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Published on: February 2, 2017
Comparative effectiveness of lifestyle interventions on children's body composition management: A systematic review
Xiwen Su1, Mohamed A Hassan2, HyunJoon Kim1
1Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA 02215, USA.
Insights
Multicomponent lifestyle interventions significantly reduce body mass index (BMI) and body fat percentage (BFP) in children. Physical activity alone is the most effective single intervention for managing childhood obesity.
Area of Science:
- Pediatrics
- Public Health
- Obesity Research
Background:
- Childhood obesity is a growing global health concern.
- Effective lifestyle interventions are crucial for managing body composition in children.
- Comparative evidence on various interventions is needed to guide clinical practice.
Purpose of the Study:
- To provide comparative evidence on the effectiveness of diverse lifestyle interventions for body composition management in children aged 4-12 years.
- To analyze the impact of single-component and combined-component lifestyle interventions on pediatric obesity metrics.
- To identify the most effective interventions for reducing body mass index (BMI) and body fat percentage (BFP) in children.
Main Methods:
- A systematic network meta-analysis was conducted using data from PubMed, Embase, CINAHL, and Web of Science.
- Included randomized controlled trials (RCTs) published between January 2010 and August 2023, involving children aged 4-12 without pre-existing conditions.
- Interventions were categorized into single-arm (physical activity, diet, behavioral, informational) and combined-arm (bicomponent, multicomponent) approaches.
Main Results:
- Analysis of 91 RCTs encompassing 58,649 children revealed that multicomponent treatment significantly reduced BMI, BMI z-score, and body fat percentage (BFP) compared to usual care.
- Bicomponent treatment also demonstrated significant reductions in BMI and BMI z-score versus usual care.
- Physical activity, diet, and behavioral/informational support were analyzed as single-component interventions.
Conclusions:
- Multicomponent lifestyle interventions are most effective for reducing children's BMI and BFP.
- Among single-component interventions, physical activity demonstrated the highest efficacy.
- Practitioners should consider comprehensive lifestyle modifications, and children with higher initial BMI/BFP may benefit more.
Purpose:
This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.
Methods:
PubMed (MEDLINE), Embase, CINAHL, and Web of Science were systematically searched for this network meta-analysis. Randomized controlled studies (RCTs) that included children aged 4-12 years with no physical or mental conditions; performed at least 1 type of lifestyle intervention; reported change in body mass index (BMI), BMI z-score, or body fat percentage (BFP); and were published between January 2010 and August 2023 were included.
Results:
The final analysis included 91 RCTs with aggregate data for 58,649 children. All interventions were categorized into single-arm approaches (physical activity, diet, and behavioral and informational support) and combined arms approaches (bicomponent and multicomponent treatment). Multicomponent treatment showed significant effectiveness on the reduction of BMI (mean deviation (MD) - 0.49, 95% confidence interval (95%CI): -0.88 to -0.12), BMI z-score (MD = -0.11, 95%CI: -0.18 to -0.04), and BFP (MD = -1.69, 95%CI: -2.97 to -0.42) compared to the usual care condition. Bicomponent treatment also significantly reduced BMI (MD = -0.28, 95%CI: -0.54 to -0.04) and BMI z-score (MD = -0.07, 95%CI: -0.12 to -0.02) compared to usual care.
Conclusion:
Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP. Among single-component approaches, physical activity engagement emerged as the most effective. These findings should guide practitioners in recommending comprehensive lifestyle modifications for children. Moreover, children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.
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