1.
The effects of school-based lifestyle interventions on body mass index and blood pressure: a multivariate multilevel meta-analysis of randomized controlled trials.
Oosterhoff, M, Joore, M, Ferreira, I
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2016;(11):1131-1153
Abstract
Primary prevention of childhood obesity and related hypertension is warrant given that both risk factors are intertwined and track into adulthood. This systematic review and meta-analysis assess the impact of school-based lifestyle interventions on children's body mass index (BMI) and blood pressure. We searched databases and prior reviews. Eligibility criteria were the following: randomized controlled trial design, evaluation of a school-based intervention, targeting children aged 4-12 years, reporting on BMI and/or related cardiovascular risk factors, reporting data on at least one follow-up moment. The effects on BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated by means of univariate and multivariate three-level random effects models. A total of 85 RCTs (91 papers) were included in the meta-analyses. In univariate models, the pooled effects were -0.072 (95%CI: -0.106; -0.038) for BMI, -0.183 (95%CI: -0.288; -0.078) for SBP and -0.071 (95%CI: -0.185; 0.044) for DBP. In multivariate analyses, the pooled effects of interventions were -0.054 (95%CI: -0.131; 0.022) for BMI, -0.182 (95%CI: -0.266; -0.098) for SBP and -0.144 (95%CI: -0.230; -0.057) for DBP. Parental involvement accentuated the beneficial effects of interventions. School-based lifestyle prevention interventions result in beneficial changes in children's BMI and blood pressure, and the effects on the latter may be stronger than and accrue independently from those in the former.
2.
Effects of intervention programs on child and adolescent BMI: A meta-analysis study.
Vasques, C, Magalhães, P, Cortinhas, A, Mota, P, Leitão, J, Lopes, VP
Journal of physical activity & health. 2014;(2):426-44
Abstract
BACKGROUND This meta-analysis study aims to assess the efficacy of school-based and after-school intervention programs on the BMIs of child and adolescents, addressing the correlation between some moderating variables. METHODS We analyzed 52 studies (N = 28,236) published between 2000-2011. RESULTS The overall effect size was 0.068 (P < .001), school (r = .069) and after-school intervention (r = .065). Programs conducted with children aged between 15-19 years were the most effective (r = .133). Interventions programs with boys and girls show better effect sizes (r = .110) than programs that included just girls (r = .073). There were no significant differences between the programs implemented in school and after-school (P = .770). The effect size was higher in interventions lasting 1 year (r = .095), with physical activity and nutritional education (r = .148), and that included 3-5 sessions of physical activity per week (r = .080). The effect size also increased as the level of parental involvement increased. CONCLUSIONS Although of low magnitude (r = .068), the intervention programs had a positive effect in prevention and decreasing obesity in children. This effect seems to be higher in older children's, involving interventions with physical activity and nutritional education combined, with parent's participation and with 1-year duration. School or after-school interventions had a similar effect.