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Meta-Analysis
. 2023 Jul;14(4):858-869.
doi: 10.1016/j.advnut.2023.04.011. Epub 2023 Apr 29.

Mediterranean Diet-Based Interventions to Improve Anthropometric and Obesity Indicators in Children and Adolescents: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

José Francisco López-Gil  1 , Antonio García-Hermoso  2 , Mercedes Sotos-Prieto  3 , Iván Cavero-Redondo  4 , Vicente Martínez-Vizcaíno  5 , Stefanos N Kales  6
Affiliations
Meta-Analysis

Mediterranean Diet-Based Interventions to Improve Anthropometric and Obesity Indicators in Children and Adolescents: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

José Francisco López-Gil et al. Adv Nutr. 2023 Jul.

Abstract

To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean diet-based interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen's d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d = -0.14; 95% CI: -0.26, -0.01; I2 = 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I2 = 84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3-18 y). This trial was registered at PROSPERO as CRD42023386789.

Keywords: eating healthy; lifestyle; obesity; overweight; preschoolers; young population; youths.

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Figures

FIGURE 1
FIGURE 1
PRISMA 2020 flow chart for systematic reviews that included database searches. MedDiet, Mediterranean diet.
FIGURE 2
FIGURE 2
Meta-analysis of Mediterranean diet-based interventions to determine the combined effect size on BMI. a3-y age group; b4-y age group; c5-y age group.
FIGURE 3
FIGURE 3
Meta-analysis of Mediterranean diet-based interventions to determine the combined effect size on the waist circumference. a3-y age group; b4-y age group; c5-y age group.
FIGURE 4
FIGURE 4
Meta-analysis of Mediterranean diet-based interventions to determine the combined effect size on waist-to-height ratio. a3-y age group; b4-y age group; c5-y age group.
FIGURE 5
FIGURE 5
Meta-analysis of Mediterranean diet-based interventions to determine the combined effect size on the relative risk difference for obesity percentage. a3-y age group; b4-y age group; c5-y age group.
FIGURE 6
FIGURE 6
Meta-analysis of Mediterranean diet-based interventions to determine the combined effect size on the relative risk difference for abdominal obesity percentage. a3-y age group; b4-y age group; c5-y age group.
See this image and copyright information in PMC

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