Non-English-language papers were included and experts were contacted.

Selection Criteria: The review includes data from childhood obesity prevention studies that used

a controlled study design (with or without randomization). Studies were included if they evaluated interventions, policies, or programs in place for 12 weeks or more. If studies were randomized at a cluster BIX 01294 supplier level, six clusters were required.

Data Collection and Analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Data were extracted on intervention implementation, cost, equity, and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity-related behaviors, or diet-related behaviors. CX-6258 Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardized BMI (zBMI) score data with subgroup analysis by age group (zero to five years, six to 12 years, and 13 to 18 years, corresponding

to stages of developmental and childhood settings).

Main Results: This review includes 55 studies (an additional 36 studies found for this update). The majority of the studies targeted children six to 12 years of age. The meta-analysis included 37 studies of 27,946 children and demonstrated that programs were effective at reducing adiposity, although not all individual interventions were effective, and there was a high level of observed heterogeneity (l(2) = 82 percent). Overall, children in the intervention group had a standardized mean difference in adiposity (measured as BMI or zBMI) of -0.15 kg per m(2) (95% confidence interval [CI], -0.21 to -0.09). Intervention effects by age subgroups were -0.26 kg per m(2) (95% CI, -0.53 to 0.00; zero to five https://www.selleckchem.com/products/Adrucil(Fluorouracil).html years),.-0.15 kg per m2 (95% CI, -0.23 to -0.08; six

to 12 years), and -0.09 kg per m2 (95% CI, -0.20 to 0.03; 13 to 18 years). Heterogeneity was apparent in all three age groups and could not be explained by randomization status or the type, duration, or setting of the intervention. Only eight studies reported on adverse effects, and no evidence of adverse outcomes, such as unhealthy dieting practices, increased prevalence of underweight, or body image sensitivities, was found. Interventions did not appear to increase health inequalities, although this was examined in fewer studies.

Authors’ Conclusions: The authors found strong evidence to support beneficial effects of childhood obesity prevention programs on BMI, particularly for programs targeted to children six to 12 years of age. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously.