Prevention and Interventional Strategies of Adolescent Obesity / Overweight - Systematic Review and Meta-analysis of 10 Years Research

The purpose of this review was to reach a consensus on the evidence of the literature investigating multiple school-based interventions (physical activity, diet, and sedentary behavior) to prevent or reduce high body mass index z-score and waist circumference among adolescents. A systematic search of five electronic databases: Pubmed, MEDLINE, Science Direct Index, HINARI, and Google Scholar were conducted to identify published studies between January 2010 and December 2020. Only studies that used randomized controlled trials to assess the effects of physical activity and/or physical education, nutritional education and/or dietary behavior, and sedentary behavior on adolescents’ body mass index z-score and waist circumference were included. The risk of bias in credible studies was evaluated using the Standard Cochrane tool. A random effects model was used to assess the impact of the interventions included on the waist circumference and body mass index z-score. Of the 2,090 citations reviewed, n = 1,954 (789 interventions, 1,165 controls) from five studies were included. Overall, a minimally significant reduction was found in BMI z-score MD -0.05 [95% CI: -0.20, 0.11, p-value < 0.0001, I2 = 87%] and waist circumference MD -0.97 [95% CI: -1.53, -0.42, p-value = 0.26, I2 = 25%] between 3 to 12 months than 12 to 24 months. Multiple school-based interventions for adolescents that last between three and twelve months are more successful. Further study should focus on the effect of coupled components on the efficacy of multicomponent therapies integrated with theoretical/conceptual aspects.