Intensive lifestyle interventions can help obese young people lose weight

O’Connor EA, Evans CV, Burda BU, et al. Screening for Obesity and Intervention for Weight Management in Children and Adolescents: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017;317(23):2427-44.

BikeObese children and adolescents can lose up to seven pounds over six to 12 months when they engage in at least 52 hours of behaviour-based lifestyle interventions. Minimal benefit was seen with shorter contact time, with less than 25 hours ineffective. The control group gained weight.

Rising obesity in the young is a global concern, which may lead to high rates of obesity-related diseases in adulthood. This review identified trials covering various weight management strategies. Lifestyle-based-interventions with sufficient contact time – as recommended by UK guidelines – showed clear benefits with no evidence of harms.

Investing in effective strategies to manage child obesity will ultimately save healthcare costs. Behaviour-based support should now be assessed for long-term weight loss and maintenance.

The evidence is still lacking whether universal child screening for obesity should be performed in the UK.

Physical activity in pregnancy

This infographic is the latest addition to a series commissioned by the UK Chief Medical Officers. It aims to provide clarity and consistency, and to equip health professionals to deliver evidence based recommendations on physical activity in pregnancy.

The aim is to ensure pregnant women are aware of the benefits of being active throughout their pregnancy and are clear about the physical activity recommendations. The infographic provides details regarding frequency, intensity and time, together with specific examples of suitable activities and key safety messages.


active pregnancy
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Cochrane reviews show impact of lifestyle changes on obesity

Two Cochrane reviews, published today, show that a combination of diet, physical activity and behavioural change interventions may reduce weight in children and adolescents | OnMedica


The two reviews look at the effects of diet, physical activity and behavioural interventions in treating children with overweight or obesity from six years old to early adulthood. They summarise the results of 114 studies which involved over 13,000 children and young people.

Improving the implementation of childrens healthy eating, physical activity and obesity prevention programmes

Wolfenden, L. et al. (2016) Cochrane Database of Systematic Reviews. Issue 10. DOI: 10.1002/14651858.CD011779.pub2.


Background: Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so.

Authors’ conclusions: Current research provides weak and inconsistent evidence of the effectiveness of such strategies in improving the implementation of policies and practices, childcare service staff knowledge or attitudes, or child diet, physical activity or weight status. Further research in the field is required.

Read the full review here

Developmental outcomes and physical activity behaviour in children post major surgery: an observational study

Dwyer, G. M. et al. BMC Pediatrics. Published online: 3 August 2016

children-1266195_960_720Background: Infants may be at neurodevelopmental risk from adverse events arising in the neonatal period. This study aimed to investigate the developmental outcomes and physical activity behaviours of term infants after neonatal major surgery, at age three years.

Methods: This prospective study enrolled infants who underwent major surgery in their first 90 days, between August 2006 and December 2008. Developmental status was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Physical activity and sedentary behaviour (i.e. small screen recreation) (SSR) were assessed using the Preschool-Age Physical Activity Questionnaire (Pre-PAQ). Activity (moving between slow to fast pace) and SSR were reported for a 3-day period.

Results: One hundred and thirty five children (68 major surgery, 67 control) were assessed, using both measures, at age three years. Both groups were within the average range across all domains of the BSID-III although the surgical group was significantly below the controls for cognition (t = −3.162, p = 0.002) receptive language (t = −3.790, p < 0.001) and fine motor skills (t = −2.153, p = 0.03). Mean activity time for the surgical group was 191−1, and 185 for controls. Mean SSR time was 77−1, and 83−1 for the respective groups. There was no significant difference between groups for either physical activity (p = 0.71) or SSR time (p = 0.49).

Conclusions: By age three, children who had major surgery in infancy are developmentally normal but have not quite caught up with their peer group in cognitive, receptive language and fine motor skill domains. Both groups met recommended 3 h of daily physical activity but exceeded 60-min SSR time recommended for preschool-age children.

Read the full article here

Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study

Nora Shields & Anneliese Synnot. BMC Pediatrics. Published: 19 January 2016

Obesity - A Positive Lifestyle

Background: Children with disability engage in less physical activity compared to their typically developing peers. Our aim was to explore the barriers and facilitators to participation in physical activity for this group.

Methods : Ten focus groups, involving 63 participants (23 children with disability, 20 parents of children with disability and 20 sport and recreation staff), were held to explore factors perceived as barriers and facilitators to participation in physical activity by children with disability. Data were analysed thematically by two researchers.

Results: Four themes were identified: (1) similarities and differences, (2) people make the difference, (3) one size does not fit all, and (4) communication and connections. Key facilitators identified were the need for inclusive pathways that encourage ongoing participation as children grow or as their skills develop, and for better partnerships between key stakeholders from the disability, sport, education and government sectors. Children with disabilities’ need for the early attainment of motor and social skills and the integral role of their families in supporting them were considered to influence their participation in physical activity. Children with disability were thought to face additional barriers to participation compared to children with typical development including a lack of instructor skills and unwillingness to be inclusive, negative societal attitudes towards disability, and a lack of local opportunities.

Conclusions: The perspectives gathered in this study are relevant to the many stakeholders involved in the design and implementation of effective interventions, strategies and policies to promote participation in physical activity for children with disability. We outline ten strategies for facilitating participation.

Read the full article here