Effectiveness of Lifestyle Interventions for Prevention of Harmful Weight Gain among Adolescents from Ethnic Minorities: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Identification of Studies
2.2. Eligibility Criteria
2.3. Study Selection
2.4. Data Extraction
2.5. Quality Assessment
2.6. Grading of Recommendations Assessment, Development and Evaluation Assessment
3. Results
3.1. Study Selection
3.2. Setting and Study Design
3.3. Study Characteristics
3.4. Participants’ Characteristics and Recruitment Strategies
3.5. Primary and Secondary Outcomes; General and Targeted
3.6. Risk of Bias
3.7. Grading of Recommendations Assessment, Development and Evaluation Quality Rating
3.7.1. Study Limitations
3.7.2. Consistency
3.7.3. Directness
3.7.4. Precision
3.7.5. Publication Bias
4. Discussion
4.1. Effectiveness of Interventions in Preventing Harmful Weight Gain in Adolescents from Ethnic Minorities: Primary Outcomes
4.2. Effectiveness of Interventions in Preventing Harmful Weight Gain in Adolescents from Ethnic Minorities: Secondary Outcomes
4.3. Setting: School or Community?
4.4. Indigenous and First Nations
4.5. Study Strengths and Limitations
4.6. Review Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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First Author, Year, Country, Citation | Duration & Follow-Up | Study Characteristics | Participant Characteristics | Recruitment Methods | Funding | |||
---|---|---|---|---|---|---|---|---|
Study Design, Setting | Intervention Description/Comparator Description | n | Age | Ethnic/Racial Group | Sex | |||
(a) Study and Participant Characteristics of interventions in the systematic review of effectiveness of prevention interventions for adolescents from ethnic/racial minorities (n = 7). | ||||||||
Multicomponent Interventions | ||||||||
Singh et al. 2006 [59], 2007 [60], 2009 [61] Netherlands RCT School | 8 mo (12, 20 mo) | Diet & PA, Environmental, Intervention mapping, Education, behaviour-change. I: 11 sessions on energy-related behaviours and reducing SSB, SB, High fat snacks + increasing active transport and sports. Individually computer-tailored advice, diary, pedometers + supportive video material. C: regular curriculum. | 1053, I:632C:476 | M: C: 12.9 ± 0.5 SD), I: 12.8 ± 0.5 (SD), F: C: 12.7 ± 0.5 (SD), I: 12.6 ± 0.5 (SD) | Ethnicity was tested in the regression model to determine any intervention but no stratified results shown. | F, M (50%) | Universal | Netherlands Heart Foundation, Ministry of VWS, Royal Association of Teachers of Physical Education |
Black et al. 2010 [33] USA RCT Community | 12 wks (24 mo) | Diet & PA, Education, SCT & MI I: 12 sessions with mentees. D and PA goals setting, tracking and evaluation. Healthy food testing + PA activity. C: No intervention | 235, I:121, C:114 | 13.3 (11–16) | African American | I: F, M (48.8%), C: F, M (52.6%) | Targeted African American adolescents from low-income urban communities. | US Department of HHS, NCRR |
Chen et al. 2011 [36] USA RCT Community (Internet) | 8 wks (6 mo) | Diet & PA, Educational, TTM, SCT, Parental Involvement I: 8 sessions teaching participants + parents on emotions, goals and self-efficacy for a healthy lifestyle. Culturally appropriate. C: Received non-tailored general health info from website | 54 I: 27, C: 27 | 12.52 ± 3.15 (SD) | NR | I: F, M (41%), C: F, M (52%) | Universal | NCRR, Hellman research grant, NIH |
Ezendam et al. 2012 [28] Netherlands Cluster RCT School (Internet) | 10 wks (4, 24 mo) | Diet & PA, TPB, Precaution Adoption Process Model, Implementation Intentions, Education I: On healthy eating, reducing SB, increasing PA. Tailored feedback on behaviour + determinants to prompt goal setting and action planning. C: regular curriculum. | 883, I:485 C:398 | 12–13 | I: Western 66%, Non-Western 34%, C: Western 78.9%, Non-Western 21.1%, | I: F, M (58.6%) C: F, M (49.7%) | Universal | ZonMw (The Netherlands Organisation for Health Care Research and Development) |
Whittemore et al.2013 [68] USA Cluster RCT School (Internet) | 6 mo | Diet & PA, SLT, Theory of Interactive Technology I: HeT program +stress reduction, assertive communication, conflict resolution and social problem skills) C: HeT program on nutrition, portion control, PA and metabolism. Individualized feedback and goal setting, encouraged self-monitoring of food intake and PA and opportunity to interact with health coach. | 384 | 15.31 ± 0.69 (SD) | 65% non-white | F, M (38%) | Universal | Jonas Centers for Nursing Excellence, NINR, NIH, |
Single Component Dietary Interventions | ||||||||
Ebbeling et al. 2006 [29] USA RCT Community | 25 wks | Diet, Environmental, Parental Involvement I: Home deliveries of non-caloric drinks. Magnets with possible side effects of SSBs mailed monthly. No SSB permitted. Telephone calls to participant + parent to reinforce and motivate. C: Continue as normal. Weekly non-caloric beverage delivery after completion of FU as incentive. | 103, I:53, C:50 | 15.9 ± 1.1 (SD) | White: C: 56%, I: 55%, Black: C: 24%, I: 24%, Asian: C: 4%, I: 4%, Multiple or other: C:17%, I: 18%, Hispanic: C: 17%, I: 25%, Non-Hispanic: C: 83%, I:75% | F, M (45.6%) | NR | None |
Nollen et al. 2012 [50], 2014 [51], USA RCT Community (Internet) | 12 wks | D, Screen Time, Behaviour-based Both targeted F &V, SSB and Screen Time I: To set 2 daily goals + behaviour plan. Also prompted girls to self-monitor goal progression 5 times/day. Girls received 1 song/day if they responded to 80% of daily prompts C: Received manuals (snapshots of respective module) at wks 1, 5 and 9 only. | 51 | 11.3 ± 1.6 (SD) | Hispanic/Latina: total 7.8, Race: African American: 83.7 Bi- or Multi-racial: 8.2, American Indian/Alaska Native: 6.1, Asian/Pacific Islander: 2.0 | 100%F | Targeted: girls from racial and ethnic minorities from low income neighbourhoods | ORWH, NICHD, NIAID, NIMH, NHLBI |
(b) Study and Participant Characteristics of interventions in the systematic review of effectiveness of prevention interventions for adolescents from ethnic/racial minorities (n = 24). | ||||||||
Multicomponent Interventions | ||||||||
Briancon et al. 2010 [35], France Bonsergent et al. 2013 [34], France RCT School | 24 wks | Education, Environmental, Screening, Parental Involvement 2 × 2 × 2 design, 3 Intervention types Education: Nutrition and PA lectures, problem solving re PA, eating habits and the environment. End of year parties for reinforcement. Environment: Increased availability of water, F & V, dairy, bread and PA in schools. Posters/signs promote changes. Screening: Students assessed against anthropometrics and psychological variables, at-risk students referred to care management implemented by external nutrition network. C: No intervention | 3538 | 15.8 ± 0.02 (SE) | NR | Sex: F, M (47.1%) | NR | Grants from Private and Public Sectors |
Haerens et al. 2006 [40], Belgium Cluster-RCT School | 12 mo (24 mo) | Education, Environmental, TTM, TPB, Parental Involvement I: (Classroom lessons + individual computer tailored intervention for PA, fat and fruit + PA sessions and cheap/free fruit wkly. Schools received sports materials + free water cans.) I + P: Included Parental Involvement. Interactive meeting on PA, healthy food, obesity and health, newsletters, CD-ROM with computer intervention on fat intake and PA. C: NR | 13.06 ± 0.81 (SD) | NR | F, M (63.4%) | NR | Policy Research Centre Sport, Physical Activity, and Health funded by the Flemish Government | |
Hollis et al. 2016 [41], Australia Sutherland et al. 2013 [65],2016 [66] Australia Cluster-RCT Schools | 19–24 mo | PA, Education, Environmental, Socio-ecological theory, SCT Parental Involvement I: Enhanced school sports program, strategies to increase PA in PE classes + school breaks + school policy changes, and parental + community engagement. C: Requested to follow usual PE and sports programs. | 1150 | 11–13 | Aboriginal and Torres Strait Islander, C: 8.8%, I: 8.4% | F, M (49%) | Universal | NSW Ministry of Health |
Singhal et al. 2010 [62] India RCT School | 6 mo | Educational, Diet & PA, Environmental, Parental Involvement I: Lectures + activities to promote PA, diet, healthy lifestyle. Individual counselling, school policy changes, health camp with parents, parent counselling, training student volunteers C: No intervention | 201 | 15–17 | NR | F, M (60%) | Universal | World Diabetes Foundation |
Thakur et al. 2016 [23], India Cluster-RCT School | 20 wks | Educational, Diet & PA, Environmental, Parental Involvement I: Diet and PA, environment, and lifestyle disorders. Mandatory inclusion one period of PA/day in school, healthy school canteen. Parents made Diet recommendations + reducing screen time. C: Diet and PA info if desired | 462 | 13.5 ± 0.7 (SD) | NR | F, M (81%) | Universal | Indian Council of Medical Research |
Dunker et al. 2017 [38], Brazil Cluster-RCT School (Phone) | 9 wks (18 wks) | Education, PA, Diet, SCT, MI I: after-school PA and education. Individual counselling, didactic resources + lunch on days of activities C: No intervention | 270 | 13.4 ± 0.64 (SD) | NR | 100% F | Universal | Sao Paulo Research Foundation, CNPq |
Leme et al. 2015 [43], 2016 [26], 2018 [42] Brazil Cluster-RCT School (Phone) | 6 mo (6 mo) | Diet & PA, Education, SCT, PI I: Cultural adaptation of NEAT Girls study, PA and low-cost healthy eating. C: No intervention | 253 | 14–18 | 62.8%% White, 11.5% Afro descendent, 0.8% Asian, 24.1% Brown, 0.8% Native Indian | 100% F | Universal | FAPESP, federal funds from USDA ARS |
Lubans et al. 2010 [46],2012 [47] Australia Dewar et al. 2013 [37], Australia Cluster-RCT School (Phone) | 12 mo (2 yrs) | Diet & PA, Education, peer support, SCT, Parental Involvement I: Enhanced school sport & lunchtime PA, interactive educational seminars and nutrition workshops. Pedometers, handbooks for participants + parents and text prompt messages. Parents received termly newsletters. C: No intervention | 357 | 13.18 ± 0.45 (SD) | NR | 100% F | Universal | ARC Discovery Project Grant |
Melnyk et al. 2013 [25], USA Cluster-RCT School | 15 wks (6 mo) | Educational, PA, CT, Parental Involvement I: Health education course with COPE taught cognitive-behavioural skills and focused on PA and diet info + PA sessions, homework activities, parental newsletters. Pedometers to increase step count 10%/wk. C: Received Healthy Teens program. Safety + common health topics (e.g., road safety, skin care, dental care). | 807 | 14.74 ± 0.73 (SD) | 2.5% American Native, 4% Asian, 9.9% black, 14.1% White, 67.5% Hispanic, 1% other | F, M (48.4%) | Universal | NIH, NINR |
Neumark et al. 2010 [24] USA Cluster-RCT, School | 16 wks (9 mo) | Diet & PA, Education, SCT, TTM, Parental Involvement, MI I: New Moves curriculum during PE class. Nutrition education and social support/self-empowerment. Counselling sessions, lunch sessions and parent outreach activities. C: No intervention, told to conduct physical education classes as usual | 356 | 15.8 ± 1.17 (SD) | Over 75% of the girls were racial/ethnic minorities: Black/African America: 28.4% White: 24.4% Asian: 23% Hispanic: 14.3% Mixed/Other: 7.3% American Indian: 2.5% | 100% F | Targeted suburban areas for their diverse student bodies. | NIDDK, NIH |
Patrick et al. 2006 [52] RCT Community (Primary Health Care Settings) (Phone) | 12 mo (2 yrs) | Behaviour change, TTM, Parental Involvement I: Participants participated in PACE+. Computer nutrition assessment (fat intake, F & V intake) + PA behaviours + stage of change, then developed a tailored behaviour change Progress Plan for 1 nutrition and 1 PA behaviour. Printed guide + telephone counselling + mailed worksheets and tips C: Received SunSmart Protection program.Parents encouraged to support via praising, active support and role-modelling. | 819 | 12.7 ± 1.3 (SD) | Asian or Pacific Islander: 3.2, African American: 6.6, Native American: 0.7, Hispanic: 13.1, White: 58.4, Multi-ethnic or other:18.0 | F, M (47%) | NR | NIH, NCI Bethesda, Md. |
Peralta et al. 2009 [53] Australia RCT School | 16 wks (6 mo) | Educational, Diet & PA, SCT, Parental Involvement I: Received curriculum sessions on PA, SSB, ST, and increasing fruit consumption via increased self-efficacy. Practical components which promoted PA + parental newsletters. C: Regular PA sessions at same time. | 33 | 12.5 ± 0.4 | NR | M (100%) | Universal | Participating students, staff and broader intervention school community (partial) |
Rodearmel et al. 2007 [55] USA RCT Community (household) | 24 wks | Diet and PA, I: To increase daily PA by 2000 steps/day + reduce EI by 420 kJ/day with changing sugar for non-caloric sweeteners C: Families were asked to maintain, monitor, and report their usual lifestyle for the duration of the study. All SM family members were asked to wear pedometers | 298 | I: 11.11 ± 2.08 (SD) C:11.28 ± 2.29 (SD) | I: White: 52.59% Black: 13.79% Hispanic: 13.79% Other: 19.38% NR: 0.00% C: White: 50.98% Black: 18.63% Hispanic: 12.75% Other: 15.69% NR: 1.96% | C: F, M (46%) I: F, M (49%) | Universal | McNeal Nutritionals, LLC, NIH |
Single Component Dietary Interventions | ||||||||
Amaro et al. 2006 [32], Italy Cluster-RCT School | 24 wks | Diet, Educational, Behaviour-change, I: Kaledo (board game) sessions re Mediterranean diet, energy intake, expenditure and balance. C: No Intervention | 291 | 11–14 | White | F, M (63%) | Universal | Italian Association Amici di Raoul Follereau, Commune of Naples, Second University of Naples |
Mihas et al. 2009 [49], Greece Cluster-RCT School | 12 wks; (15 days + 12 mo) | Diet, Social Learning Theory Model, Parental Involvement I: Workbook covering dietary issues + dental healthy hygiene + consumption attitudes. Classroom modules included health and nutrition education. Included 2 educational parent meetings. C: No health education intervention + no parental education. Medical screening results sent to parents | 218 | 13.3 ± 0.9 (SD) | NR | C: F, M (49.5%) I: F, M (49%) | Universal | Ministry of Education, National Foundation for the Youth |
Rabiei et al. 2017 [54], Iran RCT Schools | 2 mo, 3 mo | Educational, Diet, HBM, Parental Involvement I: Lectures, Q and A, educational booklets and pamphlets. Lectures targeted perceived susceptibility, severity and self-efficacy. C: NR | 140 | NR | NR | 100% F | Universal | Research Department of Isfahan University of Medical Sciences |
Viggiano et al. 2015 [15], Italy Cluster-RCT School | 20 wks (6 + 8 mo) | Education, Diet, Behaviour-based I: Play sessions involving Kaledo (as per Amaro et al. 2006). C: No play sessions with Kaledo | 3110 | 9–19 | NR | F, M (55%) | Universal | Second University of Naples, Sport, Kaledo Cultural Association, Campania Region (Department of Education), Naples, Salerno, Cercola, Department of Sport, Foundation for Child Care |
Single Component Environmental Interventions | ||||||||
French et al. 2011 [27], USA Cluster-RCT Community (household) (Phone) | 1 yr | Environmental, Behaviour-based I: Group sessions, (time-limiting devices on TVs + home scale + guidelines for food availability), GS, positive reinforcement, self-monitoring), home activities + telephone support calls C: No intervention | 90 | 12–17 | 79% White | NR | Universal | NIH/NCI |
Single Component Physical Activity Interventions | ||||||||
Lindgren et al. 2011 [44], Sweden Cluster RCT School | 6 mo | PA, self-efficacy, Health Promotion I: Participants invited to master different exercise and sports activities in safe, non-judgmental environment with other non-active girls of similar age + discussion time (e.g., healthy lifestyles) C: No intervention | 110 | C: 15.5 ± 1.1 (SD), I: 15.3 ± 1.9 (SD) | NR | 100% F | Universal | Halland Regional Development Council, The Primary Health Care Research and Development Unit, Halland County Council, Falkenberg, Sweden. |
Lubans et al. 2011 [45], 2016 [48] Australia Cluster-RCT School | 3 mo (6 mo) | Educational, PA, SCT I: Involved school sport and lunchtime PA sessions, interactive seminars, PA leadership + nutrition handbooks and pedometers for self-monitoring. C: No intervention | 100 | 14.3 ± 0.6 (SD) | NR | 100% M | Universal | HMRI, Rotary Club of Newcastle Enterprise |
Simons et al. 2014 [58], 2015 [57] (Netherlands) RCT Community (Household) (Internet) | 10 mo | PA, Parental Involvement I: Received a PlayStation Move + 5 active video games. Encouraged to substitute non-active with active gaming for at least 1 hr/week C: No intervention | 270 | 13.9 ± 1.3 (SD) | White—83% | F, M (91%) | Universal | ZonMw—The Netherlands Organization for Health Research and Development |
Smith et al. 2014 [63,64] Australia Cluster-RCT School (Phone) | 20 wks (8 + 18 mo) | Educational, PA, SDT, SCT, Parental Involvement I: Educational seminar, enhanced school sport +, lunch-time PA mentoring sessions. Pedometer + smartphone app for self-monitoring. School exercise equipment pack + 4 Parental newsletters C: Usual practice, provided with condensed program after 18-mo assessments. | 361 | 12.7 ± 0.5 (SD) | Australian 73.7%, European 17.3%, African 3.4%, Asian 1.7%, Middle Eastern 1.1% and other 2.8%. | 100% M | Universal | ARC, NHMRC NHFA Career Development Fellowship |
Weeks et al. [22] 2012 Australia RCT School | 8 mo | PA I: 10 min of supervised jumping activities at beginning of each PE class C: Regular PE warm-ups and stretching directed by usual PE teacher | 99 | 13.8 ± 0.4 (SD) | NR | F, M (46%) | Universal | No external funding sources |
First Author, Year, Citation, Country | Outcomes of Intervention | Intervention Subgroup Analysis by Racial/Ethnic Minority Status | Attrition (%) | Attrition Subgroup Analysis by Racial/Ethnic Minority Status | ||
Primary | Secondary | Primary | Secondary | |||
(a) Study outcomes of interventions in the systematic review of effectiveness of prevention interventions for adolescents from ethnic/racial minorities (n = 7) | ||||||
Multicomponent Interventions | ||||||
Singh et al. 2006 [59], 2007 [60], 2009 [61] Netherlands | F BMI ∆: −0.1 (−0.2 to 0.1) M BMI ∆: −0.0 (−0.1 to 0.2) Significant F BSF: −0.3 (−0.7 to 0.3) M BSF: −0.1 (−0.4 to 0.2) | Significant SSB F: −249 (−400 to −98), M: −287 (−527 to −47) Significant SB ∆: M at FU: −25 (−50.0 to −0.3) NS SB ∆: −22 (−55 to 2) | No effect | No effect | 21 | NR |
Black et al. 2010 [33] USA | BMI z-score: −0.03 (0.06) SE (p = 0.574) Prevalence: −0.25 (0.09) (p = 0.006) | S & D: β = −2.21 (0.66) SE, (p = 0.001) β = −0.69 (0.31) SE (p = 0.026) at FU. Fibre: β = −4.37 (2.07) SE, (p = 0.036) F: β = 0.41 (0.18) SE(p = 0.021) PA: β = 10.76 (7.53) SE (p = 0.155) V: β = −0.18 (0.31) SE (p = 0.559) Milk: β = 0.13 (0.22) SE (p = 0.556) Non-diet soda: β = −0.04 (0.13) SE (p = 0.745) Fried foods: β = −0.08 (0.09) SE (p = 0.375) Calcium: β = 10.76 (7.53) SE (p = 0.155) Saturated Fat: β = −5.54 (3.37) SE (p = 0.102) Total Fat: β = 17.01 (9.28) SE (p = 0.069) Total energy: β = −459.73 (235.37) SE (p = 0.053) | NA (100% African American) | NA (100% African American) | 23.8 | NA (100% African American) |
Chen et al. 2011 [36], USA | BMI: 0.01 (−0.3, 0.04), (p = 0.84) WHR: −0.01 (−0.01, −0.001), (p = 0.02) | F &V: 0.14 (0.06, 0.22) (p = 0.001) PA: 12.46 (6.62, 18.41) (p = 0.001) | NA (100% Chinese American) | NA (100% Chinese American) | 8.4 | NA (100% Chinese American) |
Ezendam et al. 2012 [39] Netherlands | BMI: β = 0.14 (−0.17 to 0.45), WC: β = 0.60 (−0.44 to 1.64) | SSB (OR, 95% CI): 0.54 (0.34, 0.88) Snacks: β = −0.81 (−1.33, −0.29) V: β = 19.3 g/d (7.54, 31.21) At-risk students: F: β = 0.39 g/d (0.13, 0.66) Step Count: β = 14 228 steps/wk (678, 27,838) FU Whole Wheat Bread: OR 1.08 (0.67, 1.75) SB: β = −5.4 (−25.2, 14.5) | No effect | No effect | 14 | NR |
Whittemore et al. 2013 [68] USA | BMI: I: 24.5 (5.4), 24.6 (5.4) C: 25.0 (5.7), 25.1 (5.6) (p = 0.87) | SB ∆: I: 5.6 (2.2), 5.3 (2.3), C: 5.4 (2.2), 5.2 (2.3) (p < 0.01) F&V: I: 4.9 (2.0), 5.1 (1.9), C: 5.0 (2.3), 4.9 (2.1) (p < 0.01) Total EB: I:56.8 (11.9), 56.4 (11.9), C: 56.6 (11.1), 57.2 (10.6) (p < 0.01) JF: I: 2.5 (2.2), 2.7 (2.4), C: 2.4 (2.0), 2.5 (1.9) (p < 0.01) VE: I: 4.1 (2.2), 4.1 (2.1), C: 3.7 (2.2), 4.1 (2.2) (p < 0.01) BF: I: 4.1 (2.6), 3.7 (2.7), C: 4.2 (2.4), 3.9 (2.5) (p = 0.9211) FF: I: 0.83 (1.09), 0.80 (1.03), C: 0.72 (0.91), 0.85 (1.00) (p = 0.0892) | No effect | No effect | 4.9 | NR |
Single Component Dietary Interventions | ||||||
Ebbeling et al. 2006 [29] USA | BMI: (−0.14 ± 0.21 kg/m2). If baseline BMI ≥ 25.6 kg/m: −0.75 ± 0.34 kg/m2, (p = 0.03) | SSB ∆: I: −1201± 836, C: −185 ± 945 (p < 0.001) Non caloric beverage ∆: I: 396 ± 493, C: 78 ± 523 (p = 0.002) PA∆: I: −0.12 ± 0.37, C: −0.03 ± 0.32 (p = 0.18) Television viewing∆: I: 0.05 ± 1.56, C: −0.19 ± 1.85 (p = 0.47) Total media time∆: I: −0.50 ± 2.56, C: −0.31 ± 3.33 (p = 0.75) | No effect | No effect | 0 | NR |
Nollen et al. 2012 [50], 2014 [53] USA | ES = 0.03, (p = 0.91) | F&V: 0.44, (p = 0.13) SSB: −0.34 (p = 0.25) Screen time: 0.09 (p = 0.76) | No effect | No effect | 13.7 | NR |
First Author, Year, Citation, Country | Outcomes of Intervention | Attrition (%) | Attrition Subgroup Analysis by Racial/Ethnic Minority Status | |||
Primary | Secondary | |||||
(b) Study outcomes of interventions in the systematic review of effectiveness of prevention interventions for adolescents from ethnic/racial minorities (n = 24) | ||||||
Multicomponent Interventions | ||||||
Briancon et al. 2010 [35] France Bonsergent et al. 2013 [34] France | Education BMI ∆: 0.71 ± 1.49 (p < 0.0001) BMI z-Score ∆: −0.07 ± 0.44 (p < 0.0001) No Education BMI ∆: 0.66 ± 1.45 (p < 0.0001) BMI z-Score: −0.07 ± 0.43 (p < 0.0001) Education vs. No Education: BMI ∆: 0.05 (−0.05, 0.15) (p = 0.2858) BMI z-score ∆: 0.004 (−0.026, 0.034) (p = 0.8118) Environment: BMI ∆: 0.71 ± 1.47 (p < 0.0001) BMI Z-score ∆: −0.06 ± 0.44 (p < 0.0001) Non Environment BMI ∆: 0.67 ± 1.47 (p < 0.0001) BMI Z-score ∆: −0.07 ± 0.43 (p < 0.0001) Environment vs. non environment: BMI ∆: 0.03 (−0.07, 0.13) (p = 0.5028) BMI z-score ∆: 0.005 (−0.025, 0.035) (p = 0.7460) Screening BMI ∆: 0.64 ± 1.44 (p < 0.0001), BMI z-score ∆: −0.09 ± 0.44 (p < 0.0001) No Screening BMI ∆: 0.72 ± 1.49 (p < 0.001) No screening BMI z-score ∆: −0.05 ± 0.43 (p < 0.0001) Screening vs. No screening: BMI ∆: −0.11 (−0.21, −0.01) (p = 0.303) BMI Z-score ∆: −0.036 (0.066, −0.007) (p = 0.0173) | N/A | 55.5 | NR | ||
Haerens et al. 2006 [40] Belgium | M BMI: I + P: 19.24 ± 3.62, 19.79 ± 3.64, 20.52 ± 3.68 I: 19.32 ± 3.35, 19.98 ± 3.35, 20.86 ± 3.51 C: 18.58 ± 2.91, 18.99 ± 2.82, 19.67 ± 2.89 M BMI z-score: I + P: 0.07 ± 1.09, 0.17 ± 1.03, 0.16 ± 1.04 I: 0.10 ± 1.02, 0.22 ± 0.97, 0.25 ± 0.98 C: −0.07 ± 0.98, −0.02 ± 0.092, −0.04 ± 0.94 P = NS (NR) F BMI: I + P: 20.26 ± 3.95, 20.75 ±3.90, 21.34 ± 3.83 P = Significant (NR) I: 20.23 ± 3.60, 20.94 ± 3.54, 21.66 ± 3.68 C: 19.23 ± 3.52, 19.94 ± 3.65, 20.78 ± 3.66 P = NS (NR) F BMI z-score: I + P: 0.07 ± 1.09, 0.28 ± 1.08, 0.23 ± 1.12 P = Significant (NR) I: 0.09 ± 1.06, 0.39 ± 0.90, 0.27 ± 0.96 C: 0.07 ± 0.98, 0.11 ± 1.03, −0.01 ± 1.06 P = NS (NR) | n/A | NR | NR | ||
Hollis et al. 2016 [41], Australia Sutherland et al. 2013 [65], 2016 [66] Australia | BMI ∆: −0.28 kg/m2 (−0.50; −0.06), (p = 0.01) −0.28 kg/m2 (−0.49; −0.06), (p = 0.01) FU BMI z-score ∆: −0.05 (−0.11; 0.01), (p = 0.13) −0.08 (−0.14; −0.02), (p = 0.02) FU Normal/Underweight: BMI ∆: −0.33 kg/m2 (−0.55; −0.10), (p = 0.01), BMI z-score ∆: −0.08 kg/m2 (−0.15; −0.01), (p = 0.01) FU Overweight BMI ∆: −0.39 kg/m2 (−1.01; 0.22), (p = 0.21) −0.18 kg/m2 (−0.80; 0.44), (p = 0.45) BMI z-score ∆: −0.07 (−0.21; 0.07), (p = 0.31) −0.00 (−0.14; 0.14), (p = 0.54). | n/A | 8.6 (14.3) | NR | ||
Singhal et al. 2010 [62] India | BMI ∆:95% CI (−0.18 to 0.34), (p = NR), WC ∆: −2.43 to −0.17 (p = 0.02) | Milk ∆: I: 32.8% (p < 0.001), C: 7.8 %, (p = 0.152 Whole pulses: I: 6.6 (p = 0.392), C:0.7 (p = 1) Sprouts (>2 times/wk), I: 3.7 % (0.648), C: 2.5% (p = 0.644), Nuts: I: 9.4 % (p = 0.286), C: 14.9 % (p = 0.111), Green leafy veggies: I: 7.5% (p = 0.349), C: 5.7% (p = 0.636), Fresh fruits: I: 9.9%, (p = 0.856), C: 6.5% (p = 0.268), White bread: I: 11%, (p = 0.004), C: 3.4% (p = 0.608) Biscuits: I: 7.9% (p = 0.430), C: 0.7% (p = 0.749), Aerated drinks: I: 15.1% (p = 0.001), C: 7.7% (p = 0.265), Aerated drink: I: 0.2%, (p = 1), C: 9.8% (p = 0.087), Western junk: I: 8.9%, (p = 0.031), C: 0.7% (p = 1) Chips: 7.8% (p = 0.152), C: 0.5% (p = 1), Indian junk: I:6% (p = 0.265), C: 0.8% (p = 1), PA: 2.4%, (p = 0.169), C: 5.9% (p = 0.377), PA (time): 9.8%, (p = 0.164), C: 3% (p = 0.755), Bring tiffin home, I: 14.9%, (p = 0.004), C:1.8%, (p = 0.263), Fruit in tiffin: I: 30.7% (p < 0.001), C: 3.9% (p = 0.585), Fruit in tiffin (>3 times/wk): 14.5%, (p = 0.001), C: 1% inc (p = 1) Household chores I: 8%, (p = 0.215), C: 2% (p = 0.839), Eating Out: I:1.7% (p = 0.143), C: 10.8% (p = 0.027). Eating out (canteen): I: 13.1%, (p = 0.001), C: No change, (p = 1), Watching TV: I: 4.9%, (p = 0.302), C: 3%, p = 0.629), Board game (sed activity): I:4%, (p = 0.503), C: 3%, (p = 0.607), Tuition classes (sed activity): I: 5% (p = 0.267), C: No change (p = 1) | 3.8 | NR | ||
Thakur et al. 2016 [23] India | BMI ∆: −0.09 (−0.19 to 0.01) (p = 0.09) | Energy change: −0.18 (−0.34 to−0.02) (p = 0.02), Protein: −0.25 (−0.40 to −0.10) (p = 0.001), Fat: −0.30 (−0.47 to −0.13) (p = 0.01), Dietary fibre: −0.22 (−0.42 to 0.02) (p = 0.03) School related MET: −0.56 (−0.75 to −0.37) (p < 0.001), Transport related MET: 0.30 (0.12 to 0.48) (p = 0.001), Total METs score: 0.06 (−0.12 to 0.25) (p = 0.50) | 19.3 | NR | ||
Dunker et al. 2017 [38] Brazil | BMI: I: 21.6 (95% CI 20.75, 22.45), C: 22.28 (95% CI 21.47, 23.1) | n/A | 15.2 | NR | ||
Leme et al. 2015 [43], 2016 [26], 2018 [42] Brazil | BMI ∆:−0.26 kg/m2 (p = 0.08) BMI z-score ∆: −0.07 (p = 0.14) WC ∆: −2.28 cm (p = 0.01) Prevalence of Overweight: I (20.4% vs. 19%), C: (16.2% to 18%) | F: 0.26 (0.13) (p = 0.010), V: 1.16 (0.60) (p = 0.009) Sweets: −0.62 (0.39) (p = 0.109) Oils: −0.48 (0.39) (p = 0.229) Sedentary (wknd): −0.92 (0.35) (p = 0.005) Computer time (wknd): −0.63 (0.24) (p = 0.015) | 24.9 | NR | ||
Lubans et al. 2010 [46], 2012 [47] Australia Dewar et al. 2013 [37] Australia | BMI ∆: −0.19 (−0.70 to 0.33), 0.33 (−0.97 to 0.28) (p = 0.353) FU BMI z score ∆: −0.08 (−0.20 to 0.04), −0.12 (−0.27, 0.04), (p = 0.178) FU Body Fat ∆: −1.96, (−3.02, 0.89) (p = 0.006) | NS | 17.6 (33.6) | NR | ||
Melnyk et al. 2013 [25] USA | BMI ∆: −0.20 (−0.35, −0.05) (p = 0.01), −0.34 (−0.56, −0.11) (p = 0.00) Proportion overweight: 0.45 (0.42, 50) (p = 0.03) | Steps/day ∆: 4061.83 (1437, 6686.66) (p = 0) | 13.6 (22.3) | NR | ||
Neumark et al. 2010 [24] USA | BMI: −0.08 (p = 0.512), −0.10 (p = 0.446) FU | PA: 0.08 (p = 0.894), 1.20, (p = 0.068) F&V: 0.24 (p = 0.365), SSB: −0.05 (p = 0.751) Sedentary activity: −0.12, (p = 0.834), −1.26 (p = 0.050), TV: 0.51 (p = 0.158), −0.05 (p = 0.883) | 3.1 (5.6) | NR | ||
Patrick et al. 2006 [52] | F: (p = 0.069), M: (p = 0.53) | Sedentary behaviours: F I: 4.3 to 3.4 h/d C:4.2 to 4.4 h/d (p = 0.001), M I: 4.2 to 3.2 h/d C:4.2 to 4.3 h/d (p = 0.001) M Active Time I: 4.1 to 4.4 d/wk C: 3.8 to 3.8 d/w (p = 0.01), F Fat intake: RR 1.33 (1.01–1.68) M PA: RR 1.47 (1.19–1.75) | 7.3 (19.3) | No effect | ||
Peralta et al. 2009 [53] Australia | BMI ∆: −0.2 (−0.8, 0.4) ES = 0.05 (p = 0.50) WC ∆: −1.7 (−4.7, 1.4), ES = 0.15 (p = 0.27) | SSB: −0.5 (−2.5, 1.6), ES = 0.12 (p = 0.65) Fresh fruit: 3.0 (−1.5, 7.6), ES = 0.33 (p = 0.18) Moderate PA: 3.8 (−34.8, 42.2), ES = 0.08 (p = 0.84) SSR wknd: −0.7 (−5.8, 4.4), ES = 0.08 (p = 0.78) SSR wkday: −1.1 (−5.1, 2.8), ES = 0.19 (p = 0.56) | 3 | NR | ||
Rodearmel et al. 2007 [55] USA | BMI z score ∆: −0.027 (−0.075 to 0.022) (p = 0.282) WC ∆: 0.463 (& 1.704 to 0.778) (p = 0.462) BMI z score I: 67% C: 53% (p < 0.05) I: 47% C: 33% (p < 0.05) | Steps/day: (p < 0.05) | 15.6 | NR | ||
Single Component Dietary Interventions | ||||||
Amaro et al. 2006 [32] Italy | I: 0.345 (0.299–0.390) C: 0.405 (0.345–0.465) (p = NR) | V: 21.2 (p = 0.01), I: 3.7 (3.5–4.1), C: 2.8 (2.4–3.3) PA: I: 2.1 95% C.I (1.9–2.3), C: 2.2 (2.0–2.4) | 17.2 | NR | ||
Mihas et al. 2009 [49] Greece | BMI: I: 23.3 (2.8) C:24.0 (3.1) (p < 0.001) | Energy: I:8112.4 (1412.4), C:8503.3 (1419.3) (p < 0.001) Fat: I: 31.3 (4.4), C:35.4 (4.7) (p < 0.001) Saturated Fat: I: 8.2 (1.7) (p < 0.001), 12.4 (2.4) (p < 0.001) F intake: I: 5.9 (4.3) p = 0.036 | (4.6, 12.4) | NR | ||
Rabiei et al. 2017 [54] Iran | BMI I: 26.82 (1.42), C: 27.19 (1.55) (p = 0.17), I: 26.7 (1.38), 27.13 (1.56) (p = 0.09) FU | n/A | NR | NR | ||
Viggiano et al. 2015 [67] Italy | Significant in Middle School at 6 mo (p = 0.007). Significant in high schools at 6 mo (p < 0.001) and at 18 mo (p = 0.015). | (30.7, 66.4) | NR | |||
Single Component Environmental Interventions | ||||||
French et al. 2011 [27] USA | BMI z score ∆: 0.0638 (0.10) (p = 0.53) | Significant F&V: 0.4658 (0.23) (p = 0.05) TV time: −14.45 (11.79) (p = 0.23) Fast food: 0.3847 (0.35) (p = 0.27) SSB: −0.0071 (0.16) p = 0.96 Snack/sweet: 0.1879 (0.26) p = 0.48 | 3.3 | NR | ||
Single Component Physical Activity Interventions | ||||||
Lindgren et al. 2011 [44] Sweden | NS, ES NR I: 21.9 (14.3–37.2), C: 23.2 (16.1–32) (p = 0.696). | PF I: 38.0 (19–86), C: 42 (22–69) (p = 0.675). | 43.6 | NR | ||
Lubans et al. 2011 [45], 2016 [48] Australia | BMI ∆: 0.07 (−34, 38) (p = 0.656) BMI z-score ∆: 0.04 (0.07, 0.14) (p = 0.485), WC ∆: 0.3(−0.71, 1.4) (p = 0.549) | Screen Time: −32.2 (−53.6, −10.8) (p = 0.003) SSB = 0.2 (−0.04, 0.7) (p = 0.561) MVPA %: 0.1 (−0.8, 1.0) (p = 0.805) | 10 (18) | NR | ||
Simons et al. 2014 [58], 2015 [57] Netherlands | BMI-SDS: β = 0.074, 95%CI: 0.008,0.14 Sum of skinfolds: β = 3.22, 95%CI: 0.27,6.17 | Non-active video game time: β = −1.76, 95%CI: −3.20,−0.32 Total Sed ST: β = 0.81,95%CI:0.74,0.88 SSB, OR = 0.65 (0.41;1.03), Snacks OR = −1.12 (−2.75,0.50) | 10 (4.8) | No effect | ||
Smith et al. 2014 [63,64] Australia | BMI ∆: 0.06 ± 0.12 (p = 0.84) WC ∆: 0.5 ± 0.45 (p = 0.16) | Screen Time: −30 ± 10.08, (p = 0.03) SSB: −0.6 ± 0.26, (p = 0.01) | (18.8, 26.3) | NR | ||
Weeks et al. 2012 [22] Australia | BMI: I: 20 (3.5), 20.5 (3.3) C: 20 (3.5), 20.4 (3.7) p = 0.895 Weight: I: 53.4 (12.4), 56.6 (12) (p = 0.09), C: 53.2 (11.9), 56.5 (13.1) (p = 0.951) Lean mass: I: 34,699 (7110), 36,993 (7591), C: 31,993 (4221), 32,974 (5148) (p = 0.002) | 18.2 | NR |
Category | Rating with Reasoning |
---|---|
Limitations | −2 quality due to limitations |
Consistency | No subtraction |
Directness | −1 quality level due to population |
Precision | −1 due to lack of precision |
Publication | −1 quality levels, as publication bias cannot be ruled out |
Overall Quality | Low: effect confidence is limited |
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Hayba, N.; Elkheir, S.; Hu, J.; Allman-Farinelli, M. Effectiveness of Lifestyle Interventions for Prevention of Harmful Weight Gain among Adolescents from Ethnic Minorities: A Systematic Review. Int. J. Environ. Res. Public Health 2020, 17, 6059. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176059
Hayba N, Elkheir S, Hu J, Allman-Farinelli M. Effectiveness of Lifestyle Interventions for Prevention of Harmful Weight Gain among Adolescents from Ethnic Minorities: A Systematic Review. International Journal of Environmental Research and Public Health. 2020; 17(17):6059. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176059
Chicago/Turabian StyleHayba, Nematullah, Samiha Elkheir, Jessica Hu, and Margaret Allman-Farinelli. 2020. "Effectiveness of Lifestyle Interventions for Prevention of Harmful Weight Gain among Adolescents from Ethnic Minorities: A Systematic Review" International Journal of Environmental Research and Public Health 17, no. 17: 6059. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176059