Prevention of Overweight in Children and Youth
Given the challenges of reversing existing obesity in the
pediatric population, preventive tactics are likely to be
the key to success. Unfortunately, controlled prevention
trials have been somewhat disappointing to date. In a
systematic Cochrane Database review,36 3 of 4 long-term
studies combining dietary education with physical activity
showed no difference in overweight, and 1 long-term
physical activity intervention study showed a slight reduction
in overweight. However, the randomized control
design may not be ideal for the study of most healthpromotion
interventions. This is because these are
typically population-based programs, which tend to be
complex, are delivered over long periods of time, and
present some difficulties in controlling all variables.11
Solution-oriented research, which evaluates promising
interventions, often in a quasi-experimental manner,
may be more appropriate in the long run.37 It is unlikely,
however, that any single strategy will be sufficient to
reverse current trends in pediatric obesity. Success is
more likely to be achieved by the implementation of
sustainable, economically viable, culturally acceptable
active-living policies that can be integrated into multiple
sectors of society.