Kelishadi Roya, Azizi-Soleiman Fatemeh
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2014 Oct;19(10):993-1008.
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.
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.
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.
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.
儿童肥胖是一个全球性的健康问题，会产生短期和长期的健康后果。本系统综述总结了不同的基于家庭、学校和诊所的干预措施的经验。
在MEDLINE、PubMed、ISI科学网和Scopus科学数据库中进行电子检索。我们纳入了针对18岁及以下肥胖个体开展的研究。我们的检索得到了105篇相关论文，其中70篇是高质量的临床试验。
我们的研究结果表明，基于学校的项目可以对一大目标群体产生长期影响。这可能与儿童在学校度过相当一部分时间并在那里养成一些生活方式有关。它们对健康行为有显著影响，但由于存在一些共同的局限性，它们对人体测量指标的影响尚不清楚。由于父母在儿童行为发展中起着关键作用，据报道基于家庭的干预措施在某些方面有成功的效果；但选择偏倚和高辍学率可能会混淆其结果。基于诊所的干预措施显示出良好的效果。它们包括饮食或其他生活方式的改变，如增加体育活动或行为疗法。似乎包括饮食和运动的综合干预更实用。当它们有不同的设计时，结果存在争议。
我们建议，在不同类型的干预项目中，一种让儿童家庭参与的学校多学科方法可能是管理儿童肥胖的最佳且最可持续的方法。
