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September 2007
Evidence-Based Tip
The Obesity Epidemic: Is there evidence about what can help our children?
I was listening to the news this morning, as I got ready for work. Between blasts of my hair dryer I heard "Since 2003... not one state has reported a decline in obesity." It was a story about the Trust for American's Health report "F as in Fat: How Obesity Policies are Failing in America." The report states that our South Carolina youth have the 7th highest rate of obesity in the country, at 18.9%. I wondered as I listened, has any program or any therapy been shown to be effective in preventing or reducing obesity?
I knew that there would be a lot about obesity in the medical literature. So I decided to be very precise, and start in the MeSH (Medical Subject Heading) Database of PubMed.
By choosing the correct MeSH (obesity), selecting the appropriate subheadings (prevention and control), and making this a "Major Topic" subject for the article, my results will be much more relevant.
Sending this to the search box and searching PubMed still retrieves a lot of articles. Using limits, I can make sure I am reading the best level of evidence, as well as make sure that my articles concern children. Because there are so many articles, and because this is a concern that has been with us for a while, I am betting there is a systematic review on this topic. Clicking on the "Limits" tab under the search box, I look in "Subsets" and select "Systematic Review." Under "Ages" I choose "All Child." And just for good measure, I also limit to "English" in "Languages."
Now I've gone from 2656 articles to 55 articles. A quick read of the abstracts from these articles gave me some interesting information. Some interventions proven to work include breastfeeding during infancy, and a daily after-school dance class. One study showed that a decrease in television-viewing led to weight loss in girls, but not in boys.
A Cochrane review of interventions for preventing obesity in children found "Studies that focused on combining dietary and physical activity approaches did not significantly improve BMI, but some studies that focused on dietary or physical activity approaches showed a small but positive impact on BMI status."
Many of the reviews conclude with a discussion of the complexity of the problem. Cultural, economic, and even political issues play a role. Alas, obesity is a health problem for which it is more than a cliché to say, "more research is needed."
To learn more, visit http://healthyamericans.org/reports/obesity2007/.
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