Which type of sedentary behaviour intervention is more effective at reducing body mass index in children? A meta-analytic review.

Sedentary behaviour is emerging as an independent risk factor for paediatric obesity. Some evidence suggests that limiting sedentary behaviour alone could be effective in reducing body mass index (BMI) in children. However, whether adding physical activity and diet-focused components to sedentary behaviour reduction interventions could lead to an additive effect is unclear. This meta-analysis aims to assess the overall effect size of sedentary behaviour interventions on BMI reduction and to compare whether interventions that have multiple components (sedentary behaviour, physical activity and diet) have a higher mean effect size than interventions with single (sedentary behaviour) component. Included studies (n = 25) were randomized controlled trials of children (<18 years) with intervention components aimed to reduce sedentary behaviour and measured BMI at pre- and post-intervention. Effect size was calculated as the mean difference in BMI change between children in an intervention group and a control group. Results indicated that sedentary behaviour interventions had a significant effect on BMI reduction. The pooled effect sizes of multi-component interventions (g = -0.060∼-0.089) did not differ from the single-component interventions (g = -0.154), and neither of them had a significant effect size on its own. Future paediatric obesity interventions may consider focusing on developing strategies to decrease multiple screen-related sedentary behaviours.

A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning.

Smart growth is an approach to urban planning that provides a framework for making community development decisions. Despite its growing use, it is not known whether smart growth can impact physical activity. This review utilizes existing built environment research on factors that have been used in smart growth planning to determine whether they are associated with physical activity or body mass. Searching the MEDLINE, Psycinfo and Web-of-Knowledge databases, 204 articles were identified for descriptive review, and 44 for a more in-depth review of studies that evaluated four or more smart growth planning principles. Five smart growth factors (diverse housing types, mixed land use, housing density, compact development patterns and levels of open space) were associated with increased levels of physical activity, primarily walking. Associations with other forms of physical activity were less common. Results varied by gender and method of environmental assessment. Body mass was largely unaffected. This review suggests that several features of the built environment associated with smart growth planning may promote important forms of physical activity. Future smart growth community planning could focus more directly on health, and future research should explore whether combinations or a critical mass of smart growth features is associated with better population health outcomes.