Child Nutrition and Physical Activity and Inactivity
Citation:
Study Design:
Class:
- Click here for explanation of classification scheme.
Quality Rating:
Research Purpose:
- To determine the effectiveness of interventions on diet and physical activity (PA) behaviors in school children
- To identify study characteristics affecting outcome (i.e., gender, age, socioeconomic status, setting, process indicators) .
Inclusion Criteria:
- School-aged children, five to 18 years old
- A randomized controlled trial or controlled clinical trial
- School-based lifestyle interventions vs. usual care or other active interventions
- At least 12 weeks of duration
- Reported weight outcome
- No recruitment of children on the basis of weight (or any other measure of weight).
Exclusion Criteria:
Studies in children with critical illness or eating disorders.
Description of Study Protocol:
- Sources (databases) searched: MEDLINE and EMBASE
- Search dates (beginning and end): January 2006 to September 2007
- Key question(s): What is the effectiveness of interventions on diet and physical activity (PA) behaviors in school children?
- Types of interventions: A lifestyle intervention (including healthy eating, increase in PA, reduction in sedentary behaviors, behavior therapy, social support and education for diet and activity behaviors)
- Outcomes investigated: Weight, body mass index (BMI), BMI z-score, percentage of body fat, skin-fold thickness and percentage of overweight
- Population included: School-aged children, age five to 18 years old.
Data Collection Summary:
- Population: School-aged children, ages five to 18 years old
- Intervention(s) or exposure: School-based lifestyle interventions
- Comparator or control: Usual care or other active interventions
- Outcomes: Weight
- Setting: School
- Method of analysis: Narrative summary.
Description of Actual Data Sample:
- Number of studies identified: 1,553
- Number of studies reviewed: 70
- Number of studies included: 38 studies (47 papers).
Summary of Results:
- Quantity of studies: 38 studies
- Diet studies: Three
- PA studies: 15
- Diet + PA studies: 20
- Diet studies: Three
- Quality of studies (rating or grading of the conclusion ): No study quality assessment
- Design(s) of studies included for this question: A randomized controlled trial or controlled clinical trial:
- Question 1: What is the effectiveness of interventions on diet and physical activity (PA) behaviors in school children?
- Insufficient evidence to assess the effectiveness of dietary interventions or diet vs. physical activity interventions.
- Dietary interventions: Insufficient evidence to assess the effectiveness
- Diet vs. PA interventions: Insufficient evidence to assess the effectiveness
- School-based physical activity interventions may help children maintain a healthy weight but the results are inconsistent and short-term
- Overall, the study suggests that combined diet and physical activity school-based interventions may help prevent children becoming overweight in the long term
- Insufficient evidence to assess the effectiveness of dietary interventions or diet vs. physical activity interventions.
- Question 2: What are the study characteristics might be associated with outcome (e.g., gender, age, socioeconomic status, setting, process evaluation)?
- Physical activity interventions may be more successful in younger children and in girls
- Physical activity interventions, particularly in girls in primary schools, may help to prevent these children from becoming overweight in the short term.
- Question 1: What is the effectiveness of interventions on diet and physical activity (PA) behaviors in school children?
Author Conclusion:
- Dietary interventions: insufficient evidence to assess the effectiveness
- Diet vs. PA interventions: insufficient evidence to assess the effectiveness
- School-based physical activity interventions may help children maintain a healthy weight but the results are inconsistent and short-term.
- Overall suggest that combined diet and physical activity school-based interventions may help prevent children becoming overweight in the long term.
- Physical activity interventions may be more successful in younger children and in girls.
- Physical activity interventions, particularly in girls in primary schools, may help to prevent these children from becoming overweight in the short term.
Funding Source:
Other: | not reported |
Reviewer Comments:
- Studies are heterogeneous; we cannot generalize about what interventions are more effective
- Some studies had small number of subjects to determine significant differences between the intervention and control groups
- Pilot studies are included. Studies may have insufficient duration or intensity to show the effectiveness of the program.
- Some studies rely on authors’ reporting of significant or non-significant effects of the interventions.
Quality Criteria Checklist: Review Articles
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Relevance Questions | |||
1. | Will the answer if true, have a direct bearing on the health of patients? | Yes | |
2. | Is the outcome or topic something that patients/clients/population groups would care about? | Yes | |
3. | Is the problem addressed in the review one that is relevant to dietetics practice? | Yes | |
4. | Will the information, if true, require a change in practice? | Yes | |
Validity Questions | |||
1. | Was the question for the review clearly focused and appropriate? | Yes | |
2. | Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? | Yes | |
3. | Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? | Yes | |
4. | Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? | No | |
5. | Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? | Yes | |
6. | Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? | Yes | |
7. | Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? | No | |
8. | Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? | Yes | |
9. | Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? | Yes | |
10. | Was bias due to the review's funding or sponsorship unlikely? | Yes | |