Pearson Natalie, Pradeilles Rebecca, Kingsnorth Andrew, Suarez Africa Peral, Boxer Benjamin, Griffiths Paula, Sherar Lauren B
School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.
UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), Université Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institute Agro, IRD, Montpellier, France.
Obes Rev. 2025 Sep;26(9):e13940. doi: 10.1111/obr.13940. Epub 2025 May 20.
This systematic review and meta-analysis examined the effectiveness of combined diet and physical activity interventions on changes in dietary and physical activity behaviors, and adiposity related outcomes in adolescents globally. PubMed, Embase, and Cochrane were searched for controlled interventions targeting dietary behaviors and physical activity in adolescents aged 10-19 years at baseline and reporting on the outcomes of changes in dietary and physical activity behaviors. Behavioral outcomes were synthesized narratively, and meta-analyses were conducted for changes in adiposity related outcomes (e.g., BMI z-scores, body fat percentage). Thirty-six studies were included, most (79%) were conducted in high-income countries and delivered in school settings (n = 28, 78%). Ten interventions (28%) showed no effect on any behaviors, and 5 (14%) reported changing all behaviors targeted and assessed. Most (72%) interventions changed at least one of the behaviors assessed, and 39% changed one or more indicator of adiposity. In a subsample (k = 16), there was a nonsignificant reduction in BMI (SMD -0.11 [95% CI -0.26 to 0.04]; I = 90%), a significant moderate reduction in BMI z-score (k = 14) (SMD -0.62 [-1.09 to -0.16]; I = 99%), and in body fat percentage in favor of the intervention groups (k = 11) (SMD -1.32 [-2.22 to -0.42]; I = 99%). The evidence for interventions targeting both dietary and physical activity behaviors and their effect on behavior and adiposity in adolescents is largely inconsistent. The positive findings from few studies suggests that there is potential to improve some lifestyle behaviors and associated adiposity outcomes in adolescents. However, the current evidence is focussed on high income countries with little consideration given to potential inequities in the effects of interventions.
本系统评价和荟萃分析研究了饮食与体育活动联合干预对全球青少年饮食和体育活动行为变化以及肥胖相关结局的有效性。检索了PubMed、Embase和Cochrane数据库，查找针对10 - 19岁青少年基线时饮食行为和体育活动的对照干预措施，并报告饮食和体育活动行为变化的结局。行为结局进行叙述性综合分析，对肥胖相关结局（如BMI z评分、体脂百分比）变化进行荟萃分析。纳入了36项研究，大多数（79%）在高收入国家进行，且在学校环境中实施（n = 28，78%）。10项干预措施（28%）对任何行为均无影响，5项（14%）报告改变了所有目标行为并进行了评估。大多数（72%）干预措施改变了至少一项评估行为，39%改变了一项或多项肥胖指标。在一个子样本（k = 16）中，BMI有非显著降低（标准化均值差SMD -0.11 [95%置信区间 -0.26至0.04]；I² = 90%），BMI z评分有显著中度降低（k = 14）（SMD -0.62 [-1.09至 -0.16]；I² = 99%），干预组的体脂百分比有显著降低（k = 11）（SMD -1.32 [-2.22至 -0.42]；I² = 99%）。针对青少年饮食和体育活动行为及其对行为和肥胖影响的干预证据在很大程度上不一致。少数研究的阳性结果表明，改善青少年某些生活方式行为和相关肥胖结局具有潜力。然而，目前的证据集中在高收入国家，很少考虑干预效果方面可能存在的不平等。
