scholarly journals Childhood Obesity Evidence Base Project: A Rationale for Taxonomic versus Conventional Meta-Analysis

2020 ◽  
Vol 16 (S2) ◽  
pp. S2-1-S2-6
Author(s):  
Larry V. Hedges ◽  
Jason A. Saul ◽  
Chris Cyr ◽  
Mackenzie Magnus ◽  
Lori A.J. Scott-Sheldon ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Meta Analysis ◽  
Evidence Base

scholarly journals Childhood Obesity Evidence Base Project: A Systematic Review and Meta-Analysis of a New Taxonomy of Intervention Components to Improve Weight Status in Children 2–5 Years of Age, 2005–2019

2020 ◽  
Vol 16 (S2) ◽  
pp. S2-21-S2-48
Author(s):  
Lori A.J. Scott-Sheldon ◽  
Larry V. Hedges ◽  
Chris Cyr ◽  
Deborah Young-Hyman ◽  
Laura Kettel Khan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Weight Status ◽  
Meta Analysis ◽  
Evidence Base

scholarly journals Traffic light diets have limited evidence for effects on childhood obesity: review and future recommendations

2020 ◽  
Author(s):  
Michelle M. Bohan Brown ◽  
Colby J. Vorland ◽  
Michelle I. Cardel ◽  
Andrew William Brown
Keyword(s):  
Childhood Obesity ◽  
Meta Analysis ◽  
Food Selection ◽  
Evidence Base ◽  
Health Concern ◽  
Traffic Light ◽  
Lifestyle Program ◽  
Pubmed Search ◽  
Evidence Analysis ◽  
Multicomponent Interventions

Childhood obesity continues to be a growing health concern and deserves evidence-based strategies to address it. One proposed nutritional approach to improve dietary patterns is referred to as the “Traffic Light Diet” (TLD) or “Stop Light Diet”, among other names, and is often included as a nutritional factor in pediatric multicomponent interventions. TLDs generally define foods as ‘green’ or ‘go’ foods with no restrictions on consumption; ‘yellow’ or ‘slow’ foods that should be consumed in moderation; and ‘red’ or ‘no’ foods that should be consumed minimally. The Academy of Nutrition and Dietetics Evidence Analysis Library gave TLDs Grade I evidence in its 2006 evaluation of pediatric weight management. Unfortunately, none of the studies included in the Evidence Analysis Library have tested the TLD in isolation, and few tested the entire package of interventions against an appropriate control. In reviewing all articles from a PubMed search for TLDs and weight-related outcomes, no studies tested the diet in isolation. By looking through references of papers, we were able to identify only 1 article that tested the diet mostly in isolation in 1982, and it observed no significant differences between groups. What defines a TLD varies across studies and contexts: some are based on average calories in a serving within a category of foods; others are based on energy density; and others are based on ingredients. Existing systematic reviews generally conclude that TLD-based approaches affect food selection and consumption, but none have studied the effects on obesity-related outcomes. Taken together, we believe the evidence supports the following statements: 1) at present, there is insufficient evidence supporting TLDs as a unique, isolatable factor in improving body weight in children; 2) there is confusion and lack of standardization over definitions of TLDs about which foods to include in which categories; 3) the use of the term TLD leads to some confusion regarding whether the entire intensive lifestyle program is being referenced, or simply the labeling of foods by colors; 4) a quality, systematic review and meta-analysis is needed to more robustly summarize the literature on TLDs and weight-related outcomes; 5) the Evidence Analysis Library should update their review of the TLDs given their new, more robust procedures; and 6) the limitations of the evidence base on TLDs should not be misinterpreted as concluding TLDs are ineffective because TLDs have been incorporated into many successful, intensive, childhood obesity intervention programs, and therefore the unique causal contribution of TLDs to those programs is uncertain. Further research is needed to standardize definitions of TLDs to clarify which foods to include in a given category, as well as to identify the direct impact of utilizing TLDs alone on weight loss outcomes in various intervention settings.

Physical activity interventions in the prevention and treatment of paediatric obesity: systematic review and critical appraisal

2003 ◽  
Vol 62 (3) ◽  
pp. 611-619 ◽  
Author(s):  
John J. Reilly ◽  
Zoe C. McDowell
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Childhood Obesity ◽  
Sedentary Behaviour ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
Evidence Base ◽  
Rapid Expansion ◽  
Paediatric Obesity ◽  
Prevention And Treatment

Interventions for prevention and treatment of childhood obesity typically target increases in physical activity and, more recently, reductions in physical inactivity (sedentary behaviour such as television viewing). However, the evidence base for such strategies is extremely limited. The main aim of the present review was to update the systematic review and critical appraisal of evidence in the light of the recent rapid expansion of research in this area. Randomised controlled trials (RCT) that targeted activity or inactivity, that followed up children or adolescents for at least 1 year and that included an objective weight-related outcome measure were included. Trials were appraised using previously published criteria (Harbour & Miller, 2001), and literature search strategies described previously (Reilly et al. 2002) were updated to May 2002. A total of four new RCT, two new systematic reviews and one meta-analysis were identified. The evidence base has increased markedly since the completion of earlier reviews, although high-quality evidence is still lacking. The evidence on childhood obesity prevention is not encouraging, although promising targets for prevention are now clear, notably reduction in sedentary behaviour. There is stronger evidence that targeting activity and/or inactivity might be effective in paediatric obesity treatment, but doubts as to the generalisability of existing interventions, and the clinical relevance of the interventions is unclear. Further research in settings outside the USA is urgently needed, and two ongoing RCT in Scotland are summarised.

scholarly journals Childhood Obesity Evidence Base Project: Methods for Taxonomy Development for Application in Taxonomic Meta-Analysis

2020 ◽  
Vol 16 (S2) ◽  
pp. S2-7-S2-20
Author(s):  
Heather King ◽  
Mackenzie Magnus ◽  
Larry V. Hedges ◽  
Chris Cyr ◽  
Deborah Young-Hyman ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Meta Analysis ◽  
Evidence Base ◽  
Taxonomy Development

scholarly journals Comparing the use of aggregate data and various methods of integrating individual patient data to network meta-analysis and its application to first-line ART

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Steve Kanters ◽  
Mohammad Ehsanul Karim ◽  
Kristian Thorlund ◽  
Aslam H. Anis ◽  
Michael Zoratti ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Evidence Base ◽  
Aggregate Data ◽  
World Health ◽  
Coefficient Estimates ◽  
Two Stage ◽  
Individual Patient Level ◽  
One Stage ◽  
Meta Regression ◽  
Empirical Priors

Abstract Background The 2018 World Health Organization HIV guidelines were based on the results of a network meta-analysis (NMA) of published trials. This study employed individual patient-level data (IPD) and aggregate data (AgD) and meta-regression methods to assess the evidence supporting the WHO recommendations and whether they needed any refinements. Methods Access to IPD from three trials was granted through ClinicalStudyDataRequest.com (CSDR). Seven modelling approaches were applied and compared: 1) Unadjusted AgD network meta-analysis (NMA) – the original analysis; 2) AgD-NMA with meta-regression; 3) Two-stage IPD-AgD NMA; 4) Unadjusted one-stage IPD-AgD NMA; 5) One-stage IPD-AgD NMA with meta-regression (one-stage approach); 6) Two-stage IPD-AgD NMA with empirical-priors (empirical-priors approach); 7) Hierarchical meta-regression IPD-AgD NMA (HMR approach). The first two were the models used previously. Models were compared with respect to effect estimates, changes in the effect estimates, coefficient estimates, DIC and model fit, rankings and between-study heterogeneity. Results IPD were available for 2160 patients, representing 6.5% of the evidence base and 3 of 24 edges. The aspect of the model affected by the choice of modeling appeared to differ across outcomes. HMR consistently generated larger intervals, often with credible intervals (CrI) containing the null value. Discontinuations due to adverse events and viral suppression at 96 weeks were the only two outcomes for which the unadjusted AgD NMA would not be selected. For the first, the selected model shifted the principal comparison of interest from an odds ratio of 0.28 (95% CrI: 10.17, 0.44) to 0.37 (95% CrI: 0.23, 0.58). Throughout all outcomes, the regression estimates differed substantially between AgD and IPD methods, with the latter being more often larger in magnitude and statistically significant. Conclusions Overall, the use of IPD often impacted the coefficient estimates, but not sufficiently as to necessitate altering the final recommendations of the 2018 WHO Guidelines. Future work should examine the features of a network where adjustments will have an impact, such as how much IPD is required in a given size of network.

School-based interventions for the treatment of childhood obesity: a systematic review, meta-analysis and meta-regression of cluster randomised controlled trials

2021 ◽  
pp. 1-28
Author(s):  
Tarcisus Ho ◽  
Ling Jie Cheng ◽  
Ying Lau
Keyword(s):  
Childhood Obesity ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Risk Of Bias ◽  
Medium Effect ◽  
School Based ◽  
Cluster Randomised ◽  
School Based Interventions ◽  
Meta Regression

Abstract Objective Schools offer an ideal setting for childhood obesity interventions due to their access to children and adolescents. This review aimed to systematically review the impact of school-based intervention for the treatment of childhood obesity. Design Eight databases were searched from inception till May 30, 2020. A revised Cochrane risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations criteria were used to evaluate the risk of bias and overall evidence. Meta-analysis and meta-regression were performed on Stata software using the random-effects model. Overall effect was evaluated using Hedges’ g, and heterogeneity was assessed using Cochran’s Q and I2. Setting Cluster randomised trials (cluster-RCTs) delivered in school. Participants Children and adolescents (6-18 years of age) with overweight and obesity. Results Twelve cluster-RCTs from seven countries with 1,755 participants were included in the meta-analysis. School-based interventions for the treatment of childhood obesity reduced body mass index (BMI) and BMI z-scores with a medium effect (g=0·52). Subgroup analyses showed the greater effectiveness of brief school-based interventions and the interventions conducted in lower-middle to upper-middle economies. Meta-regression assessed the heterogeneity and the final model, with covariates of the type of economies and trial duration, accounted for 41.2% of the variability. The overall quality of evidence was rated low because of the high risk of bias and inconsistency. Conclusions School-based interventions is a possible approach to provide universal healthcare for the treatment of childhood obesity, and further well-designed cluster-RCTs with longer follow-up are needed. This study is registered with PROSPERO (CRD42020160735).

Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis

2019 ◽  
Vol 32 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Mohammad Aghaali ◽  
Seyed Saeed Hashemi-Nazari
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Childhood Obesity ◽  
Early Life ◽  
Meta Analysis ◽  
Healthy Children ◽  
Antibiotic Exposure ◽  
Statistical Estimates ◽  
Childhood Weight

Abstract Background Recent studies have shown that antibiotic exposure during infancy is associated with increased body mass in healthy children. This study was performed to investigate the association between early-life antibiotic exposure and risk of childhood obesity. Methods A systematic review and meta-analysis was performed to comprehensively and quantitatively determine the association between early antibiotic exposure and risk of childhood obesity. Various databases such as PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane and Google Scholar were searched. A random-effects meta-analysis was performed to pool the statistical estimates. Additionally, a subgroup analysis was performed based on the time of follow-up. Results Nineteen studies involving at least 671,681 participants were finally included. Antibiotic exposure in early life was significantly associated with risk of childhood weight gain and obesity (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.04–1.06). Conclusions Antibiotic exposure in early life significantly increases the risk of childhood weight gain and obesity.

Childhood obesity and school absenteeism: a systematic review and meta-analysis

2017 ◽  
Vol 18 (12) ◽  
pp. 1412-1424 ◽  
Author(s):  
R. An ◽  
H. Yan ◽  
X. Shi ◽  
Y. Yang
Keyword(s):  
Systematic Review ◽  
Childhood Obesity ◽  
Meta Analysis ◽  
School Absenteeism
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