Adolescent obesity remains a critical public health issue globally, with more than a quarter of young people in North and South America, Australia, Europe, and the Gulf region affected. Despite numerous studies aiming to tackle this problem through dietary and physical activity interventions, uncertainty persists about the most effective approaches. Recent data from 74 studies involving over 83,000 participants have been analyzed to assess the impact of these interventions on BMI, zBMI scores, and the occurrence of serious adverse events.
The systematic review, conducted using Cochrane’s extensive search methods, evaluated randomized controlled trials involving adolescents aged 12 to 19. The studies compared dietary and activity interventions against control groups with no intervention, usual care, or another eligible intervention, with outcomes measured at least 12 weeks post-baseline. The interventions were implemented in various settings, predominantly in schools, but also at home, in the community, and in primary care environments.
Dietary Interventions
The evidence is highly uncertain regarding the impact of dietary interventions on BMI at short-term, medium-term, and long-term follow-ups. At short-term follow-up, dietary interventions showed a mean difference (MD) of -0.18 in BMI, with very low-certainty evidence. Similarly, medium-term follow-up showed a slight reduction in BMI (MD -0.65), while long-term follow-up indicated minimal impact on standardized BMI (zBMI). Overall, dietary interventions appeared to have little to no effect on serious adverse events.
Activity Interventions
Activity interventions were found to be more promising, though the effects varied. Short-term follow-ups showed no reduction in BMI, but medium-term and long-term follow-ups indicated slight reductions in BMI. Specifically, medium-term follow-up showed a small decrease in BMI (MD -0.32), and long-term follow-up had a minor reduction (MD -0.28), though both results were of low-certainty evidence. Serious adverse events were rarely reported, with some injuries related to exercise components.
Combined Interventions
Combined dietary and activity interventions did not show significant reductions in BMI across short-term, medium-term, and long-term follow-ups. The evidence suggested no substantial impact on zBMI either, and there was minimal effect on serious adverse events.
Key Insights
– Dietary interventions alone may not significantly impact adolescent obesity.
– Activity interventions show slight beneficial effects on BMI in the medium and long term.
– Combined interventions do not provide significant benefits over individual approaches.
– The risk of serious adverse events from these interventions is minimal.
Despite these findings, limitations such as inconsistent results, methodological issues, and small sample sizes highlight the need for further research. Future studies should focus on larger samples and investigate the effects of these interventions in diverse community settings and among young people with disabilities.
Original Article: Cochrane Database Syst Rev. 2024 May 20;5:CD015330. doi: 10.1002/14651858.CD015330.pub2.
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