Effectiveness of childhood obesity prevention interventions in the Middle East. A systematic review

Abstract

Introduction Childhood obesity is considered a critical health concern in the Middle East due to its escalating prevalence and adverse impact on the community. To address this epidemic, this review aims to assess the effectiveness of school-based interventions conducted in the Middle East on obesity- related outcomes, physical activity levels, and dietary habits and evaluate the interventions’ cost-effectiveness analyses where data are available.

Methods This systematic review conducted an electronic comprehensive search on the 2nd of June, 2023, using the databases PubMed, Embase, Medline, and Web of Science. School-based interventions, both single and multi-component, utilising a randomised control trial study design, implemented among primary school-aged children or adolescents aged 4-19 years old, assessing (BMI, body fat percentage, waist circumference, physical activity levels, or dietary habits) as the intervention’s targeted outcomes, and conducted in the Middle East were included in this review.

Results Seven RCTs were examined in this review, of which five had dietary and physical activity components; one was a dietary intervention, and the last was a physical activity intervention. All assessed RCTs effectively reported at least one positive finding of the school-based intervention on the targeted outcomes. Post- intervention between-group differences were found in the likelihood of changing to normal weight status, improved nutritional quality, increased physical activity levels, and reduced weight. Additionally, intervention groups reported physical activity levels increase, dietary habits improvement, a reduction in the likelihood of being overweight or obese, a reduction in BMI Z-score, and a reduction in waist circumference. Post-intervention self-efficacy and nutritional knowledge increased in the intervention groups (p<0.001), which served as potential mediators.

Conclusion Overall, findings from this review support the promising effects of school-based interventions on improving obesity-related outcomes, physical activity levels, and dietary habits. Further studies should be conducted to confirm the findings while measuring the intervention’s cost-effectiveness analysis.