What childhood obesity prevention programmes work? A systematic review and meta-analysis

Area of Science:

• Public Health
• Pediatrics
• Behavioral Science

Background:

• Childhood obesity is a significant public health concern with inconsistent findings from previous reviews.
• Existing reviews have predominantly focused on school-based interventions, necessitating a broader evaluation across various settings.

Purpose of the Study:

• To systematically evaluate the effectiveness of childhood obesity prevention programs implemented in high-income countries.
• To assess interventions targeting diet, physical activity, or both in children aged 2-18.
• To grade the strength of evidence (SOE) for interventions based on study setting.

Main Methods:

• Systematic review of studies including randomized controlled trials, quasi-experimental studies, and natural experiments.
• Searched multiple databases (MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov, Cochrane Library) up to April 2013.
• Data abstraction by two independent reviewers, with meta-analyses for sufficiently similar studies.

Main Results:

• 139 intervention studies were identified, with 115 primarily school-based.
• High SOE for physical activity-only interventions in schools with home involvement, and combined diet-physical activity interventions with home and community components.
• Moderate SOE for various school-based and community interventions; low SOE for childcare or home-based interventions.

Conclusions:

• School-based interventions demonstrate at least moderately strong evidence for effectiveness in preventing childhood obesity.
• Further research is recommended for interventions in non-school settings and for environmental, policy, and informatics-oriented approaches.