Su Xiwen, Hassan Mohamed A, Kim HyunJoon, Gao Zan
Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA 02215, USA.
School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA; Department of Methods and Curriculum, Physical Education College for Men, Helwan University, Cairo 12552, Egypt.
J Sport Health Sci. 2024 Nov 6;14:101008. doi: 10.1016/j.jshs.2024.101008.
This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.
PubMed (MEDLINE), Embase, CINAHL, and Web of Science were systematically searched for this network meta-analysis. Randomized controlled studies (RCTs) that included children aged 4-12 years with no physical or mental conditions; performed at least 1 type of lifestyle intervention; reported change in body mass index (BMI), BMI z-score, or body fat percentage (BFP); and were published between January 2010 and August 2023 were included.
The final analysis included 91 RCTs with aggregate data for 58,649 children. All interventions were categorized into single-arm approaches (physical activity, diet, and behavioral and informational support) and combined arms approaches (bicomponent and multicomponent treatment). Multicomponent treatment showed significant effectiveness on the reduction of BMI (mean deviation (MD) - 0.49, 95% confidence interval (95%CI): -0.88 to -0.12), BMI z-score (MD = -0.11, 95%CI: -0.18 to -0.04), and BFP (MD = -1.69, 95%CI: -2.97 to -0.42) compared to the usual care condition. Bicomponent treatment also significantly reduced BMI (MD = -0.28, 95%CI: -0.54 to -0.04) and BMI z-score (MD = -0.07, 95%CI: -0.12 to -0.02) compared to usual care.
Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP. Among single-component approaches, physical activity engagement emerged as the most effective. These findings should guide practitioners in recommending comprehensive lifestyle modifications for children. Moreover, children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.
本研究旨在提供关于各种生活方式干预对学龄前和学龄儿童身体成分管理有效性的比较证据。
对PubMed（MEDLINE）、Embase、CINAHL和Web of Science进行系统检索，以开展该网络荟萃分析。纳入的随机对照试验（RCT）需包含4至12岁无身体或精神疾病的儿童；进行至少1种生活方式干预；报告体重指数（BMI）、BMI z评分或体脂百分比（BFP）的变化；且发表于2010年1月至2023年8月之间。
最终分析纳入了91项RCT，汇总了58649名儿童的数据。所有干预措施分为单臂方法（体育活动、饮食以及行为和信息支持）和组合臂方法（双组分和多组分治疗）。与常规护理条件相比，多组分治疗在降低BMI（平均偏差（MD） - 0.49，95%置信区间（95%CI）：-0.88至-0.12）、BMI z评分（MD = -0.11，95%CI：-0.18至-0.04）和BFP（MD = -1.69，95%CI：-2.97至-0.42）方面显示出显著效果。与常规护理相比，双组分治疗也显著降低了BMI（MD = -0.28，95%CI：-0.54至-0.04）和BMI z评分（MD = -0.07，95%CI：-0.12至-0.02）。
针对多种生活方式成分的干预措施能使儿童的BMI和BFP有更大程度的降低。在单组分方法中，参与体育活动是最有效的。这些发现应指导从业者为儿童推荐全面的生活方式改变。此外，初始BMI和体脂水平较高的儿童往往对旨在管理肥胖的生活方式干预表现出更积极的反应。
