Current Guidelines for Obesity Prevention in Childhood and Adolescence

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objective: Current guidelines for prevention of obesity in childhood and adolescence are discussed. Methods: A literature search was performed in Medline via PubMed, and appropriate studies were analyzed. Results: Programs to prevent childhood obesity have so far remained mainly school-based and effects have been limited. Analyses by age group show that prevention programs have the best results in younger children (<12 years). Evidence-based recommendations for pre-school- and early school-aged children indicate the need for interventions that address parents and teachers alike. During adolescence, school-based interventions proved most effective when adolescents were addressed directly. To date, obesity prevention programs have mainly focused on behavior-oriented prevention. Recommendations for community- or environment-based prevention have been suggested by the German Alliance of Noncommunicable Diseases and include a minimum of 1 h of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals at kindergartens and schools as well as a ban on unhealthy food advertisement aimed at children. Conclusion: Behavior-oriented prevention programs showed only limited long-term effects. Certain groups at risk for the development of obesity are not reached effectively by current programs. Although universally valid conclusions cannot be drawn given the heterogeneity of available studies, clearly combining behavior-based programs with community-based prevention to counteract an ‘obesogenic environment' is crucial for sustainable success of future obesity prevention programs.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: not found

Interventions for preventing obesity in children.

Elizabeth Waters, Andrea M de Silva-Sanigorski, Belinda Hall … (2011)

Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear. This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI). Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?" The searches were re-run in CENTRAL, MEDLINE, EMBASE, PsychINFO and CINAHL in March 2010 and searched relevant websites. Non-English language papers were included and experts were contacted. The review includes data from childhood obesity prevention studies that used a controlled study design (with or without randomisation). Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more. If studies were randomised at a cluster level, 6 clusters were required. Two review authors independently extracted data and assessed the risk of bias of included studies. Data was extracted on intervention implementation, cost, equity and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity (PA)-related behaviours or diet-related behaviours. Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardised BMI (zBMI) score data with subgroup analysis by age group (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings). This review includes 55 studies (an additional 36 studies found for this update). The majority of studies targeted children aged 6-12 years. The meta-analysis included 37 studies of 27,946 children and demonstrated that programmes were effective at reducing adiposity, although not all individual interventions were effective, and there was a high level of observed heterogeneity (I(2)=82%). Overall, children in the intervention group had a standardised mean difference in adiposity (measured as BMI or zBMI) of -0.15kg/m(2) (95% confidence interval (CI): -0.21 to -0.09). Intervention effects by age subgroups were -0.26kg/m(2) (95% CI:-0.53 to 0.00) (0-5 years), -0.15kg/m(2) (95% CI -0.23 to -0.08) (6-12 years), and -0.09kg/m(2) (95% CI -0.20 to 0.03) (13-18 years). Heterogeneity was apparent in all three age groups and could not explained by randomisation status or the type, duration or setting of the intervention. Only eight studies reported on adverse effects and no evidence of adverse outcomes such as unhealthy dieting practices, increased prevalence of underweight or body image sensitivities was found. Interventions did not appear to increase health inequalities although this was examined in fewer studies. We found strong evidence to support beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeted to children aged six to 12 years. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously. A broad range of programme components were used in these studies and whilst it is not possible to distinguish which of these components contributed most to the beneficial effects observed, our synthesis indicates the following to be promising policies and strategies:· school curriculum that includes healthy eating, physical activity and body image· increased sessions for physical activity and the development of fundamental movement skills throughout the school week· improvements in nutritional quality of the food supply in schools· environments and cultural practices that support children eating healthier foods and being active throughout each day· support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities)· parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activitiesHowever, study and evaluation designs need to be strengthened, and reporting extended to capture process and implementation factors, outcomes in relation to measures of equity, longer term outcomes, potential harms and costs.Childhood obesity prevention research must now move towards identifying how effective intervention components can be embedded within health, education and care systems and achieve long term sustainable impacts.

0 comments Cited 345 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

The metabolic syndrome in children and adolescents.

Paul Zimmet, George Alberti, Francine Kaufman … (2007)

0 comments Cited 260 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Evidence that the prevalence of childhood overweight is plateauing: data from nine countries.

Tim Olds, Carol Maher, Shi Zumin … (2011)

Until quite recently, there has been a widespread belief in the popular media and scientific literature that the prevalence of childhood obesity is rapidly increasing. However, high quality evidence has emerged from several countries suggesting that the rise in the prevalence has slowed appreciably, or even plateaued. This review brings together such data from nine countries (Australia, China, England, France, Netherlands, New Zealand, Sweden, Switzerland and USA), with data from 467,294 children aged 2-19 years. The mean unweighted rate of change in prevalence of overweight and obesity was +0.00 (0.49)% per year across all age ×sex groups and all countries between 1995 and 2008. For overweight alone, the figure was +0.01 (0.56)%, and for obesity alone -0.01 (0.24)%. Rates of change differed by sex, age, socioeconomic status and ethnicity. While the prevalence of overweight and obesity appears to be stabilizing at different levels in different countries, it remains high, and a significant public health issue. Possible reasons for the apparent flattening are hypothesised.

0 comments Cited 222 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (publisher-id): OFA

Journal ID (pmc): OFA

Journal ID (nlm-ta): Obes Facts

Journal ID (doi): 10.1159/issn.1662-4025

Title: Obesity Facts

Publisher: S. Karger AG

ISSN (Print): 1662-4025

ISSN (Electronic): 1662-4033

Publication date Subscription-year: 2018

Publication date (Print): July 2018

Publication date (Electronic): 04 July 2018

Volume: 11

Issue: 3

Pages: 263-276

Affiliations

^aIFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig,Germany; ^bDepartment of Pediatrics I / Pediatric Endocrinology and Diabetology,University Hospital of Halle/Saale, Halle/Saale, Germany; ^cInstitute of Human Genetics, Jena University Medical Center, Friedrich-Schiller-University of Jena, Jena, Germany; ^dInstitute of Movement and Neuroscience, German Sport University of Cologne, Cologne, Germany; ^eDepartment Of Clinical Nutrition and Prevention, Children's Hospital, University Hospital of Vienna, Vienna, Austria; ^fDepartment of Rehabilitative and Preventive Sports Medicine, University Medical Center Freiburg, Freiburg i.Br., Germany; ^gDepartment of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany; ^hInstitute of Special and Inclusive Education, University of Leipzig, Leipzig, Germany; ⁱInstitute for Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany; ^jDepartment of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany

Author notes

*Susann Weihrauch-Blüher, MD, IFB AdiposityDiseases, Leipzig University Medical Center, Philipp-Rosenthal-Straße 27, 04103 Leipzig, Germany, susann.blueher@medizin.uni-leipzig.de

Article

Publisher ID: 486512 Pmcid ID: PMC6103347 Other ID: Obes Facts 2018;11:263-276

DOI: 10.1159/000486512

PMC ID: PMC6103347

PubMed ID: 29969778

SO-VID: c67c8ee1-daa0-458f-a950-7c98ac86ee7a

License:

This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 09 May 2017

Date accepted : 21 December 2017

Page count

Tables: 4, References: 54, Pages: 14

Comments

Comment on this article

scite_

Cited by 49

See all cited by

Most referenced authors 1,124

See all reference authors

Call for Papers: Preclinical Investigations of Nutrigenetic/Nutrigenomic Targets

Submit here before January 31, 2025

Current Guidelines for Obesity Prevention in Childhood and Adolescence

Read this article at

Abstract

Related collections

Karger: Nutrition and Dietetics

Most cited references 33

Interventions for preventing obesity in children.

The metabolic syndrome in children and adolescents.

Evidence that the prevalence of childhood overweight is plateauing: data from nine countries.

Author and article information

Journal

Affiliations

Author notes

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 28

Cited by 49

Most referenced authors 1,124