Bridging the Evidence Gap in Obesity Prevention A Framework to Inform Decision Making (2010) / Chapter Skim
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Appendix C: Review of Existing Reviews on Obesity Prevention
Appendix C: Review of Existing Reviews on Obesity Prevention
Pages 227-268
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The search strategy involved searching major databases including Scopus, PubMed, and Web of Science, from each database's inception through November 2009, for relevant and published reviews of obesity prevention interventions. Variations of the terms "overweight," "obesity," "prevention," "physical activity," "nutrition," "review," "meta-analysis," "synthesis," "summary," and "recommendations" were used in the search process.
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September effectiveness of school-based Excluded: studies that 2007 interventions focused on recruited children on the changing dietary intake and basis of weight; studies physical activity levels to in children with critical prevent childhood obesity illness or eating disorders Bridging the Evidence Gap in Obesity Prevention
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≥ 3 months Included: domestic and international Measure of weight Studies were not 7 (2 treatment studies that used physical activity status, BMI, or body fat study length excluded because and 5 prevention) and nutritional strategies in of their aim (for interventions to prevent or treat example, did not overweight have to include weight change)
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, (43) intervention programs Grey literature, for childhood obesity excluding prevention during gestation newspaper and infancy articles/editorials; manual searching of bibliographies from gathered articles and reviews; ancestry searches on key papers Bridging the Evidence Gap in Obesity Prevention 0
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environment) Follow-up Other Applying Criteria RCTs, non-RCTs with concurrent Included: had to Follow-up Not reported 7 control groups report one or more 1 year, later outcomes (estimates amended of percent body fat, to include BMI, ponderal index, studies or skin-fold thickness)
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(38) 2000 for the effectiveness of Review of school-based interventions reference list of in promoting physical retrieved articles activity and fitness in children and adolescents Bridging the Evidence Gap in Obesity Prevention
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reduce SB in a natural setting Excluded: observational crossover and cohort studies, studies of behavior in a controlled laboratory setting Included: school-based studies Included: Not reported Not reported 25 seeking to alter diet and/or physical anthropometric activity−related behaviors and measurement of body having a broad public health weight or obesity, at base; studies that monitored and baseline and follow-up evaluated in a manner that has been documented (e.g., published) Excluded: studies with aims so narrow that an impact on obesity is unlikely; clinical settings focused on treatment of obese children; pilot studies RCTs; studies with a control group Outcomes must have Included: intervention 19 and measures taken pre- and been reported for applicable to public postintervention; prospective study children and adolescents health practice; designs intervention could be implemented, facilitated, or promoted by staff in local public health units in Ontario continued Appendix C
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, (28) March primary care populations To determine whether 2002 Expert opinion; counseling adults in primary manual searching care settings improves and of bibliographies maintains physical activity from pertinent levels articles Bridging the Evidence Gap in Obesity Prevention
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environment) Follow-up Other Applying Criteria Included: controlled trials, case- Included: behavioral Not reported The patient's primary 8 (7 RCTs, control studies, observational outcomes (physical care clinician 1 non-RCT)
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, (3) data To review critically the indexed Manual searching evidence addressing three through of bibliographies questions that are pertinent November from pertinent to potential macro-level 2004 articles and environmental influences on chapters; obesity management expert opinion; grey literature (government and private foundation reports, excluded dissertations)
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study, quasi-experimental and food acquisition or experimental designs, RCTs purchasing behavior, Excluded: position or conceptual reported or weighed articles food intake, or body weight or composition For substudy 2: Included: the macro-environmental factor must be studied in such a way that it was not confounded with education-based manipulations aimed at changing behavior through structured information dissemination Excluded: comprehensive multicomponent interventions targeting multiple behaviors (because the specific effects of manipulating individual components could not be disaggregated) For substudy 3: Excluded: studies testing the effects of restrictive parental feeding practices and strategies on child eating behavior and weight (these studies, being largely confined to the home, are less central to the topic of macro-environmental influences)
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, relevant reports; Internet searches of relevant domestic and foreign organization and society sites, Google; expert opinion Bridging the Evidence Gap in Obesity Prevention
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(3) chronic diseases (or risk factors)
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Manual searching of bibliographies from relevant studies Bridging the Evidence Gap in Obesity Prevention 0
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content, fat distribution + follow-up) Included: RCTs and clinical BMI, waist girth, Not limited Seeking interventions 19 controlled trials in which odds percentage body fat, that increase physical ratios or standardized mean triceps skinfold, waist- activity, improve differences and their 95% to-hip ratio dietary behaviors, confidence intervals were reported modify poor exercise or could be calculated or dietary behaviors, or a combination of strategies continued Appendix C
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American children To explore attitudes, aged 2-18 or their perceptions, and lifestyle parents/caretakers behaviors that influence obesity risk in African Excluded: studies American children targeting subjects with BMI ≥ 85% Bridging the Evidence Gap in Obesity Prevention
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environment) Follow-up Other Applying Criteria All study designs included Data extracted Any duration Included: published 11 based on: behaviors reports of targeted for change; interventions with psychological model; the primary aim of behavior change preventing weight gain methods and modes of Excluded: if weight delivery; methodological control was part quality; characteristics of a multifactorial of participants; intervention outcomes related to aimed primarily at body weight; self preventing a specific reported diet and disease; if weight loss physical activity was primary aim ≥ 6 months Included: RCTs, non-RCTs with an Included: objective Included: school-based 18 appropriate control group data for BMI from exercise or physical before and after the activity interventions intervention (in both intervention and control groups)
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1970-2002 Systematic review Not reported Children aged 5-18 Baranowski Manual searching To study noncurricular (2004) of bibliographies approaches to increasing from gathered physical activity in children articles and and adolescents reviews; contacting of leading authors in the field for copies of articles "in press" Kahn et al.
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environment) Follow-up Other Applying Criteria Excluded: case reports, unpublished Included: any increase Not reported Included: English 9 reports, dissertations in the level of physical language; effect of a activity; objective and noncurricular physical self-report assessments activity intervention of physical activity; was evaluated interventions that measured physical activity before and after the intervention Included: interventions selected Included: aerobic Not reported Used Guide to 94 for evaluation, not guidelines capacity as an indicator Community or reviews; study design with a of physical activity Preventive Services' concurrent or before-and-after behavior methods (CDC, comparison 2005)
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February setting of school-based strategies 2000 Manual searching for obesity prevention and in (15) and other (14)
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6 months physical activity Preventive Services from the (CDC, 2005) to interventions)
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Department of aimed at increasing physical Agriculture, U.S. activity or improving Department of nutrition Transportation Bridging the Evidence Gap in Obesity Prevention
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Not reported Included: behavioral, Not reported Excluded: studies 65 psychological, or that did not provide organizational change a description of the outcomes intervention or those that reported on determinants research (individual-level only) or media-only campaigns; studies that linked the built environment to physical activity (in another review)
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diabetes) Expert opinion to find unpublished To assess the effectiveness of material school-based interventions in primary prevention of obesity and promotion of physical activity and nutrition Pignone (28)
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environment) Follow-up Other Applying Criteria Included: RCTs, pre−post trials, Did not limit these Did not limit English language 12 longitudinal, follow-up studies criteria, but reported this criterion, what they found but reported Excluded: systematic reviews, what they descriptive articles, treatment found focused studies Not specified, but followed Included: physiological Not reported Followed the 12 (7 strong, indicators (body fat, guidelines of 5 moderate)
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groups of subjects Manual searching for prevention and of bibliographies treatment of childhood from gathered obesity targeting physical systematic activity (included separate reviews and analyses of treatment and individual prevention) intervention articles; Internet Bridging the Evidence Gap in Obesity Prevention
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review physical activity guidelines (Peersman et al., 1997) ; quality of people's views studies as described by Harden et al.
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, (43) , 2006 13-19 of interventions in studies Ovid (depending that report physical activity on access)
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Excluded: studies published in non– Not reported, but Not Included: studies 12 peer reviewed journals ended up with studies reported, but outside of U.S. only that targeted nutrition a majority English language and physical activity were behaviors 1 academic year long Included: RCTs, systematic reviews, Not reported Not reported Looking to see what 6 prevention; meta-analyses they could find to 6 treatment critically appraise the current evidence continued Appendix C
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2005 Manual searching of interventions designed to of bibliographies prevent obesity in childhood from gathered through diet, physical articles and activity, and/or lifestyle and reviews; Internet; social support expert opinion Bridging the Evidence Gap in Obesity Prevention
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environment) Follow-up Other Applying Criteria Included: RCTs, evaluations of Included: proxy Not reported Excluded treatment 46 trials obesity prevention programs, trials; measure of body (61 programs)
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2003 adults of intervention strategies to promote physical activity among children, adolescents, and young adults Bridging the Evidence Gap in Obesity Prevention
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changes physical activity and nutrition programs for obesity prevention in children and youth Included: RCTs, cohort studies Included: changes in Not reported Excluded: studies 425 (prospective, with a control group) total caloric intake related to therapeutic and percent calories nutrition and physical from fat, fruit, and activity programs and vegetable intake; those that included changes in body fat; children with known changes in perception illnesses or obese/ of body image; self- overweight children; reported changes in quality assessed using duration, rate, and Mulrow et al.
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children To study the effectiveness (2005) of physical activity interventions for obesity prevention > 5,000, then Wofford (15)
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; control related to physical assessment scale 24 adolescents group (non−physical activity activity (self-reported or for methodological intervention) objectively measured)
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through high school) of bibliographies of variability in the from gathered methodological approaches articles and theoretical frameworks of school-based obesity prevention programs, focused on the following interventions: dietary, physical activity, and healthy lifestyle education; parental involvement NOTES: BMI = body mass index; CDC = Centers for Disease Control and Prevention; N/A = not available; RCT = randomized controlled trial.
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(1998) for assessing quality Included: school-based curriculum programs for obesity prevention; studies needed to manipulate at least one of the variables of dietary habits, physical activity, healthful lifestyle education, and parental involvement; English language (22)
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2009. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obe sity: An update to the obesity guidance produced by the National Institute for Health and Clinical Excellence.
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2009. Effect of school-based physical activity interventions on body mass index in children: A meta-analysis.
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2002. The effectiveness of school-based strategies for the primary prevention of obesity and for promoting physical activity and/or nutrition, the major modifiable risk factors for type diabetes: A review of reviews.
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2004. Effectiveness of physical activity enhancement and obesity prevention programs in children and youth.
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