Evidence to Guide Best Practice with Overweight Preschoolers and Preschool Children at Risk for Overweight
Leigh Small, PhD, RN, CPNP, Pediatrics, Arizona State University College of Nursing, Tempe, AZ, USA
A critical review of the available research literature has revealed a paucity of studies designed to test preventive and/or treatment intervention strategies with young children at risk for later-life obesity. This search for the best evidence targeted level one data, systematic reviews or meta-analyses, and level two data, individual randomized controlled trials. A recent Cochrane Systematic Review identified 10 prevention interventions studies that met the rigorous inclusion criteria. Of those studies, 6 involved 4-7-year-old children. Four of the 6 studies that included young children were conducted in countries other than the United States, significantly limiting the generalizability of their findings. Of the 2 studies conducted in the U.S. one included only African American female children and their mothers; the other was focused on dietary intervention only and did not include a comparison/control group. Another rigorously conducted Cochrane systematic review of 18 intervention programs designed to treat obesity/overweight in children included 6 studies that had young overweight/obese children (4-7 years). Four of the 6 studies were conducted in countries other than the U.S. again limiting the generalizability of study findings. Two of the studies conducted in the U.S. were carried out in 1985 and 1988, and thus may not have findings that are currently applicable. There were no individual randomized controlled trials that were found in addition to these studies. Therefore, to date only 4 obesity prevention or treatment RCT’s could be found that have been conducted with young children in the United States. This presentation will review the current state of the science with regard to the prevention or treatment of obesity/overweight with young children and their families. As such, the existent gap in the literature will be revealed as the urgent need to develop and test prevention and/or treatment interventions to curtail the epidemic of childhood overweight/obesity is underscored.