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Standard approaches to obesity prevention in children and adolescents
One review of interventions to treat or prevent obesity in children found that, as with adult obesity, there was no strong evidence that interventions to treat obesity in children had long-term benefits in terms of weight loss or associated morbidity. They concluded that increasing funds were required for research into new behavioural, environmental, and pharmacological approaches for the prevention and treatment of obesity in children, but emphasized that the epidemic of childhood obesity was unlikely to be resolved without concerted political action to detoxify the obesogenic environment in which we live.
A recent Cochrane systematic review identified just 22 controlled trials of interventions in childhood and adolescence to prevent obesity. Most were school based and most assessed outcomes over a short time period only. Important methodological weaknesses were noted in many studies, and in particular the authors noted that. Even with this caveat regarding their possible exaggeration of true effects, most studies found that combined promotion of healthy eating and physical activity were not effective at preventing childhood obesity. The impact of these interventions on the adverse sequelae of obesity, such as glucose intolerance, hypertension, and dyslipidaemia, were rarely assessed. While better designed studies of these interventions may provide evidence of effectiveness in terms of both weight control and metabolic and disease outcomes we believe there is also merit in exploring whether brief interventions during key periods of development might have long-term benefits in terms of obesity and obesity related disease prevention.
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Critical and sensitive periods for the primary prevention of obesity
Three periods in early life may be particularly important for the development of obesity and its associated morbidity and mortality: the perinatal period; the period of adiposity rebound; and puberty/adolescence.30,31