Effect of a lifestyle intervention on adiposity and fitness in socially disadvantaged subgroups of preschoolers: a cluster-randomized trial (Ballabeina).
ABSTRACT A multidimensional lifestyle intervention performed in 652 preschoolers (72% of migrant, 38% of low educational level (EL) parents) reduced body fat, but not BMI and improved fitness. The objective of this study is to examine whether the intervention was equally effective in children of migrant and/or low EL parents.
Cluster-randomized controlled single blinded trial, conducted in 2008/09 in 40 randomly selected preschools in Switzerland. The culturally tailored intervention consisted of a physical activity program and lessons on nutrition, media use and sleep. Primary outcomes included BMI and aerobic fitness. Secondary outcomes included %body fat, waist circumference and motor agility.
Children of migrant parents benefitted similarly from the intervention compared to their counterparts (p for interaction≥ 0.09). However, children of low EL parents benefitted less, although these differences did not reach statistical significance (p for interaction≥ 0.06). Average intervention effect sizes for BMI were -0.10, -0.05, -0.11 and 0.04 kg/m(2) and for aerobic fitness were 0.55, 0.20, 0.37 and -0.05 stages for children of non-migrant, migrant, middle/high EL and low EL parents, respectively.
This intervention was similarly effective among preschoolers of migrant parents compared to their counterparts, while children of low EL parents benefitted less.
- SourceAvailable from: Fatemeh Azizi-Soleiman[Show abstract] [Hide abstract]
ABSTRACT: Background: Childhood obesity is a global health problem with short-and long-term health consequences. This systematic review presents a summary of the experiences on different family-, school-, and clinic-based interventions. Materials and Methods: Electronic search was conducted in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases. We included those studies conducted among obese individuals aged up to 18 years. Our search yielded 105 relevant papers, 70 of them were conducted as high quality clinical trials. Results: Our findings propose that school-based programs can have long-term effects in a large target group. This can be related to this fact that children spend a considerable part of their time in school, and adopt some parts of lifestyle there. They have remarkable consequences on health behaviors, but as there are some common limitations, their effects on anthropometric measures are not clear. Due to the crucial role of parents in development of children's behaviors, family-based interventions are reported to have successful effects in some aspects; but selection bias and high dropout rate can confound their results. Clinic-based interventions revealed favorable effects. They include dietary or other lifestyle changes like increasing physical activity or behavior therapy. It seems that a comprehensive intervention including diet and exercise are more practical. When they have different designs, results are controversial. Conclusion: We suggest that among different types of interventional programs, a multidisciplinary approach in schools in which children's family are involved, can be the best and most sustainable approach for management of childhood obesity. Primordial/primary prevention of pediatrics obesity and establishment of a healthy lifestyle behaviors from early life are the favored against the epidemic of obesity at the global level.  Effective interventions for prevention and control of childhood obesity should be considered for different aspects. [11,17-24] Experts recommend specific eating and physical activity (PA) behaviors through counseling.  Along with clinic-based interventions, researchers have attempted to manage obesity by virtue of family, community, school, and after school programs. Based on Cochrane review of obesity prevention programs in children, most of the well-designed interventions had positive results especially in 6-12-year-old children.  Clearly targeted interventions for children and population-based approach for adolescents may be useful and make economic sense. The purpose of this investigation was to systematically review the effects of various clinical-, family-, and community-based interventions targeting the control of childhood obesity and make a suggestion for future interventions.Journal of research in medical sciences 12/2014; 19:993-1008. · 0.61 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Background:Socioeconomic inequalities in obesity are well established in high-income countries. There is a lack of evidence of the types of intervention that are effective in reducing these inequalities amongst adults.Objectives:To systematically review studies of the effectiveness of individual, community and societal interventions in reducing socioeconomic inequalities in obesity amongst adults.Methods:Nine electronic databases were searched from start date to October 2012 along with website and grey literature searches. The review examined the best available international evidence (both experimental and observational) of interventions at an individual, community and societal level that might reduce inequalities in obesity amongst adults (aged 18 years or over) in any setting and country. Studies were included if they reported on a body fatness related outcome and if they included a measure of socio-economic status. Data extraction and quality appraisal were conducted using established mechanisms and narrative synthesis was conducted.Results:The 'best available' international evidence was provided by 20 studies. At the individual level, there was evidence of the effectiveness of primary care delivered tailored weight loss programmes amongst deprived groups. Community based behavioural weight loss interventions and community diet clubs (including workplace ones) also had some evidence of effectiveness - at least in the short term. Societal level evaluations were few, low quality and inconclusive. Further, there was little evidence of longer term effectiveness, and few studies of men or outside the USA. However, there was no evidence to suggest that interventions increase inequalities.Conclusions:The best available international evidence suggests that some individual and community based interventions may be effective in reducing socio-economic inequalities in obesity amongst adults in the short term. Further research is required to particularly of more complex, multi-faceted and societal level interventions.International Journal of Obesity accepted article preview online, 12 May 2014; doi:10.1038/ijo.2014.75.International journal of obesity (2005) 05/2014; · 5.22 Impact Factor
- BMC Public Health 01/2014; 14:834. · 2.32 Impact Factor