The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review.
Maya Kshatriya, Kuan-Wen Wang, Julia Hildebrand, Rebecca Crawford, Ajantha Nadarajah, Michael Youssef, Angelica Rivas, Ashleen Kaushal, Laura E Banfield, Lehana Thabane, M Constantine Samaan
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Abstract
Background: Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada.
Methods: Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence.
Results: Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs.
Conclusion: Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada.
期刊介绍：
Adolescent Health, Medicine and Therapeutics is an international, peer reviewed, open access journal focusing on health, pathology, and treatment issues specific to the adolescent age group, including health issues affecting young people with cancer. Original research, reports, editorials, reviews, commentaries and adolescent-focused clinical trial design are welcomed. All aspects of health maintenance, preventative measures, disease treatment interventions, studies investigating the poor outcomes for some treatments in this group of patients, and the challenges when transitioning from adolescent to adult care are addressed within the journal. Practitioners from all disciplines are invited to submit their work as well as health care researchers and patient support groups. Areas covered include: Physical and mental development in the adolescent period, Behavioral issues, Pathologies and treatment interventions specific to this age group, Prevalence and incidence studies, Diet and nutrition, Specific drug handling, efficacy, and safety issues, Drug development programs, Outcome studies, patient satisfaction, compliance, and adherence, Patient and health education programs and studies.
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