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How to Prevent Obesity

Daniel Llao Calvet / Getty Images

• Early Prevention
• Stress Reduction
• Improving Sleep
• Next in Obesity Guide Obesity Facts and Statistics: What You Need to Know

Preventing obesity involves making healthy lifestyle choices every day. To prevent obesity, you need to stay active, follow a healthy diet, and get adequate sleep. Obesity prevention also involves saying no to certain preferences, like soft drinks, or driving short distances when you could walk instead.

Obesity is generally defined as a chronic disease characterized by excessive body fat. More than 42% of adults and 19% of children and adolescents in the U.S. have obesity, and those numbers are rising. Obesity is often caused by a combination of risk factors, including genetics , poor diet, sedentary behaviors , medical conditions, and lack of access to healthy foods.

While obesity prevention should start in childhood, it is never too late to start making healthier choices. This article discusses how to prevent obesity starting in childhood and later in life. It includes diet, exercise, and lifestyle strategies, along with how these strategies can reduce your obesity risk.

Preventing Obesity in Childhood

Obesity often begins in childhood . Research shows that if a person has obesity at age 5, they are more likely to have obesity as an adult. Conversely, if a child does not have obesity at age 5, their lifetime risk of obesity is significantly lower.

Obesity results from a combination of genetic, environmental, and lifestyle factors. Although families cannot change their genes, they can model healthy lifestyle patterns for children to start preventing obesity from a young age.

To prevent obesity in childhood, families can:

• Promote healthy eating: Families can try swapping out processed snacks like potato chips for healthier snacks like baked cinnamon apple crisps. Saying no to soft drinks is another great starting point.
• Get active together: Parents and children can both benefit from engaging in physical activity together. Make a tradition of physical activity, like playing frisbee or riding bikes together after school. Children ages 6 to 17 should get 60 minutes of physical activity per day.
• Ensure consistent sleep: Children who don't get enough sleep have a greater risk of developing obesity, type 2 diabetes, and other health conditions. The amount of uninterrupted sleep your child needs depends on their age group, but the key is a consistent bedtime—even on weekends.
• Minimize screen time: Too much screen time in childhood increases the risk of obesity, poor sleep, unhealthy eating, and more. Whenever possible, it's important to replace screen time with family time or physical activity. At a minimum, screens should be turned off at least one hour before bed.

If you are concerned about your child's weight, reach out to a healthcare provider. Your provider may be able to help you identify lifestyle factors that are contributing to your child's weight gain. They can also assess any health risks your child may have based on their weight or your family history.

Diet to Prevent Obesity

Obesity can be prevented by following basic principles of healthy eating . Here are simple changes you can make to your eating habits that will help you lose weight and prevent obesity.

Eat More Fruits and Vegetables

Eating a diet rich in fruits and vegetables decreases the risk of obesity. Fruits and vegetables contain a variety of beneficial nutrients and are associated with a lower risk for diabetes and insulin resistance . They are also high in fiber, which keeps you feeling full with fewer calories and ensures your digestive system stays regulated.

Focus on filling your plate with whole vegetables and fruits at every meal. Aim for lots of natural colors—carrots, sweet potatoes, broccoli, bananas, eggplant—the more color, the merrier.

Go easy (or eliminate) protein sources that are heavy in saturated fats, such as red meat and dairy. If you choose to cut out meat entirely, consult with a healthcare provider to ensure you are not at risk for nutritional deficiencies.

Does a Plant-Based Diet Prevent Obesity?

Eating more plant foods and less animal foods lowers insulin resistance and contributes to a healthier BMI. Following a plant-based diet will not increase the risk of obesity. However, more research is needed to evaluate the benefits of plant-based diets for reducing obesity long-term.

Avoid Processed Foods

Highly processed foods , like white bread and many boxed snack foods, are a common source of empty calories, which tend to add up quickly. A 2019 study found that people who were offered a highly processed diet consumed more calories and gained weight, while those offered a minimally processed diet ate less and lost weight.

There are many healthy alternatives to processed snacks that can be just as satisfying, such as:

• Unsalted almonds, cashews, walnuts, and pistachios
• Roasted chickpeas
• Crispy lettuce wraps
• Frozen yogurt-covered blueberries
• Baked banana chips

While it may take a little more time and creativity, planning and preparing healthy snacks can be an enjoyable and rewarding experience.

Limit Sugar and Artificial Sweeteners

It is important to keep your intake of added sugars low. According to current dietary guidelines, most adult women should have no more than 24 grams of sugar per day, while most adult men should have no more than 36.

Major sources of added sugar to avoid include: 

• Sugary beverages, including sodas and energy or sports drinks
• Grain desserts like pies, cookies, and cakes
• Fruit drinks (which are seldom 100% fruit juice)
• Dairy desserts like ice cream

Artificial sweeteners have been linked to obesity and diabetes , too. While some natural sweeteners like agave do not raise glucose as fast as table sugar, they still raise blood sugar and should also be used in moderation.

Reduce Saturated Fats

Numerous studies show that eating foods high in saturated fat contributes to obesity. Foods that are high in saturated fats include:

• Whole and reduced-fat milk
• Butter and dairy desserts
• Meat products, such as sausage, bacon, beef, hamburgers
• Cookies and other grain-based desserts
• Many fast-food dishes

Focus instead on sources of healthy fats (monounsaturated and polyunsaturated fats) like:

• Olive oil and canola oils
• Pumpkin and sesame seeds

Although these fats are healthier for you, they should still be limited to about 20% to 35% of daily calories. People with elevated cholesterol or vascular disease may need an even lower level.

Pay Attention to Beverages

A single, 12-ounce can of Coca-Cola contains 39 grams of sugar. That means one can of Coke alone exceeds the recommended daily intake of sugar.

Sugar and calories in soft drinks, energy drinks, sports drinks, and juices quickly add up and may contribute to weight gain. But drinks marketed as "sugar-free" and "low-calorie" aren't much better. Artificially sweetened drinks also carry a risk of numerous health problems, including obesity.

Rather than focusing on which artificial sweetener is best, it's better to avoid sweeteners in general. Make water or unsweetened drinks and your go-to instead.

Cook at Home

People who prepare meals at home are less likely to gain weight or develop type 2 diabetes, studies show.

One such study found that people who ate home-cooked meals more than five times per week were 28% less likely to have an overweight BMI than people who ate home-cooked meals less than three times per week. Eating more home-cooked meals was also associated with having less body fat.

Exercising to Prevent Obesity

Most national and international guidelines recommend that the average adult get at least 150 minutes of moderate-intensity physical activity per week. That means at least 30 minutes per day, five days per week.

Researchers have also found that people who walk at a brisk or fast pace are more likely to have a lower weight, lower body mass index (BMI), and lower waist circumference compared to individuals doing other activities.  

In addition, experts recommend keeping active throughout the day, whether by using a standing desk, taking frequent stretch breaks, or finding ways to work in walking meetings throughout your day.

Reducing Stress to Prevent Obesity

Chronic stress raises levels of the stress hormone cortisol and leads to weight gain. It can also result in poor dietary choices, as cortisol and other stress hormones can increase “carb cravings” and make it difficult to exercise good judgment and willpower.

Look into the many healthy ways to beat stress, and find what works best for you. This might include:

• Going for a daily walk
• Engaging in regular yoga or tai chi
• Listening to music you love
• Getting together with friends

Studies show having a pet can lower blood pressure. Additionally, pets, especially dogs, can increase your level of physical activity and help you stave off weight gain.

Improving Sleep to Prevent Obesity

The role of sleep in overall well-being cannot be overstated. This extends to the goal of preventing obesity, too. The Centers for Disease Control and Prevention recommends seven or more hours of sleep for adults 18 and over and even more sleep for younger people.

Studies have linked later bedtimes to weight gain over time. One of these studies included 137,000 people from 26 countries. It showed that, compared to people who go to bed before 10 p.m., people who go to bed after 10 have a 20% greater risk of general and abdominal obesity. Meanwhile, the risk is up to 38% higher in people who go to bed after 2 a.m.

If you are having trouble falling asleep earlier, it may help to:

• Set a consistent bedtime.
• Make sure your bedroom is quiet, dark, and a comfortable temperature.
• Keep phones, computers, and televisions out of the bedroom.
• Cut off screen time within one hour of going to bed.
• Avoid large meals and caffeine before bedtime.
• Increase physical exercise to help your body relax better at night.

There are several possible contributors to obesity. The fact that the two biggest ones—diet and activity—are ones you can influence is good news. A healthy lifestyle that puts exercise and eating at its center can also bring myriad other health benefits. Getting good sleep and finding ways to reduce stress is important, too.

If you have made significant lifestyle changes and are still gaining weight or unable to lose weight, see a healthcare professional to rule out other possible causes of weight gain.

National Institute of Diabetes and Digestive and Kidney Diseases. Overweight and obesity statistics .

Eunice Kennedy Shriver National Institute of Child Health and Human Development. Obesity begins early .

Centers for Disease Control and Prevention. Preventing childhood obesity: 5 things families can do .

Centers for Disease Control and Prevention. Defining adult overweight & obesity .

World Health Organization. Obesity and overweight .

Martins F, Conde S. Impact of diet composition on insulin resistance . Nutrients . 2022 Sep;14(18):3716. doi:10.3390/nu14183716

Hall KD, Ayuketah A, Brychta R, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake . Cell Metab . 2019;30(1):67–77.e3. doi:10.1016/j.cmet.2019.05.008

Harvard T.H. Chan. Added sugar .

Daoust L. Artificial sweeteners and type 2 diabetes . Nat Food . 2023;4(1):739. doi:10.1038/s43016-023-00846-2

University of Illinois Urbana-Champaign. Is agave nectar a healthier alternative to sugar? .

Harvard T.H. Chan. Types of fat .

PennState Extension. Fat facts, the right amount for a healthy diet .

Debras C, Chazelas E, Sellem L, et al. Artificial sweeteners and risk of cardiovascular diseases: Results from the prospective NutriNet-Santé cohort . BMJ . 2022 Sep;378(1):e071204. doi:10.1136/bmj-2022-071204

Mills S, Brown H, Wrieden W, White M, Adams J. Frequency of eating home cooked meals and potential benefits for diet and health: Cross-sectional analysis of a population-based cohort study . Int J Behav Nutr Phys Act . 2017 Aug;14(1):109. doi:10.1186/s12966-017-0567-y

Department of Health and Human Services. Physical activity guidelines for Americans . 2nd ed. Department of Health and Human Services.

Lordan G, Pakrashi D. Do all activities “weigh” equally? How different physical activities differ as predictors of weight . Risk Anal . 2015;35(11):2069-2086. doi:10.1111/risa.12417

Chao A, Jastreboff A, White M, Grilo C, Sinha R. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight . Obesity (Silver Spring) . 2017 Apr;25(4):713-720. doi:10.1002/oby.21790

Surma S, Oparil S, Narkiewicz K. Pet ownership and the risk of arterial hypertension and cardiovascular disease . Curr Hypertens Rep . 2022;24(8):295–302. doi:10.1007/s11906-022-01191-8

Miyake K, Kito K, Kotemori A, et al. Association between pet ownership and obesity: A systematic review and meta-analysis . Int J Environ Res Pub Health . 2020 May;17(10):3498. doi:10.3390/ijerph17103498

Centers for Disease Control and Prevention. How much sleep do I need?

Tse L, Wang C, Rangarajan S, et al. Timing and length of nocturnal sleep and daytime napping and associations with obesity types in high-, middle-, and low-income countries . JAMA Netw Open . 2021;4(6):e2113775. doi:10.1001/jamanetworkopen.2021.13775

Centers for Disease Control and Prevention. Tips for better sleep .

Asarnow LD, McGlinchey E, Harvey AG. Evidence for a possible link between bedtime and change in body mass index . Sleep . 2015;38(10):1523-1527. doi:10.5665/sleep.5038

Flint E, Cummins S, Sacker A. Associations between active commuting, body fat, and body mass index: population based, cross sectional study in the United Kingdom [correction published in BMJ. 2015;350:h2056]. BMJ . 2014;349:g4887. doi:10.1136/bmj.g4887

World Health Organization. Promoting fruit and vegetable consumption around the world .

By Yasmine S. Ali, MD, MSCI Yasmine Ali, MD, is board-certified in cardiology. She is an assistant clinical professor of medicine at Vanderbilt University School of Medicine and an award-winning physician writer.

How to Reduce Obesity and Maintain Health?

Health and obesity.

Health is becoming a matter of grave concern, especially the health of teenagers and adolescents, who are becoming increasingly overweight and obese. Obesity is now being regarded as an epidemic by the World Health Organization (WHO, 2000) due to the increasing occurrence of obesity among children and young adults. Studies confirm that obesity and other health problems related to health among adolescents are on the constant rise in America with fewer than five percent of adolescents being overweight in the mid-1960s (Ogden, Flegal, Carroll and Johnson, 2002) which increased to seventeen percent within four decades (Ogden et al., 2006).

The CDC reports that about 16 to 33 percent of children and adolescents in America are overweight and obese, with fewer than fifty percent of adolescents engaging in regular physical activities. Obesity is believed to be the primary cause of chronic disease in later life due to the chronic diseases caused due to obesity.

The average hours of television viewing activities among adolescents between the ages of fourteen to eighteen years was found to be above 28 hours per week, which could have influenced the elevation in obesity among adolescents (Roberts, Foehr and Rideout, 2005). Activities like watching television and playing video games reduce physical activity among children and exposes them to advertisements about fast foods which have an unhealthy impact on the perception and desire of foods that are unhealthy and promote gain of weight, increasing the chances of obesity (Barr-Anderson et. al., 2009).

Sedentary activities like watching television and engaging in media-related activities reduce the playtime of children which in turn reduces the number of calories burnt due to physical activities. Research indicates that obesity among children and adolescents is not an issue for the United States of America but is also of grave concern globally, with high prevalence rates of teenagers and children becoming obese (Janssen et. al., 2005).

Numerous factors have impacted the occurrence of obesity conditions among the younger generations, physical activity, and a healthy diet are believed to have a positive impact on maintaining healthy body weight. However, adolescence is a difficult stage in life during which the psychological and social development of children occurs, it is, therefore, essential for parents to be included in treatment programs to treat their obese children.

This paper aims to analyze the negative implications and impact of obesity on the new generations and how obesity needs to be tackled effectively.

Obesity is a term, commonly used to denote excess weight in individuals which is calculated according to the body mass index (BMI) depending on the age and gender of the individual. According to the International Obesity Task Force (IOTF) children and adolescents between the age of 2 years and 18 years, having a BMI between 85th and 95th percentile are at high risk of obesity, while those children whose BMI is equal to and more than 95th percentile are stated to be overweight (Centres for Disease Control and Prevention, 2005).

Adolescence occurs through three important phases initiating at the age of ten years to thirteen years and is termed early adolescence followed by middle adolescence which occurs from fourteen to sixteen years and finally late adolescence which is between the ages of seventeen to twenty-one years (Neinstein, Juliani, and Shapiro, 1996). During these phases, adolescents undergo several crucial changes in their psychological and social status, for instance, they gain additional independence from their parents and begin to adopt lifestyles that are in fashion; as such, there is greater importance on body image and the ego during these phases (Regber, Berg-Kelly, and Marild, 2007).

The occurrence of obesity in adolescents has numerous negative consequences, especially concerning the psychosocial development in adolescents. Studies also indicate that an egocentric thought process is common among adolescents, which also has social implications for them since they could tend to feel that they are being observed by an “imaginary” audience who is constantly watching over them and scrutinizing their looks, behaviors, and their overall personality (Elkind, 1967). As such, when adolescents do not have positive feelings about themselves and their body image, lack of self-confidence could have negative social implications for them.

Obesity could have various consequences including psychological and social problems resulting from low self-esteem and stigmatization (Strauss, 2000). In his study, Strauss (2000) found that obese teenagers are found to have an augmented level of loneliness and sadness in addition to greater nervousness. More importantly, obese adolescents are likely to have serious negative implications concerning their health which is reported to be lower than that of healthier and fit children (Schwimmer, Burwinkle & Varni, 2003).

Studies indicate that obese children are more likely to develop several diseases related to obesity including hypertension, type-2 diabetes, diseases of the gall bladder, and osteoarthritis (Ebbeling, Pawlak & Ludwig 2002). Ebbeling, Pawlak, and Ludwig (2002) have also found that obese children and adolescents have a greater likelihood of developing musculoskeletal disorders which could initiate in childhood, with the onset of obesity. Besides the many physical and health problems which could be triggered and initiated due to obesity, the disease could result in greater problems about social and economic problems resulting from discrimination.

In their investigation of obese and non-obese adolescents, Gortmaker, Must, Perrin, Sobol, and Dietz (1993) found a strong relationship between obesity and socio-economic outcomes. The research indicates that adolescents who were obese illustrated reduced education levels and were less likely to marry. It was also reported that the household income of obese individuals was much lower than other non-obese subjects. Moreover, the self-esteem levels among obese adolescents were found to be lower than non-obese counterparts, irrespective of the socio-economic status of the participants in the study.

Considering the severe health, social and economic implications of obesity, it is essential to communicate the appropriate information and impact of the disease to parents of obese children and the children themselves (Regber, Berg-kelly, and Marild, 2007). Researchers have affirmed that an empathetic attitude is necessary when informing teenagers regarding the consequences of the disease and when enabling them to realize that their situation can be changed with appropriate effort (Regber, Berg-kelly, and Marild, 2007). Parents play a vital role in raising their children and with their parenting styles, have an important influence on the health of children, especially due to eating habits.

Studies have indicated that the diet of children should consist of three principal meals including breakfast, lunch, and dinner in addition to a small snack consisting of fresh fruits or a sandwich between these main meals (Regber, Berg-kelly, and Marild, 2007). Eating fruits and vegetables is also considered extremely important to reduce obesity. It is also essential for parents to reduce the inclusion of sweets like candies and aerated drinks from the menu, which should be replaced by fresh fruits and milk.

Exercise should be encouraged among children of all ages and children should be encouraged to engage regularly in physical activities such as climbing stairs instead of using the elevator or walking and cycling to school instead of being transported in a car or bus. Commuting to school by cycling and walking is confirmed to be an ideal way of incorporating physical activity in the daily lives and routines of children and adolescents (Nelson et al., 2008).

Parents should additionally ensure that their children develop regular exercise habits which promote physical activity such as swimming, playing sports like basketball or baseball rather than being addicted to media-based activities involving videogames, television, and computers. Sedentary activities should be reduced and children must be encouraged to play outside to burn the calories and provide appropriate exercise to the body.

Schools can also contribute substantially to the reduction of obesity by promoting healthy food choices among students and offering health education to students regarding the ill effects of fast food and the benefits of physical activity and exercise. Thus the epidemic of obesity can be reduced with active support and intervention from all aspects of society including parental, familial, and social. The children, youth, and adolescents of any country are its future and their health must be in good shape and condition so that they can function as responsible healthy beings rather than ill individuals who are affected by diseases due to obesity and being overweight.

Barr-Anderson, Daheia J., Nicole I. Larson, Melissa C. Nelson, Dianne Neumark-Sztainer, and Mary Story. “Does television viewing predict dietary intake five years later in high school students and young adults?(Research)(Report).” The International Journal of Behavioral Nutrition and Physical Activity 6.7 (2009): 7.

Centers for Disease Control and Prevention. (2005). BMI-Body Mass Index : BMI for children and teens. Web.

Ebbeling, C., Pawlak, B., & Ludwig, D. (2002). Childhood obesity: Public health crisis, common sense and cure. Lancet, 360, 473-482.

Elkind, D. (1967). Egocentrism in adolescence. Child Development, 38(4), 1025-1034.

Gortmaker, S.L., Must, A., Perrin, J.M, Sobol, A.M., & Dietz, W.H. (1993). Social and economic consequences of overweight in adolescence and young adulthood. The New England Journal of Medicine, 329(14), 1008-1012.

Janssen, I., Katzmarzyk, RT., Boyce, W.F., Vereecken, C., Mulvihill, C., Roberts, C., Currie, C., & Pickett, W. (2005). The Health Behavior in School-Aged Children Obesity Working Group, Comparison of overweight and obesity prevalence in school aged youth from 34 countries and their relationship with physical activity and dietary patterns. Obesity Reviews, 6, 123-32.

Neinstein L.S., Juliani, M.A., & Shapiro, J. (1996). Psychosocial development in normal adolescents. In L.S. Neinstein (Ed.), Adolescent health care, A practical guide (pp. 40-45). Los Angeles: Williams & Wilkins.

Nelson, Norah M., Eimear Foley, Donal J. O’Gorman, Niall M. Moyna, and Catherine B. Woods. “Active commuting to school: How far is too far?(Research).” The International Journal of Behavioral Nutrition and Physical Activity 5.1 (2008): 1.

Ogden CL, Flegal KM, Carroll MD, Johnson CL: Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002, 288(14): 1728-1732.

Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM: Prevalence of Overweight and Obesity in the United States, 1999-2004. JAMA 2006, 295(13): 1549-1555.

Roberts D, Foehr UG, Rideout V: Generation M: media in the lives of 8-18 year-olds. Menlo Park: Kaiser Family Foundation; 2005: 1-145.

Schwimmer, J.B., Burwinkle, T.M., & Varni, J.W. (2003). Health-related quality of life of severely obese children and adolescents. JAMA, 289, 14.

World Health Organization (WHO). (2000). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation, technical report series 894. Geneva: World Health Organization.

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What Can Be Done

Obesity is a complex disease with many contributing factors. Neighborhood design, access to healthy, affordable foods and beverages, and access to safe and convenient places for physical activity can all impact obesity. Racial and ethnic disparities in obesity underscore the need to address social determinants of health such as poverty, education, and housing to remove barriers to health. Equitable access to obesity prevention and treatment is also needed to slow the obesity epidemic. Policy makers and community leaders can work to ensure that their communities, environments, and systems support a healthy, active lifestyle for all.

The Federal government is

• Studying what works in communities to make it easier for people to be more physically active and have a healthier diet.
• Measuring trends in obesity and related risk factors.
• Developing and promoting guidelines on dietary patterns  and amounts of physical activity Americans need for good health .
• Helping  families with lower incomes get affordable, nutritious foods  through programs such as the Supplemental Nutrition Program for Women, Infants, and Children (WIC), Pandemic Electronic Benefit Transfer, and farm-to-education programs.
• Supporting children and families who are at higher risk for obesity through services at Federally Qualified Health Centers, Head Start, WIC, and other service agencies.
• Funding programs and providing training and resources for initiatives that support breastfeeding, promote healthy eating, food and nutrition security, and physical activity .

Some states and communities are

• Making it easier to choose healthy food options where people live, work, learn, and play.
• Making healthy foods more available by connecting local producers with retailers and organizations such as childcare, schools, hospitals, and food hubs.
• Promoting nutrition standards in early care and education settings, food pantries, and faith-based organizations.
• Partnering with business and civic leaders to plan and carry-out local, culturally tailored interventions to address poor nutrition, and physical inactivity and tobacco use.
• Designing communities that connect sidewalks, bicycle routes, and public transportation with homes, early care and education settings, schools, parks, and workplaces.

Healthcare providers can

• Measure patients’ weight, height, and body mass index, and counsel them on keeping a healthy weight and its role in disease prevention.
• Screen children and adults for overweight and obesity and refer patients with obesity to intensive programs, including family healthy weight programs and the Diabetes Prevention Program .
• Counsel patients about nutrition, physical activity, and optimal sleep.
• Use respectful and non-stigmatizing, person-first language with all individuals in weight-related discussions.
• Connect patients and families with community services to help them have easier access to healthy food and ways to be active.
• Discuss the use of medications and other treatments for excess weight.
• Seek out continuing medical education on the latest on obesity science.

Everyone can

• Eat a healthy diet by following the 2020-2025 Dietary Guidelines for Americans.
• Get the amount of physical activity recommended by the Physical Activity Guidelines for Americans, 2 nd edition.
• Get involved in community efforts to improve options for healthier foods and physical activity.
• Lose weight, if they weigh more than recommended, to help reduce risk for many chronic diseases.
• Get enough sleep .
• Manage stress .
• Talk to their healthcare providers about available obesity prevention and treatment options to help reduce potential health risks.

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Physical Activity

Exercise Can Help Control Weight

Obesity results from energy imbalance: too many calories in, too few calories burned. A number of factors influence how many calories (or how much “energy”) people burn each day, among them, age, body size, and genes. But the most variable factor-and the most easily modified-is the amount of activity people get each day.

Keeping active can help people stay at a healthy weight or lose weight. It can also lower the risk of heart disease, diabetes, stroke, high blood pressure, osteoporosis, and certain cancers, as well as reduce stress and boost mood. Inactive (sedentary) lifestyles do just the opposite.

Despite all the health benefits of physical activity, people worldwide are doing less of it-at work, at home, and as they travel from place to place. Globally, about one in three people gets little, if any, physical activity. ( 1 ) Physical activity levels are declining not only in wealthy countries, such as the U.S., but also in low- and middle-income countries, such as China. And it’s clear that this decline in physical activity is a key contributor to the global obesity epidemic, and in turn, to rising rates of chronic disease everywhere.

The World Health Organization, the U.S. Dept. of Health and Human Services, and other authorities recommend that for good health, adults should get the equivalent of two and a half hours of moderate-to-vigorous physical activity each week. ( 2 – 4 ) Children should get even more, at least one hour a day. There’s been some debate among researchers, however, about just how much activity people need each day to maintain a healthy weight or to help with weight loss, and the most recent studies suggest that a total of two and a half hours a week is simply not enough.

This article defines physical activity and explains how it is measured, reviews physical activity trends, and discusses the role of physical activity in weight control.

Definitions and Measurement

Though people often use physical activity and exercise interchangeably, the terms have different definitions. “Physical activity” refers to any body movement that burns calories, whether it’s for work or play, daily chores, or the daily commute. “Exercise,” a subcategory of physical activity, refers to -planned, structured, and repetitive- activities aimed at improving physical fitness and health. ( 5 ) Researchers sometimes use the terms “leisure-time physical activity” or “recreational physical activity” as synonyms for exercise.

Experts measure the intensity of physical activity in metabolic equivalents or METs. One MET is defined as the calories burned while an individual sits quietly for one minute. For the average adult, this is about one calorie per every 2.2 pounds of body weight per hour; someone who weighs 160 pounds would burn approximately 70 calories an hour while sitting or sleeping. Moderate-intensity physical activity is defined as activities that are strenuous enough to burn three to six times as much energy per minute as an individual would burn when sitting quietly, or 3 to 6 METs. Vigorous-intensity activities burn more than 6 METs.

It is challenging for researchers to accurately measure people’s usual physical activity, since most studies rely on participants’ reports of their own activity in a survey or daily log. This method is not entirely reliable: Studies that measure physical activity more objectively, using special motion sensors (called accelerometers), suggest that people tend to overestimate their own levels of activity. ( 6 )

Worldwide, people are less active today than they were decades ago. While studies find that sports and leisure activity levels have remained stable or increased slightly, ( 7 – 10 ) these leisure activities represent only a small part of daily physical activity. Physical activity associated with work, home, and transportation has declined due to economic growth, technological advancements, and social changes. ( 7 , 8 , 10 , 11 ) Some examples from different countries:

• United Kingdom. Over the past few decades, it’s become more common for U.K. households to own second cars and labor-saving appliances. ( 13 ) Work outside the home has also become less active. In 2004, about 39 percent of men worked in active jobs, down from 43 percent in 1991-1992. ( 11 )
• China. Between 1991 and 2006, work-related physical activity in China dropped by about 35 percent in men and 46 percent in women; women also cut back on physical activity around the house-washing clothes, cooking, cleaning-by 66 percent. ( 10 ) Transportation-related physical activity has also dropped-no surprise, perhaps, given that car ownership is on the rise: Sales of new cars in China have gone up by about 30 percent per year in recent years. ( 14 )

The flip side of this decrease in physical activity is an increase in sedentary activities-watching television, playing video games, and using the computer. Add it up, and it’s clear that globally, the “energy out” side of the energy balance equation is tilting toward weight gain.

How Much Activity Do People Need to Prevent Weight Gain?

Weight gain during adulthood can increase the risk of heart disease, diabetes, and other chronic conditions. Since it’s so hard for people to lose weight and keep it off, it’s better to prevent weight gain in the first place. Encouragingly, there’s strong evidence that staying active can help people slow down or stave off “middle-age spread”: ( 13 ) The more active people are, the more likely they are to keep their weight steady; ( 15 , 16 ) the more sedentary, the more likely they are to gain weight over time. ( 17 ) But it’s still a matter of debate exactly how much activity people need to avoid gaining weight. The latest evidence suggests that the recommended two and a half hours a week may not be enough.

The Women’s Health Study, for example, followed 34,000 middle-age women for 13 years to see how much physical activity they needed to stay within 5 pounds of their weight at the start of the study. Researchers found that women in the normal weight range at the start needed the equivalent of an hour a day of moderate-to-vigorous physical activity to maintain a steady weight. ( 18 )

Vigorous activities seem to be more effective for weight control than slow walking. ( 15 , 19 , 20 ) The Nurses’ Health Study II, for example, followed more than 18,000 women for 16 years to study the relationship between changes in physical activity and weight. Although women gained, on average, about 20 pounds over the course of the study, those who increased their physical activity by 30 minutes per day gained less weight than women whose activity levels stayed steady. And the type of activity made a difference: Bicycling and brisk walking helped women avoid weight gain, but slow walking did not.

How Much Activity Do People Need to Lose Weight?

In one study, for example, researchers randomly assigned 175 overweight, inactive adults to either a control group that did not receive any exercise instruction or to one of three exercise regimens-low intensity (equivalent to walking 12 miles/week), medium intensity (equivalent to jogging 12 miles/week), or high intensity (equivalent to jogging 20 miles per week). All study volunteers were asked to stick to their usual diets. After six months, those assigned to the high-intensity regimen lost abdominal fat, whereas those assigned to the low- and medium-intensity exercise regimens had no change in abdominal fat. ( 21 )

More recently, researchers conducted a similar trial with 320 post-menopausal women, randomly assigning them to either 45 minutes of moderate-to-vigorous aerobic activity, five days a week, or to a control group. Most of the women were overweight or obese at the start of the study. After one year, the exercisers had significant decreases in body weight, body fat, and abdominal fat, compared to the non-exercisers. ( 23 )

How Does Activity Prevent Obesity?

Researchers believe that physical activity prevents obesity in multiple ways: ( 24 )

• Physical activity increases people’s total energy expenditure, which can help them stay in energy balance or even lose weight, as long as they don’t eat more to compensate for the extra calories they burn.
• Physical activity decreases fat around the waist and total body fat, slowing the development of abdominal obesity .
• Weight lifting, push-ups, and other muscle-strengthening activities build muscle mass, increasing the energy that the body burns throughout the day-even when it’s at rest-and making it easier to control weight.
• Physical activity reduces depression and anxiety, ( 3 ) and this mood boost may motivate people to stick with their exercise regimens over time.

The Bottom Line: For Weight Control, Aim for an Hour of Activity a Day

Being moderately active for at least 30 minutes a day on most days of the week can help lower the risk of chronic disease. But to stay at a healthy weight, or to lose weight, most people will need more physical activity-at least an hour a day-to counteract the effects of increasingly sedentary lifestyles, as well as the strong societal influences that encourage overeating.

Keep in mind that staying active is not purely an individual choice: The so-called “built environment”-buildings, neighborhoods, transportation systems, and other human-made elements of the landscape-influences how active people are. ( 25 ) People are more prone to be active, for example, if they live near parks or playgrounds, in neighborhoods with sidewalks or bike paths, or close enough to work, school, or shopping to safely travel by bike or on foot. People are less likely to be active if they live in sprawling suburbs designed for driving or in neighborhoods without recreation opportunities.

Local and state governments wield several policy tools for shaping people’s physical surroundings, such as planning, zoning, and other regulations, as well as setting budget priorities for transportation and infrastructure. ( 27 ) Strategies to create safe, active environments include curbing traffic to make walking and cycling safer, building schools and shops within walking distance of neighborhoods, and improving public transportation, to name a few. Such changes are essential to make physical activity an integral and natural part of people’s everyday lives-and ultimately, to turn around the obesity epidemic.

1. World Health Organization. Notes for the media: New physical activity guidance can help reduce risk of breast, colon cancers ; 2011. Accessed January 28, 2012.

2. World Health Organization. Global recommendations on physical activity for health ; 2011. Accessed January 30, 2012.

3. U.S. Dept. of Health and Human Services. 2008 Physical Activity Guidelines for Americans ; 2008. Accessed January 30, 2012.

4. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation . 2007; 116:1081-93.

5. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep . 1985; 100:126-31.

6. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc . 2008; 40:181-8.

7. Juneau CE, Potvin L. Trends in leisure-, transport-, and work-related physical activity in Canada 1994-2005. Prev Med . 2010; 51:384-6.

8. Brownson RC, Boehmer TK, Luke DA. Declining rates of physical activity in the United States: what are the contributors? Annu Rev Public Health . 2005; 26:421-43.

9. Petersen CB, Thygesen LC, Helge JW, Gronbaek M, Tolstrup JS. Time trends in physical activity in leisure time in the Danish population from 1987 to 2005. Scand J Public Health . 2010; 38:121-8.

10. Ng SW, Norton EC, Popkin BM. Why have physical activity levels declined among Chinese adults? Findings from the 1991-2006 China Health and Nutrition Surveys. Soc Sci Med . 2009; 68:1305-14.

11. Stamatakis E, Ekelund U, Wareham NJ. Temporal trends in physical activity in England: the Health Survey for England 1991 to 2004. Prev Med . 2007; 45:416-23.

12. McDonald NC. Active transportation to school: trends among U.S. schoolchildren, 1969-2001. Am J Prev Med . 2007; 32:509-16.

13. Wareham NJ, van Sluijs EM, Ekelund U. Physical activity and obesity prevention: a review of the current evidence. Proc Nutr Soc . 2005; 64:229-47.

14. Kjellstrom T, Hakansta C, Hogstedt C. Globalisation and public health-overview and a Swedish perspective. Scand J Public Health Suppl . 2007; 70:2-68.

15. Mekary RA, Feskanich D, Malspeis S, Hu FB, Willett WC, Field AE. Physical activity patterns and prevention of weight gain in premenopausal women. Int J Obes (Lond) . 2009; 33:1039-47.

16. Seo DC, Li K. Leisure-time physical activity dose-response effects on obesity among US adults: results from the 1999-2006 National Health and Nutrition Examination Survey. J Epidemiol Community Health . 2010; 64:426-31.

17. Lewis CE, Smith DE, Wallace DD, Williams OD, Bild DE, Jacobs DR, Jr. Seven-year trends in body weight and associations with lifestyle and behavioral characteristics in black and white young adults: the CARDIA study. Am J Public Health . 1997; 87:635-42.

18. Lee IM, Djousse L, Sesso HD, Wang L, Buring JE. Physical activity and weight gain prevention. JAMA . 2010; 303:1173-9.

19. Mekary RA, Feskanich D, Hu FB, Willett WC, Field AE. Physical activity in relation to long-term weight maintenance after intentional weight loss in premenopausal women. Obesity (Silver Spring) . 2010; 18:167-74.

20. Lusk AC, Mekary RA, Feskanich D, Willett WC. Bicycle riding, walking, and weight gain in premenopausal women. Arch Intern Med . 2010; 170:1050-6.

21. Slentz CA, Aiken LB, Houmard JA, et al. Inactivity, exercise, and visceral fat. STRRIDE: a randomized, controlled study of exercise intensity and amount. J Appl Physiol . 2005; 99:1613-8.

22. McTiernan A, Sorensen B, Irwin ML, et al. Exercise effect on weight and body fat in men and women. Obesity (Silver Spring) . 2007; 15:1496-512.

23. Friedenreich CM, Woolcott CG, McTiernan A, et al. Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes (Lond) . 2010.

24. Hu FB. Physical Activity, Sedentary Behaviors, and Obesity. In: Hu FB, ed. Obesity Epidemiology. New York: Oxford University Press; 2008:301-19.

25. Sallis JF, Glanz K. Physical activity and food environments: solutions to the obesity epidemic . Milbank Q . 2009; 87:123-54.

26. Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm Rep . 2009; 58:1-26.

27. Robert Wood Johnson Foundation, Leadership for Healthy Communities. Action Strategies Toolkit . Accessed January 30, 2012.

Does Healthy Food Prevent Obesity? Essay

Obesity has been a problem in the United States for some decades; it affects the population across all ages, and income: according to a report by Centers for Disease Control and Prevention 34 percent of American adults and 17 percent of American children are believed to be obese; the report further states that the condition is getting worse.

Despite having an obesity policy and engaging in massive campaigns to educate the people on the dangers of being obese, a lasting solution seems not to have been gotten. One way that has been recommended by medical practitioners is healthy eating. This paper, in support of healthy eating as a remedy to obesity, discusses how eating healthy can be a solution to obesity.

How eating health can resolve obesity issues in the United States

Obesity is accumulation of body fat and weight to a point that it can cause danger in the life of human being; it is caused by human eating and outdoor activities programs. When human being eats food with high fats and oils contents, they are increasing their fats intake that accumulated in the body.

When fat has accumulated in the body, human beings risk the danger of suffering from obesity and other related complications. Junk foods have high fats content and when they are fed on, they result to high accumulation of fats in human body.

Checking on what people eat is likely to reduce the chances of being obese; people should aim at eating foods with low food content. “Supermarket” foods, which are regarded as junks, and fast foods cause the most danger as far as obesity is concerned. They should be avoided at all lengths.

Unhealthy food is all over in the United States, they come in different shapes and targets different ages and population in the country; when people eat the foods, they have the tendency of repeating the same in the future a factor that further threatens their health.

The right food for a good health life is well-balanced food; every nutrient should be represented in the diet in a good position depending with the level of activities that a person is going to involve. Organic foods are highly recommended, they have low fat content thus they cannot lead to obesity. To instill the discipline of eating healthy, mothers should train their children on the right meals, at infancy; they should be kept off junk foods and in-organic foods as possible.

The current moves to genetically modified foods is also a major contributor to the growth of obesity among the Americans, the government should control their consumption. One reason why there are increased junk foods eating habits is the growth of fast foods and restaurants, the government should ensure that these places of eating should be controlled.

Other than eating healthy foods, the challenge can also be attached by a combination of eating healthy and engaging in a number of exercises (outdoor) activities. This will assist burning the calories of food and reduce chances of being obese.

Obesity continues to be a challenge to Americans; to get a remedy for the disease, the government, parents, communities, and patients should join efforts and promote healthy eating habits.

At all lengths, junk foods and foods with high fat /oil contents should be avoided; the government has the role of controlling fast food and restaurants businesses. Parents should train their children right eating habits from infancy.

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How Should We Reduce Obesity in America?

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Obesity is a health problem that is growing rapidly in the United States and other parts of the world. In this country, it is epidemic. About one in three Americans is obese.

It may be natural for people to gain at least a little weight later in life. But that is no longer the issue. The problem today is that by the time American children reach their teens, nearly one in five is already obese, a condition all too likely to continue into adulthood.

This issue guide asks: How should we reduce obesity in America? It presents three different options for deliberation, each rooted in something held widely valuable and representing a different way of looking at the problem. No one option is the “correct” one, and each option includes drawbacks and trade-offs that we will have to face if we are to make progress on this issue. The options are presented as a starting point for deliberation.

Help People Lose Weight Take a proactive stance in helping people lose weight— persuasion and education by families and doctors, and the establishment of consequences by employers and insurance companies. Losing weight is a personal decision but it is one that affects all of us.

Improve the Way Our Food Is Produced and Marketed   Although our food system does a good job of keeping the cost of food low, many of the resulting products are both very unhealthy and very enticing. We need to get better control of our food production system, including how foods are marketed to us, and ensure more equitable access to healthy foods.

Create a Culture of Healthy Living and Eating   This option would promote overall, lifelong wellness by making sure our children start learning to make better choices as early as possible. This option also calls for reshaping our neighborhoods and buildings to help us get more exercise.

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Obesity Essay

Essay on obesity for children.

Obesity is a condition that involves excessive weight gain in the body. There will be a higher risk of health problems due to increased amounts of body fat. It is basically an excessive accumulation of fat in the body. The height and weight of the body determines the Body Mass Index (BMI). Generally, people are considered overweight if their BMI is above 25. Moreover, it is said that a BMI above 30 is considered to be obesity. With an ever changing way of living, people are gaining obesity due to unhealthy lifestyles. Obesity results in various health conditions in humans. Due to this, a person  suffers from heart diseases, high cholesterol level, high blood pressure, respiratory and other chronic ailments. 

The main cause of obesity is due to overeating and unhealthy lifestyles. In today’s world, we have seen kids from an early age exposed to junk food and reduction in physical activity. This leads to excess accumulation of fat in the body. In order to overcome obesity, kids must be introduced to a healthy lifestyle along with nutritious food. Besides this, regular exercise and physical activity would help in reducing the weight leading to a healthy life. In this obesity essay, we will discuss the causes, complications and preventive measures. 

Causes Of Obesity 

When an excessive amount of energy is consumed and returned in less quantity, then the rest gets accumulated in the adipose tissue leading to obesity. Therefore, a person consuming more food and releasing less energy results in weight gain. Some of the causes of obesity are mentioned below:

• Overeating: Do you think eating junk food or unhealthy eating habits can lead to obesity? Yes, it has a repercussion on health. There are certain habits that result in obesity such as eating fried snacks, eating fast, eating more and eating food irregularly. Food items with high calories can lead to an increase in weight. For example, sugar, oily and fried items, processed foods, etc. These food items may taste better but eventually leads to increase in weight followed by health complications. 
• Reduction in physical activity: Due to sedentary lifestyle, there is reduction in physical activities such as running, walking or doing household chores. With growing technology, people are dependent on machines and appliances for their work. Therefore, it leads to less movement resulting in fat accumulation in the body. People who do not burn their calories with physical activities tend to put on more weight. Nowadays, people want to eat food and relax without doing any physical activity. 
• Hormonal change: A person tends to put on weight if they have hormonal problems.
• Genetic factor: A person can also gain obesity due to genetic factors. Due to hereditary, a person can become obese even if they eat balanced food or do regular physical exercise. If the ancestors of the family were facing this condition, then they are more likely to gain obesity. 
• Psychological factors: If the person is suffering from psychological problems, they tend to eat more in order to reduce their stress. During sadness or boredom, people like to eat more food. They want to eat more and forget their problems. This eventually leads to an increase in weight. 

Also explore: Essay on Sports and motivation essay .

Complications Of Obesity

Obesity is increasing rapidly across the world. The intake of calories and outlet of energy determines the body weight. If a person is eating more and not burning their calories, it will lead to an increase in body fat. There are major health problems due to obesity. Some of the problems are mentioned below:

• Health Disorders: Due to obesity, there will be an increase in heart related disease in humans. Besides this, people may suffer from high blood pressure, diabetes, gall bladder disorders, respiratory problems, psychological issues, etc.  
• Laziness: When there is excess fat accumulation in the body, a person tends to become lazy in doing things. They look for support or seek help in order to get their things done. 
• Economic problems: A person suffering from obesity faces low economic growth due to their health problems associated with weight gain. They become lazy and reduce the quality of work. It leads to huge loss in work and economy. Due to increased health issues, a person tends to spend more money on diagnosis and treatment.
• Low productivity: There might be a reduction in productivity of work. Due to this, a person will feel lethargic towards work and eventually result in low productivity of the work that they are doing. 

How To Prevent Obesity?

Obesity creates major health issues in humans. To overcome this Issue, it is important to focus on losing weight and avoiding things that can cause weight gain. Preventing obesity will help people in reducing the high risk of health problems. It is vital for everyone to stay fit, eat healthy and sleep well to avoid weight gain.  Some of the ways to prevent obesity are mentioned below:

• Eating balanced food: To maintain weight, it is mandatory for people to eat balanced meals. It should include carbohydrates, proteins, fibers, etc. Anything in excess can lead to weight gain. Therefore, including a balanced diet in the meal will not only provide nutrition to the body but also avoid accumulation of excess fat. Avoid junk food and eat more vegetables and fruits for a healthy diet. Encourage children from an early age to inculcate the habit of eating healthy food. This will help them in growing into a healthy person. Besides this, encourage kids to eat only when they are hungry as excess food might get stored in the body as fat. Also, slow eating is one of the factors for reduction in weight. It helps in proper digestion of the food particles. 
• Exercise regularly: Apart from eating food, it is also important for people to exercise on a regular basis. The amount of calories taken should be burned with the help of physical activities. Some of the ways to burn calories are jogging, walking, dancing, yoga or any form of exercise. Try to avoid continuous sitting while working or studying. Take up activities that require more physical activity such as using stairs instead of lift, walking to nearby stores instead of taking a car, etc.
• Eating on time: Irregular patterns of eating may lead to overeating and weight gain. Therefore, inculcating a habit of eating on time will lead to proper digestion of food. The person eating on time will eat food in a limited amount. If there is delay, a person tends to eat food in large quantities. This will result in weight gain. Most importantly, try to eat smaller portions so that there is enough time for digestion. Drink more water to eliminate all the toxic materials from the body. 
• Avoid unhealthy food: Though unhealthy food tastes good, it is important to avoid them. There are many food items available in the market that are processed and rich in sugar. These food products are difficult to digest leading to accumulation of fat in the body. Therefore, avoiding such food items would be the best option for a healthy life. Try to consume food which is low in calories for proper digestion such as fruits and vegetables. These food items have lots of nutrients which can help in lowering the risk of health problems. 
• Improve physical activities: To digest food in the body, there has to be a proper workout or physical activity that people must incorporate in their lifestyles. Incorporating fun physical activities such as playing sports, working out in the gym and doing household chores will help in weight reduction. Avoid sitting or sleeping immediately after intake of food. This will reduce the process of digestion in the body leading to weight gain. 
• Take proper sleep: It is important to take enough rest and sleep at night. Reduction in sleep may cause health problems leading to weight gain. Therefore, introduce bedtime rituals in your lifestyle in order to get proper sleep. 

Obesity is the condition which leads to weight gain due to overeating and unhealthy lifestyles. The main cause of obesity is overeating, reduced physical activities and sleep. Due to this, a person may suffer from severe health problems such as heart diseases, high cholesterol and blood pressure, respiratory problems, etc. To prevent obesity, a person must eat a balanced diet, avoid overeating, exercise regularly, eat food on time, get enough sleep, etc. 

We hope this obesity essay was useful to you. Check essays for kids for more topics. 

Frequently Asked Questions On Obesity Essay

What is an obesity essay.

It is a short write up on obesity which is a condition that results in weight gain leading to many health problems.

What is the main cause of obesity?

The main causes of obesity are overeating, unhealthy lifestyle, less physical activities, genetic and psychological factors.

How to prevent obesity?

The different ways to prevent obesity are eating balanced food, regular exercise, eating food on time, avoiding unhealthy food, increasing physical activity, getting enough sleep, etc.

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The effectiveness of nurse‐led interventions to prevent childhood and adolescent overweight and obesity: A systematic review of randomised trials

Lisa whitehead.

1 School of Nursing and Midwifery, Edith Cowan University, Joondalup Western Australia, Australia

Istvan Kabdebo

Melissa dunham, robyn quinn.

2 Chronic Disease Policy Chapter, Australian College of Nursing, Deakin Australian Capital Territory, Australia

Jennifer Hummelshoj

3 Centenary Hospital for Women and Children, Canberra Australian Capital Territory, Australia

Cobie George

Elizabeth denney‐wilson.

4 Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney New South Wales, Australia

Associated Data

Author elects to not share data.

Obesity among children and adolescents continues to rise worldwide. Despite the efforts of the healthcare workforce, limited high‐quality evidence has been put forward demonstrating effective childhood obesity interventions. The role of nurses as primary actors in childhood obesity prevention has also been underresearched given the size of the workforce and their growing involvement in chronic disease prevention.

To examine the effectiveness of nurse‐led interventions to prevent childhood and adolescent overweight and obesity.

A systematic review of randomised trials.

Data sources

Medline, CINAHL, EMBASE, Cochrane (CENTRAL), ProQuest Central and SCOPUS were searched from inception to March 2020.

Review methods

This review was informed by the Cochrane handbook for systematic reviews of interventions.

Twenty‐six publications representing 18 discrete studies were included (nine primary prevention and nine secondary prevention). Nurse‐led interventions were conducted in diverse settings, were multifaceted, often involved parents and used education, counselling and motivational interviewing to target behaviour change in children and adolescents’ diet and physical activity. Most studies did not determine that nurse‐led interventions were more effective than their comparator(s) in preventing childhood and adolescent overweight and obesity.

Conclusions

Nurse‐led interventions to prevent juvenile obesity are feasible but have not yet determined effectiveness. With adequate training, nurses could make better use of existing clinical and situational opportunities to assist in the effort to prevent childhood obesity.

What problem did the study address?

• Interventions to adequately prevent childhood and adolescent overweight and obesity are largely unsuccessful.
• The effectiveness of nurse‐led interventions to prevent childhood and adolescent overweight and obesity warrants investigation.

What were the main findings?

• There are limited rigorous, nurse‐led interventions focusing on the prevention of childhood and adolescent overweight and obesity.
• Nurses readily facilitate the delivery of childhood obesity interventions but are underrepresented as stake holders in their conceptualisation. Few nurse‐led interventions have demonstrated effectiveness in the prevention of childhood obesity.

Where and on whom will the research have an impact?

• Given the size and geographical spread of the nursing workforce and their growing contribution towards chronic disease prevention, nurses are well positioned to lead and contribute in childhood and adolescent obesity prevention.

1. INTRODUCTION

Obesity among children and adolescents is a global issue. The number of obese children worldwide is predicted to reach 250 million by 2030, or one in five children, up from the current figure of 150 million (World Obesity Federation, 2019 ). Since 1975, the global prevalence of childhood and adolescent overweight and obesity has risen from 4% to 18% (World Health Organisation, 2020 ). No country has reported a reduction in obesity rates in the last three decades (Ng et al., 2014 ), and only one in 10 countries is predicted to have a 50% chance of meeting WHO's target of no rise in childhood obesity between 2010 and 2025 (World Obesity Federation, 2019 ).

The link between childhood obesity and obesity in adulthood is strong and related to the early onset of diabetes, fatty liver disease, cardiovascular disease and multiple cancers (Biro & Wien, 2010 ; World Cancer Research Fund (WCRF), & American Institute for Cancer Research (AICR), 2018 ). There is a substantial cost‐burden associated with childhood obesity, which is compounded by its lasting effects into adolescence and adulthood (Lobstein et al., 2004 ). For example, the total lifetime excess cost of childhood obesity has been estimated at €150,000, resulting from both direct healthcare costs to the individual and indirect costs from losses in productivity (Hamilton et al., 2018 ). Although much effort has been devoted into childhood obesity prevention across the healthcare workforce (Hennessy et al., 2019 ), limited high‐quality evidence has demonstrated clinically meaningful reductions in childhood obesity‐related outcomes (Rajjo et al., 2017 ). The role of nurses as primary actors in childhood obesity prevention has also been underresearched given their growing contribution towards chronic disease management (Sargent et al., 2012 ) and their position as the largest registered health workforce worldwide (World Health Organization, 2018 ).

1.1. Background

Increases in population weight and obesity have been attributed to an obesogenic environment, one which promotes sedentary behaviour coupled with easy access to high‐energy‐dense foods (Swinburn et al., 2011 ). In addition to diet, children and adolescents are more sedentary (Global Health Observatory data repository ‐ World Health Organisation, 2019 ), with the majority not taking the recommended daily 60 min of moderate to vigorous‐intensity physical activity (PA; World Health Organisation, 2011 ). This problem has been amplified during the COVID‐19 pandemic due to mandatory lockdowns and forced school closures, which is often the only outlet for organised PA for children (Cuschieri & Grech, 2020 ). While international, national and state policies to address the obesity epidemic are required at a population level, major environmental changes take time to be implemented. Meanwhile, the proportion of people who are overweight and obese continues to rise.

Countless childhood obesity interventions have been trialled with some determining effectiveness (Chai et al., 2019 ; Hennessy et al., 2019 ; Liu et al., 2019 ). However, very few studies have been able to demonstrate clinically meaningful reductions in obesity‐related outcomes. Prior reviews on childhood obesity interventions have focused on their setting (Liu et al., 2019 ), their mode of delivery (Chai et al., 2019 ) and the provider responsible for their delivery (Hennessy et al., 2019 ). The prevailing recommendations from these reviews are the need for high‐dose, multicomponent interventions targeting the family, delivered in a variety of settings. Nurses operate in a variety of settings, including primary care, hospitals, schools and the general community. Nursing models are increasingly moving towards preventive care, particularly in the primary healthcare setting where nurses represent a growing proportion of the healthcare workforce devoted to chronic disease prevention and management (Sargent et al., 2012 ). Despite this significant presence, scarce evidence has been put forward to evaluate the effectiveness of nurse‐delivered interventions to prevent obesity in either adult or juvenile populations (Sargent et al., 2012 ). Only one prior review has investigated the effectiveness of school nurses in childhood and adolescent obesity prevention, showing minimal effectiveness (Schroeder et al., 2016 ). Building on this evidence, the present review considered all types of nurses acting in a leading role to prevent childhood and adolescent obesity in both clinical and community settings.

2. THE REVIEW

The aim of this systematic review was to determine the effectiveness of nurse‐led interventions to prevent childhood and adolescent overweight and obesity.

2.2. Design

This review was informed by the Cochrane handbook for systematic reviews of interventions (Higgins et al., 2019 ). A PICOS (Population, Intervention, Comparator, Outcome, Study) framework was used to conceptualise the search strategy and develop search strings. Each concept of the search strategy was mapped to a MeSH term appropriate to each database. The concepts broadly represented: children and adolescents, nurse‐led interventions, weight‐related outcomes and randomised (controlled) trials. Search strings included a mix of MeSH headings and key words. The search string used for MEDLINE is described in the supplementary file.

2.3. Search methods

A systematic search was performed in the following electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane (CENTRAL), ProQuest Central and SCOPUS. Databases were searched from inception to March 2020, and records were restricted to peer‐reviewed journal articles, human studies and English language only. The protocol for this review was registered with the International Prospective Register of Systematic Reviews (PROSPERO); CRD42020138969. Reporting has been structured according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines (Moher et al., 2009 ).

2.3.1. Inclusion criteria

Randomised trials evaluating the effectiveness of nurse‐led interventions to prevent child and adolescent overweight and obesity were included in this review. Children and adolescents were defined as persons ≤18 years of age at study baseline. Effectiveness was determined by assessing the between‐group difference in means of the following weight‐related outcome measures: body mass index (BMI), BMI standard deviation score (BMI SDS), z ‐BMI or BMI z ‐score (BMI adjusted for age and sex) and weight‐for‐length (WFL) percentile. Prenatal studies were eligible for inclusion provided the offspring's weight‐related outcomes were the primary outcome(s) of the study. Interventions were classified as ‘nurse‐led’ if it could reasonably be determined that nurses had a dominant role in their delivery. For example, where nurses were part of a multidisciplinary team, predominance was established using the specified number of nurse contacts or measures of contact time with nurses relative to other interventionists. Interventions where nurses had an equal or minority role (e.g., screening prospective participants or collecting anthropometric measurements) were not eligible for inclusion. Trials that compared two or more interventions, compared different ‘doses’ of the same intervention or compared interventions against standard care were eligible for inclusion, provided at least one arm of the trial was clearly nurse‐led. Relevant pilot studies, secondary analyses of trial data and follow‐up publications of randomised trials were eligible for inclusion provided weight‐related outcomes were a targeted objective of the intervention. Conference proceedings, grey literature, protocol papers and systematic reviews were not eligible for inclusion. In the case of primary prevention studies, participants were required to be healthy at baseline. In the case of secondary prevention studies, participants were required to be ‘otherwise healthy’. Therefore, other than being overweight or obese, participants could not have other pre‐existing illnesses or diseases.

2.3.2. Screening

Database searches were undertaken by one reviewer (I.K.). Abstract screening was blinded and undertaken independently by two reviewers (I.K. and M.D.) using the Rayyan screening tool (Ouzzani et al., 2016 ). Potentially eligible articles identified during abstract screening were retrieved in full and independently assessed according to the eligibility criteria by two reviewers (I.K. and L.W.). Disagreements were resolved by discussion. The reference lists of all included studies and related systematic reviews were hand searched to ensure completeness.

2.4. Quality appraisal

The methodological quality of all included studies (and their follow‐up publications) was appraised using the Risk of Bias (RoB) tool (version 2.0) developed by Cochrane (The Cochrane Collaboration, 2019 ). Individually randomised (parallel group) trials were assessed using the standard RoB2.0 tool (The Cochrane Collaboration, 2019 ), which addresses bias across five domains: (1) the randomisation process, (2) deviations from intended interventions, (3) missing outcome data, (4) outcome measurement and (5) outcome reporting. Clustered‐randomised trials were assessed using the clustered‐variant of the RoB2.0 tool (Higgins et al., 2016 ), which includes additional questions unique to cluster‐specific study designs. This variant covers the initial five bias domains and an additional domain: ‘the timing of identification and recruitment of individual participants in relation to timing of randomisation’. Each bias domain asks a series of questions related to the procedures undertaken in the study. Based on the responses to these questions, the algorithm in the accompanying guides suggest marking a bias domain as either ‘low risk’, ‘some concerns’ or ‘high risk’ (Higgins et al., 2016 ; The Cochrane Collaboration, 2019 ). Quality appraisal was undertaken independently by two reviewers (I.K. and L.W.). Disagreements were resolved by deliberation. Publication bias was not addressed.

2.5. Data abstraction

Data were extracted by one reviewer (I.K.). Included studies were grouped by primary or secondary prevention and study characteristics were reported separately to study results. The following data pertaining to study characteristics were extracted: primary author, year, country, study design and setting, population demographics at baseline, intervention and timeframe, nurse type and role, and comparator group(s). The following data pertaining to study results were extracted: outcome measure, duration of follow‐up, number of participants from each group used in the analysis, the mean difference of the stated outcome between the experimental and comparator group(s), presented with 95% confidence intervals (CIs) or the stated p value (where 95% CIs were not presented) and key findings.

Where possible, population demographics reflected the sample prior to randomisation or the start of the intervention. Where included studies only provided demographics of the analysed sample, these data were used. Duration of follow‐up was defined as the length of time from the first outcome measurement (baseline) to the final outcome measurement. Where follow‐up publications presented additional data points to an original study, these were documented for completeness.

2.6. Synthesis

Given the heterogeneity of studies included in this review, meta‐analysis was not pursued. Heterogeneity was assessed in consideration of substantial differences in demographic characteristics (particularly subjects’ ages), length of follow‐up, outcome measures and types and dosage of interventions. In lieu, a narrative synthesis of results was conducted, where studies were broadly grouped by either primary or secondary prevention. Results were then discussed in groupings based on similar types of interventions used across primary or secondary prevention studies.

3.1. Systematic search results

The PRISMA flow diagram representing study selection is described in Figure ​ Figure1. 1 . The search strategy returned 1,195 records, with seven further records identified through hand searching. After removing duplicates ( n  = 516) and screening abstracts, 102 articles remained, which were retrieved and assessed in‐full for eligibility. The titles of all full‐text articles excluded during assessment ( n  = 76) is presented in the supplementary file, along with the primary reason for their exclusion. In total, 26 published articles (representing 18 discrete studies) were deemed eligible for inclusion in the structured synthesis. Five of these studies (and two follow‐up publications) were identified by hand searching the reference lists of included studies, related articles and reviews (Hennessy et al., 2019 ; Hollinghurst et al., 2014 ).

PRISMA flow diagram

3.2. Summary of quality appraisal

The methodological quality of the included studies (and their follow‐up publications) was generally poor, with most publications ( n  = 19, 73%) judged as having high bias (Chahal et al.s, 2017 ; Christie et al., 2017 ; Döring et al., 2016 ; Enö Persson et al., 2018 ; Ford, Bergh, et al., 2010 ; Forsell et al., 2019 ; Jonsdottir et al., 2014 ; Kokkvoll et al., 2014 , 2015 , 2019 ; Kong et al., 2014 ; Lakshman et al., 2018 ; Marild et al., 2013 ; Paul et al., 2011 , 2018 ; Savage et al., 2016 ; Taylor et al., 2017 ; Wen et al., 2012 , 2015 ), six showing ‘some concerns’ (Alkon et al., 2014 ; De Vries et al., 2015 ; Pbert et al., 2013 , 2016 ; Rifas‐Shiman et al., 2017 ; Taveras et al., 2011 ), and only one receiving a low‐bias rating (Taylor et al., 2018 ). In some cases, the scores for individual domains varied between the source study and subsequent publication(s). However, in all but one study, the overall bias assessment score of follow‐up publications mirrored the final rating of their source study. For clustered randomised (controlled) trials, the only source of high bias was the domain related to missing outcome data. By contrast, there were several sources of high bias across the domains for individually randomised (controlled) trials, including randomisation, deviations from intended interventions, missing outcome data and the reporting of outcome data. Across all but three individually randomised (controlled) trials, the description, treatment and analysis of missing outcome data resulted in a high bias score. A comprehensive list of scores for each study and their follow‐up publications are included in the supplementary file.

3.3. Publication bias

As meta‐analysis was not conducted, testing for publication bias was deemed superfluous. However, given that most included studies (13/18, 72.2%) reported non‐significant findings, publication bias was unlikely.

3.4. Effects of nurse‐led primary prevention interventions

In total, nine of the 18 included studies evaluated the effect of a nurse‐led intervention to prevent childhood overweight and obesity (Alkon et al., 2014 ; De Vries et al., 2015 ; Döring et al., 2016 ; Jonsdottir et al., 2014 ; Lakshman et al., 2018 ; Paul et al., 2011 ; Savage et al., 2016 ; Taylor et al., 2017 ; Wen et al., 2012 ). A full description of their characteristics and results are presented in the Table ​ Table1 1 .

Overview of included studies

Abbreviations: x ¯  = sample mean; ANOVA, analysis of variance; BMI, body mass index; BMISDS, body mass index standard deviation score; CBT, cognitive behavioural therapy; CHC, child healthcare centre(s); CI, confidence interval; kg, kilogram; MI, motivational interview; n , number; Nc, number in comparator group; NP, nurse practitioner; Nx, number in experimental group(s); PA, physical activity; RCT, randomised controlled trial; SD, standard deviation; UK, United Kingdom; USA, United States of America; WFL, weight‐for‐length; z ‐BMI, body mass index adjusted for age and sex.

3.4.1. Infant feeding, sleep and play

The majority of nurse‐led primary prevention studies focused on infants below the age of one (De Vries et al., 2015 ; Jonsdottir et al., 2014 ; Lakshman et al., 2018 ; Paul et al., 2011 ; Savage et al., 2016 ; Taylor et al., 2017 ; Wen et al., 2012 ). Interventions focused on a combination of infant feeding (including breastfeeding) sleep and play (PA). In De Vries et al. ( 2015 ), paediatric nurses delivered an educational intervention, over an 11‐month period, concerning daily infant care, developing food habits, and stimulating motor development. At 29 months old, there was no significant difference in infant mean BMI in the intervention group. In Jonsdottir et al. ( 2014 ), the intervention, delivered by a Nurse lactation consultant, consisted of mothers exclusively breastfeeding until 6 months old, relative to the control group who did so only until 4 months old. The results did not show a significant difference in infant BMI at either 18‐ or 29‐ to 38‐month follow‐up for the prolonged breastfeeding group. A similar intervention, delivered by a Research Nurse in Lakshman et al. ( 2018 ), focused on the promotion of responsive feeding, healthy weaning and reduced intake of formula milk and found no significant difference in mean BMISDS at either 6 or 12 months old. By contrast, Paul et al. ( 2011 ) combined two interventions on infant soothing techniques, duration of sleep and education on infant satiety cues for hunger and reported a significant difference in mean WFL percentile after 12‐month follow‐up, when compared to infants who received only the sleep component or the hunger satiety component of the combined intervention. Another multiintervention study (Taylor et al., 2017 ) combined an educational intervention involving components on breastfeeding, PA and the timing of introduction of solid foods, with an intervention on infant sleep habits, and found no significant difference between intervention groups in terms of mean z ‐BMI at either 24, 42 or 60 months of age (Taylor et al., 2017 , 2018 ). In Savage et al. ( 2016 ), research nurses provided hands‐on demonstrations with mothers on infant feeding, soothing and playing during home visits. Additionally, nurses counselled mothers on sleeping habits, feeding, portion sizes, age‐appropriate PA and regulating infant emotions. At 12 months old, infants in the intervention group had a significantly lower mean BMI: ~ −0.4 (~ −0.7 to ~ −0.1) relative to the control group. However, this significant difference was not maintained at either 24‐ or 36‐month follow‐up (Paul et al., 2018 ). Lastly, in Wen et al. ( 2012 ), a community nurse delivered an intervention targeting improved infant feeding, active play time and reduced screen time during eight home visits over a period of 2 years. At 24 months, there was a significant difference in mean z ‐BMI in children whose mothers received the intervention: −0.29, (−0.50 to −0.07). However, this effect was not sustained at 42 or 60 months old (Wen et al., 2015 ).

3.4.2. Motivational interviews

Motivational interviewing (MI) techniques were applied in one primary prevention study targeting primiparous mothers (Döring et al., 2016 ) attending child healthcare centres. The intervention consisted of nine MI sessions conducted by registered nurses, delivered over a 39‐month period. MI sessions adopted a cognitive behavioural therapy (CBT) approach, oriented towards goal‐setting to reduce unhealthy behaviours and promoted healthy food habits and PA for the benefit of their 9‐ to 10‐month‐old infants. At 39‐ and 51‐month follow‐up, there was no significant difference in mean BMI of children whose mothers received the intervention (Döring et al., 2016 ; Enö Persson et al., 2018 ).

3.4.3. Childhood nutrition and PA

Only one primary prevention study targeted children above the age of one (Alkon et al., 2014 ). This cluster‐RCT was conducted across 18 childcare centres and focused on children between 3 and 5 years old. The intervention consisted of educational workshops delievered to childcare staff delivered by a nurse childcare health consultant. These workshops centred on improving children's nutrition and increasing their PA while at the childcare centre. After 7‐month follow‐up, the difference in mean z ‐BMI was significantly lower amongst childcare centres who received the intervention: −0.14 (−0.26 to −0.02).

3.5. Effects of nurse‐led secondary prevention interventions

In total, nine of the 18 included studies evaluated the effect of a nurse‐led intervention to manage childhood and adolescent overweight and obesity (Chahal et al., 2017 ; Christie et al., 2017 ; Ford, Bergh, et al., 2010 ; Kokkvoll et al., 2014 ; Kong et al., 2014 ; Marild et al., 2013 ; Pbert et al., 2013 , 2016 ; Taveras et al., 2011 ). A full description of their characteristics and results is presented in the Table ​ Table1 1 .

3.5.1. Motivational interviews

The majority of secondary prevention studies delivered an MI‐based intervention for the benefit of children and adolescents (Chahal et al., 2017 ; Christie et al., 2017 ; Kokkvoll et al., 2014 ; Marild et al., 2013 ; Taveras et al., 2011 ). In Chahal et al. ( 2017 ), four MI sessions were delivered by a nurse practitioner (NP) to children and adolescents (and their parents) over a 6‐month period. The focus of the MIs was to develop a plan to effect behaviour change by focusing on personal strengths and self‐efficacy. The experimental group received MIs with their parents, whereas the comparator group received MIs alone. At 6‐month follow‐up, there was no significant difference between groups in terms of mean BMI. In Taveras et al. ( 2011 ), an MI‐based intervention was delivered by a paediatric NP over 2 years to parents of 2‐ to 6‐year‐olds attending paediatric practices. MI sessions targeted a reduction in television viewing time and unhealthy food consumption. The control group received standard care. There was no difference in mean BMI between groups at either 12‐ or 24‐month follow‐up. Similarly, in Marild et al. ( 2013 ), 12 MIs were delivered exclusively to parents of 8‐ to 13‐year‐olds over a 1‐year period. MI sessions adopted a CBT approach and encouraged behaviour changes in the diet and PA level of the child and reinforced dietary and behavioural guidance regarding sleep, screen‐time and sedentary behaviour. MIs were mostly delivered by dietitians and physiotherapists in the experimental group but were predominantly nurse‐delivered in the comparator group. At both 12‐ and 48‐month follow‐ups, there was no significant difference between groups in terms of mean BMISDS suggesting that adding a physiotherapist to a nurse‐led intervention, with the view of further promoting PA, did not lead to a significant reduction in mean BMI for the experimental group. Similarly, in Christie et al. ( 2017 ), the comparator group received a 40‐ to 60‐min educational session on healthy eating and PA by a primary care nurse and trained NP. By contrast, the experimental group received a MI‐based intervention and weight management programme delivered by mental health workers. The intervention delivered to the experimental group focused on changing eating behaviours, decreasing sedentariness and improving nutritional intake. At both 6‐ and 12‐month follow‐ups, there was no significant difference between groups in terms of mean BMI. Lastly in Kokkvoll et al. ( 2014 ), both the experimental and comparator group received multicomponent interventions which included MI‐based counselling with the aim of helping families increase PA, decrease sedentary activity and increase their intake of healthy foods. This was supplemented with counselling provided by public health nurses in the local community and paediatric nurses in a hospital setting. In addition, the experimental group attended a 3‐day inpatient programme, 4‐day camp and scheduled PA activities with a multidisciplinary team over a 12‐month period. Adding 28 h of contact time with a multidisciplinary team and adding a PA component totalling 38 h to a nurse‐led intervention did not lead to a significant difference in mean BMI between the experimental and comparator group at either 12‐, 24‐ or 36‐month follow‐up (Kokkvoll et al., 2014 , 2015 , 2019 ).

3.5.2. Counselling

A counselling‐based intervention was conducted in three secondary prevention studies (Kong et al., 2014 ; Pbert et al., 2013 , 2016 ). In Kong et al. ( 2014 ), the experimental group received a dietician‐led counselling intervention which included a behavioural assessment of diet and lifestyle and education to reduce caloric intake and increase PA. The comparator group consisted of nurse‐led counselling sessions which focused on dietary advice centred around the standard food pyramid. At 6‐month follow‐up, there was no significant difference between groups in terms of mean BMI. In Pbert et al. ( 2013 and 2016 ), counselling‐based interventions were delivered to adolescents by school nurses in high schools. Counselling involved CBT techniques to support behaviour change relating to diet and PA. The goal of counselling was to improve health knowledge, self‐control and self‐efficacy. Control groups visited the school nurse where anthropometric measurements were taken and behaviour change intentions were discussed. At both 2‐ and 6‐month follow‐ups, there was no significant difference in terms of mean BMI between groups (Pbert et al., 2013 ). In Pbert et al.'s follow‐up study (2016), a PA component was added to the counselling‐based intervention. PA sessions were delivered by physical education teachers or school nurses three times per week over an 8‐month period. Adding a PA component to the counselling‐based intervention did not result in a significant difference in mean BMI between groups at 8‐month follow‐up.

3.5.3. Eating device

The intervention in Ford, Bergh, et al. ( 2010 ) was highly specialised and involved 12 consultations with a research nurse during which children and adolescents (ages 9–17) were taught how to use a Mandometer eating device. A Mandometer is a computerised weighing scale that measures depletion of food weight and encourages correct eating speed via audio vocalisation. Obese children and adolescents were encouraged to use this device daily to reduce food intake and build positive eating habits. The control group received an MI‐based intervention targeting improved diet and increased PA delivered by a multidisciplinary team. At both 12‐ and 18‐month follow‐ups, there was a significant difference between the intervention and control groups in terms of mean BMISDS: −0.24 (−0.36 to −0.11) and −0.27 (−0.11 to −0.43), respectively. Of the nine included secondary prevention studies, this was the only one to demonstrate a significant reduction in obesity‐related outcomes.

4. DISCUSSION

Interventions to prevent childhood overweight and obesity have the potential to mitigate the trajectory of obesity into adulthood, thereby improving long‐term quality of life, reducing risk for chronic disease and lowering future healthcare costs (Oude Luttikhuis et al., 2009 ; US Preventive Services Task Force, 2010 ). Comprehensive, high‐intensity behavioural interventions for childhood obesity, compared with usual clinical care, have demonstrated effectiveness in reducing obesity‐related outcomes (Chai et al., 2019 ). However, inroads into clinically meaningful reductions are yet to be achieved (Ho et al., 2013 ). This problem is amplified by the slow adoption of expert recommendations and nationally standardised performance measures in relation to the prevention and management of overweight and obesity in children and young people (Australian College of Nursing (ACN), 2020 ).

Nurses have the potential to facilitate the delivery of interventions across community, health and education settings, by virtue of the size, scale and adaptability of the workforce. In this review, nurse‐led interventions were conducted in the home, childcare, primary care and school settings. Nurses delivered complex multicomponent interventions and were often the leading or most utilised member of a multidisciplinary team. Interventions were diverse and included counselling and MIs, the development of nutritional and PA guidelines and the establishment of workshops, all with the aim of promoting lifestyle and behaviour change in children and their parents.

Despite nurses’ leading roles in the delivery of childhood obesity interventions, they were heavily underrepresented in their conceptualisation. For example, nurses were only included in a consultative capacity in three of the 18 included studies. In Wen et al. ( 2012 ), their home‐based intervention was conceptualised following wide consultation with community‐based child and family health nurses who had experience in providing home visits to first time mothers within the community. Similarly, in Pbert et al. ( 2013 and 2016 ), their school‐based interventions were conceptualised following focus‐group consultation with school nurses. Paradoxically, in nearly all cases, interventions were designed by the research team (doctors, nutritionists, epidemiologists, public health experts) but carried out by nurses, typically following a brief training period with the intervention. The failure to leverage nurse knowledge, training, practice and experience in the design of these interventions may have been a contributing factor to the lack of observed effect. Therefore, future studies should look to integrate nurses into the design of these interventions to improve intervention fidelity.

Eight of the nine included primary prevention studies focused on infants below the age of one (De Vries et al., 2015 ; Döring et al., 2016 ; Jonsdottir et al., 2014 ; Lakshman et al., 2018 ; Paul et al., 2011 ; Savage et al., 2016 ; Taylor et al., 2017 ; Wen et al., 2012 ). This shift in obesity prevention paradigms to early infancy emphasises the unique opportunity afforded to health professionals such as maternal child health (MCH) nurses to provide early obesity interventions. As MCH nurses have regular consultations with parents where they provide advice on infant feeding, they could be leveraged to provide other obesity prevention strategies at a critical juncture of a child's life, if given additional training and education. This overlap in opportunities has previously been discussed in an Australian study which determined that while MCH nurses were suitable professionals to provide obesity interventions, they were underutilised in their delivery (Laws et al., 2015 ). Similarly, other nurses in routine contact with parents, children or adolescents in a school, community or clinical setting could be leveraged to provide childhood and adolescent obesity interventions as part of routine healthcare practice. As nurses provide care across the life course, they could be used to prevent obesity from birth through to adolescence as part of their model of care in the prevention of chronic disease.

Overall, prevention studies for childhood overweight and obesity reported small to moderate decreases in weight‐related outcomes. However, significant differences between groups were not consistently established. Notably, only one secondary prevention study reported a significantly different decrease in BMISDS between groups at both 12 and 18 months: −0.24 (−0.36 to −0.11) and −0.27 (−0.43 to −0.11), respectively (Ford, Bergh, et al., 2010 ). In this study, the nurse‐led obesity intervention was more effective at reducing mean BMISDS than the multidisciplinary‐led comparator obesity intervention. In the included secondary prevention studies, nurses were more likely to be leading but working with other healthcare professionals in either or both the experimental and comparator/control groups. This makes it difficult to render a verdict on the direct effect of nurses’ roles in delivering these interventions, and the optimal mix of healthcare professionals best suited to tackle this problem.

Several included studies demonstrated no significant difference in terms of obesity prevention/reduction between nurse‐led interventions and interventions delivered by other healthcare professionals (Christie et al., 2017 ; De Vries et al., 2015 ; Döring et al., 2016 ). To improve and widen access to interventions, further studies should attempt to investigate whether nurses can have a better (or at least no worse effect) in reducing childhood and adolescent obesity comparative to other healthcare professionals, such as those identified in this review: doctors, dietitians, nutritionists, exercise specialists, physiotherapists, clinicians and psychologists.

Although five of the 18 included studies (27.8%) found statistically significant improvements in weight‐related outcomes between groups, most improvements were modest and not sustained over time. In this context, it is important to distinguish between statistical significance versus clinical significance. Similarly, change in BMI is often used as a proxy measure for change in percentage of body fat, and the use of BMI for the assessment of adiposity in early life is not without challenge (Marild et al., 2013 ; Wells & Fewtrell, 2006 ). Necessarily, many of the studies were designed to detect a statistically significant reduction in BMI where other measures may have been more appropriate from a clinical perspective. For example, it has been suggested that a decrease of 0.25 in BMISDS is the minimum clinically significant marker for improvements in body composition and cardiometabolic risk for adolescents who are already obese (Ford et al., 2010 ). However, a decrease of ≥0.5 BMISDS accrue greater clinical benefits (Ford, Hunt, et al., 2010 ). Ong et al. ( 2000 ) state that a difference of 0.67 (BMI z ‐score) is commonly used in evaluating associations with later morbidity in epidemiologic studies. The reality is that even small reductions in weight can improve longer term health outcomes and the value of raising awareness and changing behaviours have the potential to affect life‐long improvements. The difficulty is capturing these potential and actual changes in RCTs, and the value of running a process evaluation to capture qualitative data across an intervention could provide valuable insight into the impact of an intervention.

The interventions reviewed broadly focused on behavioural factors with goals to reduce energy intake and increase energy expenditure. While these are important factors, understanding the context of obesity from a population perspective is imperative. Societal, cultural and economic influences on obesity and PA are important considerations (Crawford et al., 2001 ). Factors include socio‐economic status, race, PA, dietary patterns, maternal factors and the home environment (Crawford et al., 2001 ). Socio‐economic factors were highlighted as important variables in understanding rates of obesity and the inverse relationship between obesity and socio‐economic status is well documented (Drewnowski & Specter, 2004 ). Money to purchase foods that are not energy dense is a major barrier for people on low incomes (Drewnowski & Specter, 2004 ). Therefore, interventions that take a ‘one‐size‐fits all’ approach are unlikely to be effective across diverse cultural and socio‐demographic groups, representative of today's society. It was notable that participants’ culture and socio‐economic status was rarely a key feature in the design of interventions, despite their link to many outcomes reported in this review. For example, numerous studies reported on ethnicity as background data but did not report subanalysis by ethnicity or perhaps could not due to homogeneity of samples. All these potential factors should be accounted for in the design of future studies to better understand their potential effects, which will also serve to enhance the generalisability of findings.

In this review, consistency with which the interventions were delivered and the quantity of the intervention to which participants were exposed differed across interventions. The outcomes could be attributed to the variations in programme implementation. Greater understanding of the optimal treatment ‘dose’ is needed, such as the number of sessions, length of intervention and impact on outcomes. A further common issue is the duration of follow‐up data to determine if the changes reported post‐intervention were maintained. Follow‐up in this review ranged from 6 to 60 months (mode 12 months) for primary prevention studies and 2–48 months (mode 12 months) for secondary prevention studies.

The effectiveness of parental involvement was mixed. It is important that the intensity, duration and activities that parents were involved in are reported across studies. This should include the reporting of proportions of parents that were involved and remained engaged throughout follow‐up. Qualitative work might capture parents’ perceptions of their child's obesity status prior to participating in obesity interventions to help their children remain engaged. Additionally, qualitative data may help improve the understanding of what involvement in the study parents do and do not find acceptable. Closer monitoring of parental activities could also assist in understanding the effectiveness of parental involvement to effect obesity reduction/prevention in their children.

4.1. Limitations

This systematic review aimed to present the results of intention‐to‐treat (ITT) analyses. Results of ITT analyses present an unbiased estimate of effect for an intervention, thus making them the most reliable indicator of its effectiveness in the real‐world setting, which is necessary for policy development (McCoy, 2017 ). In many of the reported studies, the simple definition of ITT ‘once randomised always analysed’ was misrepresented or misunderstood (McCoy, 2017 ). Many studies referred to ITT analyses, or implied their analyses were ITT, when they were either modified‐ITT analyses or some form of per‐protocol analysis. This reflects the need for the application of more sophisticated methods and transparency in reporting of results to help the healthcare community make better‐informed decisions as to the effect of these interventions.

While RCTs are the gold‐standard in study design, their application in pragmatic settings often leads to a difficulty in the interpretation of intervention effects. This is particularly true where comparator groups are effectively ethically required to receive some form of intervention, beyond what is expected in usual care. Operating under these constraints, it can be difficult to demonstrate a clear effect of nurse‐led interventions on weight‐related outcomes using an RCT framework. Therefore, future studies investigating the effectiveness of nurse‐led interventions should look to use wait‐list controls who receive the intervention after a pre‐specified period of time, as this would allow for a better demarcation of effects, while also preserving ethical integrity.

5. CONCLUSION

This review has identified that relatively few interventions have harnessed the potential of nurses to lead interventions to reduce the burden of overweight and obesity among children and young people. However, the ability of nurses to lead programmes across a range of settings was evident. There are numerous methodological issues that need to be addressed in order to determine the effectiveness of primary and secondary prevention programmes to reduce the burden of overweight and obesity. The research to date has illustrated a number of potential directions that should be further explored, in particular the opportunity afforded to early childcare nurses and the general need to involve nurses as stakeholders in the design of interventions. Childhood obesity is a serious issue that warrants the resources necessary to find effective prevention strategies.

CONFLICTS OF INTEREST

None to declare.

AUTHOR CONTRIBUTIONS

L.W.: Conceptualisation, methodology, screening, bias assessment, write‐up and review. I.K.: Methodology, literature search, screening, data extraction, data analysis, bias assessment, write‐up and review. M.D.: Methodology, literature search, screening and review. R.Q., J.H., C.G. and E.D.W.: Conceptualisation and review.

PEER REVIEW

The peer review history for this article is available at https://publons.com/publon/10.1111/jan.14928 .

Supporting information

Supplementary Material

ACKNOWLEDGEMENTS

The authors would like to thank Pam Thornton and Lisa Webb, librarians at ECU, for their assistance in the design of the systematic search strategy. This work was undertaken by the Chronic Disease Policy Chapter, Australian College of Nursing and we acknowledge the support of the College in conducting and publishing this review.

Whitehead, L. , Kabdebo I., Dunham M., Quinn R., Hummelshoj J., George C., & Denney‐Wilson E. (2021). The effectiveness of nurse‐led interventions to prevent childhood and adolescent overweight and obesity: A systematic review of randomised trials . Journal of Advanced Nursing , 77 , 4612–4631. 10.1111/jan.14928 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

This research did not receive any specific grant from funding agencies in the public, commercial or not‐for‐profit sectors.

DATA AVAILABILITY STATEMENT

• Alkon, A. , Crowley, A. A. , Neelon, S. E. B. , Hill, S. , Pan, Y. , Nguyen, V. , Rose, R. , Savage, E. , Forestieri, N. , Shipman, L. , & Kotch, J. B. (2014). Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index ‐ Additional File 1. Changes in children’s center ‐level zBMIs from pre‐ to post‐intervention (n=17 centers) . BMC Public Health , 32 ( 11 ), 57. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Australian College of Nursing (ACN) . (2020). The effectiveness of nurse‐led interventions in the assessment and management of overweight and obese children and young people ‐ Position Statement . Retrieved from https://www.acn.edu.au/wp‐content/uploads/position‐statement‐assessment‐management‐overweight‐obese‐children‐young‐people.pdf [ Google Scholar ]
• Biro, F. M. , & Wien, M. (2010). Childhood obesity and adult morbidities . American Journal of Clinical Nutrition , 91 , 1499S–1505S. 10.3945/ajcn.2010.28701B.1 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chahal, N. , Rush, J. , Manlhiot, C. , Boydell, K. M. , Jelen, A. , & McCrindle, B. W. (2017). Dyslipidemia management in overweight or obese adolescents: A mixed‐methods clinical trial of motivational interviewing . SAGE Open Medicine , 5 , 10.1177/2050312117707152 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chai, L. K. , Collins, C. , May, C. , Brain, K. , Wong See, D. , & Burrows, T. (2019). Effectiveness of family‐based weight management interventions for children with overweight and obesity: An umbrella review . JBI Database of Systematic Reviews and Implementation Reports , 17 ( 7 ), 1341–1427. 10.11124/JBISRIR-2017-003695 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Christie, D. , Hudson, L. D. , Kinra, S. , Wong, I. C. K. , Nazareth, I. , Cole, T. J. , Sovio, U. , Gregson, J. , Kessel, A. S. , Mathiot, A. , Morris, S. , Panca, M. , Costa, S. , Holt, R. , & Viner, R. M. (2017). A community‐based motivational personalised lifestyle intervention to reduce BMI in obese adolescents: Results from the Healthy Eating and Lifestyle Programme (HELP) randomised controlled trial . Archives of Disease in Childhood , 102 ( 8 ), 695–701. 10.1136/archdischild-2016-311586 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Crawford, P. B. , Story, M. , Wang, M. C. , Ritchie, L. D. , & Sabry, Z. I. (2001). Ethnic issues in the epidemiology of childhood obesity . Pediatric Clinics of North America , 48 ( 4 ), 855–878. 10.1016/S0031-3955(05)70345-X [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cuschieri, S. , & Grech, S. (2020). COVID‐19: A one‐way ticket to a global childhood obesity crisis? Journal of Diabetes and Metabolic Disorders , 19 ( 2 ), 2027–2030. 10.1007/s40200-020-00682-2 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• De Vries, A. G. M. , Huiting, H. G. , Van Den Heuvel, E. R. , L’Abée, C. , Corpeleijn, E. , & Stolk, R. P. (2015). An activity stimulation programme during a child’s first year reduces some indicators of adiposity at the age of two‐and‐a‐half . Acta Paediatrica, International Journal of Paediatrics , 104 ( 4 ), 414–421. 10.1111/apa.12880. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Döring, N. , Ghaderi, A. , Bohman, B. , Heitmann, B. L. , Larsson, C. , Berglind, D. , Hansson, L. , Sundblom, E. , Magnusson, M. , Blennow, M. , Tynelius, P. , Forsberg, L. , & Rasmussen, F. (2016). Motivational interviewing to prevent childhood obesity: A cluster RCT . Pediatrics , 137 ( 5 ), 1. 10.1542/peds.2015-3104. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Drewnowski, A. , & Specter, S. (2004). Poverty and obesity: The role of energy density and energy costs . The American Journal of Clinical Nutrition , 79 ( 1 ), 6–16. 10.1093/ajcn/79.1.6 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Enö Persson, J. , Bohman, B. , Tynelius, P. , Rasmussen, F. , & Ghaderi, A. (2018). Prevention of childhood obesity in child health services: Follow‐up of the PRIMROSE trial . Childhood Obesity , 14 ( 2 ), 99–105. 10.1089/chi.2017.0117 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ford, A. L. , Bergh, C. , Södersten, P. , Sabin, M. A. , Hollinghurst, S. , Hunt, L. P. , & Shield, J. P. H. (2010). Treatment of childhood obesity by retraining eating behaviour: Randomised controlled trial . BMJ (Online) , 340 ( 7740 ), 250. 10.1136/bmj.b5388 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ford, A. L. , Hunt, L. P. , Cooper, A. , & Shield, J. P. H. (2010). What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health? Archives of Disease in Childhood , 95 ( 4 ), 256–261. 10.1136/adc.2009.165340 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Forsell, C. , Gronowitz, E. , Larsson, Y. , Kjellberg, B.‐M. , Friberg, P. , Mårild, S. , Staffan, M. , & Mårild, S. (2019). Four‐year outcome of randomly assigned lifestyle treatments in primary care of children with obesity . Acta Paediatrica, International Journal of Paediatrics , 108 ( 4 ), 718–724. 10.1111/apa.14583 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Global Health Observatory data repository ‐ World Health Organisation . (2019, November 14). Prevalence of insufficient physical activity among adolescents – Data by WHO region . Retrieved from https://apps.who.int/gho/data/view.main.GSWCAH27REG?lang=en [ Google Scholar ]
• Hamilton, D. , Dee, A. , & Perry, I. J. (2018). The lifetime costs of overweight and obesity in childhood and adolescence: A systematic review . Obesity Reviews , 19 ( 4 ), 452–463. 10.1111/obr.12649 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hennessy, M. , Heary, C. , Laws, R. , van Rhoon, L. , Toomey, E. , Wolstenholme, H. , & Byrne, M. (2019). The effectiveness of health professional‐delivered interventions during the first 1000 days to prevent overweight/obesity in children: A systematic review . Obesity Reviews , 20 ( 12 ), 1691–1707. 10.1111/obr.12924 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Higgins, J. P. , Savović, E. , Page, M. J. , & Sterne, J. A. (2016). Revised Cochrane risk of bias tool for randomized trials (RoB 2.0): Additional considerations for cluster‐randomized trials . Cochrane Methods , 10 ( Suppl 1 ), 52. [ Google Scholar ]
• Higgins, J. , Thomas, J. , Cumpston, M. , Li, T. , Page, M. , & Welcha, V. (2019). Cochrane Handbook for Systematic Reviews of Interventions (2nd ed.). John Wiley and Sons. Retrieved from https://training.cochrane.org/handbook/current [ Google Scholar ]
• Ho, M. , Garnett, S. P. , Baur, L. A. , Burrows, T. , Stewart, L. , Neve, M. , & Collins, C. (2013). Impact of dietary and exercise interventions onweight change andmetabolic outcomes in obese children and adolescents a systematic review and meta‐analysis of randomized trials . JAMA Pediatrics , 167 ( 8 ), 759–768. 10.1001/jamapediatrics.2013.1453 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hollinghurst, S. , Hunt, L. P. , Banks, J. , Sharp, D. J. , & Shield, J. P. (2014). Cost and effectiveness of treatment options for childhood obesity . Pediatric Obesity , 9 ( 1 ), e26–e34. 10.1111/j.2047-6310.2013.00150.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Jonsdottir, O. H. , Kleinman, R. E. , Wells, J. C. , Fewtrell, M. S. , Hibberd, P. L. , Gunnlaugsson, G. , & Thorsdottir, I. (2014). Exclusive breastfeeding for 4 versus 6 months and growth in early childhood . Acta Paediatrica, International Journal of Paediatrics , 103 ( 1 ), 105–111. 10.1111/apa.12433 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kokkvoll, A. S. , Grimsgaard, S. , Flaegstad, T. , Andersen, L. B. , Ball, G. D. C. , Wilsgaard, T. , Njølstad, I. , Flægstad, T. , Andersen, L. B. , Ball, G. D. C. , Wilsgaard, T. , & Njølstad, I. (2019). No additional long‐term effect of group versus individual family intervention in the treatment of childhood obesity – A randomised trial . Acta Paediatrica (Oslo, Norway : 1992) , November 2018, 1–10. 10.1111/apa.14916 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kokkvoll, A. , Grimsgaard, S. , Ødegaard, R. , Flægstad, T. , & Njølstad, I. (2014). Single versus multiple‐family intervention in childhood overweight–Finnmark Activity School: A randomised trial . Archives of Disease in Childhood , 99 ( 3 ), 225–231. 10.1136/archdischild-2012-303571 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kokkvoll, A. , Grimsgaard, S. , Steinsbekk, S. , Flægstad, T. , & Njølstad, I. (2015). Health in overweight children: 2‐Year follow‐up of Finnmark Activity School ‐ A randomised trial . Archives of Disease in Childhood , 100 ( 5 ), 441–448. 10.1136/archdischild-2014-307107 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kong, A. P. S. , Choi, K. C. , Chan, R. S. M. , Lok, K. , Ozaki, R. , Li, A. M. , Ho, C. S. , Chan, M. H. M. , Sea, M. , Henry, C. J. , Chan, J. C. N. , & Woo, J. (2014). A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents . BMC Public Health , 14 , 180. 10.1186/1471-2458-14-180 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lakshman, R. , Sharp, S. J. , Whittle, F. , Schiff, A. , Hardeman, W. , Irvine, L. , Wilson, E. , Griffin, S. J. , & Ong, K. K. (2018). Randomised controlled trial of a theory‐based behavioural intervention to reduce formula milk intake . Archives of Disease in Childhood , 103 ( 11 ), 1054–1060. 10.1136/archdischild-2018-314784 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Laws, R. , Campbell, K. J. , Pligt, P. , Ball, K. , Lynch, J. , Russell, G. , Taylor, R. , & Denney‐Wilson, E. (2015). Obesity prevention in early life: An opportunity to better support the role of Maternal and Child Health Nurses in Australia . BMC Nursing , 14 ( 1 ), 1–14. 10.1186/s12912-015-0077-7 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Liu, Z. , Xu, H. M. , Wen, L. M. , Peng, Y. Z. , Lin, L. Z. , Zhou, S. , Li, W. H. , & Wang, H. J. (2019). A systematic review and meta‐analysis of the overall effects of school‐based obesity prevention interventions and effect differences by intervention components . International Journal of Behavioral Nutrition and Physical Activity , 16 ( 1 ), 1–12. 10.1186/s12966-019-0848-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lobstein, T. , Baur, L. , & Uauy, R. (2004). Obesity in children and young people: A crisis in public health . Obesity Reviews, Supplement , 5 ( 1 ), 4–104. 10.1111/j.1467-789x.2004.00133.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Marild, S. , Gronowitz, E. , Forsell, C. , Dahlgren, J. , & Friberg, P. (2013). A controlled study of lifestyle treatment in primary care for children with obesity . Pediatric Obesity , 8 ( 3 ), 207–217. 10.1111/j.2047-6310.2012.00105.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• McCoy, C. E. (2017). Understanding the intention‐to‐treat principle in randomized controlled trials . Western Journal of Emergency Medicine , 18 ( 6 ), 1075–1078. 10.5811/westjem.2017.8.35985 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moher, D. , Liberati, A. , Tetzlaff, J. , & Altmas, D. , & The PRISMA Group . (2009). Preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement . PLoS Med , 6 ( 7 ), e1000097. 10.1371/journal.pmed.1000097 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ng, M. , Fleming, T. , Robinson, M. , Thomson, B. , Graetz, N. , Margono, C. , Mullany, E. C. , Biryukov, S. , Abbafati, C. , Abera, S. F. , Abraham, J. P. , Abu‐Rmeileh, N. M. E. , Achoki, T. , AlBuhairan, F. S. , Alemu, Z. A. , Alfonso, R. , Ali, M. K. , Ali, R. , Guzman, N. A. , … Gakidou, E. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013 . The Lancet , 384 ( 9945 ), 766–781. 10.1016/S0140-6736(14)60460-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ong, K. K. L. , Ahmed, M. L. , Dunger, D. B. , Emmett, P. M. , & Preece, M. A. (2000). Association between postnatal catch‐up growth and obesity in childhood: Prospective cohort study . British Medical Journal , 320 ( 7240 ), 967–971. 10.1177/000992280003901210 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Oude Luttikhuis, H. , Baur, L. , Jansen, H. , Shrewsbury, V. A. , O’Malley, C. , Stolk, R. P. , & Summerbell, C. D. (2009). Interventions for treating obesity in children (Review) . The Cochrane Database of Systematic Reviews , 1 . 10.1002/14651858.CD001872.pub2 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ouzzani, M. , Hammady, H. , Fedorowicz, Z. , & Elmagarmid, A. (2016). Rayyan‐a web and mobile app for systematic reviews . Systematic Reviews , 5 ( 1 ). 10.1186/s13643-016-0384-4 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Paul, I. M. , Savage, J. S. , Anzman, S. L. , Beiler, J. S. , Marini, M. E. , Stokes, J. L. , & Birch, L. L. (2011). Preventing obesity during infancy: A pilot study . Obesity , 19 ( 2 ), 353–361. 10.1038/oby.2010.182 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Paul, I. M. , Savage, J. S. , Anzman‐Frasca, S. , Marini, M. E. , Beiler, J. S. , Hess, L. B. , Loken, E. , & Birch, L. L. (2018). Effect of a responsive parenting educational intervention on childhood weight outcomes at 3 years of age: The INSIGHT randomized clinical trial . JAMA , 320 ( 5 ), 461–468. 10.1001/jama.2018.9432 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pbert, L. , Druker, S. , Barton, B. , Schneider, K. L. , Olendzki, B. , Gapinski, M. A. , Kurtz, S. , & Osganian, S. (2016). A school‐based program for overweight and obese adolescents: A randomized controlled trial . Journal of School Health , 86 ( 10 ), 699–708. 10.1111/josh.12428 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pbert, L. , Druker, S. , Gapinski, M. A. , Gellar, L. , Magner, R. , Reed, G. , Schneider, K. , & Osganian, S. (2013). A school nurse‐delivered intervention for overweight and obese adolescents . Journal of School Health , 83 ( 3 ), 182–193. 10.1111/josh.12014 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rajjo, T. , Mohammed, K. , Alsawas, M. , Ahmed, A. T. , Farah, W. , Asi, N. , Almasri, J. , Prokop, L. J. , & Murad, M. H. (2017). Treatment of pediatric obesity: An umbrella systematic review . Journal of Clinical Endocrinology and Metabolism , 102 ( 3 ), 763–775. 10.1210/jc.2016-2574 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rifas‐Shiman, S. L. , Taveras, E. M. , Gortmaker, S. L. , Hohman, K. H. , Horan, C. M. , Kleinman, K. P. , Price, S. , Prosser, L. A. , & Gillman, M. W. (2017). Two year follow‐up of a primary care‐based intervention to prevent and manage childhood obesity: the high five for kids study . Pediatric Obesity , 12 ( 3 ). 10.1111/ijpo.12141.Two [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sargent, G. M. , Forrest, L. E. , & Parker, R. M. (2012). Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity: A systematic review . Obesity Reviews , 13 ( 12 ), 1148–1171. 10.1111/j.1467-789X.2012.01029.x [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Savage, J. S. , Birch, L. L. , Marini, M. , Anzman‐Frasca, S. , & Paul, I. M. (2016). Effect of the INSIGHT responsive parenting intervention on rapid infantweight gain and overweight status at age 1 year a randomized clinical trial . JAMA Pediatrics , 170 ( 8 ), 742–749. 10.1001/jamapediatrics.2016.0445 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Schroeder, K. , Travers, J. , & Smaldone, A. (2016). Are school nurses an overlooked resource in reducing childhood obesity? A systematic review and meta‐analysis . The Journal of School Health , 86 ( 5 ), 309–321. 10.1111/josh.12386 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Swinburn, B. A. , Sacks, G. , Hall, K. D. , McPherson, K. , Finegood, D. T. , Moodie, M. L. , & Gortmaker, S. L. (2011). The global obesity pandemic: Shaped by global drivers and local environments . The Lancet , 378 ( 9793 ), 804–814. 10.1016/S0140-6736(11)60813-1 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Taveras, E. M. , Gortmaker, S. L. , Hohman, K. H. , Horan, C. M. , Kleinman, K. P. , Mitchell, K. , Price, S. , Prosser, L. A. , Rifas‐Shiman, S. L. , & Gillman, M. W. (2011). Randomized controlled trial to improve primary care to prevent and manage childhood obesity the high five for kids study . Archives of Pediatrics and Adolescent Medicine , 165 ( 8 ), 714–722. 10.1001/archpediatrics.2011.44 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Taylor, B. J. , Gray, A. R. , Galland, B. C. , Heath, A. L. M. , Lawrence, J. , Sayers, R. M. , Cameron, S. , Hanna, M. , Dale, K. , Coppell, K. J. , & Taylor, R. W. (2017). Targeting sleep, food, and activity in infants for obesity prevention: An RCT . Pediatrics , 139 ( 3 ), 10.1542/peds.2016-2037 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Taylor, R. W. , Gray, A. R. , Heath, A. L. M. , Galland, B. C. , Lawrence, J. , Sayers, R. , Healey, D. , Tannock, G. W. , Meredith‐Jones, K. A. , Hanna, M. , Hatch, B. , & Taylor, B. J. (2018). Sleep, nutrition, and physical activity interventions to prevent obesity in infancy: Follow‐up of the Prevention of Overweight in Infancy (POI) randomized controlled trial at ages 3.5 and 5 y . American Journal of Clinical Nutrition , 108 ( 2 ), 228–236. 10.1093/ajcn/nqy090 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• The Cochrane Collaboration . (2019). RoB 2: A revised Cochrane risk‐of‐bias tool for randomized trials. July, 1–24 . Retrieved from https://methods.cochrane.org/bias/resources/rob‐2‐revised‐cochrane‐risk‐bias‐tool‐randomized‐trials [ Google Scholar ]
• US Preventive Services Task Force . (2010). Screening for obesity in children and adolescents: US preventive services task force recommendation statement . Pediatrics , 125 ( 2 ), 361–367. 10.1542/peds.2009-2037 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wells, J. C. K. , & Fewtrell, M. S. (2006). Measuring body composition . Archives of Disease in Childhood , 91 ( 7 ), 612–617. 10.1136/adc.2005.085522 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wen, L. M. , Baur, L. A. , Simpson, J. M. , Rissel, C. , Wardle, K. , & Flood, V. M. (2012). Effectiveness of home based early intervention on children’s BMI at age 2: Randomised controlled trial . BMJ (Online) , 344 ( 7865 ), 1–11. 10.1136/bmj.e3732 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wen, L. M. , Baur, L. A. , Simpson, J. M. , Xu, H. , Hayes, A. J. , Hardy, L. L. , Williams, M. , Rissel, C. , Hons, M. P. H. , Williams, M. , & Rissel, C. (2015). Sustainability of effects of an early childhood obesity prevention trial over time: A further 3‐year follow‐up of the healthy beginnings trial . JAMA Pediatrics , 169 ( 6 ), 543–551. 10.1001/jamapediatrics.2015.0258 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• World Cancer Research Fund (WCRF), & American Institute for Cancer Research (AICR) . (2018). Diet, nutrition, physical activity and cancer: a global perspective. In Continuous update project expert report 2018 . Retrieved from http://gco.iarc.fr/today%0Adietandcancerreport.org [ Google Scholar ]
• World Health Organisation . (2011). Global recommendations on physical activity for health 5–17 years old . World Health Organisation. 10.1097/PAS.0b013e31827ab703 [ CrossRef ] [ Google Scholar ]
• World Health Organisation . (2020). Obesity and overweight . Retrieved from https://www.who.int/news‐room/fact‐sheets/detail/obesity‐and‐overweight [ Google Scholar ]
• World Health Organization . (2018). The 2018 update, Global Health Workforce Statistics . World Health Organisation. [ Google Scholar ]
• World Obesity Federation . (2019). Atlas of childhood obesity. In World obesity federation (Vol. 1, Issue October). Retrieved from https://www.worldobesity.org/nlsegmentation/global‐atlas‐on‐childhood‐obesity [ Google Scholar ]