Luis Rajmil1, Joan Bel2, Rosa Clofent3, Carmen Cabezas4, Conxa Castell4, Mireia Espallargues5. 1. Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Biomèdiques, Barcelona, España; Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública CIBERESP, Madrid, España. Electronic address: lrajmil@gencat.cat. 2. Servicio de Pediatria, Hospital Universitario Germans Trias i Pujol, Badalona, España. 3. Centro de Atención Primaria Llefià, Institut Català de la Salut (ICS), Badalona, España. 4. Departament de Salut, Subdirecció de Promoció de la Salut, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, España. 5. Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, España.
Abstract
OBJECTIVE: To update the literature review on the effectiveness of clinical interventions on childhood obesity, proposed in Clinical Practice Guidelines, excluding prevention and pharmacological and surgical treatments. METHOD: A systematic review was carried out in electronic databases of the Cochrane Database of Systematic Reviews (The Cochrane Library), MEDLINE, and SCOPUS, replicating the search for the Clinical Practice Guidelines, from 2009 to 2014. The Clinical Practice Guidelines of National Institute for Health and Care Excellence were taken as a reference. Systematic reviews were given priority, and the quality of the studies was assessed. RESULTS: Out of a total of 3,703 documents initially identified, 48 were finally included. Studies showed great heterogeneity in the type and duration of interventions, and in outcome measures. Adherence to treatment was, in general, low. Multi-component interventions including diet, physical activity, sedentary lifestyle, and behaviour changes, involving the family, and starting at early ages, were the most effective for reducing body mass index. There is no consensus on criteria for referral to specialised care. CONCLUSIONS: It is recommended to implement multi-component programs conducted by professionals with previous training, involving the family, and addressing behavioural, individual and socio-demographic aspects. Lack of adherence is one of the reasons for failure of interventions. Diagnostic and referral criteria, the outcome measures, and the type and duration of interventions need to be improved and standardised.
OBJECTIVE: To update the literature review on the effectiveness of clinical interventions on childhood obesity, proposed in Clinical Practice Guidelines, excluding prevention and pharmacological and surgical treatments. METHOD: A systematic review was carried out in electronic databases of the Cochrane Database of Systematic Reviews (The Cochrane Library), MEDLINE, and SCOPUS, replicating the search for the Clinical Practice Guidelines, from 2009 to 2014. The Clinical Practice Guidelines of National Institute for Health and Care Excellence were taken as a reference. Systematic reviews were given priority, and the quality of the studies was assessed. RESULTS: Out of a total of 3,703 documents initially identified, 48 were finally included. Studies showed great heterogeneity in the type and duration of interventions, and in outcome measures. Adherence to treatment was, in general, low. Multi-component interventions including diet, physical activity, sedentary lifestyle, and behaviour changes, involving the family, and starting at early ages, were the most effective for reducing body mass index. There is no consensus on criteria for referral to specialised care. CONCLUSIONS: It is recommended to implement multi-component programs conducted by professionals with previous training, involving the family, and addressing behavioural, individual and socio-demographic aspects. Lack of adherence is one of the reasons for failure of interventions. Diagnostic and referral criteria, the outcome measures, and the type and duration of interventions need to be improved and standardised.
Authors: Sofia Ramalho; Pedro F Saint-Maurice; Diana Silva; Helena Ferreira Mansilha; Cátia Silva; Sónia Gonçalves; Paulo Machado; Eva Conceição Journal: Eat Weight Disord Date: 2018-12-05 Impact factor: 4.652
Authors: Pedro Juan Carpena Lucas; Francisco Sánchez-Cubo; Manuel Vargas Vargas; José Mondéjar Jiménez Journal: Int J Environ Res Public Health Date: 2022-03-31 Impact factor: 3.390