Nutrition Interventions for Pediatric Obesity Prevention: An Umbrella Review of Systematic Reviews

Abstract

Nutrition interventions to prevent pediatric obesity can help to establish healthy habits to improve current and future health. The objective of this umbrella review of systematic reviews (SRs) is to examine the impact of obesity prevention interventions with a nutrition component on body mass index measures, overweight/obesity prevalence, and cost-effectiveness in participants 2-17 years old. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used, and this umbrella review was registered on PROSPERO (CRD42023443033). Included SRs were required to search ≥2 databases and to assess the risk of bias (RoB) of primary studies, and they were published 2017-June 2023. Database searches identified 4776 articles, and 31 SRs were included. In all age groups combined, interventions with both nutrition and physical activity were effective and cost-effective in all settings combined, and in the community setting specifically. In children ≤5 years old, interventions in the home and family, community, and healthcare settings demonstrated some efficacy, whereas in children 6-12 years old, school interventions were most effective. Evidence with individuals 13-17 years was limited. The certainty of evidence was generally low due to RoB in included studies, inconsistency, and imprecision. Pediatric obesity prevention interventions with nutrition should be tailored to the developmental stage to ensure appropriateness and efficacy.

Keywords: diet; dietitian; exercise; nutrition; obesity; pediatrics; primary prevention; schools; systematic review.

Figure 1

PRISMA flow chart demonstrating the study inclusion process for the umbrella review of systematic reviews on nutrition interventions to prevent pediatric obesity.

Figure 2

Impact of obesity pediatric prevention interventions with nutrition according to age and intervention setting. Nutrition and physical activity interventions in all settings and age groups combined are effective in improving BMI measures and overweight and obesity prevalence, as were interventions in all age groups combined in the community setting. Interventions in the home and family setting and in healthcare settings were beneficial for children ≤5 years old, school interventions were most effective for children 6–12 years old, and there is evidence of benefits from food assistance programs in children ≤12 years old. Beyond the impacts of interventions seen in all age groups combined, little is known about effective interventions for adolescents 13–17 years old.