Impact of Lifestyle Intervention Programs for Children and Adolescents with Overweight or Obesity on Body Weight and Selected Cardiometabolic Factors-A Systematic Review

Abstract

Excessive body mass is a health problem among children and adolescents that contributes to the occurrence of lipid disorders and abnormal blood pressure. Effective treatment of excessive body mass in children is essential for the health of population in the future. The aim of the study was to identify universal components of lifestyle interventions in children and adolescents with overweight or obesity leading to weight loss and improvement of selected cardiometabolic parameters. The review included studies from the PubMed and Google Scholar databases published in 2010-2019, which were analyzed for eligibility criteria including age of the participants, BMI defined as overweight or obese, nutritional intervention and the assessment of BMI and/or BMI z-score and at least one lipid profile parameter. Eighteen studies were included in the review, presenting the results of 23 intervention programs in which a total of 1587 children and adolescents participated. All interventions, except one, were multi-component. Data analysis suggests a relationship between a decrease in BMI and/or BMI z-score with diet and physical activity, the involvement of a dietician/nutrition specialist and physician in the treatment team and a longer duration of intervention. Moreover, it seems that a decrease in BMI is mostly associated with decreases in total cholesterol, triglycerides, low density lipoprotein cholesterol and blood pressure. No change in BMI and/or BMI z-score is associated with no change in blood pressure. Our data can be used by public health authorities to design effective weight loss programs for children and adolescents.

Keywords: BMI; blood pressure; childhood obesity; diet; dyslipidemia; excess body weight; intervention program; lifestyle.

Figure 1

The flow diagram of the literature review process.

Figure 2

Presentation of the correspondence analysis results defining the relationship between the nutritional and physical activity interventions and changes in BMI and/or BMI z-score (n = 23).

Figure 3

Presentation of the correspondence analysis results defining the relationship between the changes in BMI and/or BMI z-score and changes in lipid parameters (n = 16).

Figure 4

Presentation of the correspondence analysis results defining the relationship between the changes in BMI and/or BMI z-score and changes in blood pressure (n = 20).

Figure 5

Presentation of the correspondence analysis results defining the relationship between the changes in BMI and/or BMI z-score and parental and therapeutic team involvement (n = 18).

Figure 6

Presentation of the correspondence analysis results defining the relationship between the changes in BMI and/or BMI z-score and duration of the intervention (n = 23).