Department of Medicine, NYU Grossman School of Medicine, 462 First Avenue CD 673, New York, NY, 10016, USA.
Department of Anthropology, Durham University, South Road, Durham, DH1 3LE, UK.
BMC Public Health. 2020 Jun 29;20(1):1019. doi: 10.1186/s12889-020-08805-3.
This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants.
Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups.
Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = - 1.14 kg/m; (95% CI: - 2.06, - 0.21), I = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was - 6.08 mmHg (95% CI - 9.42, - 2.73), I = 0% and - 3.81 mmHg (95% CI: - 6.34, - 1.28), I = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG).
This review is the first to summarize the effectiveness of diet and physical activity interventions specifically designed for Chinese immigrants living in high income countries. There were clinically meaningful changes in BMI and blood pressure among adults, but evidence was weak for other cardiometabolic outcomes (weight, WC, LDL, HgbA1c, and FBG), and among children, there was no evidence of effect for any cardiometabolic outcomes. Given our mixed findings, more work is needed to support the design of successful interventions, particularly those targeting children and their families.
The systematic review protocol was registered in PROSPERO on December 17, 2018, the international prospective register of systematic reviews (registration number: CRD42018117842 ).
本综述考察了饮食和身体活动干预措施在降低生活在高收入国家的中国移民及其后代的心血管代谢风险方面的有效性。本综述的目的是提供信息，帮助构建未来的干预措施，旨在改善中国移民的饮食和增加身体活动水平。
研究结果包括 BMI、体重、腰围（WC）、腰臀比（WHR）、胆固醇（LDL、HDL）、收缩压和舒张压（SBP、DBP）、糖化血红蛋白（HgbA1c）、空腹血糖（FBG）和 HOMA-IR。从数据库建立之初到搜索日期（2020 年 2 月），系统地在六个数据库中进行了搜索。使用随机效应模型对干预组与对照组的结局进行荟萃分析，以估计结局的汇总效应，并使用 95%置信区间进行估计。评估的结果是干预组与对照组之间的平均结局（干预后与基线相比）的变化。
共纳入 21 篇文章进行综合分析，其中 8 篇文章进行了荟萃分析。在儿童/青少年中，对于有足够数据进行荟萃分析的任何结局（BMI、WHR、SBP 和 DBP），干预均无显著效果。在成年人中，纳入三项研究的汇总效应显示 BMI 有显著变化（效应大小为-1.14kg/m；95%CI：-2.06，-0.21），I²=31%）。干预对成年人的 SBP 和 DBP 也有显著影响，因为纳入三项研究的汇总效应分别为-6.08mmHg（95%CI-9.42，-2.73），I²=0%和-3.81mmHg（95%CI：-6.34，-1.28），I²=0%。在成年人中，进行的荟萃分析中没有其他显著效果（体重、WC、LDL、HgbA1c 和 FBG）。
这是第一项专门总结生活在高收入国家的中国移民饮食和身体活动干预措施有效性的综述。成年人的 BMI 和血压有临床意义上的变化，但其他心血管代谢结局（体重、WC、LDL、HgbA1c 和 FBG）的证据较弱，儿童的任何心血管代谢结局均无证据表明有效果。鉴于我们的混合发现，需要做更多的工作来支持成功干预措施的设计，特别是针对儿童及其家庭的干预措施。
系统评价方案于 2018 年 12 月 17 日在 PROSPERO 注册，国际前瞻性系统评价注册（登记号：CRD42018117842）。
