“Important” Findings in Child Obesity with No Significance
“The findings have important implications for future intervention research in terms of the effectiveness of intervention components and characteristics … It is important that policy makers continue to recognise the school setting as a vehicle for tackling childhood obesity.” These conclusions from a systematic review and meta-analysis of effectiveness for school-based interventions in child obesity sound like findings of great significance. Sarah Nally and colleagues had found “a small treatment effect” on BMI scores for these interventions.
The only trouble is that upon a close examination, the treatment effect has no significance.
A group of scholars led by Keara Ginell dug into the data for the meta-analysis and found miscalculations and errors in the original analysis. Re-analyzing the data and taking those issues into account, there’s no significant difference to favor these interventions.
Thus, Ginell et al recommend the Nally publication be retracted.
An Article of Faith
The significance of the problem that child obesity presents is undeniable. Poor metabolic health in childhood persists into adulthood and the complications accumulate. Diabetes, heart disease, liver disease, and cancer related to obesity are all taking a toll on health at younger ages. Because these all have a link to dietary and physical activity behaviors it makes intuitive sense to promote healthier behaviors at an early age in school.
It is clear enough that school-based interventions can have an effect on these health behaviors. But it has been harder to show that those behavior changes actually deliver a change in obesity rates.
A recently updated Cochrane review found only “a very small effect on body mass index” for school-base interventions. It found none for after-school, community, or home-based programs.
Is Behavior Change Enough?
It seems increasingly likely that merely changing behaviors we presume are contributing to obesity is not sufficient to move the needle on child obesity. Ginell et al point to the need for more rigorous analysis and perhaps more innovative approaches for preventing obesity in children.
Time and health are slipping away while we keep pressing on with ineffective strategies in which we have unjustified faith.
Click here for the analysis by Nally et al and here for the re-analysis by Ginell et al.
Children and Kid, painting by Pierre Bonnard / WikiArt
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October 10, 2023
October 10, 2023 at 11:32 pm, David Brown said:
Excerpt from an article by Annadie Krygsman: “This risk of developing obesity and T2D has largely been blamed on the increased consumption of energy dense foods and fat intake, particularly saturated fat, but it is interesting to know that the mean fat intake of the human population has not increased much in the past 50 years. It is true that the vast advancement in technological developments has led to a reduction in physical activity worldwide, but as obesity now involves infants and the populations of developing countries, this obesity pandemic cannot be attributed to this alone.In addition, laboratory and other domesticated animals have also been subject to the increased prevalence of obesity, despite having largely unchanged living conditions for many years.” https://www.intechopen.com/chapters/41405