以家庭为基础的运动干预对学龄前儿童超重肥胖影响的Meta分析

doi:10.11852/zgetbjzz2024-0504

摘要/Abstract

摘要： 目的探索以家庭为基础的运动干预对学龄前儿童超重肥胖身体形态、饮食模式、身体活动、睡眠的影响,以期为肥胖干预提供参考。方法在PubMed、Scopus和CNKI等数据库检索文献,检索时间截止2022年7月20日,收集以家庭为基础的干预对学龄前儿童超重肥胖影响的文献,数据分析采用STATA 14.0。结果共纳入24篇文献,其中文献质量A、B级各12篇。Meta分析显示:干预后学龄前儿童BMI(WMD=-0.193)、BMI-Z评分(WMD=-0.241)、BMI%(WMD=-1.258)、体重(WMD=-0.639)、能量摄入(WMD=-139.266)、脂肪摄入(WMD=-1.170)、饱和脂肪摄入(WMD=-0.324)、含糖饮料摄入(WMD=-1.313)、看电视时间(WMD=-0.111)、久坐行为时间(SMD=-1.491)明显下降(P＜0.05),水果蔬菜摄入(WMD=0.592)、水果摄入(WMD=1.052)明显增加(P＜0.05)。结论以家庭为基础的干预对降低学龄前超重肥胖儿童BMI、Z评分、BMI%和体重,改善饮食模式、减少看电视和久坐时间是有效的。

关键词: 家庭, 学龄前儿童, 超重肥胖, 联合干预, Meta分析

Abstract: Objective To explore the effect of family-based intervention on the body shape, dietary pattern, physical activity and sleep of preschool children with overweight and obesity, in order to provide refernec for obesity intervention. Methods A literature search was conducted in databases such as PubMed, Scopus, and CNKI up to July 20th, 2022, to collect articles on the impact of family-based interventions on overweight and obesity in preschool children. Data analysis was performed using STATA 14.0. Results A total of 24 articles were included, with 12 articles rated as high-quality(Grade A) and 12 as moderate-quality(Grade B). Meta-analysis results showed that after family-based interventions, there were significant decreases in body mass index(BMI)(WMD=-0.193), BMI-Z score(WMD=-0.241), BMI percentile(WMD=-1.258), weight(WMD=-0.639), energy intake(WMD=-139.266), fat intake(WMD=-1.170), saturated fat intake(WMD=-0.324), sugary beverage consumption(WMD=-1.313), television viewing time(WMD=-0.111), and sedentary behavior time(SMD=-1.491) among preschool children(P<0.05). Additionally, there were significant increases in fruit and vegetable intake (WMD=0.592) and fruit intake (WMD=1.052)(P<0.05). Conclusion Family-based interventions were effective in reducing BMI, BMI-Z score, BMI%, and body weight, improving dietary patterns, and reducing screen time and sedentary time in preschool overweight and obese children.

Key words: family, preschool children, overweight and obesity, joint intervention, Meta-analysis

中图分类号:

R723.14

李望, 陈培友, 吴志建, 叶巍. 以家庭为基础的运动干预对学龄前儿童超重肥胖影响的Meta分析[J]. 中国儿童保健杂志, 2025, 33(2): 214-220.

LI Wang, CHEN Peiyou, WU Zhijian, YE Wei. Meta-analysis of the effect of family-based exercise intervention on overweight and obesity in preschool children[J]. Chinese Journal of Child Health Care, 2025, 33(2): 214-220.

参考文献

[1] De HK, Bell BM, Sally SJ. The role of maternal social networks on the outcomes of a home-based childhood obesity prevention pilot intervention[J]. J Soc Struct, 2019,20(3): 7-28.
[2] 刘月姣. 《中国居民营养与慢性病状况报告(2020年)》发布[J]. 中国食物与营养, 2020,26(12): 2-12.
[3] Singh AS, Mulder C, Twist JW, et al. Tracking of childhood overweight into adulthood: a systematic review of the literature[J]. Obes Rev, 2008,9(5): 474-488.
[4] Foster BA, Faragher J, Parker P, et al. Treatment interventions for early childhood obesity: A systematic review[J]. Acad Pediatr, 2015,15(4): 353-361.
[5] Mado FG, Sirajuddin S, Musi M, et al. Intervention empowerment of families in preventing and controlling overweight and obesity in children: A systematic review[J]. J Public Health Res, 2021,10(2):121-133.
[6] Harvey-Barrino J, Rourke J. Obesity prevention in preschool native-American children: A pilot study using home visiting[J]. Obes Res, 2003,11(5): 606-611.
[7] Stark LJ, Spear S, Boles R, et al. A pilot randomized controlled trial of a clinic and home-based behavioral intervention to decrease obesity in preschoolers[J]. Obesity(Silver Spring), 2011,19(1): 134-141.
[8] Bocca G, Corpulent E, Stolk RP, et al. Results of a multidisciplinary treatment program in 3-year-old to 5-year-old overweight or obese children: A randomized controlled clinical trial[J]. Arch Pediatr Adolesc Med, 2012,166(12): 1109-1115.
[9] Ostbye T, Krause KM, Strop M, et al. Parent-focused change to prevent obesity in preschoolers: Results from the KAN-DO study[J]. Prev Med, 2012,55(3): 188-195.
[10] Foster BA, Aqino CA, Gil M, et al. A pilot study of parent mentors for early childhood obesity[J]. J Obes, 2016,2016: 2609504.
[11] Stark LJ, Clifford LM, Towner EK, et al. A pilot randomized controlled trial of a behavioral family-based intervention with and without home visits to decrease obesity in preschoolers[J]. J Pediatr Psychol, 2014,39(9): 1001-1012.
[12] Haines J, Rifas-Shiman SL, Gross D, et al. Randomized trial of a prevention intervention that embeds weight-rela ted messages within a general parenting program[J]. Obesity(Silver Spring), 2016,24(1): 191-199.
[13] Sherwood NE, Jaka MM, Crain AL, et al. Pediatric primary care-based obesity prevention for parents of preschool children: A pilot study[J]. Child Obes, 2015,11(6): 674-682.
[14] Wen LM, Baur LA, Simpson JM, et al. Sustainability of effects of an early childhood obesity prevention trial over time: A further 3-year follow-up of the healthy beginnings trial[J]. JAMA Pediatr, 2015,169(6): 543-551.
[15] Tomayko EJ, Prince RJ, Cronin KA, et al. The healthy children, strong families intervention promotes improvements in nutrition, activity and body weight in American Indian families with young children[J]. Public Health Nutr, 2016,19(15): 2850-2859.
[16] Mirotta JA, Darlington GA, Buchholz AC, et al. Guelph family health study′s home-based obesity prevention intervention increases fibre and fruit intake in preschool-aged children[J]. Can J Diet Pract Res, 2018,79(2): 86-90.
[17] French SA, Sherwood NE, Veblen S, et al. Multicomponent obesity prevention intervention in low-income preschoolers: Primary and subgroup analyses of the NET-Works randomized clinical trial, 2012-2017[J]. Am J Public Health, 2018,108(12): 1695-1706.
[18] Barkin SL, Heerman WJ, Sommer EC, et al. Effect of a behavioral intervention for underserved preschool-age children on change in body mass index: A randomized clinical trial[J]. JAMA, 2018,320(5): 450-460.
[19] Taverno RS, Barone GB, Documet PI, et al. ANDALE Pittsburgh:Results of a promotora-led, home-based intervention to promote a healthy weight in Latino preschool children[J]. BMC Public Health, 2018,18(1): 360.
[20] Haines J, Douflas S, Mirotta JA, et al. Guelph Family Health Study: Pilot study of a home-based obesity prevention intervention[J]. Can J Public Health, 2018,109(4): 549-560.
[21] Taylor RW, Gray AR, Heath AM, et al. 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[J]. Am J Clin Nutr, 2018,108(2): 228-236.
[22] Stark LJ, Spear FS, Bolling C, et al. Clinic and home-based behavioral intervention for obesity in preschoolers: A randomized trial[J]. J Pediatr, 2018,192: 115-121.
[23] Tomayko EJ, Prince RJ, Cronin KA, et al. The Healthy Children, Strong Families 2(HCSF2) randomized controlled trial improved healthy behaviors in american Indian families with young children[J]. Curr Dev Nutr, 2019,3(Suppl 2): 53-62.
[24] Fisher JO, Serrano EL, Foster GD, et al.Efficacy of a food parenting intervention for mothers with low income to reduce preschooler′s solid fat and added sugar intakes: A randomized controlled trial[J]. Int J Behav Nutr Phys Act, 2019,16(1): 6-17.
[25] Haye K, Bell BM, Salvy SJ. The role of maternal social networks on the outcomes of a home-based childhood obesity prevention pilot intervention[J]. J Soc Struct, 2019,20(3): 7-28.
[26] Heskett KD, Salmon J, McNaughton SA, et al. Long-term outcomes(2 and 3.5 years post-intervention) of the INFANT early childhood intervention to improve health behaviors and reduce obesity: Cluster randomised controlled trial follow-up[J]. Int J Behav Nutr Phys Act, 2020,17(1): 95.
[27] Stark LJ, Filigno SS, Kichler JC, et al. Maintenance following a randomized trial of a clinic and home-based behavioral intervention of obesity in preschoolers[J]. J Pediatr, 2019,213: 128-136.
[28] Linville D, Mintz B, Martinez C, et al. Preliminary effects of tailoring an obesity prevention intervention program for latino immigrant families[J]. Fam Community Health, 2020,43(2): 118-130.
[29] Pamungkas RA, Chamroonsawadi K. Home-based interventions to treat and prevent childhood obesity: A systematic review and Meta-analysis[J]. Behav Sci(Basel), 2019,9(4):38-45.
[30] Loveman E, Al-Khudairy L, Johnson RE, et al. Parent-only interventions for childhood overweight or obesity in children aged 5 to 11 years[J]. Cochrane Database Syst Rev, 2015(12): CD012008.
[31] 吴玉婉, 刘彦鹏, 向蔓, 等. 学龄前儿童饮食行为特征与超重肥胖的关联[J]. 环境与职业医学, 2022,39(6): 672-678.
Wu YW,Liu YP,Xiang M,et al.Association between dietary behaviors and overweight or obesity in preschool children[J].Journal of Environmental and Occupational Medicine,2022,39(6):672-678.(in Chinese)
[32] Bender MS, Nader PR, Kennedy C, et al. A culturally appropriate intervention to improve health behaviors in Hispanic mother-child dyads[J]. Child Obes, 2013,9(2): 157-163.