What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression

Objective Using meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.Design Meta-regression.Setting Studies were identified as part of a large-scale systematic revie...

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Main Authors: Rachel Perry, Julian PH Shield, Laura Birch, Linda P Hunt, Rhys Matson, Amanda Chong, Rhona Beynon
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e028231.full
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author Rachel Perry
Julian PH Shield
Laura Birch
Linda P Hunt
Rhys Matson
Amanda Chong
Rhona Beynon
author_facet Rachel Perry
Julian PH Shield
Laura Birch
Linda P Hunt
Rhys Matson
Amanda Chong
Rhona Beynon
author_sort Rachel Perry
collection DOAJ
description Objective Using meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.Design Meta-regression.Setting Studies were identified as part of a large-scale systematic review of the following electronic databases: AMED, Embase, MEDLINE via OVID, Web of Science and CENTRAL via Cochrane library.Participants Individuals aged 4–19 years with a diagnosis of obesity according to defined BMI thresholds.Interventions Studies of lifestyle treatment interventions that included dietary, physical activity and/or behavioural components with the objective of reducing obesity were included. Interventions of <2 weeks duration and those that involved surgical and/or pharmacological components (eg, bariatric surgery, drug therapy) were excluded.Primary and secondary outcome measures To be included in the review, studies had to report baseline and post-intervention BMI-SDS or change measurements (primary outcome measures) plus one or more of the following markers of metabolic health (secondary outcome measures): adiposity measures other than BMI; blood pressure; glucose; inflammation; insulin sensitivity/resistance; lipid profile; liver function. This paper focuses on adiposity measures only. Further papers in this series will report on other outcome measures.Results This paper explores the potential impact of BMI-SDS reduction in terms of change in percentage body fat. Thirty-nine studies reporting change in mean percentage body fat were analysed. Meta-regression demonstrated that reduction of at least 0.6 in mean BMI-SDS ensured a mean reduction of percentage body fat mass, in the sense that the associated 95% prediction interval for change in mean percentage body fat was wholly negative.Conclusions Interventions demonstrating reductions of 0.6 BMI-SDS might be termed successful in reducing adiposity, a key purpose of weight management interventions.Trial registration number CRD42016025317.
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spelling doaj-art-a99e0af5c4b3472bb6ffb4ae5fee3a972025-08-20T01:53:27ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-028231What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regressionRachel Perry0Julian PH Shield1Laura Birch2Linda P Hunt3Rhys Matson4Amanda Chong5Rhona Beynon6National Institute for Health Research Bristol Biomedical Research Centre; University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK3 Paediatric Diabetes and Endocrinology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK1 NIHR Bristol Biomedical Research Centre—Nutrition theme, Level 3 University Hospitals Bristol Education Centre, Bristol, UKsenior lecturer1 NIHR Bristol Biomedical Research Centre—Nutrition theme, Level 3 University Hospitals Bristol Education Centre, Bristol, UKNIHR Bristol BRC, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK1 NIHR Bristol Biomedical Research Centre—Nutrition theme, Level 3 University Hospitals Bristol Education Centre, Bristol, UKObjective Using meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.Design Meta-regression.Setting Studies were identified as part of a large-scale systematic review of the following electronic databases: AMED, Embase, MEDLINE via OVID, Web of Science and CENTRAL via Cochrane library.Participants Individuals aged 4–19 years with a diagnosis of obesity according to defined BMI thresholds.Interventions Studies of lifestyle treatment interventions that included dietary, physical activity and/or behavioural components with the objective of reducing obesity were included. Interventions of <2 weeks duration and those that involved surgical and/or pharmacological components (eg, bariatric surgery, drug therapy) were excluded.Primary and secondary outcome measures To be included in the review, studies had to report baseline and post-intervention BMI-SDS or change measurements (primary outcome measures) plus one or more of the following markers of metabolic health (secondary outcome measures): adiposity measures other than BMI; blood pressure; glucose; inflammation; insulin sensitivity/resistance; lipid profile; liver function. This paper focuses on adiposity measures only. Further papers in this series will report on other outcome measures.Results This paper explores the potential impact of BMI-SDS reduction in terms of change in percentage body fat. Thirty-nine studies reporting change in mean percentage body fat were analysed. Meta-regression demonstrated that reduction of at least 0.6 in mean BMI-SDS ensured a mean reduction of percentage body fat mass, in the sense that the associated 95% prediction interval for change in mean percentage body fat was wholly negative.Conclusions Interventions demonstrating reductions of 0.6 BMI-SDS might be termed successful in reducing adiposity, a key purpose of weight management interventions.Trial registration number CRD42016025317.https://bmjopen.bmj.com/content/9/8/e028231.full
spellingShingle Rachel Perry
Julian PH Shield
Laura Birch
Linda P Hunt
Rhys Matson
Amanda Chong
Rhona Beynon
What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression
BMJ Open
title What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression
title_full What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression
title_fullStr What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression
title_full_unstemmed What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression
title_short What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression
title_sort what change in body mass index is associated with improvement in percentage body fat in childhood obesity a meta regression
url https://bmjopen.bmj.com/content/9/8/e028231.full
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