scholarly journals Effectiveness of lifestyle intervention in overweight children

2011 ◽  
Vol 70 (4) ◽  
pp. 494-505 ◽  
Author(s):  
Thomas Reinehr
Keyword(s):  
Weight Loss ◽  
Children And Adolescents ◽  
Lifestyle Intervention ◽  
Randomised Controlled Trials ◽  
Longitudinal Research ◽  
Cochrane Review ◽  
Specific Treatment ◽  
Controlled Trials ◽  
Overweight Children ◽  
Randomised Controlled

Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.

SDCCAG8 Obesity Alleles and Reduced Weight Loss After a Lifestyle Intervention in Overweight Children and Adolescents

Obesity ◽  
2012 ◽  
Vol 20 (2) ◽  
pp. 466-470 ◽  
Author(s):  
André Scherag ◽  
Michaela Kleber ◽  
Tanja Boes ◽  
Andreea-Liliana Kolbe ◽  
Anne Ruth ◽  
...  
Keyword(s):  
Weight Loss ◽  
Children And Adolescents ◽  
Lifestyle Intervention ◽  
Overweight Children

scholarly journals Protective effects of dietary PUFA against chronic disease: evidence from epidemiological studies and intervention trials

2013 ◽  
Vol 73 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Thomas A. B. Sanders
Keyword(s):  
Chronic Disease ◽  
Cohort Studies ◽  
Cardiac Death ◽  
Lower Risk ◽  
Randomised Controlled Trials ◽  
Cochrane Review ◽  
Total Mortality ◽  
Partial Replacement ◽  
Controlled Trials ◽  
Randomised Controlled

This review considers evidence for a protective effect of PUFA on chronic disease. Estimates of PUFA intakes in prospective cohort studies are usually based on FFQ or biomarkers of intake. Cohort studies suggest that both linoleic and linolenic acid intake are associated with a lower risk of CHD. The intake of fish, the major source of long-chainn-3 PUFA is associated with a lower risk of both stroke and CHD, particularly sudden cardiac death. No relationship with common sites of cancer (breast and colon) and PUFA has been found. However, some recent studies suggest an association of high intakes ofn-3 PUFA with risk of prostate cancer. An updated Cochrane review of dietary fat modification (replacing SFA with PUFA) randomised controlled trials to prevent CHD found a 14 % lower incidence and a non-significant 7 % lower mortality from CHD. The effects of an increased intake ofn-3 PUFA on CHD incidence mortality have been tested in patients with pre-existing CHD in randomised controlled trials. Meta-analysis of these trials showed no overall benefit on total mortality or CVD incidence but a trend for lower risk of cardiac death was 0·91 (95 % CI 0·85, 0·98). At present, there is little evidence from other trials demonstrating the clear benefits or harm from increased intakes of PUFA. In conclusion, present evidence intakes benefit from partial replacement of SFA with a balanced mixture ofn-6 andn-3 PUFA which may contribute to CVD prevention.

scholarly journals Pharmacotherapy for weight loss in adults with type 2 diabetes: a systematic review of randomised controlled trials

2021 ◽  
Author(s):  
Claudia Coelho ◽  
Rachel Agius ◽  
James Crane ◽  
Barbara McGowan
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Randomised Controlled Trials ◽  
Current Evidence ◽  
Controlled Trials ◽  
Medical Treatments ◽  
Randomised Controlled

Background: Clinically significant weight loss improves glycaemic control and cardiovascular disease risk in patients with type 2 diabetes (T2DM).Aim: To identify and assess the efficacy of medical treatments for weight loss in adults with T2DM.Methods: A systematic review was conducted of peer- reviewed literature between July 2004 and July 2020 via PubMed, Embase, Web of Science, medRxiv and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) in English investigating medical treatments for weight loss in patients with T2DM were included. RCTs of pharmacotherapy withdrawn from the market were excluded. No minimum length of follow-up time was established. Outcomes of interest were changes from baseline in body weight (%), changes from baseline in HbA1c (%, mmol/mol) and proportion of patients who achieved ≥5% weight loss. Quality assessment was evaluated using the Jadad score.Results: Fifteen RCTs were included with a total of 4,207 participants with T2DM. Interventions included medications approved for obesity management (orlistat, liraglutide, naltrexone-bupropion and phentermine-topiramate) and other agents investigated for the primary purpose of weight loss (topiramate, metreleptin, dapagliflozin and exenatide) compared with placebo. The duration of the intervention varied from 12 to 56 weeks. Placebo-adjusted body weight loss ranged from 2.2% to 7.3%. Furthermore, 30.5–77.0% of patients achieved ≥5% weight loss. Placebo-adjusted change in glycated haemoglobin was 0.3–1.5% (3.3–16.4 mmol/mol).Conclusion: Current evidence demonstrates that pharmacotherapy for weight loss, except for leptin, is associated with weight loss and glycaemic improvement in patients with T2DM.

scholarly journals Protocol for a systematic review and network meta-analysis of randomised controlled trials examining the effectiveness of early parenting interventions in preventing internalising problems in children and adolescents.

2020 ◽  
Author(s):  
Ilaria Costantini ◽  
Elise Paul ◽  
Deborah M Caldwell ◽  
José A López-López ◽  
Rebecca M Pearson
Keyword(s):  
Children And Adolescents ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Parenting Interventions ◽  
Bias Assessment ◽  
Statistical Heterogeneity ◽  
Randomised Controlled ◽  
Internalising Problems

Abstract Background: Internalising problems, such as depression and anxiety, are common and represent an important economical and societal burden. The effectiveness of parenting interventions in reducing risk of internalising problems in children and adolescents has not yet been summarised. The aims of this review are to:1. assess the effectiveness of parenting interventions in the primary, secondary and tertiary prevention of internalising problems in children and adolescents;2. determine which intervention components and which intervention aspects are most effective for reducing risk of internalising problems in children and adolescents. Methods: Electronic searches in OVID SP versions of Medline, EMBASE and PsycINFO; Cochrane Central Register of Controlled Trials; EBSCO version of ERIC and clinicaltrials.gov have been performed to identify randomised controlled trials or quasi-randomised controlled trials of parenting interventions. At least two independent researchers will assess studies for inclusion and extract data from each paper. The risk of bias assessment will be conducted independently by two reviewers using the Cochrane Collaboration’s Risk of Bias Assessment Tool. Statistical heterogeneity is anticipated given potential variation in participant characteristics, intervention type and mode of delivery, and outcome measures. Random effects models, assuming a common between-study variability, will be used to account for statistical heterogeneity. Results will be analysed using a network meta-analysis (NMA). If appropriate, we will also conduct a component-level NMA, where the ‘active ingredients’ of interventions are modelled using a network meta-regression approach.Discussion: Preventing and reducing internalising problems could have major beneficial effects at the economic and societal level. Informing policy makers on the effectiveness of parenting interventions and on which intervention’s component is driving the effect is important for the development of treatment strategies. Systematic review registration: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42020172251

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