Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context
Summary: Background: Public health attempts to prevent obesity in children and young people should aim to minimize health inequalities. Two Cochrane reviews examining interventions aiming to prevent childhood obesity found that interventions promoting (only) physical activity have a small beneficia...
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2025-03-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537025000628 |
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| author | Jennifer C. Palmer Annabel L. Davies Francesca Spiga Berit L. Heitmann Russell Jago Carolyn D. Summerbell Julian P.T. Higgins Arne Astrup Valter Cordeiro Barbosa Filho Mark E. Benden Lynne Boddy Laura M. Bogart Blakely Brown Angela Carlin Diana P. Pozuelo Carrascosa Li Kheng Chai Clare Drummy Scott Duncan Cara Ebbeling Eva Martos Stuart Fairclough Jayne Fulkerson Douglas A. Gentile Mary B. Gruber May Grydeland Amy S. Ha Carla Habib Mourad Kate Gilstad-Hayden Douglas L. Hill Gill ten Hoor Kiya Hurley Alison Hurst Nahla Hwalla Jeannette R. Ickovics Kate Jolly Juliana Kain Susanne Kobel Viktoria Anna Kovacs Susi Kriemler Sarahmarie Kuroko Alberto Lana Teresa Shamah Levy Mairena Sánchez-López David Lubans Brian Lynch Kristine A. Madsen Claude Marcus Méndez-Gómez Humarán Carmen Morales-Ruan Philip Morgan Ivan Müller Robert Newton Analise Nicholl Teresia O'Connor Russell R. Pate Sebastián Peña Lorraine B. Robbins Jardena J. Puder Thomas Robinson Rafaela Rosário Richard Rosenkranz Jennifer Sacheck Jo Salmon Rebecca A. Seguin-Fowler Nancy E. Sherwood Hajnalka Takacs Rachael Taylor Haixue Wang Haijun Wang Robin Whittemore Simon Wilksch Zenong Yin Zhixiong Zhou Katie Breheny Deborah M. Caldwell Sarah Dawson Yang Gao Frances Hillier-Brown Rebecca K. Hodder Sofus C. Larsen Theresa HM. Moore James D. Nobles Sophie M. Phillips Jelena Savović Fanney Thorsteinsdottir Eve Tomlinson Luke Wolfenden |
| author_facet | Jennifer C. Palmer Annabel L. Davies Francesca Spiga Berit L. Heitmann Russell Jago Carolyn D. Summerbell Julian P.T. Higgins Arne Astrup Valter Cordeiro Barbosa Filho Mark E. Benden Lynne Boddy Laura M. Bogart Blakely Brown Angela Carlin Diana P. Pozuelo Carrascosa Li Kheng Chai Clare Drummy Scott Duncan Cara Ebbeling Eva Martos Stuart Fairclough Jayne Fulkerson Douglas A. Gentile Mary B. Gruber May Grydeland Amy S. Ha Carla Habib Mourad Kate Gilstad-Hayden Douglas L. Hill Gill ten Hoor Kiya Hurley Alison Hurst Nahla Hwalla Jeannette R. Ickovics Kate Jolly Juliana Kain Susanne Kobel Viktoria Anna Kovacs Susi Kriemler Sarahmarie Kuroko Alberto Lana Teresa Shamah Levy Mairena Sánchez-López David Lubans Brian Lynch Kristine A. Madsen Claude Marcus Méndez-Gómez Humarán Carmen Morales-Ruan Philip Morgan Ivan Müller Robert Newton Analise Nicholl Teresia O'Connor Russell R. Pate Sebastián Peña Lorraine B. Robbins Jardena J. Puder Thomas Robinson Rafaela Rosário Richard Rosenkranz Jennifer Sacheck Jo Salmon Rebecca A. Seguin-Fowler Nancy E. Sherwood Hajnalka Takacs Rachael Taylor Haixue Wang Haijun Wang Robin Whittemore Simon Wilksch Zenong Yin Zhixiong Zhou Katie Breheny Deborah M. Caldwell Sarah Dawson Yang Gao Frances Hillier-Brown Rebecca K. Hodder Sofus C. Larsen Theresa HM. Moore James D. Nobles Sophie M. Phillips Jelena Savović Fanney Thorsteinsdottir Eve Tomlinson Luke Wolfenden |
| author_sort | Jennifer C. Palmer |
| collection | DOAJ |
| description | Summary: Background: Public health attempts to prevent obesity in children and young people should aim to minimize health inequalities. Two Cochrane reviews examining interventions aiming to prevent childhood obesity found that interventions promoting (only) physical activity have a small beneficial effect on BMI for people aged 5–18 years, as do interventions promoting physical activity alongside healthy eating for 5–11 year olds. We examined whether the effectiveness of the interventions included in these reviews differed according to eight factors associated with inequity: place, race/ethnicity, occupation, gender/sex, religion, education, socio-economic status, and social capital (the PROGRESS framework). Methods: We collected data on change in BMI (standardized or unstandardized), subgrouped by baseline measures of PROGRESS factors, for intervention and control groups, from trial authors. We calculated the intervention effect per subgroup (mean difference), then contrasted these to estimate interactions between intervention and the baseline factors. We combined interaction estimates for each factor across trials using meta-analyses. Findings: We collected subgrouped data from 81 trials that took place between 2001 and 2020, involving 84,713 participants. We found no substantial differences in effectiveness of interventions for PROGRESS subgroups in most scenarios. However, in the younger age group (5–11 years), the effect of interventions on standardized BMI appeared to be higher in boys (average difference in mean differences 0.03; 95% CI 0.01 to 0.06; 45 studies, n = 44,740), which was consistent in direction with the BMI effect (average difference in mean differences 0.06 kg/m2; 95% CI −0.02 to 0.13; 31 studies, n = 27,083). Interpretation: Our findings suggest that those responsible for public health can promote these beneficial interventions without major concerns about increasing inequalities but should be mindful that these interventions may work better in boys aged 5–11 years than girls. More data are needed, so we encourage future trialists to perform subgroup analyses on PROGRESS factors. Funding: National Institute for Health and Care Research (NIHR). |
| format | Article |
| id | doaj-art-709f0688a0ee4c97ae4e45600e8e7084 |
| institution | DOAJ |
| issn | 2589-5370 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj-art-709f0688a0ee4c97ae4e45600e8e70842025-08-20T03:15:28ZengElsevierEClinicalMedicine2589-53702025-03-018110313010.1016/j.eclinm.2025.103130Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in contextJennifer C. Palmer0Annabel L. Davies1Francesca Spiga2Berit L. Heitmann3Russell Jago4Carolyn D. Summerbell5Julian P.T. Higgins6Arne AstrupValter Cordeiro Barbosa FilhoMark E. BendenLynne BoddyLaura M. BogartBlakely BrownAngela CarlinDiana P. Pozuelo CarrascosaLi Kheng ChaiClare DrummyScott DuncanCara EbbelingEva MartosStuart FaircloughJayne FulkersonDouglas A. GentileMary B. GruberMay GrydelandAmy S. HaCarla Habib MouradKate Gilstad-HaydenDouglas L. HillGill ten HoorKiya HurleyAlison HurstNahla HwallaJeannette R. IckovicsKate JollyJuliana KainSusanne KobelViktoria Anna KovacsSusi KriemlerSarahmarie KurokoAlberto LanaTeresa Shamah LevyMairena Sánchez-LópezDavid LubansBrian LynchKristine A. MadsenClaude MarcusMéndez-Gómez HumaránCarmen Morales-RuanPhilip MorganIvan MüllerRobert NewtonAnalise NichollTeresia O'ConnorRussell R. PateSebastián PeñaLorraine B. RobbinsJardena J. PuderThomas RobinsonRafaela RosárioRichard RosenkranzJennifer SacheckJo SalmonRebecca A. Seguin-FowlerNancy E. SherwoodHajnalka TakacsRachael TaylorHaixue WangHaijun WangRobin WhittemoreSimon WilkschZenong YinZhixiong ZhouKatie BrehenyDeborah M. CaldwellSarah DawsonYang GaoFrances Hillier-BrownRebecca K. HodderSofus C. LarsenTheresa HM. MooreJames D. NoblesSophie M. PhillipsJelena SavovićFanney ThorsteinsdottirEve TomlinsonLuke WolfendenPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Corresponding author.Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UKPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UKThe Research Unit for Dietary Studies, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark; Section for General Medicine, Department of Public Health, University of Copenhagen, DenmarkPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UKDepartment of Sport and Exercise Sciences, Durham University, Durham, UK; Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UKPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UKSummary: Background: Public health attempts to prevent obesity in children and young people should aim to minimize health inequalities. Two Cochrane reviews examining interventions aiming to prevent childhood obesity found that interventions promoting (only) physical activity have a small beneficial effect on BMI for people aged 5–18 years, as do interventions promoting physical activity alongside healthy eating for 5–11 year olds. We examined whether the effectiveness of the interventions included in these reviews differed according to eight factors associated with inequity: place, race/ethnicity, occupation, gender/sex, religion, education, socio-economic status, and social capital (the PROGRESS framework). Methods: We collected data on change in BMI (standardized or unstandardized), subgrouped by baseline measures of PROGRESS factors, for intervention and control groups, from trial authors. We calculated the intervention effect per subgroup (mean difference), then contrasted these to estimate interactions between intervention and the baseline factors. We combined interaction estimates for each factor across trials using meta-analyses. Findings: We collected subgrouped data from 81 trials that took place between 2001 and 2020, involving 84,713 participants. We found no substantial differences in effectiveness of interventions for PROGRESS subgroups in most scenarios. However, in the younger age group (5–11 years), the effect of interventions on standardized BMI appeared to be higher in boys (average difference in mean differences 0.03; 95% CI 0.01 to 0.06; 45 studies, n = 44,740), which was consistent in direction with the BMI effect (average difference in mean differences 0.06 kg/m2; 95% CI −0.02 to 0.13; 31 studies, n = 27,083). Interpretation: Our findings suggest that those responsible for public health can promote these beneficial interventions without major concerns about increasing inequalities but should be mindful that these interventions may work better in boys aged 5–11 years than girls. More data are needed, so we encourage future trialists to perform subgroup analyses on PROGRESS factors. Funding: National Institute for Health and Care Research (NIHR).http://www.sciencedirect.com/science/article/pii/S2589537025000628Meta-analysisHealth inequitiesChildhood obesity prevention |
| spellingShingle | Jennifer C. Palmer Annabel L. Davies Francesca Spiga Berit L. Heitmann Russell Jago Carolyn D. Summerbell Julian P.T. Higgins Arne Astrup Valter Cordeiro Barbosa Filho Mark E. Benden Lynne Boddy Laura M. Bogart Blakely Brown Angela Carlin Diana P. Pozuelo Carrascosa Li Kheng Chai Clare Drummy Scott Duncan Cara Ebbeling Eva Martos Stuart Fairclough Jayne Fulkerson Douglas A. Gentile Mary B. Gruber May Grydeland Amy S. Ha Carla Habib Mourad Kate Gilstad-Hayden Douglas L. Hill Gill ten Hoor Kiya Hurley Alison Hurst Nahla Hwalla Jeannette R. Ickovics Kate Jolly Juliana Kain Susanne Kobel Viktoria Anna Kovacs Susi Kriemler Sarahmarie Kuroko Alberto Lana Teresa Shamah Levy Mairena Sánchez-López David Lubans Brian Lynch Kristine A. Madsen Claude Marcus Méndez-Gómez Humarán Carmen Morales-Ruan Philip Morgan Ivan Müller Robert Newton Analise Nicholl Teresia O'Connor Russell R. Pate Sebastián Peña Lorraine B. Robbins Jardena J. Puder Thomas Robinson Rafaela Rosário Richard Rosenkranz Jennifer Sacheck Jo Salmon Rebecca A. Seguin-Fowler Nancy E. Sherwood Hajnalka Takacs Rachael Taylor Haixue Wang Haijun Wang Robin Whittemore Simon Wilksch Zenong Yin Zhixiong Zhou Katie Breheny Deborah M. Caldwell Sarah Dawson Yang Gao Frances Hillier-Brown Rebecca K. Hodder Sofus C. Larsen Theresa HM. Moore James D. Nobles Sophie M. Phillips Jelena Savović Fanney Thorsteinsdottir Eve Tomlinson Luke Wolfenden Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context EClinicalMedicine Meta-analysis Health inequities Childhood obesity prevention |
| title | Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context |
| title_full | Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context |
| title_fullStr | Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context |
| title_full_unstemmed | Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context |
| title_short | Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviewsResearch in context |
| title_sort | do the effects of interventions aimed at the prevention of childhood obesity reduce inequities a re analysis of randomized trial data from two cochrane reviewsresearch in context |
| topic | Meta-analysis Health inequities Childhood obesity prevention |
| url | http://www.sciencedirect.com/science/article/pii/S2589537025000628 |
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