Lifestyle interventions significantly reduced BMI compared to no-treatment controls (difference -1.25 kg/m2; 95% CI -2.18 to -0.32) and improved cardio-metabolic outcomes in overweight children.
Meta-Analysis
Do lifestyle interventions incorporating a dietary component improve weight and cardio-metabolic risks in overweight/obese children?
Lifestyle interventions incorporating a dietary component significantly improve BMI and cardio-metabolic risk factors in overweight and obese children up to 1 year.
Effect estimate: Difference -1.25 kg/m2 (95% CI -2.18 to -0.32)
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/m(2), 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/m(2), 95% CI -1.58 to -1.03) and posttreatment effects (-0.92 kg/m(2), 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.
Ho et al. (Tue,) conducted a meta-analysis in Overweight and obese children. Lifestyle interventions vs. No treatment/wait-list control, usual care, or written education materials was evaluated on Weight change (BMI) (Difference -1.25 kg/m2, 95% CI -2.18 to -0.32). Lifestyle interventions significantly reduced BMI compared to no-treatment controls (difference -1.25 kg/m2; 95% CI -2.18 to -0.32) and improved cardio-metabolic outcomes in overweight children.
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