Li Liubai, Sun Feng, Du Jian, Li Zhixia, Chen Tianjiao, Shi Xuanyu
Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Peking University, Beijing, China.
Peking University Center for Evidence Based Medicine and Clinical Research, Peking University, Beijing, China.
Ann N Y Acad Sci. 2025 Jan;1543(1):31-41. doi: 10.1111/nyas.15278. Epub 2024 Dec 23.
Behavior-change lifestyle interventions are fundamental in children and adolescent obesity management. This scoping review discusses optimal behavior-change lifestyle interventions in the treatment of overweight and obesity in children and adolescents. A literature search on diet, physical activity, and behavioral intervention for obesity treatment in children and adolescents aged 0-19 years was conducted in the Cochrane Library, MEDLINE (OVID), EMBASE, and ClinicalTrials.gov. Systematic reviews and meta-analyses with randomized controlled trials (RCTs) published in English from June 2016 to November 2022 were retrieved to identify recent advancements. Obesity outcomes included body weight, body mass index (BMI), BMI z-score, and fat percentage, among others. The 28 located reviews included: four studies on diet therapy; five on physical activity (exercise training); one on sedentary activities; 18 on multicomponent behavior-change lifestyle interventions, including three that incorporated gaming; three with eHealth, mobile health (mHealth), or telehealth, with one in each category; and two on motivational interviewing. Behavior-change lifestyle interventions to reduce obesity in children and adolescents were associated with moderate effects, with low-quality evidence for diet therapy and high-quality evidence for exercise training, both for weight or BMI reduction. Long-term intensive multicomponent behavioral interventions with parental involvement demonstrated better effects.
行为改变生活方式干预是儿童和青少年肥胖管理的基础。本范围综述讨论了治疗儿童和青少年超重与肥胖的最佳行为改变生活方式干预措施。我们在Cochrane图书馆、MEDLINE(OVID)、EMBASE和ClinicalTrials.gov上对0至19岁儿童和青少年肥胖治疗的饮食、体育活动及行为干预进行了文献检索。检索了2016年6月至2022年11月期间发表的英文随机对照试验(RCT)的系统评价和荟萃分析,以确定近期进展。肥胖相关结果包括体重、体重指数(BMI)、BMI z评分和脂肪百分比等。找到的28篇综述包括:四项关于饮食疗法的研究;五项关于体育活动(运动训练)的研究;一项关于久坐活动的研究;18项关于多成分行为改变生活方式干预的研究,其中三项纳入了游戏;三项涉及电子健康、移动健康(mHealth)或远程医疗,各有一项;以及两项关于动机性访谈的研究。改变行为的生活方式干预措施对降低儿童和青少年肥胖有中等效果,饮食疗法证据质量低,运动训练证据质量高,二者在减轻体重或BMI方面均如此。有家长参与的长期强化多成分行为干预效果更好。