Primary prevention of overweight in children and adolescents: a meta-analysis of the effectiveness of interventions aimi
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Primary prevention of overweight in children and adolescents: a meta-analysis of the effectiveness of interventions aiming to decrease sedentary behaviour Amy van Grieken1, Nicole PM Ezendam1, Winifred D Paulis2, Johannes C van der Wouden2 and Hein Raat1*
Abstract The objectives of this meta-analysis were to provide an overview of the evidence regarding the effects of interventions, implemented in the school- and general population setting, aiming to prevent excessive sedentary behaviour in children and adolescents on (1) the amount of sedentary behaviour and (2) BMI. Differences in effects on sedentary behaviour and BMI between single health behaviour interventions (sedentary behaviour only) and multiple health behaviour interventions were explored. A literature search was conducted in PubMed, EMBASE, Web of Science, PsycINFO and Cochrane Database of Systematic Reviews. Thirty-four (R)CT studies evaluating 33 general population interventions, published between 1990 and April 2011, aiming to decrease sedentary behaviour in normal weight children or adolescents (0–18 years) were included. Intervention duration ranged from 7 days to 4 years. Mean change in sedentary behaviour and BMI from baseline to post-intervention was calculated using a random effects model. Results showed significant decreases for the amount of sedentary behaviour and BMI. For sedentary behaviour the post-intervention mean difference was −17.95 min/day (95%CI:-26.61;–9.28); the change-from-baseline mean difference was −20.44 min/day (95%CI:-30.69;–10.20). For BMI the post-intervention mean difference was −0.25 kg/m² (95%CI:-0.40;–0.09); the change-from-baseline mean difference was −0.14 kg/m² (95%CI:-0.23;–0.05). No differences were found between single and multiple health behaviour interventions. Interventions in the school- and general population setting aiming to reduce only sedentary behaviour and interventions targeting multiple health behaviours can result in significant decreases in sedentary behaviour. Studies need to increase follow-up time to estimate the sustainability of the intervention effects found. Keywords: Sedentary behaviour, Intervention, Overweight prevention, Children, General population
Introduction The high prevalence of overweight and obesity among children and adolescents is of worldwide concern [1]. Obese children are more likely than normal-weight children to maintain a high body weight throughout their life making them more vulnerable to health problems in adulthood [2,3]. Studies have demonstrated the relationship between an increase in television viewing or screen time and * Correspondence: [email protected] 1 Department of Public Health, Erasmus MC, University Medical Center, P.O. Box 20403000 CA, Rotterdam, The Netherlands Full list of author information is available at the end of the article
weight gain [4,5]. Recently, Tremblay et al. (2011) suggested that TV viewing of more than 2 hours a day is associated with reduced physical and psychosocial health [6]. Sedentary behaviour may be a
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