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数字健康干预措施在儿童和青少年体重管理中的应用:系统评价和荟萃分析。

Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis.

机构信息

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.

Faculty of Health, University of Canberra, Canberra, Australia.

出版信息

J Med Internet Res. 2022 Feb 14;24(2):e30675. doi: 10.2196/30675.

Abstract

BACKGROUND

Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. Similar meta-analytic approaches for children are scarce.

OBJECTIVE

The aim of this meta-analysis is to examine the effect of technology-based interventions on overweight and obesity treatment in children and adolescents.

METHODS

A systematic literature search was performed using MEDLINE (PubMed), Scopus, and Cochrane Library for randomized clinical trials to identify interventional studies published between January 2000 and February 2021.

RESULTS

In total, 9 manuscripts from 8 clinical trials of 582 children or adolescents were considered eligible. BMI, BMI z-score, and other BMI-related baseline metrics during and after intervention were considered as primary outcomes. In 7 of 8 studies, a technology-based intervention was applied in addition to conventional care. Of the 8 studies, 6 studies were conducted in the United States, 1 in Australia, and 1 in northwestern Europe. In total, 5 studies included adolescents, whereas the rest addressed children aged 9 to 12 years. Intervention duration ranged from 3 to 24 months. Significant differences between groups in BMI metric changes were reported by 5 of the 8 studies. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group (standardized mean difference -0.61, 95% CI -1.10 to -0.13; P=.01). Subgroup analysis revealed that significance was lost in case of no parental involvement (standardized mean difference -0.36, 95% CI -0.83 to 0.11; P=.14). The small number of clinical trials found, the varying study quality, and the study heterogeneity are some limitations of this review.

CONCLUSIONS

The studies reported herein describe functional and acceptable technology-based approaches, in addition to conventional treatments, to enhance weight loss in young populations.

摘要

背景

最近的荟萃分析表明,使用基于技术的干预措施是治疗成年人肥胖的一种选择。类似的针对儿童的荟萃分析方法很少。

目的

本荟萃分析旨在研究基于技术的干预措施对儿童和青少年超重和肥胖治疗的效果。

方法

使用 MEDLINE(PubMed)、Scopus 和 Cochrane 图书馆系统地检索了 2000 年 1 月至 2021 年 2 月期间发表的随机临床试验,以确定干预性研究。

结果

共有 8 项临床试验的 9 篇文献被认为符合条件,涉及 582 名儿童或青少年。BMI、BMI z 评分和干预期间及之后的其他 BMI 相关基线指标被视为主要结局。在 8 项研究中的 7 项研究中,除了常规护理外,还应用了基于技术的干预措施。这 8 项研究中有 6 项在美国进行,1 项在澳大利亚进行,1 项在北欧进行。共有 5 项研究纳入了青少年,其余研究则针对 9 至 12 岁的儿童。干预持续时间从 3 至 24 个月不等。8 项研究中有 5 项报告了两组之间 BMI 指标变化的显著差异。荟萃分析显示,干预组 BMI 指标总体显著下降(标准化均数差-0.61,95%置信区间-1.10 至-0.13;P=.01)。亚组分析显示,在没有父母参与的情况下,这种显著差异消失(标准化均数差-0.36,95%置信区间-0.83 至 0.11;P=.14)。本综述的一些局限性包括发现的临床试验数量少、研究质量不同以及研究异质性。

结论

本文报道的研究描述了除常规治疗外,还可以使用功能和可接受的基于技术的方法来增强年轻人群的减肥效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/488f/8887634/4f40e9ceee7d/jmir_v24i2e30675_fig1.jpg

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