Lifestyle interventions in obese children (Cochrane, 2014)

Lifestyle intervention for improving school achievement in overweight or obese children and adolescents.
Cochrane Database Syst Rev. 2014 Mar 14;3:CD009728.
Martin A1, Saunders DH, Shenkin SD, Sproule J.
http://www.ncbi.nlm.nih.gov/pubmed/24627300

BACKGROUND:
The prevalence of overweight and obesity in childhood and adolescence is high.
Excessive body fat at a young age is likely to persist into adulthood and is associated with physical and psychosocial co-morbidities, as well as lower cognitive, school and later life achievement.
Lifestyle changes, including reduced caloric intake, decreased sedentary behaviour and increased physical activity, are recommended for prevention and treatment of child and adolescent obesity.
Evidence suggests that lifestyle interventions can benefit cognitive function and school achievement in children of normal weight.
Similar beneficial effects may be seen in overweight or obese children and adolescents.

OBJECTIVES:
To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function and future success in overweight or obese children and adolescents compared with standard care, waiting list control, no treatment or attention control.

AUTHORS’ CONCLUSIONS:
Despite the large number of childhood obesity treatment trials, evidence regarding their impact on school achievement and cognitive abilities is lacking.
Existing studies have a range of methodological issues affecting the quality of evidence.
Multicomponent interventions targeting physical activity and healthy diet could benefit general school achievement, whereas a physical activity intervention delivered for childhood weight management could benefit mathematics achievement, executive function and working memory.
Although the effects are small, a very large number of children and adolescents could benefit from these interventions. Therefore health policy makers may wish to consider these potential additional benefits when promoting physical activity and healthy eating in schools.
Future obesity treatment trials are needed to examine overweight or obese children and adolescents and to report academic and cognitive as well as physical outcomes.

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