Birch L, Perry R, Hunt LP, Matson R, Chong A, Beynon R, Shield JP. What change in body mass index is associated with improvement in percentage body fat in childhood obesity? A meta-regression.
BMJ Open 2019;
9:e028231. [PMID:
31473614 PMCID:
PMC6720247 DOI:
10.1136/bmjopen-2018-028231]
[Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/12/2019] [Accepted: 06/25/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE
Using meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.
DESIGN
Meta-regression.
SETTING
Studies were identified as part of a large-scale systematic review of the following electronic databases: AMED, Embase, MEDLINE via OVID, Web of Science and CENTRAL via Cochrane library.
PARTICIPANTS
Individuals aged 4-19 years with a diagnosis of obesity according to defined BMI thresholds.
INTERVENTIONS
Studies of lifestyle treatment interventions that included dietary, physical activity and/or behavioural components with the objective of reducing obesity were included. Interventions of <2 weeks duration and those that involved surgical and/or pharmacological components (eg, bariatric surgery, drug therapy) were excluded.
PRIMARY AND SECONDARY OUTCOME MEASURES
To be included in the review, studies had to report baseline and post-intervention BMI-SDS or change measurements (primary outcome measures) plus one or more of the following markers of metabolic health (secondary outcome measures): adiposity measures other than BMI; blood pressure; glucose; inflammation; insulin sensitivity/resistance; lipid profile; liver function. This paper focuses on adiposity measures only. Further papers in this series will report on other outcome measures.
RESULTS
This paper explores the potential impact of BMI-SDS reduction in terms of change in percentage body fat. Thirty-nine studies reporting change in mean percentage body fat were analysed. Meta-regression demonstrated that reduction of at least 0.6 in mean BMI-SDS ensured a mean reduction of percentage body fat mass, in the sense that the associated 95% prediction interval for change in mean percentage body fat was wholly negative.
CONCLUSIONS
Interventions demonstrating reductions of 0.6 BMI-SDS might be termed successful in reducing adiposity, a key purpose of weight management interventions.
TRIAL REGISTRATION NUMBER
CRD42016025317.
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