Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta-analysis.

School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia. Health and Wellbeing Queensland, Queensland Government, Milton, QLD, Australia. Centre for Children's Health Research, Institute of Health and Biomedical Innovation Exercise and Nutrition, Queensland University of Technology, South Brisbane, QLD, Australia. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, NSW, Australia. Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia. School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong. School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK. Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, Middlesbrough, UK. Appletree Healthy Lifestyle Consultancy, Perth, UK. Priority Research Centre Grow Up Well and Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia. Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden. School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia. Victorian Health Promotion Foundation, Carlton South, VIC, Australia. The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia. The University of Newcastle Centre for Evidence Based Healthcare Informing Research (CEBHIR): a Joanna Briggs Institute Centre of Excellence, Callaghan, NSW, Australia.

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2021;(1):147-177

Abstract

BACKGROUND The impact of obesity interventions on dietary intake in children and adolescents with overweight or obesity is unclear. This systematic review aimed to investigate the impact of the dietary component of weight management interventions on the change in diet in children and adolescents with overweight or obesity. METHODS Eligible randomised controlled trials (RCTs) published between 1975 and 2020 were identified by a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Meta-analyses of eligible study outcomes were performed using statistical software. A multilevel random effects model was used with three significant random effects fitted using restricted maximum likelihood estimation. RESULTS This review identified 109 RCTs, including 95 that reported at least one statistically significant dietary outcome change and 14 reporting no significant dietary change. Results from the meta-analyses (n = 29 studies) indicated that, compared to control groups, intervention groups achieved significantly greater reductions in mean total energy intake at ≤6 months (-194 kcal day-1 , 95% confidence interval = -275.80 to -112.90 kcal day-1 , P < 0.001) and up to 12 months (-112 kcal day-1 95% confidence interval = -218.92 to -5.83 kcal day-1 ) P = 0.038), increases in fruit and/or vegetable intakes over 2-12 months (n = 34, range +0.6 to +1.5 servings day-1 ) and reductions in consumption of sugar-sweetened beverages (n = 28, range -0.25 to -1.5 servings day-1 ) at 4-24 months follow-up. CONCLUSIONS Obesity interventions with a dietary component have a modest but sustained impact on reducing total energy intake and improving intakes of specific food groups in children and adolescents with overweight or obesity. High quality RCTs that are powered to detect change in diet as a primary outcome are warranted.

Methodological quality

Publication Type : Meta-Analysis

Metadata

MeSH terms : Diet ; Overweight ; Pediatric Obesity