The long-term effects of primary school-based obesity prevention interventions in children: A systematic review and meta-analysis.

INTRODUCTION: This systematic review and meta-analysis investigate the long-term effects of primary school-based obesity prevention interventions on body-mass index (and z-scores), waist circumference (and z-scores) and weight status. METHODS: Four databases were searched for studies from date of inception until June 8th, 2021. We included randomized controlled trials (RCT) and non-RCTs investigating effects ≥12 months post-intervention of primary school-based interventions with intervention duration ≥6 months and containing a diet and/or physical activity component on outcomes of interest. Articles were assessed on risk of bias and methodological quality by RoB2 and ROBINS-I. Meta-analysis was performed and results were narratively summarized. Evidence quality was assessed with GRADE. RESULTS: Nineteen studies were included, 9 were pooled in a meta-analysis. No long-term effects were found on body-mass index (+0.06 kg/m2 ; CI95% = -0.38, 0.50; I2  = 66%), body-mass index z-scores (-0.08; CI95% = -0.20, 0.04; I2  = 36%), and waist circumference (+0.57 cm; CI95% = -0.62, 1.75; I2  = 13%). Non-pooled studies reported mixed findings regarding long-term effects on body-mass index, body-mass index z-scores and weight status, and no effects on waist circumference and waist circumference z-scores. Evidence certainty was moderate to very low. DISCUSSION: No clear evidence regarding long-term effects of primary school-based interventions on obesity-related outcomes was found. Recommendations for further research and policy are discussed. Prospero registration ID: CRD42021240446.

Associations between organised leisure-time activities and mental health problems in children.

Previous studies conducted mainly among adolescents have found associations between participation in sport organised leisure-time activities (OLTAs) and mental health problems (MHP). Fewer research studies have been performed to primary school-aged children and to organised non-sport OLTAs. Therefore, the objective is to examine whether there is an association between participation in sport and non-sport OLTAs and a high risk of MHP in 4- to 12-year-olds. Data were used on 5010 children from a cross-sectional population-based survey conducted between May and July 2018 in Rotterdam, the Netherlands. Associations between sport OLTAs, non-sport OLTAs and breadth of OLTAs and a high risk of MHP were explored using logistic regression models adjusting for sociodemographic characteristics, stressful life events and physical activity. Of all children, 58% participated in sport OLTAs and 22% in non-sport OLTAs. The proportion of children with high risk of MHP among participants in sport OLTAs is smaller than among non-participants (OR 0.66, 95% CI: 0.53, 0.81). The proportion of children with high risk of MHP among participants in non-sport OLTAs is smaller than among non-participants (OR 0.69, 95% CI: 0.53, 0.91). The proportion of children with a high risk of MHP among participants in 1 category of OLTAs (OR 0.61, 95% CI: 0.49, 0.76) and in 2-5 categories of OLTAs (OR 0.48, 95% CI: 0.32, 0.71) is smaller than among non-participants.  Conclusion: The proportion of children with high risk of MHP among participants in OLTAs is smaller than among non-participants. What is Known: • Around 10--20% of children and adolescents experiences mental health problems. • Sport organised leisure-time activities have been found to be associated with a lower risk of mental health problems in adolescents. What is New: • The proportion of children with a high risk of mental health problems in participants in organised leisure-time activities is smaller than among non-participants. • The proportion of children with a high risk of mental health problems in participants with a higher breadth of organised leisure-time activities is smaller compared to non-participants.

Impact of organized activities on mental health in children and adolescents: An umbrella review.

Mental health problems are a leading cause of health-related disability among children and adolescents. Organized activities are a possible preventive factor for mental health problems. An aggregated overview of evidence is relevant for youth policymakers and is lacking so far. Thus we aim to provide an overview of published systematic reviews and meta-analyses on the impact of participation in organized sport and non-sport activities (e.g. arts, music) on childhood and adolescent mental health. Systematic reviews were identified through a search in five databases (Embase, MEDLINE, Web of Science core collection, CINAHL and PsycINFO) on 25-March-2021. Systematic reviews about organized activities and mental health outcomes in 0-21-year-olds published in English were included. Two independent reviewers assessed titles, abstracts and full texts, performed data-extraction and quality assessment using the AMSTAR-2 and assessed the quality of evidence. Out of 833 studies, six were considered eligible. Quality of the reviews ranged from critically low to moderate. Most reviews focused on organized sport activities, focusing on: team sport, level of sport involvement, extracurricular and community sport activities. Indications of a positive impact on mental health outcomes were found for participation in team sport, in (school) clubs, and in extracurricular and community sport and non-sport activities. We found a small positive impact of organized sport activities on mental health outcomes among children and adolescents. This seems not to depend on any specific type of organized sport activity. Limited evidence was found for organized non-sport activities.