Obesity prevention in children: prescribe diet and activity

  • Brown T & al.
  • Cochrane Database Syst Rev
  • 24 Jul 2019

  • International Clinical Digest
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Takeaway

  • For reducing obesity risk in children, physical activity (PA) interventions alone do not seem to be sufficient in children ages 0-5 years but might work in older children.

Why this matters

  • Childhood obesity prevention remains a global public health target.

Key results

  • In 16 randomized controlled trials (RCTs; n=6261), diet+PA bested control for BMI reductions in children ages 0-5 years, with a mean difference (MD) of −0.07 (95% CI, −0.14 to −0.01) kg/m2.
  • BMI z-score difference was similar in 11 RCTs (n=5536): MD, −0.11 (95% CI, −0.21 to 0.01).
  • Neither had an effect when used alone.
    • All moderate-certainty evidences.
  • For older children (6-12, 13-18 years), PA interventions were effective in reducing BMI, although with limited effect on BMI z-scores (moderate certainty).
  • Diet alone was not effective (high certainty), but diet+PA showed some potential for effective BMI reduction in these age groups (low certainty).
  • Adverse effects were not detected, and neither were increases in health disparities in the few studies addressing these factors.

Study design

  • Cochrane review, meta-analysis of 153 RCTs from different regions (mostly USA, Europe).
  • Funding: WHO; National Institute for Health Research Collaboration, the UK, many others. 

Limitations

  • The limitations are those of the included studies.