Johnson Lisa G, Cho Hwayoung, Lawrence Samantha M, Keenan Gail M
College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States.
College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States.
Prev Med. 2024 Apr;181:107918. doi: 10.1016/j.ypmed.2024.107918. Epub 2024 Feb 26.
Globally 38.9 million children under age 5 have overweight or obesity, leading to type 2 diabetes, cardiovascular complications, depression, and poor educational outcomes. Obesity is difficult to reverse and lifestyle behaviors (healthy or unhealthy) can persist from 1.5 years of age. Targeting caregivers to help address modifiable behaviors may offer a viable solution.
Evaluate the impact of multicomponent family interventions on weight-based outcomes in early childhood and explore related secondary behavior outcomes.
Four databases were searched (1/2017-6/2022) for randomized controlled trials (RCTs) of obesity-prevention interventions for children (1-5 years). Eligible studies included an objectively measured weight-based outcome, family interventions targeting the caregiver or family, and interventions including at least two behavioral components of nutrition, physical activity, or sleep.
Eleven interventions were identified consisting of four delivery modes: self-guided (n = 3), face-to-face group instruction (n = 3), face-to-face home visits (n = 2), and multiple levels of influence (n = 3). The reviewed studies reported almost no significant effects on child weight-based outcomes. Only two studies (one was an underpowered pilot study) resulted in significant positive child weight-management outcomes. Seven of the interventions significantly improved children's dietary intake.
Except for one, the reviewed studies reported that family based interventions had no significant effects on child weight-based outcomes. Future studies of this type should include measurements of age and sex-based body mass index (BMI) and trajectories, and also examine other important benefits to the children and families.
全球有3890万5岁以下儿童超重或肥胖，这会导致2型糖尿病、心血管并发症、抑郁症以及不良学业成绩。肥胖难以逆转，且生活方式行为（健康或不健康）可能从1.5岁起就持续存在。针对照顾者以帮助解决可改变的行为可能提供一个可行的解决方案。
评估多成分家庭干预对幼儿基于体重的结果的影响，并探索相关的次要行为结果。
检索了四个数据库（2017年1月至2022年6月），以查找针对1至5岁儿童的肥胖预防干预措施的随机对照试验（RCT）。符合条件的研究包括客观测量的基于体重的结果、针对照顾者或家庭的家庭干预，以及包括营养、身体活动或睡眠中至少两个行为成分的干预措施。
确定了11项干预措施，包括四种实施模式：自我指导（n = 3）、面对面小组指导（n = 3）、面对面家访（n = 2）和多层次影响（n = 3）。综述的研究报告称，对儿童基于体重的结果几乎没有显著影响。只有两项研究（一项是功效不足的试点研究）产生了显著的儿童体重管理积极结果。其中七项干预措施显著改善了儿童的饮食摄入量。
除一项研究外，综述的研究报告称，基于家庭的干预对儿童基于体重的结果没有显著影响。未来此类研究应包括基于年龄和性别的体重指数（BMI）及轨迹测量，还应研究对儿童和家庭的其他重要益处。
