title: Prevention of overweight and obesity in children and youth: a systematic review and meta-analysis.
abstract: BACKGROUND
  One-third of Canadian children are overweight or obese. This problem carries considerable concern for negative impacts on current and future health. Promoting healthy growth and development is critical. This review synthesized evidence on the effectiveness of behavioural interventions for preventing overweight and obesity in children and adolescents.
  
  
  METHODS
  We updated the search of a previous Cochrane review. Five databases were searched up to August 2013. Randomized trials of primary care-relevant behavioural (diet, exercise and lifestyle) interventions for preventing overweight and obesity in healthy normal- or mixed-weight children or youth aged 0-18 years were included if 12-week postbaseline data were provided for body mass index (BMI), BMI z-score, or prevalence of overweight or obesity. Any study reporting harms was included. Meta-analyses were performed if possible. Features of interventions showing significant benefits were examined.
  
  
  RESULTS
  Ninety studies were included, all with mixed-weight populations. Compared with controls, interventions showed a small but significant effect on BMI and BMI z-score (standardized mean difference -0.07, 95% confidence interval [CI] -0.10 to -0.03, I (2) = 74%), a reduction in BMI (mean difference -0.09 kg/m(2), 95% CI -0.16 to -0.03, I (2) = 76%) and a reduced prevalence of overweight and obesity (risk ratio [RR]; RRintervention - RRcontrol 0.94, 95% CI 0.89 to 0.99, I (2) = 0%; number needed to treat 51, 95% CI 29 to 289). Little evidence was available on harms. There was variability across efficacious interventions, although many of the interventions were short-term, involved school-aged children and were delivered in educational settings.
  
  
  CONCLUSIONS
  Behavioural prevention interventions are associated with small improvements in weight outcomes in mixed-weight populations of children and adolescents. No intervention strategy consistently produced benefits.
  
  
  BACKGROUND
  PROSPERO no. CRD42012002754.
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, Master University, Hamilton, Ont.
authors.forename: Leslea
authors.initials: L
authors.lastname: Peirson
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, Master University, Hamilton, Ont.
authors.forename: Donna
authors.initials: D
authors.lastname: Fitzpatrick-Lewis
authors.affiliation: Department of Pediatrics, McMaster University, Hamilton, Ont.
authors.forename: Katherine
authors.initials: K
authors.lastname: Morrison
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, Master University, Hamilton, Ont.
authors.forename: Donna
authors.initials: D
authors.lastname: Ciliska
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
authors.forename: Meghan
authors.initials: M
authors.lastname: Kenny
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Usman Ali
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
keywords: This article has been peer reviewed.
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