled trials showed significant improvement in weight for adults but no significant differences in body mass index and waist circumference. One high quality study in South Asian children found that a school-based physical activity intervention that was delivered within the normal school day which was culturally sensitive, was effective. There is also evidence of culturally appropriate approaches to, and characteristics of, effective interventions in adults which we believe could be transferred and used to develop effective interventions in children.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/ijerph120100566

Cites

72 of 72 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Evidence to support the effectiveness of culturally adapted complex interventions for UK South Asian populations with type 2 diabetes is inconclusive in demonstrating sufficient health-related gain to make such interventions cost effective.

    “However, evidence to support the effectiveness of these interventions is inconclusive in demonstrating sufficient health-related gain to make such interventions cost effective [32,33].”

    From British South Asian Patients’ Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study (2020) · cites this paper as [32]

    The Results (section 3.6, Economic Outcomes; page unavailable) report that a nurse-led diabetes-care intervention was not cost effective at £28,933 per QALY gained. But the review gives only additional costs for a second intervention in South Asian adults at high risk of type 2 diabetes; it does not establish that culturally adapted complex interventions for UK South Asians with type 2 diabetes generally fail to produce sufficient health-related gain to be cost effective. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

4 of the 76 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [16]Keleher H. The drivers for health lie outside the health sector Understanding Health Promotion Keleher H. MacDougall C. Murphy B. Oxford University Press Melbourne, Australia 2007 47 60
  2. [27]Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children, Clinical guideline CG43 National Institute for Health and Clinical Excellence (NICE) London, UK 2006 22497033

Cited by

Sorted by citations

Related

Authors
Brown, T., Smith, S., Bhopal, R., Kasim, A., & Summerbell, C.
Affiliations
  • Durham University (GB)
  • University of Edinburgh (GB)
Corresponding author
Brown, Tamara
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2015-01-09
Volume
12
Issue
1
Pages
566-594
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph120100566
PMC
PMC4306880
OpenAlex
W2172247960
Cited by
91
References
76
Citations by year
2026: 3 · 2025: 2 · 2024: 13 · 2023: 8 · 2022: 7 · 2021: 10 · 2020: 9 · 2019: 8 · 2018: 11 · 2017: 7 · 2016: 12 · 2015: 1
FWCI
1.50
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Durham Research Online (Durham University) (publishedVersion, other-oa)
  • Durham Research Online (Durham University) (acceptedVersion, other-oa)
  • Durham Research Online (Durham University) (submittedVersion, cc-by)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute for Health Research (DRN 214)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
obesity prevention, obesity treatment, South Asian populations, dietary intervention, physical activity interventions, lifestyle intervention, childhood obesity, body mass index, waist circumference, weight loss, South Asian adults, South Asian men, ethnic minority health disparities, metabolic risk, intervention characteristics, cost-effectiveness, implementation barriers, intervention sustainability
MeSH terms
Adolescent, Adult, Aged, Asia, Western, Child, Female, Humans, Life Style, Male, Middle Aged, Motor Activity, Obesity, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review