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Campisi SC, Zasowski C, Shah S, Bradley-Ridout G, Madigan S, Szatmari P, Korczak DJ. Do Healthy Dietary Interventions Improve Pediatric Depressive Symptoms? A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:2495-2507. [PMID: 34302170 PMCID: PMC8634309 DOI: 10.1093/advances/nmab088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/05/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Dietary recommendations have been proposed as a way of impacting current and future mental health. There exists a limited body of conflicting literature related to pediatric nutritional interventions and depression. This meta-analysis aims to determine the efficacy of child and adolescent dietary interventions on depression. Systematic searches in electronic databases and gray literature were conducted. After screening 6725 citations, 17 studies were included in this systematic review. Quality assessment was performed using the Cochrane risk-of-bias tool and the Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies. A meta-analysis of Hedges g values was calculated using the Hartung-Knapp-Sidik-Jonkman method. Publication bias was assessed with funnel plots and the Egger test. The results of the meta-analysis of the RCTs (k = 7) demonstrated a nonsignificant effect of dietary intervention (g = 0.05; 95% CI: -0.25, 0.35; P = 0.70) whereas the results of the pre-post intervention studies (k = 9) demonstrated a significant small-to-medium effect favoring dietary intervention for reducing depression (g = -0.45; 95% CI: -0.64, -0.27; P = 0.001). Publication bias was not detected by the Egger test or by funnel plot asymmetry. The current meta-analysis demonstrates that "healthy" dietary interventions for children or adolescents in the community have little impact on nonclinical depression. Confusion will persist until better-designed studies in pediatric nutritional psychiatry research focusing on adolescents with depressive illness are conducted.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Clare Zasowski
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Shailja Shah
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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El Mikati HK, Boateng AO, McKinney BM, Haberlin-Pittz K, Pike J, Perry P, Hannon TS, Yazel-Smith L. Forever-Fit Summer Camp: The Impact of a 6-Week Summer Healthy Lifestyle Day Camp on Anthropometric, Cardiovascular, and Physical Fitness Measures in Youth With Obesity. J Prim Care Community Health 2021; 11:2150132720903888. [PMID: 31994432 PMCID: PMC6990606 DOI: 10.1177/2150132720903888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pediatric obesity is a public health concern with lifestyle intervention as the first-line treatment. Forever-Fit Summer Camp (FFSC) is a 6-week summer day program offering physical activity, nutrition education, and well-balanced meals to youth at low cost. The aim of the study was to assess the efficacy of this program that does not emphasize weight loss rather emphasizes healthy behaviors on body mass index, cardiovascular and physical fitness. Methods: The inclusion criteria were adolescents between 8 and 12 years and body mass index (BMI) ≥85th percentile. The data were collected at baseline and week 6 (wk-6) and was analyzed for 2013-2018 using paired-sample t tests. Results: The participants’ (N = 179) average age was 10.6 ± 1.6 years with a majority of females (71%) and black race/ethnicity (70%). At wk-6, BMI and waist circumference decreased by 0.8 ± 0.7 kg/m2 and 1.0 ± 1.3 in, respectively. Resting heart rate, diastolic and systolic blood pressure decreased by 8.5 ± 11.0 bpm, 6.3 ± 8.8 mmHg, and 6.4 ± 10.1 mmHg, respectively. The number of pushups, curl-ups, and chair squats were higher by 5.8 ± 7.5, 6.7 ± 9.1, and 7.7 ± 8.5, respectively. Conclusion: The FFSC is efficacious for improving BMI, cardiovascular, and physical fitness in the short term. The effect of similar episodic efforts that implement healthy lifestyle modifications throughout the school year should be investigated.
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Affiliation(s)
| | | | | | | | - Julie Pike
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick Perry
- American Foundation for Preventive Medicine, Indianapolis, IN, USA
| | - Tamara S Hannon
- Indiana University School of Medicine, Indianapolis, IN, USA
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Gow ML, Tee MSY, Garnett SP, Baur LA, Aldwell K, Thomas S, Lister NB, Paxton SJ, Jebeile H. Pediatric obesity treatment, self-esteem, and body image: A systematic review with meta-analysis. Pediatr Obes 2020; 15:e12600. [PMID: 32020780 DOI: 10.1111/ijpo.12600] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pediatric obesity impacts on multiple domains of psychological health, including self-esteem and body image. OBJECTIVE To determine the effect of multicomponent pediatric obesity treatment interventions on self-esteem and body image. METHODS A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self-esteem and/or body image. Data were extracted by one reviewer and cross-checked. Meta-analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes. RESULTS 64 studies were identified. Meta-analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self-esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I2 87%), maintained at follow-up (0.35 [0.05] P < .001, I2 79%, 17 studies). Similarly, meta-analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I2 73%), maintained at follow-up (0.41 [0.08], P < .001, I2 89%, 16 studies). CONCLUSIONS Pediatric obesity treatment improves self-esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.
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Affiliation(s)
- Megan L Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Melissa S Y Tee
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Weight Management Services, The Children's Hospital at Westmead, Sydney, Australia
| | - Katharine Aldwell
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Sarah Thomas
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
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Jebeile H, Gow ML, Baur LA, Garnett SP, Paxton SJ, Lister NB. Association of Pediatric Obesity Treatment, Including a Dietary Component, With Change in Depression and Anxiety: A Systematic Review and Meta-analysis. JAMA Pediatr 2019; 173:e192841. [PMID: 31524933 PMCID: PMC6749546 DOI: 10.1001/jamapediatrics.2019.2841] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Children and adolescents with obesity are at higher risk of developing depression and anxiety, and adolescent dieting is a risk factor for the development of depression. Therefore, determining the psychological effect of obesity treatment interventions is important to consider. OBJECTIVE To investigate the association between obesity treatment interventions, with a dietary component, and the change in symptoms of depression and anxiety in children and adolescents with overweight/obesity. DATA SOURCES Searches of MEDLINE, Embase, Cochrane Library, and PsychINFO were conducted from inception to August 2018. Hand searching of references was conducted to identify missing studies. STUDY SELECTION Obesity treatment interventions, with a dietary component, conducted in children and adolescents (age <18 years) with overweight/obesity, and validated assessment of depression and/or anxiety were included. DATA EXTRACTION AND SYNTHESIS Data were independently extracted by 1 reviewer and checked for accuracy. Meta-analysis, using a random-effects model, was used to combine outcome data and moderator analysis conducted to identify intervention characteristics that may influence change in depression and anxiety. The meta-analyses were finalized in May 2019. MAIN OUTCOMES AND MEASURES Change in symptoms of depression and anxiety postintervention and at the latest follow-up. RESULTS Of 3078 articles screened, 44 studies met inclusion criteria with a combined sample of 3702 participants (age range, 5.6 to 16.6 years) and intervention duration of 2 weeks to 15 months. Studies reported either no change or a statistically significant reduction in symptoms of depression or anxiety. Meta-analyses of 36 studies found a reduction in depressive symptoms postintervention (standardized mean difference [SE], -0.31 [0.04]; P < .001), maintained at follow-up in 11 studies at 6 to 16 months from baseline (standardized mean difference [SE], -0.25 [0.07]; P < .001). Anxiety was reduced postintervention (10 studies; standardized mean difference [SE], -0.38 [0.10]; P < .001) and at follow-up (4 studies; standardized mean difference [SE], -0.32 [0.15]; P = .03). Longer intervention duration was associated with a greater reduction in anxiety (R2 = 0.82; P < .001). Higher body mass index z score at baseline was associated with a greater reduction in depression (R2 = 0.19; P = .03). CONCLUSIONS AND RELEVANCE Structured, professionally run pediatric obesity treatment is not associated with an increased risk of depression or anxiety and may result in a mild reduction in symptoms. Treatment of weight concerns should be considered within the treatment plan for young people with depression and obesity.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Megan L. Gow
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A. Baur
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P. Garnett
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Natalie B. Lister
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
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Jebeile H, Gow ML, Baur LA, Garnett SP, Paxton SJ, Lister NB. Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta-analysis. Obes Rev 2019; 20:1287-1298. [PMID: 31131531 PMCID: PMC6851692 DOI: 10.1111/obr.12866] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/25/2019] [Accepted: 03/31/2019] [Indexed: 12/20/2022]
Abstract
This review aimed to investigate the impact of obesity treatment, with a dietary component, on eating disorder (ED) prevalence, ED risk, and related symptoms in children and adolescents with overweight or obesity. Four databases were searched to identify pediatric obesity treatment interventions, with a dietary component, and validated pre-post intervention assessment of related outcomes. Of 3078 articles screened, 36 met inclusion criteria, with a combined sample of 2589 participants aged 7.8 to 16.9 years. Intervention duration ranged from 1 week to 13 months, with follow-up of 6 months to 6 years from baseline. Prevalence of ED was reported in five studies and was reduced post-intervention. Meta-analyses showed a reduction in bulimic symptoms (eight studies, standardized mean difference [SE], -0.326 [0.09], P < 0.001), emotional eating (six studies, -0.149 [0.06], P = 0.008), binge eating (three studies, -0.588 [0.10], P < 0.001), and drive for thinness (three studies, -0.167 [0.06], P = 0.005) post-intervention. At follow-up, a reduction in ED risk (six studies, -0.313 [0.13], P = 0.012), emotional eating (five studies, -0.259 [0.05], P < 0.001), eating concern (three studies, -0.501 [0.06], P < 0.001), and drive for thinness (two studies, -0.375 [0.07], P < 0.001) was found. Structured and professionally run obesity treatment was associated with reduced ED prevalence, ED risk, and symptoms.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes and Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Megan L Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes and Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes and Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes and Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes and Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
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Moreno JP, Vézina-Im LA, Vaughan EM, Baranowski T. Impact of child summertime obesity interventions on body mass index, and weight-related behaviours: a systematic review and meta-analysis protocol. BMJ Open 2017; 7:e017144. [PMID: 29061614 PMCID: PMC5665220 DOI: 10.1136/bmjopen-2017-017144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION In previous studies, it has been found that on average, children consistently gained weight during the summer months at an increased rate compared with the 9-month school year. This contributed to an increased prevalence of overweight and obesity in children. Several obesity-related interventions have occurred during or targeting the summer months. We propose to conduct a systematic review and meta-analysis of the impact of obesity prevention and treatment interventions for school-age children conducted during the summer or targeting the summer months when children are not in school on their body mass index (BMI), or weight-related behaviours. METHODS AND ANALYSES A literature search will be conducted by the first author (JPM) using MEDLINE/PubMed, Cochrane Library, Scopus, CINAHL, PsycINFO, EMBASE and Proquest Dissertations and Theses databases from the date of inception to present. Studies must examine interventions that address the modification or promotion of weight-related behaviours (eg, dietary patterns, eating behaviours, physical activity (PA), sedentary behaviour or sleep) and target school-age children (ages 5-18). The primary outcomes will be changes from baseline to postintervention and/or the last available follow-up measurement in weight, BMI, BMI percentile, standardised BMI or per cent body fat. Secondary outcomes will include changes in dietary intake, PA, sedentary behaviour or sleep. Risk of bias will be assessed using the Cochrane risk of bias tool for randomised and non-randomised studies, as appropriate. ETHICS AND DISSEMINATION Because this is a protocol for a systematic review, ethics approval will not be required. The findings will be disseminated via presentations at scientific conferences and published in a peer-reviewed journal. All amendments to the protocol will be documented and dated and reported in the PROSPERO trial registry. PROSPERO REGISTRATION NUMBER CRD42016041750.
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Affiliation(s)
- Jennette P Moreno
- Department of Pediatrics-Nutrition, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Lydi-Anne Vézina-Im
- Department of Pediatrics-Nutrition, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Tom Baranowski
- Department of Pediatrics-Nutrition, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
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Abujudeh BA, Abu Al Rub RF, Al-Faouri IG, Gharaibeh MK. The impact of lifestyle modification in preventing or delaying the progression of type 2 diabetes mellitus among high-risk people in Jordan. J Res Nurs 2010. [DOI: 10.1177/1744987110387482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To investigate (1) the effectiveness of educational interventions in reducing the risk for developing type 2 diabetes mellitus (DM) among Jordanian adults at high risk, and (2) whether levels of self-esteem and self-efficacy affect the responses of participants towards educational interventions in reducing risks for developing type 2 DM. Design: A comparative experimental pretest–post-test control group design was used. One hundred and thirteen participants at high risk for developing type 2 DM were randomly assigned to a study group ( n = 57) and a control group ( n = 56) based on the matching technique according to the risk factors. Methods: The participants in the study group received 12 educational sessions about healthy diet guidelines and five educational sessions about guidelines for moderately intense physical activity. Participants in the control group received general written information about diet and exercises, but no specific individualised interventions were offered to them. Results: The risk of type 2 DM among the study group was reduced by 28%. The results also indicated that participants in the study group had significant reduction in their body weight, and body mass index, and fasting blood sugar level. Participants in the study group with higher self-esteem and self-efficacy levels before receiving interventions achieved lower weight loss comparing to those who had lower self-esteem and self-efficacy levels. Implications: The findings of the present study confirmed that lifestyle interventions concerned with educational sessions about dietary behaviours and exercises illustrate promising results in preventing or delaying the risk of developing type 2 DM by modifying its risk factors.
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Affiliation(s)
- Bashar A. Abujudeh
- Head Nurse of General Intermediate Care Unit, King Abdulla University Hospital, Irbid, Jordan
| | - Raeda F. Abu Al Rub
- Associate Professor, College of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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