Kshatriya Maya, Wang Kuan-Wen, Hildebrand Julia, Crawford Rebecca, Nadarajah Ajantha, Youssef Michael, Rivas Angelica, Kaushal Ashleen, Banfield Laura E, Thabane Lehana, Samaan M Constantine
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Adolesc Health Med Ther. 2023 Sep 28;14:175-193. doi: 10.2147/AHMT.S405814. eCollection 2023.
Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada.
Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence.
Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs.
Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada.
PROSPERO CRD42017072781.
加拿大的原住民儿童肥胖率和2型糖尿病（T2DM）发病率很高。以基于原住民健康知识观为指导的文化适宜性干预措施对于应对这些情况至关重要。本系统评价的目的是评估基于原住民知识的生活方式干预措施对加拿大原住民儿童预防肥胖和T2DM的影响。
从数据库建立至2022年2月22日进行检索。主要结局为体重指数（BMI）z评分的变化和T2DM的发生情况。其他结局包括肥胖、代谢和健康的生活方式决定因素。采用GRADE方法评估证据的可信度。
共纳入4项非随机对照试验（非RCT）和6项无对照研究。同伴主导的干预措施使BMI z评分和腰围降低。由于缺乏随机分组和样本量较小，GRADE评估显示证据质量极低。未报告有针对糖尿病的特定项目。
非随机研究的有限证据表明，同伴主导的基于原住民知识的生活方式干预措施可改善BMI z评分和中心性肥胖。对于旨在治疗和预防加拿大原住民儿童肥胖和T2DM的干预措施，需要开展社区主导且样本量充足的随机研究。
PROSPERO CRD42017072781。
