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Akhtar TN, McGibbon E. Blindspot in the evidence base: A systematic review of psychological interventions for children and adolescents with intellectual disabilities and co-occurring obesity. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104240. [PMID: 35500443 DOI: 10.1016/j.ridd.2022.104240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/25/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Children and adolescents with intellectual disabilities (C&A-ID) face many disadvantages in healthcare research and service delivery. Intellectual disabilities have been found to precipitate weight-related problems, and together, they may be indicators of rare genetic diseases (RGDs). C&A-ID may require support for health problems exacerbated by primary diagnoses. While it is generally agreed that C&A-ID have more complex needs than typically developing individuals, psychological services to address these needs are under-explored. AIMS This systematic review aimed to identify psychological interventions for weight management in C&A-ID. METHOD MEDLINE, PsycINFO, CINAHL, The Cochrane Library and SCOPUS were systematically searched. Data extraction and quality appraisal were performed for all eligible studies RESULTS: The search strategy yielded seven studies published in English between 2010 and 2022. All interventions addressed obesity through multi-disciplinary programmes and resulted in weight reductions, with most interventions theoretically influenced by principles of behaviourism. Quality appraisal revealed methodological weaknesses in six of seven studies, such as heterogeneity in samples, interventions, and outcome measures, disallowing meta-analyses and weakening the generalisability of interventions to diverse contexts and groups CONCLUSIONS AND IMPLICATIONS: A genuine disconnect between empirical evidence and services for C&A with complex needs was observed. This emphasises an urgency for increased inclusion in clinical and behavioural research and for robust enquiries to test/adapt psychological interventions for weight management for C&A-ID. The findings of this review hold clinical utility for clinicians working with C&A-ID, and with RGDs such as Bardet-Biedl, Prader-Willi and Down syndromes. Recommendations and a conceptual framework are provided herein for enhanced efficacy of interventions.
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Affiliation(s)
- Tooba Nadeem Akhtar
- The Great Ormond Street Institute of Child Health, University College London, United Kingdom.
| | - Emma McGibbon
- Wolfson Neurodisability Service, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom.
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2
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Hargreaves D, Mates E, Menon P, Alderman H, Devakumar D, Fawzi W, Greenfield G, Hammoudeh W, He S, Lahiri A, Liu Z, Nguyen PH, Sethi V, Wang H, Neufeld LM, Patton GC. Strategies and interventions for healthy adolescent growth, nutrition, and development. Lancet 2022; 399:198-210. [PMID: 34856192 DOI: 10.1016/s0140-6736(21)01593-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/04/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022]
Abstract
Adolescence is a pivotal point in the life course, characterised by transformative physical, cognitive, and emotional growth, an openness to change, and a drive to reshape the social environment. It offers unique opportunities to adopt changes in diet and physical activity that can persist into later life. Yet pre-existing nutritional problems, including micronutrient deficiencies, food insecurity, and poor-quality diets, persist at the same time as adolescents face the rapid emergence of an obesity epidemic. Adolescent growth and nutrition has been largely overlooked in intervention and policy research. Most intervention studies have emphasised micronutrient supplementation, with few taking into account the multiple drivers of adolescent diets. This Series paper highlights that effective interventions and policies will need to cut across sectors; be supported by multifaceted and multilevel policy; and extend across education, health, food systems, social protection, and digital media. Better data standardisation and systems will be essential in coordinating and monitoring these responses. In a context of shifts in planetary ecosystems and commercial drivers, resilient food systems will need to both ensure access to healthy and affordable foods and provide the infrastructure and incentives for continuing physical activity. Intergenerational partnerships with young people will be essential in bringing about transformative change and ensuring that food policies reflect their needs and aspirations.
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Affiliation(s)
- Dougal Hargreaves
- Mohn Centre for Children's Health and Wellbeing, Imperial College London, London, UK.
| | | | - Purnima Menon
- International Food Policy Research Institute, New Delhi, India
| | - Harold Alderman
- International Food Policy Research Institute, Washington, DC, USA
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
| | - Wafai Fawzi
- Departments of Global Health, Epidemiology, and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Geva Greenfield
- Department of Primary Care & Public Health, School of Public Health, Imperial College London, London, UK
| | - Weeam Hammoudeh
- Institute of Community and Public Health, Birzeit University, Birzeit, West Bank, occupied Palestinian territory
| | - Shanshan He
- Youth Nework for the Lancet Standing Commission on Adolescent Health and Wellbeing, Beijing, China
| | | | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | | | | | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | | | - George C Patton
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia
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3
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Wang X, Liu J, Gao D, Li Y, Ma Q, Chen L, Chen M, Ma T, Ma Y, Zhang Y, Yang J, Dong Y, Song Y, Ma J. Effectiveness of national multicentric school-based health lifestyles intervention among chinese children and adolescents on knowledge, belief, and practice toward obesity at individual, family and schools' levels. Front Pediatr 2022; 10:917376. [PMID: 36061391 PMCID: PMC9433560 DOI: 10.3389/fped.2022.917376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aims to evaluate the effectiveness of the trial of national multicentric school-based health lifestyles intervention toward childhood obesity on the KBP at individual, family and schools' levels. METHODS The national trial was a multi-centered, cluster-controlled trial, which was conducted in seven provinces from September 2013 to February 2014, aiming at preventing childhood overweight and obesity. Integrated intervention strategies focused on changing specific practice related to energy intake and expenditure, such as decreasing the consumption of sweetened fizzy drinks, increasing the consumption of vegetables, ensuring proper protein intake, reducing sedentary practice including screen time, and maintaining at least 1 h of moderate to vigorous physical activity. A total of 27,477 children and adolescents in the control group and 30,997 in the intervention group were recruited with a mean follow-up period of 6.7 months. The binomial response mixed-effects model was used for assessing the effects of the national school-based health lifestyles intervention on obesity-related KBP at students individual, parents' and schools' levels. RESULTS Children and adolescents in the intervention group mastered better obesity-related knowledge, and they had higher correct response rates to all questions about obesity-related knowledge compared to the control group (P < 0.05). In terms of obesity-related belief, individuals in the intervention group was more motivated than the control group, participants in the intervention group had higher correctness of 71.18, 52.94, and 56.60% than the control group of 68.61, 49.86, and 54.43%, (P < 0.05). In addition, healthier habits of eating breakfast and drinking milk every day were observed in the intervention group. For the beliefs toward obesity, parents of the intervention group had higher correctness than the control group. At the same time except for the fruit consumption, other obesity-related practice in the intervention group were healthier than the control group (P < 0.05). Except for some beliefs and practice, the intervention effect at the parent level was not significant in other aspects. CONCLUSION The obesity-related knowledge and beliefs of children and adolescents got improved significantly. However, the effects on the knowledge, beliefs and certain practices of their parents and school administrators failed to reach significance.
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Affiliation(s)
- Xinxin Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Jieyu Liu
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Di Gao
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanhui Li
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Qi Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Li Chen
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Manman Chen
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Tao Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Ying Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Zhang
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jianjun Yang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Yanhui Dong
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Song
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jun Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
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Djalalinia S, Yoosefi M, Shahin S, Ghasemi E, Rezaei N, Ahmadi N, Rezaei N, Azmin M, Rezaei S, Nasserinejad M, Mohammadi E, Haghshenas R, Shabestari AN, Jamshidi H, Dastjerdi MV, Larijani B, Farzadfar F. The levels of BMI and patterns of obesity and overweight during the COVID-19 pandemic: Experience from the Iran STEPs 2021 survey. Front Endocrinol (Lausanne) 2022; 13:1043894. [PMID: 36589796 PMCID: PMC9798439 DOI: 10.3389/fendo.2022.1043894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/09/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Obesity and its increasing burden have become an urgent health problem all over the world. Benefiting from a national representative sample, the present study aimed to estimate the distribution of body mass index (BMI) levels and its association with metabolic and lifestyle risk factors in an Iranian adult population by sex, age, and geographical distribution. METHODS This study involves a national survey of noncommunicable disease risk factor surveillance (STEPs) in Iran. Through systematic random sampling, in compliance with safety considerations during the COVID-19 pandemic, of the 28,520 adults who gave voluntary consent and included in the study, 27,874 participants completed the questionnaires (step 1), 27,745 individuals were anthropometrically measured (step 2), and 18,119 individuals completed laboratory evaluation (step 3). Anthropometric measurements followed based on standard protocols and by using calibrated instruments. RESULTS In 2021, the national prevalence of normal weight, obesity, and overweight/obesity in ≥18-year-old Iranian adults was estimated at 33.61% (95% CI: 32.99-34.23), 24.96% (24.39-25.53), and 63.02% (62.39-63.65), respectively. Compared to women, Iranian men had a lower mean BMI [25.54 (24.95-26.13 vs. 27.6 (27.07-28.12) kg/m2] (p < 0.001). There was also a significant difference in the national prevalence rate of overweight/obesity [women: 66% (61-71), men: 53% (46-60) (p < 0.001)]. The prevalence of obesity was significantly higher in participants suffering from metabolic and lifestyle risk factors. The study of the geographical extent of obesity and overweight shows that compared to national levels, the highest prevalence of being underweight was seen in the southeastern provinces. On the other hand, the highest prevalence of obesity belonged to the northeastern and central provinces. The highest provincial prevalence of obesity was almost 2.5-fold higher than the lowest provincial prevalence. CONCLUSION The study reveals a significant difference between the prevalence of obesity in male and female participants and between different regions of the country. These findings will help policymakers, clinicians, and researchers to more accurately estimate the obesity/overweight problem and to implement more effective interventional programs to promote strategies of prevention and control of weight gain.
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Affiliation(s)
- Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahabeddin Rezaei
- Human Nutrition Program, Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Jamshidi
- Department of Pharmacology, Research Institute for Endocrine Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Farshad Farzadfar,
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Atoofi MK, Qorbani M, Asayesh H, Rezaei N, Moghaddam SS, Djalalinia S. Obesity researches in youth: A scientometrics study in Middle East countries. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:54. [PMID: 34729062 PMCID: PMC8506246 DOI: 10.4103/jrms.jrms_415_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 06/21/2020] [Accepted: 02/11/2021] [Indexed: 11/04/2022]
Abstract
Background The alarming trends of obesity/overweight in youth have been interested policy makers and other stakeholders to exact follow and analysis of related scientific evidence. The present paper quantify the trends of outputs of youth obesity/overweight researches in Middle East countries. Materials and Methods The Scopus database systematically searched as the most comprehensive multidisciplinary database, for all related obesity/overweight that focused on youth age groups concerns, from 2000 to 2017. These scientometrics analysis included the trends of scientific products, citations, and other scientometric index in Middle East countries. Results During 2000-2017, in the field of youth obesity, 2350 papers published (0.40% of total 591,105 indexed paper of this region) by Middle East countries. In this regard, Iran with 574 publication (24.43%) had the first rank. After that Turkey and Saudi Arabia, respectively, with 489 (20.81%) and 313 (13.32%) papers, had the next ranks. Over 18-year period, based on the findings all of Eastern Mediterranean countries follow the progressive plans for topics related to youth obesity. Between them, Iran and Turkey have significant growth rates (0.77% and 0.40%, respectively). Scientometric indicators such as "number of published papers," "number of citations" confirmed that during the 2000-2017 the P-trends of total number of related published papers and the correspond citations, in region countries, were significant (2168 papers and 34,132 citations, P < 0.001). Conclusion Most of countries at global and regional levels follow ascending trends in publications and citations in obesity/overweight fields. Iran's position has grown significantly among them. Maintaining and promoting this position requires careful planning and special attention. The findings also could be used for better health policy and complementary researches.
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Affiliation(s)
- Mehrdad Kazemzadeh Atoofi
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
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School-based interventions for the treatment of childhood obesity: a systematic review, meta-analysis and meta-regression of cluster randomised controlled trials. Public Health Nutr 2021; 24:3087-3099. [PMID: 33745501 PMCID: PMC9884753 DOI: 10.1017/s1368980021001117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Schools offer an ideal setting for childhood obesity interventions due to their access to children and adolescents. This review aimed to systematically review the impact of school-based intervention for the treatment of childhood obesity. DESIGN Eight databases were searched from inception till 30 May 2020. A revised Cochrane risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations criteria were used to evaluate the risk of bias and overall evidence. Meta-analysis and meta-regression were performed on Stata software using the random effects model. Overall effect was evaluated using Hedges' g, and heterogeneity was assessed using Cochran's Q and I2. SETTING Cluster randomised controlled trials (cluster-RCT) delivered in school. PARTICIPANTS Children and adolescents (6-18 years of age) with overweight and obesity. RESULTS Twelve cluster-RCT from seven countries with 1755 participants were included in the meta-analysis. School-based interventions for the treatment of childhood obesity reduced BMI and BMI z-scores with a medium effect (g = 0·52). Subgroup analyses showed greater effectiveness of brief school-based interventions and the interventions conducted in lower-middle to upper-middle economies. Meta-regression assessed the heterogeneity and the final model, with covariates of the type of economies and trial duration, accounted for 41·2 % of the variability. The overall quality of evidence was rated low because of the high risk of bias and inconsistency. CONCLUSIONS School-based interventions are a possible approach to provide universal healthcare for the treatment of childhood obesity, and further well-designed cluster-RCT with longer follow-up are needed. This study is registered with PROSPERO (CRD42020160735).
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Jacob CM, Hardy-Johnson PL, Inskip HM, Morris T, Parsons CM, Barrett M, Hanson M, Woods-Townsend K, Baird J. A systematic review and meta-analysis of school-based interventions with health education to reduce body mass index in adolescents aged 10 to 19 years. Int J Behav Nutr Phys Act 2021; 18:1. [PMID: 33397403 PMCID: PMC7784329 DOI: 10.1186/s12966-020-01065-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adolescents are increasingly susceptible to obesity, and thus at risk of later non-communicable diseases, due to changes in food choices, physical activity levels and exposure to an obesogenic environment. This review aimed to synthesize the literature investigating the effectiveness of health education interventions delivered in school settings to prevent overweight and obesity and/ or reduce BMI in adolescents, and to explore the key features of effectiveness. METHODS A systematic search of electronic databases including MEDLINE, CINAHL, PsychINFO and ERIC for papers published from Jan 2006 was carried out in 2020, following PRISMA guidelines. Studies that evaluated health education interventions in 10-19-year-olds delivered in schools in high-income countries, with a control group and reported BMI/BMI z-score were selected. Three researchers screened titles and abstracts, conducted data extraction and assessed quality of the full text publications. A third of the papers from each set were cross-checked by another reviewer. A meta-analysis of a sub-set of studies was conducted for BMI z-score. RESULTS Thirty-three interventions based on 39 publications were included in the review. Most studies evaluated multi-component interventions using health education to improve behaviours related to diet, physical activity and body composition measures. Fourteen interventions were associated with reduced BMI/BMI z-score. Most interventions (n = 22) were delivered by teachers in classroom settings, 19 of which trained teachers before the intervention. The multi-component interventions (n = 26) included strategies such as environment modifications (n = 10), digital interventions (n = 15) and parent involvement (n = 16). Fourteen studies had a low risk of bias, followed by 10 with medium and nine with a high risk of bias. Fourteen studies were included in a random-effects meta-analysis for BMI z-score. The pooled estimate of this meta-analysis showed a small difference between intervention and control in change in BMI z-score (- 0.06 [95% CI -0.10, - 0.03]). A funnel plot indicated that some degree of publication bias was operating, and hence the effect size might be inflated. CONCLUSIONS Findings from our review suggest that school-based health education interventions have the public health potential to lower BMI towards a healthier range in adolescents. Multi-component interventions involving key stakeholders such as teachers and parents and digital components are a promising strategy.
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Affiliation(s)
- Chandni Maria Jacob
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK.
- Institute of Developmental Sciences, Faculty of Medicine, Southampton General Hospital, University of Southampton, Mail point 887, Tremona Road, Southampton, SO16 6YD, UK.
| | - Polly Louise Hardy-Johnson
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Level two, room 306, Tremona Road, Southampton, SO16 6YD, UK.
| | - Hazel M Inskip
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Level two, room 306, Tremona Road, Southampton, SO16 6YD, UK
| | - Taylor Morris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Level two, room 306, Tremona Road, Southampton, SO16 6YD, UK
| | - Camille M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Level two, room 306, Tremona Road, Southampton, SO16 6YD, UK
| | - Millie Barrett
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Level two, room 306, Tremona Road, Southampton, SO16 6YD, UK
| | - Mark Hanson
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
- Institute of Developmental Sciences, Faculty of Medicine, Southampton General Hospital, University of Southampton, Mail point 887, Tremona Road, Southampton, SO16 6YD, UK
| | - Kathryn Woods-Townsend
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
- Southampton Education School, Faculty of Social Sciences, University of Southampton, Southampton, UK
| | - Janis Baird
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Level two, room 306, Tremona Road, Southampton, SO16 6YD, UK
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Taghizadeh S, Farhangi MA. The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose-response meta-analysis of controlled clinical trials. J Transl Med 2020; 18:480. [PMID: 33317542 PMCID: PMC7734784 DOI: 10.1186/s12967-020-02640-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/27/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Childhood obesity persists as a serious public health problem. In the current meta-analysis, we summarized the results of controlled trials that evaluated the effect of obesity prevention policies in children and adolescents. METHODS Three databases (SCOPUS, PubMed and Embase) were searched for studies published before the 6th April 2020, by reported outcome measures of body mass index (BMI) and BMI-Zscore. Forty-seven studies reported BMI, while 45 studies reported BMI-Zscore as final outcome. RESULTS The results showed that the obesity-prevention policies had significant effect in reducing BMI (WMD: - 0.127; CI - 0.198, - 0.056; P < 0.001). These changes were not significant for BMI-Zscore (WMD: - 0.020; CI - 0.061, 0.021; P = 0.340). In dose-response meta-analysis, a non-linear association was reported between the duration of intervention and BMI (Pnonlinearity < 0.001) as well as BMI-Zscore (Pnonlinearity = 0.023). In subgroup analysis, the more favorite results were observed for 5-10 years old, with combination of physical activity and diet as intervention materials. CONCLUSION In conclusion, the obesity prevention policies in short-term periods of less than 2 years, in rather early age of school with approaches of change in both of diet and physical activity, could be more effective in prevention of childhood obesity. Trial registration PROSPERO registration number: CRD42019138359.
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Affiliation(s)
- Shahnaz Taghizadeh
- Student Research Committee, Department of Community Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Attar Nishabouri St., POBOX: 14711, 5166614711, Tabriz, Iran.
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9
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Brown V, Williams J, McGivern L, Sawyer S, Orellana L, Luo W, Hesketh KD, Wilfley DE, Moodie M. Protocol for economic evaluation alongside the SHINE (Supporting Healthy Image, Nutrition and Exercise) cluster randomised controlled trial. BMJ Open 2020; 10:e038050. [PMID: 32747351 PMCID: PMC7402000 DOI: 10.1136/bmjopen-2020-038050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/10/2020] [Accepted: 05/29/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Limited evidence exists on the cost-effectiveness of interventions to prevent obesity and promote healthy body image in adolescents. The SHINE (Supporting Healthy Image, Nutrition and Exercise) study is a cluster randomised control trial (cRCT) aiming to deliver universal education about healthy nutrition and physical activity to adolescents, as well as targeted advice to young people with body image concerns who are at risk of developing disordered eating behaviours. This paper describes the methods for the economic evaluation of the SHINE cRCT, to determine whether the intervention is cost-effective as an obesity prevention measure. METHODS AND ANALYSIS A public payer perspective will be adopted, with intervention costs collected prospectively. Within-trial cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) will quantify the incremental costs and health gains of the intervention as compared with usual practice (ie, teacher-delivered curriculum). CEA will present results as cost per body mass index unit saved. CUA will present results as cost per quality-adjusted life year gained. A modelled CUA will extend the target population, time horizon and decision context to provide valuable information to policymakers on the potential for incremental cost offsets attributable to disease prevention arising from intervention. Intervention costs and effects will be extrapolated to the population of Australian adolescents in Grade 7 of secondary school (approximate age 13 years) and modelled over the cohort's lifetime. Modelled CUA results will be presented as health-adjusted life years saved and healthcare cost-savings of diseases averted. Incremental cost-effectiveness ratios will be calculated as the difference in costs between the intervention and comparator divided by the difference in benefit. Semi-structured interviews with key intervention stakeholders will explore the potential impact of scalability on cost-effectiveness. These data will be thematically analysed to inform sensitivity analysis of the base case economic evaluation, such that cost-effectiveness evidence is reflective of the potential for scalability. ETHICS AND DISSEMINATION Ethics approval was obtained from the Deakin University Human Research Ethics Committee (#2017-269) and the Victorian Department of Education and Training (#2018_003630). Study findings will be disseminated through peer-reviewed academic papers and participating schools will receive annual reports over the 3 years of data collection. TRIAL REGISTRATION NUMBER ACTRN 12618000330246; Pre-results.
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Affiliation(s)
- Victoria Brown
- Deakin University, Geelong, Deakin Health Economics, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Joanne Williams
- Deakin University, Geelong, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia
| | - Lisa McGivern
- Deakin University, Geelong, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia
| | - Susan Sawyer
- Department of Paediatrics, The University of Melbourne; Centre for Adolescent Health Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Liliana Orellana
- Deakin University, Geelong, Faculty of Health, Geelong, Victoria, Australia
| | - Wei Luo
- Deakin University, Geelong, School of Information Technology, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Deakin University, Geelong, Institute for Physical Activity and Nutrition, Faculty of Health, Geelong, Victoria, Australia
| | - Denise E Wilfley
- School of Medicine, Washington University in St. Louis, Missouri, Missouri, USA
| | - Marj Moodie
- Deakin University, Geelong, Deakin Health Economics, Institute for Health Transformation, Geelong, Victoria, Australia
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10
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Importance of Self-Efficacy in Eating Behavior and Physical Activity Change of Overweight and Non-Overweight Adolescent Girls Participating in Healthy Me: A Lifestyle Intervention with Mobile Technology. Nutrients 2020; 12:nu12072128. [PMID: 32709005 PMCID: PMC7400873 DOI: 10.3390/nu12072128] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 02/08/2023] Open
Abstract
Very little is known about how multicomponent interventions directed to entire populations work in selected groups of adolescents. The aim was to evaluate the effectiveness of the Healthy Me one-year program on changes in healthy eating and physical activity among overweight and non-overweight female students. Randomization involved the allocation of full, partial or null intervention. The randomized field trial was implemented in 48 secondary schools (clusters) all over Poland among 1198 15-year-old girls. In this study, a sample of N = 1111 girls who participated in each evaluation study was analyzed. Using multimedia technologies, efforts were made to improve health behaviors and increase self-efficacy. The main outcome was a health behavior index (HBI), built on the basis of six nutritional indicators and one related to physical activity. HBI was analyzed before and immediately after intervention and at three months' follow-up, and the HBI change was modeled. Statistical analysis included nonparametric tests and generalized linear models with two-way interactions. Comparing the first and third surveys, in the overweight girls, the HBI index improved by 0.348 (SD = 3.17), while in the non-overweight girls it had worsened. After adjusting for other factors, a significant interaction between body weight status and level of self-efficacy as predictors of HBI changes was confirmed. The program turned out to be more beneficial for overweight girls.
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11
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Partridge SR, Raeside R, Singleton A, Hyun K, Redfern J. Effectiveness of Text Message Interventions for Weight Management in Adolescents: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e15849. [PMID: 32348264 PMCID: PMC7284408 DOI: 10.2196/15849] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/19/2019] [Accepted: 02/10/2020] [Indexed: 12/27/2022] Open
Abstract
Background The incidence of obesity among adolescents is increasing. Text messages are a primary communication form for adolescents and potentially a scalable strategy for delivering population health interventions. Objective This study aimed to determine the effectiveness of text message interventions in reducing BMI in adolescents and describe characteristics that are common to effective interventions. Methods This systematic review included randomized controlled trials of text message lifestyle interventions involving adolescents aged 10 to 19 years with outcomes focused on obesity prevention or management. Primary outcome was objective or self-report change in BMI. Results In total, 4362 records were identified, and 215 full-text articles were assessed for eligibility. A total of 8 unique studies were identified, including 767 participants, mean age 14.3 (SD 0.9) years, BMI 29.7 (SD 1.6) kg/m2 and 53.1% (407/767) female (31/101, 30.7%-172/172, 100.0%). All interventions were multicomponent. The median active intervention period was 4.5 months. During the active and extended intervention phases, text messages accounted for >50% (8 studies) and >85% (3 studies) of contact points, respectively. Text messages were heterogeneous, with a median of 1.5 text messages sent per week (range: 1-21). A total of 4 studies utilized two-way text message communication with health professionals Of the 8 studies, 7 demonstrated reductions in BMI or BMI z-score in the intervention group compared with the control at the end of the final follow-up. The effect was only statistically significant in 1 study at 6 months. Over 6 months, reductions in BMI (kg/m2) ranged from 1.3% to 4.5% and BMI z-score ranged from 4.2% to 28.1%. Overall quality of the studies was low. Conclusions Further research is required to elucidate the effectiveness and potential impact of text message interventions on weight and weight-related behaviors in adolescents.
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Affiliation(s)
- Stephanie Ruth Partridge
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia.,The University of Sydney, Prevention Research Collaboration, Charles Perkins Centre, Sydney School Public Health, Sydney, Australia
| | - Rebecca Raeside
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia
| | - Anna Singleton
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia
| | - Karice Hyun
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia
| | - Julie Redfern
- The University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia
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12
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Djalalinia S, Saeedi Moghaddam S, Sheidaei A, Rezaei N, Naghibi Iravani SS, Modirian M, Zokaei H, Yoosefi M, Gohari K, Kousha A, Abdi Z, Naderimagham S, Soroush AR, Larijani B, Farzadfar F. Patterns of Obesity and Overweight in the Iranian Population: Findings of STEPs 2016. Front Endocrinol (Lausanne) 2020; 11:42. [PMID: 32174887 PMCID: PMC7055062 DOI: 10.3389/fendo.2020.00042] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 01/23/2020] [Indexed: 01/28/2023] Open
Abstract
Background: Obesity has become a common health problem all over the world. Benefiting from a national representative sample, the present study aimed to estimate the prevalence of overweight/obesity and the distribution of Body Mass Index (BMI) levels in the Iranian adult population, by sex, age, and geographical distribution. Methods: This was a large-scale national cross-sectional study of Non-communicable Diseases risk factor surveillance in Iran. Through a systematic random sampling cluster, 31,050 Iranian adult participants aged 18 years and over were enrolled in the study. The main research tools were used to assess three different levels of data, namely: (1) demographic, epidemiologic, and risk-related behavioral data, (2) physical measurements, and (3) lab measurements. Anthropometric measurements were taken using standard protocols and calibrated instruments. Results: In 2016, the national prevalence rates of normal weight, obesity, and overweight/obesity among Iranian adults were, 36.7% (95% CI: 36.1-37.3), 22.7% (22.2-23.2), and 59.3% (58.7-59.9), respectively. There was a significant difference between the prevalence of obesity among males [15.3% (14.7-15.9)] and females [29.8% (29.0-30.5)] (p < 0.001). The 55-64 [31.5% (30.1-33.0)] and the 18-24 [8.3% (7.3-9.4)] year-old age groups had the highest and lowest prevalence of obesity, respectively. The results show a geographical pattern at provincial level, where the level of BMI increases among populations ranging from the southeastern to the northwestern regions of the country. The highest provincial prevalence of obesity was almost 2.5-fold higher than the lowest provincial prevalence. Conclusion: We found a significant difference between the prevalence of obesity in males and females. Moreover, there was a considerable difference in the geographical pattern of the prevalence of obesity and overweight. Further evidence is warranted to promote strategies and interventions related to prevention and control of factors that are associated with weight gain.
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Affiliation(s)
- Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Sina Naghibi Iravani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ahmad Kousha
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zhaleh Abdi
- Department of Research and Education, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Soroush
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Farshad Farzadfar
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13
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Moores CJ, Maeder A, Miller J, Prichard I, Lewis LK, Bell LK, Macoustra A, Miller MD. A Digital Intervention for Australian Adolescents Above a Healthy Weight (Health Online for Teens): Protocol for an Implementation and User Experience Study. JMIR Res Protoc 2019; 8:e13340. [PMID: 31603435 PMCID: PMC6913688 DOI: 10.2196/13340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/24/2019] [Accepted: 05/05/2019] [Indexed: 01/16/2023] Open
Abstract
Background More than one-fourth of Australian adolescents are overweight or obese, with obesity in adolescents strongly persisting into adulthood. Recent evidence suggests that the mid-teen years present a final window of opportunity to prevent irreversible damage to the cardiovascular system. As lifestyle behaviors may change with increased autonomy during adolescence, this life stage is an ideal time to intervene and promote healthy eating and physical activity behaviors, well-being, and self-esteem. As teenagers are prolific users and innate adopters of new technologies, app-based programs may be suitable for the promotion of healthy lifestyle behaviors and goal setting training. Objective This study aims to explore the reach, engagement, user experience, and satisfaction of the new app-based and Web-based Health Online for Teens (HOT) program in a sample of Australian adolescents above a healthy weight (ie, overweight or obese) and their parents. Methods HOT is a 14-week program for adolescents and their parents. The program is delivered online through the Moodle app–based and website-based learning environment and aims to promote adolescents’ lifestyle behavior change in line with Australian Dietary Guidelines and Australia’s Physical Activity and Sedentary Behaviour Guidelines for Young People (aged 13-17 years). HOT aims to build parental and peer support during the program to support adolescents with healthy lifestyle behavior change. Results Data collection for this study is ongoing. To date, 35 adolescents and their parents have participated in one of 3 groups. Conclusions HOT is a new online-only program for Australian adolescents and their parents that aims to reduce cardiovascular disease risk factors. This protocol paper describes the HOT program in detail, along with the methods to measure reach, outcomes, engagement, user experiences, and program satisfaction. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000465257; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374771 International Registered Report Identifier (IRRID) DERR1-10.2196/13340
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Affiliation(s)
- Carly Jane Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Anthony Maeder
- Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Jacqueline Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Healthy Mothers Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Ivanka Prichard
- Health Sciences, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Sport, Health, Activity, Performance and Exercise Research Centre, Flinders University, Adelaide, Australia
| | - Lucy Kate Lewis
- Physiotherapy, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lucinda Kate Bell
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Aimee Macoustra
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Michelle D Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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14
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Camilleri M, Staiano A. Insights on Obesity in Children and Adults: Individualizing Management. Trends Endocrinol Metab 2019; 30:724-734. [PMID: 31395427 PMCID: PMC6779521 DOI: 10.1016/j.tem.2019.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 12/24/2022]
Abstract
For the management of obesity in childhood and adolescence, nonoperative approaches have limited efficacy, including community-based and behavioral interventions and pharmacotherapy approved for use in adults. Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy are efficacious in reducing weight, body mass index, and comorbidities in adolescents. Understanding the phenotype associated with obesity provides an opportunity to individualize patients' treatments directed at the brain-gut axis. These phenotypes include rapid gastric emptying, increased fasting gastric volume, reduced postprandial incretins, and central mechanisms that impact appetite and satiation including hedonic eating and affective disorders. Further studies are required in adolescents. Identifying phenotypes could enhance the efficacy of behavioral, dietary, and pharmacotherapeutic interventions alone or in combination in children and adolescents.
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Affiliation(s)
- Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA.
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University 'Federico II', Naples, Italy
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15
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De Giuseppe R, Di Napoli I, Porri D, Cena H. Pediatric Obesity and Eating Disorders Symptoms: The Role of the Multidisciplinary Treatment. A Systematic Review. Front Pediatr 2019; 7:123. [PMID: 31024868 PMCID: PMC6463004 DOI: 10.3389/fped.2019.00123] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/12/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of obesity in children/adolescents has increased worldwide during the past 30 years, becoming a significant public health concern; prevention, and management of pediatric obesity onset is one of the most critical public health goals for both industrialized and developing countries. Pediatric obesity has been identified as a risk factor for various psychopathologies, including eating disorders (ED). Although it has been demonstrated that a comprehensive multidisciplinary treatment (MT), with small steps and practical approaches to lifestyle change, can be an effective treatment for children and adolescents with obesity, to the best of our knowledge, this is the first systematic review investigating the effect of MT on the development, progression or decrease of ED symptoms (EDS) in this target population. PubMed and Web of Science databases were searched (last search on 18 February 2019) according to a predetermined search strategy, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines and Statement. Original studies published in English examining the effect of MT on pediatric overweight/obesity, paying particularly attention at the development of EDS, were eligible for inclusion. Seven hundred and forty-four records have been identified; nine articles with study quality ranging from weak to moderate have been included. MTs were heterogeneous in nature including length, number, frequency and type of sessions, parent-involvement and use of technology, besides several psychometric questionnaires were used to screen for EDS, since there are no standardized criteria. In 3 studies there was a significant decrease in external and emotional eating and in four studies a significant increase in restraint eating post MT. Two studies found a significant decrease of binge eating symptoms and other two studies showed an improvement of self-perception, weight, and shape concern. A statistical significant decrease in BMI, BMIz, BMISDS, and adjusted BMI was observed after all MTs, except one. A narrative summary of the evidences reported highlighted the positive impact of MT on the EDS. Moreover, since weight loss post MTs was not necessarily related to EDS, clinicians should also look for the presence of EDS and treat them accordingly.
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Affiliation(s)
- Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Ilaria Di Napoli
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Debora Porri
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
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16
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Soltero EG, Olson ML, Williams AN, Konopken YP, Castro FG, Arcoleo KJ, Keller CS, Patrick DL, Ayers SL, Barraza E, Shaibi GQ. Effects of a Community-Based Diabetes Prevention Program for Latino Youth with Obesity: A Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:1856-1865. [PMID: 30426694 PMCID: PMC6249045 DOI: 10.1002/oby.22300] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/26/2018] [Accepted: 07/18/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study examined the short- and long-term effects of a community-based lifestyle intervention among Latino youth with obesity. METHODS Latino adolescents (14-16 years old) were randomized to a 3-month lifestyle intervention (n = 67) or comparison control (n = 69) and followed for 12 months. The intervention included weekly nutrition and health classes delivered to groups of families and exercise sessions (3 days/week) delivered to groups of adolescents. Comparison youth received laboratory results and general health information. Primary outcomes included insulin sensitivity and weight-specific quality of life (QoL) with secondary outcomes of BMI percentile (BMI%), waist circumference, and percent body fat. RESULTS At 3 months, youth in the intervention group exhibited significant increases in insulin sensitivity (P < 0.05) and weight-specific QoL (P < 0.001), as well as reductions in BMI%, waist circumference, and percent body fat compared with controls. Increases in weight-specific QoL and reductions in BMI% and percent body fat remained significant at 12 months (P < 0.001), while changes in insulin sensitivity did not. In a subsample of youth with prediabetes at baseline, insulin sensitivity (P = 0.01), weight-specific QoL (P < 0.001), and BMI% (P < 0.001) significantly improved at 3 months. CONCLUSIONS Lifestyle intervention can improve cardiometabolic and psychosocial health in a vulnerable population of Latino adolescents at high risk for developing type 2 diabetes.
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Affiliation(s)
- Erica G Soltero
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
| | - Yolanda P Konopken
- Family Wellness Program, St. Vincent de Paul Medical and Dental Clinic, Phoenix, Arizona, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | | | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Donald L Patrick
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Stephanie L Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
| | - Estela Barraza
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
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