Treatment Interventions for Early Childhood Obesity: A Systematic Review.

CONTEXT

With 25% of preschool-age children in the United States being overweight or obese, effective interventions for these children would have significant public health implications. Randomized trials targeting this age group have been performed since the last systematic review.

OBJECTIVE

To systematically review the literature on treatment interventions for overweight or obesity in preschool-age children.

DATA SOURCES

Medline (1948-July 2014), the Cochrane Central Registry (1991-July 2014), CINAHL (1990-July2014), and PAS abstracts (2000-2014).

STUDY SELECTION

Inclusion criteria were children aged 0 to 6 in the study and adiposity as an outcome. Exclusions were having normal-weight children in the trial and not having a comparison group.

DATA EXTRACTION

Data were extracted independently by 2 authors using a template.

RESULTS

The initial search yielded 1981 results, narrowed to 289 abstracts after initial review. Further analysis and cross-referencing led to the selection of 6 randomized controlled trials representing 1222 children. Two studies used systems changes and motivational interviewing and showed no significant effect on adiposity. Two studies used an intensive, multidisciplinary approach over 6 months and demonstrated significant decreases in adiposity. One study tested parental coaching and showed a significant reduction in adiposity at 6 months. One study used education on a dairy-rich diet and showed a possible effect on adiposity.

LIMITATIONS

The study designs were too heterogeneous for meta-analysis; few ethnic minority subjects were included.

CONCLUSIONS

Multidisciplinary, intensive interventions have some evidence of efficacy in reducing adiposity in preschool children.

Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.