June 22, 2017

expert reaction to two Cochrane reviews on diet, physical activity and behavioural interventions and obesity in children and adolescents

Two new Cochrane Reviews summarise the results of 114 studies which involved over 13,000 children and young people. They argue that a combination of diet, physical activity and behavioural change interventions may reduced weight in children aged 6-11 and adolescents aged 12-17.

Prof. Russell Viner, Officer for Health Promotion, Royal College of Paediatrics and Child Health, said:

“With a third of 11 year old children in England overweight and almost one in five obese, urgently tackling the childhood obesity epidemic is absolutely vital.  To develop effective evidence-based policy and interventions we must have reliable data, and these reviews suggest improvements should be made to enhance our approach to research on weight management interventions, by testing new approaches and delivery methods.

“Cochrane Reviews are internationally recognised as having very high standards of methodology and, as such, the findings of these reviews should be taken seriously.  They add support to our standard approaches to intervention, which focus on diet, physical activity and behaviour change, but the results are variable with generally low effects, suggesting some interventions are less effective than others.

“We know that healthy children make healthy adults and that prevention is by far preferable to cure.  We therefore need a new and sustained research focus to develop new interventions which include younger infants, who are missing from these reviews.”

Dr Amelia Lake, Dietitian and Public Health Nutritionist, Durham University, said:

“These are two rigorous and well-conducted reviews of the current evidence on the treatment of overweight or obese children and adolescents. Globally we are very concerned about overweight and obesity in young people. Overweight and obesity and their health consequences track into adulthood. Finding effective methods of treatment is of high importance.

“While the reviewers examined large numbers of studies it was difficult to draw conclusive results.  However what is evident is that interventions in children have a small and short-term effect.  With both children and adolescents there was great variability in what the interventions delivered and what was measured, as well as there being differing lengths of time in following up participants.

“Treatment of obesity and overweight is complex – evidence suggests that combining diet, physical activity and behaviour change can reduce adolescents’ weight.”

* Review 1: ‘Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years (Review)’ by Al-Khudairy L et al. will be published in the Cochrane Library at 00:01 UK time on Thursday 22 June 2017, which is also when the embargo will lift. 

Review 2: ‘Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years (Review)’ by Mead E et al. will be published in the Cochrane Library at 00:01 UK time on Thursday 22 June 2017, which is also when the embargo will lift. 

Declared interests

Prof. Russell Viner: “1.   No declarations of interest.”

Dr Amelia Lake: “Paid employment or self-employment – Durham University & Fuse.

Grant funding – NIHR SPHR (current).

Voluntary appointments – BNF scientific committee.

Memberships – BNF, BDA, Nutrition Society, Association for Nutritionists, ASO.”