Obesogenic environment – intervention opportunities

Fisberg, Mauro; Maximino, Priscila; Kain, Juliana; Kovalskys, Irina

doi:10.1016/j.jped.2016.02.007

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review articles • J. Pediatr. (Rio J.) 92 (3 Suppl 1) • May-Jun 2016 • https://doi.org/10.1016/j.jped.2016.02.007 copy

Obesogenic environment – intervention opportunities^☆ ☆ Please cite this article as: Fisberg M, Maximino P, Kain J, Kovalskys I. Obesogenic environment – intervention opportunities. J Pediatr (Rio J). 2016;92(3 Suppl 1):S30–9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

To evaluate environmental obesogenic-related factors, such as physical activity in neighborhoods and schools, nutritional behavior, and intervention programs.

Sources:

Critical analysis of literature with personal point of view from infant obesity experts and political advisors for public intervention.

Data synthesis:

Although obesity is a public health problem affecting several age groups, it is among children and adolescents that it plays a more important role, due to treatment complexity, high likelihood of persistence into adulthood, and association with other non- transmissible diseases while still in early age. Environment is a main component of the genesis and outcomes in the near future or long term. Modification of intake with high-density food, meal skipping, and high intake of saturated fat, sugar, and salt, associated to high levels of sedentarism are main causes of obesity.

Conclusion:

Intervention opportunities are related to modifications in political, environmental, and individual settings. School and physical activities in the educational environment are intertwined with nutrition intervention in continuous education. A critical review of some different scenarios in Latin American countries is presented.

KEYWORDS
School environment; Phyisical activity; Children; Adolescents; Obesity

Author & aim		Kind of study	Criteria for considering studies	Main outcomes	Final conclusions
Jaime, PC		Systematic Review Up to Nov. 2007 Primary and Secondary Schools 18 Studies USA-Europe	Policy assessed More efficacy in: - Implementation of recommendations and price interventions - Regulation of access to foods and beverages	Some policies have been effective in improving food environment and dietary intake Little evaluation of impact on IMC	More long term studies are necessary
	2009- Effectiveness of school nutrition policies.				More long term studies are necessary
Khambalia, A		Systematic Review 1990-2010 8 studies:, 3 meta-analysis and 5 systematic reviews All in English	School-based Reviews that considered individual studies which examined behavioural interventions for preventing or controlling overweight or obesity (PA, diet or both).	The meta-analyses concluded that school-based obesity interventions had a significant, albeit modest, effect in achieving weight reduction in school settings	Little evidence. More high quality Studies are needed
	2012- Effectiveness of School based obesity interventions				Little evidence. More high quality Studies are needed
Lobelo, F		Systematic review 1965-2010 10 studies Latin America	School-based Evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z -score), - Comparative (exposed vs not exposed)	Most successful interventions were focused on: Prevention Longer follow-ups Multidisciplinary team, Fewer limitations in execution 5/10 Positive outcomes	Sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America.
	2013- School-Based Programs Aimed at the Prevention and Treatment of Obesity	Systematic review 1965-2010 10 studies Latin America
Lavelle, H		Systematic review & meta-analysis 1991-2010 43 studies Population =<18 y. Europe-US-Brazil	Stratified analysis 26% studies PA only 7% education alone 69% combined PA interventions with nutrition	PA alone and or PA plus nutrition, was associated with significant improvements in BMI	School-based interventions that contain a physical activity component may be to reduce BMI
	2012- Effectiveness of school-based interventions to reduce BMI
Metcalf		Systematic review & Meta-analysis 2003-2011 30 Studies 16 years or younger	Randomized controlled trials or controlled clinical trials Studies designed to increase the physical activity of children/adolescents. At least four week.	Physical activity Interventions do not affect the overall activity levels of children	Strong evidence that physical activity interventions have had only a small effect (approximately 4 minutes more walking or running per day) on children's overall activity levels
	2012-2013 Effectiveness of intervention on physical activity of children
Brown, T		Systematic Review 38 RCT 13 from NICE 7 NE and PA	School-based Only includes studies that reported a weight outcome. Studies with a lifestyle intervention (diet, PA, diet plus PA)	Physical activity interventions may help children maintain a healthy weight The results are inconsistent and short-term. Physical activity interventions may be more successful in younger children and in girls.	Use qualititave and quantitative outcomes Combination of both PA and diet intervention tend to be more effective
	2009 Interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity	Systematic Review 38 RCT 13 from NICE 7 NE and PA
Waters, E		Review & Meta-analysis Case-Control Studies (Randomized or not) At least 12 weeks 55 Studies (37 meta-analysis) 6-12 years old	Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more	Programs were effective at reducing adiposity, although not all individual interventions were effective	Strong evidence to support beneficial effects of child obesity prevention programs on BMI, Include recommendations and strategies
	2011 Cochrane Review
Guerra, PH		Meta-analysis Published after 2000 33 articles 6-18 years old	School based RCT on PA and NE Performed PA and NE interventions for children and adolescents Described the BMI outcome in both intervention and control groups	Showed no statistically significant mean reduction on children's and adolescents' BMI in normal population. Little positive effect was observed when including OW and OB	More studies are needed in order to provide an effective framework to be implemented in the school setting.
	2013 School-based physical activity and nutritional education interventions on body mass index

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mails: mauro.fisberg@gmail.com nutrociencia@nutrociencia.com.br (M. Fisberg).

Brasil

Brasil

Obesogenic environment – intervention opportunities☆ ☆ Please cite this article as: Fisberg M, Maximino P, Kain J, Kovalskys I. Obesogenic environment – intervention opportunities. J Pediatr (Rio J). 2016;92(3 Suppl 1):S30–9.

ABSTRACT

Objectives:

Sources:

Data synthesis:

Conclusion:

Obesogenic environment – intervention opportunities^☆ ☆ Please cite this article as: Fisberg M, Maximino P, Kain J, Kovalskys I. Obesogenic environment – intervention opportunities. J Pediatr (Rio J). 2016;92(3 Suppl 1):S30–9.