体重管理营养干预对超重或肥胖儿童和青少年饮食结果的影响：系统评价和荟萃分析。

Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta-analysis.

机构信息

School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.

Health and Wellbeing Queensland, Queensland Government, Milton, QLD, Australia.

出版信息

J Hum Nutr Diet. 2021 Feb;34(1):147-177. doi: 10.1111/jhn.12831. Epub 2020 Dec 6.

DOI:10.1111/jhn.12831

PMID:33283363

Abstract

BACKGROUND

The impact of obesity interventions on dietary intake in children and adolescents with overweight or obesity is unclear. This systematic review aimed to investigate the impact of the dietary component of weight management interventions on the change in diet in children and adolescents with overweight or obesity.

METHODS

Eligible randomised controlled trials (RCTs) published between 1975 and 2020 were identified by a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Meta-analyses of eligible study outcomes were performed using statistical software. A multilevel random effects model was used with three significant random effects fitted using restricted maximum likelihood estimation.

RESULTS

This review identified 109 RCTs, including 95 that reported at least one statistically significant dietary outcome change and 14 reporting no significant dietary change. Results from the meta-analyses (n = 29 studies) indicated that, compared to control groups, intervention groups achieved significantly greater reductions in mean total energy intake at ≤6 months (-194 kcal day , 95% confidence interval = -275.80 to -112.90 kcal day , P < 0.001) and up to 12 months (-112 kcal day 95% confidence interval = -218.92 to -5.83 kcal day ) P = 0.038), increases in fruit and/or vegetable intakes over 2-12 months (n = 34, range +0.6 to +1.5 servings day ) and reductions in consumption of sugar-sweetened beverages (n = 28, range -0.25 to -1.5 servings day ) at 4-24 months follow-up.

CONCLUSIONS

Obesity interventions with a dietary component have a modest but sustained impact on reducing total energy intake and improving intakes of specific food groups in children and adolescents with overweight or obesity. High quality RCTs that are powered to detect change in diet as a primary outcome are warranted.

摘要

背景

肥胖干预措施对超重或肥胖儿童和青少年饮食摄入的影响尚不清楚。本系统评价旨在研究体重管理干预措施的饮食成分对超重或肥胖儿童和青少年饮食变化的影响。

方法

根据系统评价和荟萃分析（PRISMA）指南，通过系统搜索确定了 1975 年至 2020 年期间发表的合格随机对照试验（RCT）。使用统计软件对合格研究结果进行荟萃分析。使用多级随机效应模型，使用最大似然估计进行限制的三个显著随机效应拟合。

结果

本综述确定了 109 项 RCT，其中 95 项报告了至少一项具有统计学意义的饮食变化结果，14 项报告了没有显著饮食变化的结果。荟萃分析（n=29 项研究）的结果表明，与对照组相比，干预组在≤6 个月时（-194 千卡/天，95%置信区间=-275.80 至-112.90 千卡/天，P<0.001）和长达 12 个月时（-112 千卡/天，95%置信区间=-218.92 至-5.83 千卡/天，P=0.038），总能量摄入显著减少，2-12 个月时水果和/或蔬菜摄入量增加（n=34，范围为+0.6 至+1.5 份/天），4-24 个月时含糖饮料摄入量减少（n=28，范围为-0.25 至-1.5 份/天）。