Face-to-face physical activity incorporated into dietary intervention for overweight/obesity in children and adolescents: a Bayesian network meta-analysis

Jing Hong Liang; Yu Zhao; Yi Can Chen; Nan Jiang; Shu Xin Zhang; Shan Huang; Aerziguli Kakaer; Ya Jun Chen

doi:10.1186/s12916-022-02462-6

Face-to-face physical activity incorporated into dietary intervention for overweight/obesity in children and adolescents: a Bayesian network meta-analysis

BMC Med. 2022 Sep 2;20(1):325. doi: 10.1186/s12916-022-02462-6.

Authors

Jing Hong Liang¹, Yu Zhao¹, Yi Can Chen¹, Nan Jiang¹, Shu Xin Zhang¹, Shan Huang¹, Aerziguli Kakaer¹, Ya Jun Chen²

Affiliations

¹ Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.
² Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China. chenyj68@mail.sysu.edu.cn.

Abstract

Background: Adolescent obesity has been reported to have deleterious consequences but is considered a promising modifiable risk factor. We aimed to investigate the optimal intervention for obese and overweight children and adolescents.

Methods: We searched the Medline (PubMed, 1946-December 2020), PsycINFO (Ovid, 1927-December 2020), Cochrane library (1966-December 2020), Web of Science (1900-December 2020), Embase (1974-December 2020), CINAHL (1937-December 2020), Chinese Biomedical Literature (1978-December 2020), and ClinicalTrials.gov (December 2020) databases. We included randomized controlled trials (RCTs) reporting the association between various interventions and obese/overweight children and adolescents. The quality of the included studies was judged by two independent reviewers using the Cochrane Collaboration Risk of Bias Tool. A Bayesian network meta-analysis was conducted to summarize the comparative effectiveness of interventions based on several outcomes.

Results: We included 118 RCTs comprising 71,064 participants in our analyses. Based on the outcome of the body mass index (BMI), face-to-face physical activity (FTF PA) combined with dietary intervention (DI) (mean difference [MD] = - 0.98; 95% credible interval [CrI] - 1.19, - 0.77), FTF multi-lifestyle intervention (MLI) (MD = - 0.95; 95% CrI - 1.14, - 0.75), and mobile health (MH)-delivered MLI (MD = - 0.87; 95% CrI - 1.63, - 0.09) showed significant benefits over the named control group (NCG). For the outcome of BMI z-score, FTF PA+DI (MD = - 0.10; 95% CrI - 0.15, - 0.04) and MH-delivered PA+DI (MD = - 0.09; 95% CrI - 0.14, - 0.04) were more effective than the NCG. Sensitivity analyses revealed similar findings after exclusion of studies with < 12-month and 24-month outcome assessments for the intervention, which indicated the results were stable.

Conclusions: Based on limited quality evidence and limited direct evidence, our preliminary findings showed that FTF-PA+DI, FTF-MLI, and MH-delivered MLI improved the health-related parameters in obese adolescents, in comparison with NCG. Owing to the absence of strong, direct evidence of a significant difference between the various interventions for the four outcomes, we can only cautiously suggest that FTF-PA+DI is likely the most effective intervention.

Keywords: Bayesian network meta-analysis; Children and adolescents; Nutrition; Obesity; Physical activity.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Body Mass Index
Child
Exercise
Humans
Network Meta-Analysis
Overweight* / therapy
Pediatric Obesity* / epidemiology
Pediatric Obesity* / prevention & control