School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK.
Nutrients. 2023 May 29;15(11):2524. doi: 10.3390/nu15112524.
Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity-related comorbidities among adult populations but less so among children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in Western high-income countries (HICs). Our systematic review included 53 studies, involving 26,045 children from minority ethnic populations who followed lifestyle intervention programmes lasting between 8 weeks and 5 years with the aim of preventing and/or managing childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. The studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after-school settings). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body mass index (BMI) outcomes (pooled BMI mean change = -0.09 (95% CI = -0.19, 0.01); = 0.09). This was irrespective of the intervention programme duration (<6 months vs. ≥6 months), type (PA vs. nutrition/combined intervention) and weight status (overweight or obese vs. normal weight) as all showed nonsignificant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reductions in BMI, BMI z-score and body fat percentage. However, the majority of lifestyle interventions adopting a quasi-design with combined primary and secondary obesity measures (11 out of 15 studies) were effective in reducing the obesity comorbidities of cardiometabolic risks, including metabolic syndrome, insulin sensitivity and blood pressure, in overweight and obese children. Preventing childhood obesity in high-risk ethnic minority groups is best achieved using combined PA and nutrition intervention approaches, which jointly target preventing obesity and its comorbidities, especially the outcomes of diabetes, hypertension and cardiovascular disease. Therefore, public health stakeholders should integrate cultural and lifestyle factors and contextualise obesity prevention strategies among minority ethnic groups in Western HICs.
生活方式的体育活动（PA）和营养已被证实是预防和管理成年人群体肥胖相关合并症的有效干预措施，但在儿童和青少年中效果较差。我们研究了西方高收入国家（HIC）少数民族儿童中生活方式干预的效果。我们的系统评价包括 53 项研究，涉及 26045 名来自少数民族群体的儿童，他们参加了持续 8 周至 5 年的生活方式干预计划，旨在预防和/或管理儿童肥胖症及其相关合并症，包括肥胖和心血管代谢风险。这些研究在生活方式干预措施组成部分（营养、PA、行为咨询）和环境（社区与学校和课后环境）方面存在异质性。我们的荟萃分析包括 31 项符合条件的研究，结果表明，生活方式干预对体重指数（BMI）结果没有显著影响（BMI 平均变化的汇总值为-0.09（95%CI=-0.19，0.01）； = 0.09）。这与干预计划持续时间（<6 个月与≥6 个月）、类型（PA 与营养/联合干预）和体重状况（超重或肥胖与正常体重）无关，因为所有类型在敏感性分析中均显示无显著影响。尽管如此，53 项研究中有 19 项报告了 BMI、BMI z 分数和体脂百分比的降低。然而，采用主要和次要肥胖措施相结合的准设计的大多数生活方式干预措施（15 项研究中有 11 项）在减少超重和肥胖儿童的肥胖合并症方面是有效的，包括代谢综合征、胰岛素敏感性和血压。在高风险少数民族群体中预防儿童肥胖症，最好采用联合 PA 和营养干预措施，共同针对预防肥胖症及其合并症，尤其是糖尿病、高血压和心血管疾病的结果。因此，公共卫生利益相关者应整合文化和生活方式因素，并使西方 HIC 中少数民族群体的肥胖预防策略本地化。
