Körperliche Aktivität, Ernährung und andere Verhaltensmaßnahmen zur Verbesserung der Kognition und schulischen Leistungen bei Kindern und Jugendlichen mit Adipositas oder Übergewicht
Appendices
Appendix 1. Search strategies
Cochrane Central Database of Controlled Trials (CENTRAL), in the Cochrane Library which includes the Cochrane Developmental, Psychosocial and Learning Problems Specialised Register
2012 Issue 2 searched on 2 March 2012 (2145 records)
2013 Issue 4 searched on 8 May 2013. Limited to publication year = 2012 to 2013 (98 records)
2017 Issue 1 searched on 02 February 2017: Limited to publication year = 2013 to 2017 (1854 records)
#1 MeSH descriptor Overweight explode all trees
#2 MeSH descriptor Body Weight, this term only
#3 (obes* or overweight or over‐weight)
#4 MeSH descriptor Body Weight Changes explode all trees
#5 (weight near/2 (loss or lost or losing or reduc*))
#6 (weight near/2 (gain* or increas*))
#7 MeSH descriptor Body Fat Distribution explode all trees
#8 MeSH descriptor Body Mass Index explode all trees
#9 MeSH descriptor Skinfold Thickness explode all trees
#10 MeSH descriptor Waist‐Hip Ratio explode all trees
#11 ("body weigh*" or bodyweigh* or "body mass*" or bodymass or "body fat*" or bodyfat*)
#12 MeSH descriptor Overnutrition, this term only
#13 (overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*)
#14 (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13)
#15 MeSH descriptor Child explode all trees
#16 MeSH descriptor Adolescent, this term only
#17 (child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or "young people" or "young person*" or pediatr* or paediatr*)
#18 (#15 OR #16 OR #17)
#19 MeSH descriptor Exercise, this term only
#20 MeSH descriptor Exercise Therapy, this term only
#21 MeSH descriptor Physical Exertion, this term only
#22 MeSH descriptor Motor Activity, this term only
#23 MeSH descriptor Sports, this term only
#24 (sport*)
#25 MeSH descriptor Physical Education and Training explode all trees
#26 (physical near/3 (activit* or education* or exertion* or training))
#27 (exercise*)
#28 MeSH descriptor Diet Therapy explode all trees
#29 ((diet or dieting) near/5 (health* or weight*))
#30 (calorie near/3 (control or reduc* or restriction))
#31 "food choice*"
#32 ("fat camp*" or "weight loss camp*")
#33 "nutrition education"
#34 MeSH descriptor Nutrition Therapy, this term only
#35 MeSH descriptor Behavior Therapy, this term only
#36 MeSH descriptor Cognitive Therapy, this term only
#37 MeSH descriptor Psychotherapy, this term only
#38 (behavio?r* near/3 (therap* or technique* or modif* or intervention*))
#39 (cognit* near/3 (therap* or technique* or modif* or intervention*))
#40 CBT
#41 (psychotherap* or psycho‐therap*)
#42 MeSH descriptor Family Therapy, this term only
#43 (family near/3 (therap* or intervention*))
#44 family‐based
#45 MeSH descriptor Sedentary Lifestyle, this term only
#46 sedentary near/3 (lifestyle or behavio?r*))
#47 MeSH descriptor Video Games, this term only
#48 MeSH descriptor Television, this term only
#49 (television or tv)
#50 "screen time"
#51 (psycho‐social or psychosocial)
#52 MeSH descriptor Health Promotion explode all trees
#53 MeSH descriptor Health Education, this term only
#54 (health* near/3 (promot* or educat* or lifestyle))
#55 MeSH descriptor Life Style, this term only
#56 (lifestyle* or life‐style*)
#57 ((video or computer) next game*)
#58 (#19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34 OR #35 OR #36 OR #37 OR #38 OR #39 OR #40 OR #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48 OR #49 OR #50 OR #51 OR #52 OR #53 OR #54 OR #55 OR #56 OR #57)
#59 (#14 AND #18 AND #58)
Ovid MEDLINE
1950 to 17 February 2012, searched 22 February 2012 (2145 records)
1946 to Week 4 April 2013, searched 7 May 2013, Limited to ED=20120217‐20130507 (1009 records)
1946 to January Week 4 2017, searched 2 February 2017, Limited to publication year = 2013 ‐ 2017 (3078 records)
1 exp Overweight/
2 Body Weight/
3 (obes$ or overweight or over‐weight).tw.
4 exp Body Weight Changes/
5 (weight adj2 (loss or lost or losing or reduc$)).tw.
6 (weight adj2 (gain$ or increas$)).tw.
7 exp body fat distribution/ or body mass index/ or skinfold thickness/ or waist‐hip ratio/
8 (body weigh$ or bodyweigh$ or body mass$ or bodymass or body fat$ or bodyfat$).tw.
9 Overnutrition/
10 (overeat$ or over‐eat$ or overnourish$ or over‐nourish$ or overnutrit$ or over‐nutrit$).tw.
11 or/1‐10
12 exp Child/
13 Adolescent/
14 (child$ or schoolchild$ or preschool$ or pre‐school$ or schoolage$ or school‐age$ or schoolboy$ or schoolgirl$ or boy$ or girl$ or preteen$ or teen$ or adolescen$ or youth$ or young people or young person$ or pediatr$ or paediatr$).tw. (1087380)
15 12 or 13 or 14
16 Exercise/ or Exercise Therapy/
17 Physical Exertion/
18 Motor Activity/
19 Sports/
20 sport$.tw.
21 exp "Physical Education and Training"/
22 (physical adj3 (activit$ or education$ or exertion$ or training)).tw.
23 exercise$.tw.
24 exp diet therapy/
25 ((diet or dieting) adj5 (health$ or weight$)).tw.
26 (calorie adj3 (control or reduc$ or restriction)).tw.
27 food choice$.tw.
28 (fat camp$ or weight loss camp$).tw.
29 nutrition education.tw.
30 Nutrition Therapy/
31 behavior therapy/
32 Cognitive Therapy/
33 psychotherapy/
34 (behavio?r$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
35 (cognit$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
36 CBT.tw.
37 (psychotherap$ or psycho‐therap$).tw.
38 family therapy/
39 (family adj3 (therap$ or intervention$)).tw.
40 family‐based.tw.
41 sedentary lifestyle/
42 (sedentary adj3 (lifestyle or behavio?r$)).tw.
43 video games/
44 television/
45 (television or tv).tw.
46 "screen time".tw.
47 (psycho‐social or psychosocial).tw.
48 exp Health Promotion/
49 Health Education/
50 (health$ adj3 (promot$ or educat$ or lifestyle)).tw.
51 lifestyle/
52 (lifestyle$ or life‐style$).tw.
53 ((video or computer) adj game$).tw.
54 or/16‐53
55 11 and 15 and 54
56 randomized controlled trial.pt.
57 controlled clinical trial.pt.
58 randomi#ed.ab.
59 placebo$.ab.
60 drug therapy.fs.
61 randomly.ab.
62 trial.ab.
63 groups.ab.
64 or/56‐63
65 exp animals/ not humans.sh.
66 64 not 65
67 55 and 66
Ovid MEDLINE Epub Ahead of Print
Searched 2 February 2017 (275 records)
1 (obes$ or overweight or over‐weight).tw.
2 (weight adj2 (loss or lost or losing or reduc$)).tw.
3 (weight adj2 (gain$ or increas$)).tw.
4 (body weigh$ or bodyweigh$ or body mass$ or bodymass or body fat$ or bodyfat$).tw.
5 (overeat$ or over‐eat$ or overnourish$ or over‐nourish$ or overnutrit$ or over‐nutrit$).tw.
6 or/1‐5
7 (child$ or schoolchild$ or preschool$ or pre‐school$ or schoolage$ or school‐age$ or schoolboy$ or schoolgirl$ or boy$ or girl$ or preteen$ or teen$ or adolescen$ or youth$ or young people or young person$ or pediatr$ or paediatr$).tw.
8 6 and 7
9 sport$.tw. (8
10 (physical adj3 (activit$ or education$ or exertion$ or training)).tw.
11 exercise$.tw. (2
12 ((diet or dieting) adj5 (health$ or weight$)).tw.
13 (calorie adj3 (control or reduc$ or restriction)).tw.
14 food choice$.tw.
15 (fat camp$ or weight loss camp$).tw.
16 (behavio?r$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
17 (cognit$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
18 CBT.tw.
19 (psychotherap$ or psycho‐therap$).tw.
20 (family adj3 (therap$ or intervention$)).tw.
21 family‐based.tw.
22 (sedentary adj3 (lifestyle or behavio?r$)).tw.
23 (television or tv).tw.
24 "screen time".tw.
25 ((video or computer) adj game$).tw.
26 (psycho‐social or psychosocial).tw.
27 (lifestyle$ or life‐style$).tw.
28 (health$ adj3 (promot$ or educat$)).tw.
29 (multi‐component$ or multiple component$).tw.
30 or/9‐29
31 8 and 30
32 (Random$ or trial$ or control$ or placebo$ or blind$ or prospectiv$ or meta‐analysis or group or systematic review).tw.
33 31 and 32
Ovid MEDLINE In‐Process & Other Non‐Indexed Citations
Searched 2 February 2017 (918 records)
1 (obes$ or overweight or over‐weight).tw.
2 (weight adj2 (loss or lost or losing or reduc$)).tw.
3 (weight adj2 (gain$ or increas$)).tw.
4 (body weigh$ or bodyweigh$ or body mass$ or bodymass or body fat$ or bodyfat$).tw.
5 (overeat$ or over‐eat$ or overnourish$ or over‐nourish$ or overnutrit$ or over‐nutrit$).tw.
6 or/1‐5
7 (child$ or schoolchild$ or preschool$ or pre‐school$ or schoolage$ or school‐age$ or schoolboy$ or schoolgirl$ or boy$ or girl$ or preteen$ or teen$ or adolescen$ or youth$ or young people or young person$ or pediatr$ or paediatr$).tw.
8 6 and 7
9 sport$.tw. (8
10 (physical adj3 (activit$ or education$ or exertion$ or training)).tw.
11 exercise$.tw. (2
12 ((diet or dieting) adj5 (health$ or weight$)).tw.
13 (calorie adj3 (control or reduc$ or restriction)).tw.
14 food choice$.tw.
15 (fat camp$ or weight loss camp$).tw.
16 (behavio?r$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
17 (cognit$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
18 CBT.tw.
19 (psychotherap$ or psycho‐therap$).tw.
20 (family adj3 (therap$ or intervention$)).tw.
21 family‐based.tw.
22 (sedentary adj3 (lifestyle or behavio?r$)).tw.
23 (television or tv).tw.
24 "screen time".tw.
25 ((video or computer) adj game$).tw.
26 (psycho‐social or psychosocial).tw.
27 (lifestyle$ or life‐style$).tw.
28 (health$ adj3 (promot$ or educat$)).tw.
29 (multi‐component$ or multiple component$).tw.
30 or/9‐29
31 8 and 30
32 (Random$ or trial$ or control$ or placebo$ or blind$ or prospectiv$ or meta‐analysis or group or systematic review).tw.
33 31 and 32
Embase Ovid
1980 to Week 7 2012, searched 22 February 2012 (3887 records)
1980 to Week 18 2013, searched 7 May 2013. Limited to EM=201209‐21318 (860 records)
1974 to Week 05 2017, searched 3 February 2017, Limited to year: 2013 to current (4255 records)
1 exp Overweight/
2 Body Weight/
3 (obes$ or overweight or over‐weight).tw.
4 exp Body Weight Changes/
5 (weight adj2 (loss or lost or losing or reduc$)).tw.
6 (weight adj2 (gain$ or increas$)).tw.
7 exp body fat distribution/ or body mass index/ or skinfold thickness/ or waist‐hip ratio/
8 (body weigh$ or bodyweigh$ or body mass$ or bodymass or body fat$ or bodyfat$).tw.
9 Overnutrition/
10 (overeat$ or over‐eat$ or overnourish$ or over‐nourish$ or overnutrit$ or over‐nutrit$).tw.
11 or/1‐10
12 exp Child/
13 Adolescent/
14 (child$ or schoolchild$ or preschool$ or pre‐school$ or schoolage$ or school‐age$ or schoolboy$ or schoolgirl$ or boy$ or girl$ or preteen$ or teen$ or adolescen$ or youth$ or young people or young person$ or pediatr$ or paediatr$).tw.
15 12 or 13 or 14
16 Exercise/ or Exercise Therapy/
17 Physical Exertion/
18 Motor Activity/
19 Sports/
20 sport$.tw.
21 exp "Physical Education and Training"/
22 (physical adj3 (activit$ or education$ or exertion$ or training)).tw.
23 exercise$.tw.
24 exp diet therapy/
25 ((diet or dieting) adj5 (health$ or weight$)).tw.
26 (calorie adj3 (control or reduc$ or restriction)).tw.
27 food choice$.tw.
28 (fat camp$ or weight loss camp$).tw.
29 nutrition education.tw.
30 Nutrition Therapy/
31 behavior therapy/
32 Cognitive Therapy/
33 psychotherapy/
34 (behavio?r$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
35 (cognit$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
36 CBT.tw.
37 (psychotherap$ or psycho‐therap$).tw.
38 family therapy/
39 (family adj3 (therap$ or intervention$)).tw.
40 family‐based.tw.
41 sedentary lifestyle/ (1338)
42 (sedentary adj3 (lifestyle or behavio?r$)).tw.
43 video games/
44 television/
45 (television or tv).tw.
46 "screen time".tw.
47 (psycho‐social or psychosocial).tw.
48 exp Health Promotion/
49 Health Education/
50 (health$ adj3 (promot$ or educat$ or lifestyle)).tw.
51 lifestyle/
52 (lifestyle$ or life‐style$).tw.
53 ((video or computer) adj game$).tw.
54 or/16‐53
55 11 and 15 and 54
56 random$.tw.
57 factorial$.tw.
58 crossover$.tw.
59 cross over$.tw.
60 cross‐over$.tw.
61 placebo$.tw.
62 (doubl$ adj blind$).tw.
63 (singl$ adj blind$).tw.
64 assign$.tw.
65 allocat$.tw.
66 volunteer$.tw.
67 Crossover Procedure/
68 double‐blind procedure.tw.
69 Randomized Controlled Trial/
70 Single Blind Procedure/
71 or/56‐70
72 55 and 71
PsycINFO Ovid
1806 to Week 2 February 2012, searched 22 February 2012 (1460 records)
1806 to Week 4 April 2013, searched 7 May 2013, limited to UP=20120218‐20130507 (311 records)
1806 to Week 5 January 2017, searched 3 February 2017, limited to up=20130501‐20170130 (723 records)
1 exp Overweight/
2 Body Weight/
3 (obes$ or overweight or over‐weight).tw.
4 (weight adj2 (loss or lost or losing or reduc$)).tw.
5 (weight adj2 (gain$ or increas$)).tw.
6 exp body fat distribution/ or body mass index/ or skinfold thickness/ or waist‐hip ratio/
7 (body weigh$ or bodyweigh$ or body mass$ or bodymass or body fat$ or bodyfat$).tw.
8 (overeat$ or over‐eat$ or overnourish$ or over‐nourish$ or overnutrit$ or over‐nutrit$).tw.
9 (child$ or schoolchild$ or preschool$ or pre‐school$ or schoolage$ or school‐age$ or schoolboy$ or schoolgirl$ or boy$ or girl$ or preteen$ or teen$ or adolescen$ or youth$ or young people or young person$ or pediatr$ or paediatr$).tw.
10 Exercise/ or Exercise Therapy/
11 Physical Activity/
12 Sports/
13 sport$.tw.
14 exp Physical Education/
15 (physical adj3 (activit$ or education$ or exertion$ or training)).tw.
16 exercise$.tw.
17 ((diet or dieting) adj5 (health$ or weight$)).tw.
18 (calorie adj3 (control or reduc$ or restriction)).tw.
19 food choice$.tw.
20 (fat camp$ or weight loss camp$).tw.
21 nutrition education.tw.
22 behavior therapy/
23 Cognitive Therapy/
24 psychotherapy/
25 (behavio?r$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
26 (cognit$ adj3 (therap$ or technique$ or modif$ or intervention$)).tw.
27 CBT.tw.
28 (psychotherap$ or psycho‐therap$).tw.
29 family therapy/
30 (family adj3 (therap$ or intervention$)).tw.
31 family‐based.tw.
32 sedentary lifestyle/
33 (sedentary adj3 (lifestyle or behavio?r$)).tw.
34 video games/
35 television/
36 (television or tv).tw.
37 "screen time".tw.
38 (psycho‐social or psychosocial).tw.
39 exp Health Promotion/
40 Health Education/
41 (health$ adj3 (promot$ or educat$ or lifestyle)).tw.
42 lifestyle/
43 (lifestyle$ or life‐style$).tw.
44 ((video or computer) adj game$).tw.
45 or/1‐8
46 or/10‐44
47 9 and 45 and 46
48 Treatment Effectiveness Evaluation/
49 exp Treatment Outcomes/
50 Psychotherapeutic Outcomes/
51 PLACEBO/
52 exp Followup Studies/
53 placebo$.tw.
54 random$.tw.
55 comparative stud$.tw.
56 randomi#ed controlled trial$.tw.
57 (clinical adj3 trial$).tw.
58 (research adj3 design).tw.
59 (evaluat$ adj3 stud$).tw.
60 (prospectiv$ adj3 stud$).tw.
61 ((singl$ or doubl$ or trebl$ or tripl$) adj3 (blind$ or mask$)).tw.
62 control$.tw.
63 62 or 54 or 52 or 60 or 59 or 55 or 48 or 53 or 49 or 61 or 57 or 51 or 50 or 58 or 56
64 47 and 63
CINAHL Plus EBSCOhost (Cumulative Index to Nursing and Allied Health Literature)
1937 to current, searched 22 February 2012 (1933 records)
1937 to current, searched 7 May 2013, limited to EM=20120222 ‐ current (484 records)
1937 to current, searched 3 February 2017, limited to EM 20130501 ‐ current (2729 records]
S47 (S44 or S45) and (S43 and S46)
S46 S44 or S45
S45 (MH "Randomized Controlled Trials")
S44 ((random* or blind* or allocat* or assign* or trial* or placebo* or crossover* or cross‐over*))
S43 S9 and S10 and S42
S42 (S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20 or S21 or S22 or S23 or S24 or S25 or S26 or S27 or S28 or S29 or S30 or S31 or S32 or S33 or S34 or S35 or S36 or S37 or S38 or S39 or S40 or S41)
S41 (((video or computer) N1 game*))
S40 ((lifestyle* or life‐style*))
S39 ((health* N3 (promot* or educat* or lifestyle)))
S38 ((psycho‐social or psychosocial))
S37 ("screen time")
S36 ((television or tv))
S35 ((sedentary N3 (lifestyle or behavio?r*)))
S34 (family‐based)
S33 ((family N3 (therap* or intervention*)))
S32 ((psychotherap* or psycho‐therap*))
S31 CBT
S30 ((cognit* N3 (therap* or technique* or modif* or intervention*)))
S29 ((behavio#r* N3 (therap* or technique* or modif* or intervention*)))
S28 ("nutrition education")
S27 (("fat camp*" or "weight loss camp*"))
S26 ("food choice*")
S25 ((calorie N3 (control or reduc* or restriction)))
S24 (((diet or dieting) N5 (health* or weight*)))
S23 (exercise*)
S22 ((physical N3 (activit* or education* or exertion* or training)))
S21 (sport*)
S20 (MH "Health Education")
S19 (MH "Health Promotion")
S18 (MH "Life Style")
S17 (MH "Television")
S16 (MH "Video Games")
S15 (MH "Family Therapy")
S14 (MH "Cognitive Therapy")
S13 (MH "Diet Therapy") OR (MH "Behavior Therapy")
S12 (MH "Sports")
S11 (MH "Exercise") OR (MH "Physical Fitness")
S10 ((child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or young people or young person* or pediatr* or paediatr*))
S9 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8
S8 ((overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*))
S7 (("body weigh*" or bodyweigh* or body mass* or bodymass or "body fat*" or bodyfat*))
S6 ((weight N2 (gain* or increas*)))
S5 ((weight N2 (loss or lost or losing or reduc*)))
S4 (MH "Hyperphagia")
S3 (MH "Weight Loss")
S2 (MH "Obesity")
S1 ((obes* or overweight or over‐weight))
ERIC Proquest (Educational Resources Information Centre)
1966 to current, searched 22 February 2012 (1363 records)
1966 to current, searched 8 May 2013, limited to publication year 2012 to 2013 (205 records)
1966 to current, searched 3 February 2017, limited to publication year 2013 to 2017 (223 records)
S1 ((obes* or overweight or over‐weight))
S2 ((weight near/2 (loss or lost or losing or reduc*)))
S3 ((weight near/2 (gain* or increas*)))
S4 (("body weigh*" or bodyweigh* or body mass* or bodymass or "body fat*" or bodyfat*))
S5 ((overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*))
S6 s1 or s2 or s3 or s4 or s5
S7 ((child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or young people or young person* or pediatr* or paediatr*))
S8 (sport*)
S9 ((physical near/3 (activit* or education* or exertion* or training)))
S10 (exercise*)
S11 (((diet or dieting) near/5 (health* or weight*)))
S12 ((calorie near/3 (control or reduc* or restriction)))
S13 ("food choice*")
S14 (("fat camp*" or "weight loss camp*"))
S15 ("nutrition education")
S16 ((behavio?r* near/3 (therap* or technique* or modif* or intervention*)))
S17 ((cognit* near/3 (therap* or technique* or modif* or intervention*)))
S18 (CBT)
S19 ((psychotherap* or psycho‐therap*))
S20 ((family near/3 (therap* or intervention*)))
S21 (family‐based)
S22 ((sedentary near/3 (lifestyle or behavio?r*)))
S23 ((television or tv))
S24 ("screen time")
S25 ((psycho‐social or psychosocial))
S26 ((health* near/3 (promot* or educat* or lifestyle)))
S27 ((lifestyle* or life‐style*))
S28 (((video or computer) near/1 game*))
S29 s8 or s9 or s10 or s11 or s12 or s13 or s14 or s15 or s16 or s17 or s18 or s19 or s20
S30 s21 or s22 or s23 or s24 or s25 or s26 or s27 or s28
S31 s29 or s30
S32 s6 and s7 and s31
SPORTDiscus EBSCO
Searched from 1980 to current on 05 March 2012 and 06 May 2013, 6 February 2017, limited to 2013 to current (2186 records)
S66 (S63 and S65)
S65 S17 and S57 and S64
S64 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13
S63 S61 NOT S62
S62 SU animals NOT SU humans
S61 (S58 or S59 or S60)
S60 AB (random* or blind* or allocat* or assign* or trial* or placebo* or crossover or cross‐over)
S59 SU controlled clinical trial
S58 SU randomized controlled trials
S57 (S19 or S20 or S21 or S22 or S23 or S24 or S25 or S26 or S27 or S28 or S29 or S30 or S31 or S32 or S33 or S34 or S35 or S36 or S37 or S38 or S39 or S40 or S41 or S42 or S43 or S44 or S45 or S46 or S47 or S48 or S49 or S50 or S51 or S52 or S53 or S54 or S55 or S56)
S56 TX ((computer or video or internet) N1 game)
S55 SU computer game
S54 TX lifestyle* or life‐style*
S53 TX (health* N3 (lifestyle or promotion or education or behavio?r))
S52 SU lifestyle
S51 SU Health Education or SU Health Promotion
S50 TX psycho‐social or psychosocial
S49 TX "screen time"
S48 TX television or TV
S47 SU video games
S46 SU television
S45 TX (Sedentary N3 (behavio?r or lifestyle))
S44 SU Sedentary
S43 TX family‐based
S42 TX (family N3 (therap* or intervention*))
S41 SU family therapy
S40 TX psychotherap* or psycho‐therap* Rerun View Details Edit Interface ‐
S39 TX (behavio?r N3 (therap* or technique* or modif* or intervention*))
S38 TX CBT
S37 SU Cognitive therapy
S36 SU Behavior therapy
S35 SU Psychotherapy
S34 TX "food choice"
S33 TX (calorie N3 (control or reduc* or restriction))
S32 TX ((diet or dieting) N5 (health* or weight*))
S31 TX "fat camp*" or "weight loss camp*"
S30 SU food habit
S29 SU nutrition therapy
S28 SU diet therapy
S27 TX exercise*
S26 TX sport*
S25 TX (Physical N2 (activit* or education* or training or fitness))
S24 SU Physical training
S23 SU Physical activity
S22 SU Physical education
S21 SU Sport
S20 SU Exercise Therapy
S19 SU Exercise
S18 (S14 or S15 or S16 or S17)
S17 TX child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or young people or young person* or pediatr* or paediatr*
S16 SU teenager
S15 SU adolescent
S14 SU child
S13 TX Overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*
S12 TX "waist‐hip ratio"
S11 TX "body weigh*" or bodyweigh* or body mass* or bodymass or "body fat*" or bodyfat*
S10 TX waist‐hip ration
S9 TX skin fold thickness
S8 TX body fat distribution
S7 SU body composition
S6 TX (weight N2 (gain* or increas*))
S5 TX (weight N2 (loss or lost or losing or reduc*))
S4 TX obes* or overweight or over‐weight
S3 SU body weight change
S2 SU body weight
S1 SU overweight
IBSS (International Bibliography of Social Studies) Proquest
1951 to current, searched 22 February 2012 (459 records)
1951 to current, searched 8 May 2013, limited to publication year 2012 to 2013 (113 records)
1951 to current searched 3 Feburary 2017, limited to publication year 2013 to 2017 (200 records)
S1 ((obes* or overweight or over‐weight))
S2 ((weight near/2 (loss or lost or losing or reduc*)))
S3 ((weight near/2 (gain* or increas*)))
S4 (("body weigh*" or bodyweigh* or body mass* or bodymass or "body fat*" or bodyfat*))
S5 ((overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*))
S6 s1 or s2 or s3 or s4 or s5
S7 ((child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or young people or young person* or pediatr* or paediatr*))
S8 (sport*)
S9 ((physical near/3 (activit* or education* or exertion* or training)))
S10 (exercise*)
S11 (((diet or dieting) near/5 (health* or weight*)))
S12 ((calorie near/3 (control or reduc* or restriction)))
S13 ("food choice*")
S14 (("fat camp*" or "weight loss camp*"))
S15 ("nutrition education")
S16 ((behavio?r* near/3 (therap* or technique* or modif* or intervention*)))
S17 ((cognit* near/3 (therap* or technique* or modif* or intervention*)))
S18 (CBT)
S19 ((psychotherap* or psycho‐therap*))
S20 ((family near/3 (therap* or intervention*)))
S21 (family‐based)
S22 ((sedentary near/3 (lifestyle or behavio?r*)))
S23 ((television or tv))
S24 ("screen time")
S25 ((psycho‐social or psychosocial))
S26 ((health* near/3 (promot* or educat* or lifestyle)))
S27 ((lifestyle* or life‐style*))
S28 (((video or computer) near/1 game*))
S29 s8 or s9 or s10 or s11 or s12 or s13 or s14 or s15 or s16 or s17 or s18 or s19 or s20
S30 s21 or s22 or s23 or s24 or s25 or s26 or s27 or s28
S31 s29 or s30
S32 s6 and s7 and s31
Conference Proceeding Citation Index–Science (CPCI‐S) and Conference Proceeding Citation Index–Social Sciences & Humanities (CPCI‐SS&H) Web of Science (Clarivate)
1990 to 17 February 2012, searched 22 February 2012 (871 records)
1990 to 3 May 2013, searched 8 May 2013 (12 records)
1990 to 2 February 2017, searched 3 February 2017, limited to 2013 to current (35 records)
#32 #31 AND #30
#31 Topic=((random* or blind* or allocat* or assign* or trial* or placebo* or crossover* or cross‐over*))
#30 #29 AND #7
#29 #28 OR #27 OR #26 OR #25 OR #24 OR #23 OR #22 OR #21 OR #20 OR #19 OR #18 OR #17 OR #16 OR #15 OR #14 OR #13 OR #12 OR #11 OR #10 OR #9 OR #8
#28 Topic=(((video or computer) near/1 game*))
#27 Topic=((lifestyle* or life‐style*))
#26 Topic=((health* near/3 (promot* or educat* or lifestyle)))
#25 Topic=((psycho‐social or psychosocial))
#24 Topic=("screen time")
#23 Topic=((television or tv))
#22 Topic=((sedentary near/3 (lifestyle or behavio?r*)))
#21 Topic=(family‐based)
#20 Topic=((family near/3 (therap* or intervention*)))
#19 Topic=((psychotherap* or psycho‐therap*))
#18 Topic=(CBT)
#17 Topic=((cognit* near/3 (therap* or technique* or modif* or intervention*)))
#16 Topic=((behavio?r* near/3 (therap* or technique* or modif* or intervention*)))
#15 Topic=("nutrition education")
#14 Topic=(("fat camp*" or "weight loss camp*"))
#13 Topic=("food choice*")
#12 Topic=((calorie near/3 (control or reduc* or restriction)))
#11 Topic=(((diet or dieting) near/5 (health* or weight*)))
#10 Topic=(exercise*)
#9 Topic=((physical near/3 (activit* or education* or exertion* or training)))
#8 Topic=(sport*)
#7 Topic=((child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or young people or young person* or pediatr* or paediatr*))
#6 #5 OR #4 OR #3 OR #2 OR #1
#5 Topic=((overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*))
#4 Topic=(("body weigh*" or bodyweigh* or body mass* or bodymass or "body fat*" or bodyfat*))
#3 Topic=((weight near/2 (gain* or increas*)))
#2 Topic=((weight near/2 (loss or lost or losing or reduc*)))
#1 Topic=((obes* or overweight or over‐weight))
Cochrane Database of Systematic Reviews (CDSR) part of the Cochrane Library
2012 (Issue 12), searched 15 January 2012 (22 records)
2013 (Issue 4), searched 8 May 2013, limited to publication year 2012 to 2013 (11 records)
2017 (Issue 1), searched 2 February 2017, limited to online publications date from May 2013 to Jan 2017 (32 records)
#1MeSH descriptor: [Overweight] explode all trees
#2MeSH descriptor: [Body Weight] this term only
#3(obese or obesity or overweight or over‐weight):ti,ab
#4MeSH descriptor: [Body Weight Changes] explode all trees
#5(weight near/2 (loss or lost or losing or reduc*)):ti,ab
#6(weight near/2 (gain* or increas*)):ti,ab
#7MeSH descriptor: [Body Fat Distribution] explode all trees
#8MeSH descriptor: [Body Mass Index] explode all trees
#9MeSH descriptor: [Skinfold Thickness] explode all trees
#10MeSH descriptor: [Waist‐Hip Ratio] explode all trees
#11("body weigh*" or bodyweigh* or "body mass*" or bodymass or "body fat*" or bodyfat*):ti,ab
#12MeSH descriptor: [Overnutrition] this term only
#13(overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*):ti,ab
#14#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 #11 or #12 or #13
#15MeSH descriptor: [Child] explode all trees
#16MeSH descriptor: [Adolescent] this term only
#17(child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or "young people" or "young person*" or pediatr* or paediatr*):ti,ab
#18#15 or #16 or #17
#19#14 and #18
#20MeSH descriptor: [Exercise] this term only
#21MeSH descriptor: [Exercise Therapy] this term only
#22MeSH descriptor: [Physical Exertion] this term only
#23MeSH descriptor: [Motor Activity] this term only
#24MeSH descriptor: [Sports] this term only
#25(sport*):ti,ab
#26MeSH descriptor: [Physical Education and Training] explode all trees
#27(physical near/3 (activit* or education* or exertion* or training)):ti,ab
#28(exercise*):ti,ab
#29MeSH descriptor: [Diet Therapy] explode all trees
#30((diet or dieting) near/5 (health* or weight*)):ti,ab
#31(calorie near/3 (control or reduc* or restriction)):ti,ab
#32("food choice*"):ti,ab
#33("fat camp*" or "weight loss camp*"):ti,ab
#34("nutrition education") ti,ab
#35MeSH descriptor: [Nutrition Therapy] this term only
#36MeSH descriptor: [Behavior Therapy] this term only
#37MeSH descriptor: [Cognitive Therapy] this term only
#38MeSH descriptor: [Psychotherapy] this term only
#39((behavior* or behavior*) near/3 (therap* or technique* or modif* or intervention*)):ti,ab
#40(cognit* near/3 (therap* or technique*or modif* or intervention*)):ti,ab
#41(CBT) ti,ab
#42(psychotherap* or psycho‐therap*) ti,ab
#43MeSH descriptor: [Family Therapy] this term only
#44(family near/3 (therap* or intervention*)):ti,ab
#45(family‐based):ti,ab
#46MeSH descriptor: [Sedentary Lifestyle] this term only
#47(sedentary near/3 (lifestyle or behavio*r*)):ti,ab
#48MeSH descriptor: [Video Games] this term only
#49MeSH descriptor: [Television] this term only
#50(television or tv):ti,ab
#51("screen time"):ti,ab
#52(psycho‐social or psychosocial):ti,ab
#53MeSH descriptor: [Health Promotion] explode all trees
#54MeSH descriptor: [Health Education] this term only
#55(health* near/3 (promot* or educat* or lifestyle)):ti,ab
#56MeSH descriptor: [Life Style] this term only
#57(lifestyle* or life‐style*):ti,ab
#58((video or computer) next game*):ti,ab
#59#20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 or #49 or #50 or #51 or #52 or #53 or #54 or #55 or #56 or #57 or #58
#60#19 and #59
Database of Abstracts of Reviews of Effects (DARE) part of the Cochrane Library
2012 (4), searched 15 January 2013 (8 records)
2013 (2), searched 8 May 2013, limited to publication year 2012 to 2013 (16 records)
2015 (2), searched 2 February 2017 (0 records)
#1MeSH descriptor: [Overweight] explode all trees
#2MeSH descriptor: [Body Weight] this term only
#3(obese or obesity or overweight or over‐weight):ti,ab
#4MeSH descriptor: [Body Weight Changes] explode all trees
#5(weight near/2 (loss or lost or losing or reduc*)):ti,ab
#6(weight near/2 (gain* or increas*)):ti,ab
#7MeSH descriptor: [Body Fat Distribution] explode all trees
#8MeSH descriptor: [Body Mass Index] explode all trees
#9MeSH descriptor: [Skinfold Thickness] explode all trees
#10MeSH descriptor: [Waist‐Hip Ratio] explode all trees
#11("body weigh*" or bodyweigh* or "body mass*" or bodymass or "body fat*" or bodyfat*):ti,ab
#12MeSH descriptor: [Overnutrition] this term only
#13(overeat* or over‐eat* or overnourish* or over‐nourish* or overnutrit* or over‐nutrit*):ti,ab
#14#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 #11 or #12 or #13
#15MeSH descriptor: [Child] explode all trees
#16MeSH descriptor: [Adolescent] this term only
#17(child* or schoolchild* or preschool* or pre‐school* or schoolage* or school‐age* or schoolboy* or schoolgirl* or boy* or girl* or preteen* or teen* or adolescen* or youth* or "young people" or "young person*" or pediatr* or paediatr*):ti,ab
#18#15 or #16 or #17
#19#14 and #18
#20MeSH descriptor: [Exercise] this term only
#21MeSH descriptor: [Exercise Therapy] this term only
#22MeSH descriptor: [Physical Exertion] this term only
#23MeSH descriptor: [Motor Activity] this term only
#24MeSH descriptor: [Sports] this term only
#25(sport*):ti,ab
#26MeSH descriptor: [Physical Education and Training] explode all trees
#27(physical near/3 (activit* or education* or exertion* or training)):ti,ab
#28(exercise*):ti,ab
#29MeSH descriptor: [Diet Therapy] explode all trees
#30((diet or dieting) near/5 (health* or weight*)):ti,ab
#31(calorie near/3 (control or reduc* or restriction)):ti,ab
#32("food choice*"):ti,ab
#33("fat camp*" or "weight loss camp*"):ti,ab
#34("nutrition education") ti,ab
#35MeSH descriptor: [Nutrition Therapy] this term only
#36MeSH descriptor: [Behavior Therapy] this term only
#37MeSH descriptor: [Cognitive Therapy] this term only
#38MeSH descriptor: [Psychotherapy] this term only
#39((behavior* or behavior*) near/3 (therap* or technique* or modif* or intervention*)):ti,ab
#40(cognit* near/3 (therap* or technique*or modif* or intervention*)):ti,ab
#41(CBT) ti,ab
#42(psychotherap* or psycho‐therap*) ti,ab
#43MeSH descriptor: [Family Therapy] this term only
#44(family near/3 (therap* or intervention*)):ti,ab
#45(family‐based):ti,ab
#46MeSH descriptor: [Sedentary Lifestyle] this term only
#47(sedentary near/3 (lifestyle or behavio*r*)):ti,ab
#48MeSH descriptor: [Video Games] this term only
#49MeSH descriptor: [Television] this term only
#50(television or tv):ti,ab
#51("screen time"):ti,ab
#52(psycho‐social or psychosocial):ti,ab
#53MeSH descriptor: [Health Promotion] explode all trees
#54MeSH descriptor: [Health Education] this term only
#55(health* near/3 (promot* or educat* or lifestyle)):ti,ab
#56MeSH descriptor: [Life Style] this term only
#57(lifestyle* or life‐style*):ti,ab
#58((video or computer) next game*):ti,ab
#59#20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 or #49 or #50 or #51 or #52 or #53 or #54 or #55 or #56 or #57 or #58
#60#19 and #59
DoPHER (Database of Promoting Health Effectiveness Reviews)
(www.eppi.ioe.ac.uk/webdatabases4/SearchIntro.aspx)
Searched 23 February 2012, 06 May 2013 and 06 February 2017 (113 records)
(Child* OR adolesc* OR youth OR boy* OR girl* OR paediatr* OR pediatr*) AND (obes* OR overweight OR BMI OR “body mass index” OR “body weight change”)
Bibliomap
(eppi.ioe.ac.uk/webdatabases/SearchIntro.aspx)
Searched 23 February 2012, 06 May 2013 and 06 February 2017 (0 records)
(child* OR adolesc* OR youth OR boy* OR girl* OR paediatr* OR pediatr*)) AND (obes* OR overweight)
Trials Register of Promoting Health Interventions (TRoPHI)
(eppi.ioe.ac.uk/webdatabases4/SearchIntro.aspx)
Searched 23 February 2012, 06 May 2013 and 06 February 2017 (255 records)
(child* OR adolesc* OR youth OR boy* OR girl* OR paediatr* OR pediatr*) AND (obes* OR overweight)
Dissertations and Theses Global (Proquest)
2012 to 2017, searched 8 February 2017, limited to publication year 2013 to 2017 (24 records)
(ab(weight NEAR/2 (gain* OR increas*)) OR ab(obes* or overweight or over‐weight) OR ab(weight NEAR/2 (loss OR lost OR losing OR reduc*)) OR ab(("body weigh*" OR bodyweigh* OR body mass* OR bodyarts OR "body fat*" OR bodyfat*)) OR su(obesity) OR su(overweight))
AND
(su(child) OR ab(child* OR schoolchild* OR preschool* OR pre‐school* OR schoolage* OR school‐age* OR schoolboy* OR schoolgirl* OR boy* OR girl* OR preteen* OR teen* OR adolescen* OR youth* OR young people OR young person* OR pediatr* OR paediatr*))
AND
(ab(physical NEAR/3 (activit* OR education* OR exertion* OR training)) OR ab(exercis* OR sport*) OR ab((diet OR dieting) NEAR/5 (health* OR weight*)) OR ab(calorie NEAR/3 (control OR reduc* OR restriction)) OR ab("fat camp*" OR "weight loss camp*") OR ab("nutrition education") OR su(nutrition education) OR ab(behavio?r* NEAR/3 (therap* OR technique* OR modif* OR intervention*)) OR ab(cognit* NEAR/3 (therap* OR technique* OR modif* OR intervention*)) OR ab(psychotherap* OR psycho‐therap*) OR ab(family near/3 (therap* or intervention*)) OR ab(sedentary NEAR/3 (lifestyle OR behavio?r*)) OR ab(“screen time”) OR ab(health* near/3 (promot* or educat* or lifestyle)) OR ab(lifestyle* or life‐style*))
AND
(ab("random* controlled trial*") OR ab(random* controlled trial*) OR su(randomized controlled trial))
ISRCTN Registry
2001 to current, searched 08 February 2017 (67 records)
Obes* child*
Obes* youth
Obes* adolesc*
Overweight child*
World Health Organization International Clinical Trials Registry Platform (WHO ICTRP)
searched 27 February 2012, 06 May 2013, and 08 February 2017 limited to 07/05/2013 ‐ 31/01/2017 (600 records)
Condition: (obes% or overweight) restricted to “Search for clinical trials in children” option
Database on Obesity and Sedentary Behaviour Studies
Searched 23 February 2012 and 06 May 2013
Child* OR adolesc* OR youth OR boy* Or girl* Or paediatr* OR pediatr*
MIT Cognet
Searched 23 February 2012 and 06 May 2013
(child* OR adolesc*) AND (obes* OR overweight)
Networked Digital Library of Theses and Dissertations
Searched 28 February 2012 and 06 May 2013
(children OR adolescents OR youth) and (overweight OR obesity) AND (randomised controlled trial)
OpenSIGLE (Open Grey)
searched 23 February 2012 and 06 May 2013
(child* OR adolesc* OR youth or boy* or girl*) AND (obes* OR overweight)
Appendix 2. Additional methods
| Method item | Additional methods |
| Measures of treatment effect | Dichotomous data Dichotomous outcomes will be summarised as a risk ratio (RR) with a 95% confidence interval (CI). Using the risk ratio rather than the odds ratio minimises misinterpretation of the occurrence of the treatment effect and avoids subsequent conversion of odds ratios to risk ratios for correct interpretation. In the ‘Summary of findings’ table, we will express dichotomous data as relative (risk ratio) and absolute (number of children per 1000) risk. Ordinal data For ordinal data, we will analyse longer ordinal scales (e.g. Wechsler Intelligence Scale for Children) as continuous data (Section 9.2.4. in Higgins 2011). When studies use short ordinal scales (e.g. A to F classification of educational achievement), we will convert these to dichotomous data by combining adjacent categories and calculating the risk ratio (Section 9.2.4. in Higgins 2011). Dichotomisation will be done according to the cut‐offs considered as ‘pass’ or ‘fail’ |
| Unit of analysis issues | Multiple time points We will analyse data from studies that reported results at more than one time point in a separate meta‐analysis with comparable data from other studies at similar time points. We will group post‐intervention time points as immediately after intervention, one to five months, six to 11 months, 12 to 23 months and ≥ 24 months after intervention |
| Assessment of reporting biases | We will assess reporting bias by using a funnel plot to evaluate the association between effect size and standard error, if a sufficient number of studies (at least 10 studies) are included in a meta‐analysis. An asymmetrical plot may indicate publication bias or a real relationship between study size and effect size, as when larger trials have lower compliance rates and compliance is positively related to effect size. If we find such a relationship, we will explore clinical variation as a possible explanation. When the number of included studies is low, an asymmetrical funnel plot may be due to heterogeneity in the intervention effect or chance |
| Synthesis of continuous and dichotomous data | If similar outcome data are extracted as both dichotomous and continuous measures (e.g. exam results expressed as pass or fail or as a percentage score), we will used the inverse variance method to combine data; to do this, we will convert the risk ratio to lnRR and standard error (SE) of lnRR for entry into Review Manager 5 |
| Subgroup analysis and investigation of heterogeneity | We will conduct subgroup analyses on the following:
These subgroups are exploratory because they are based on non‐experimental conditions (cross‐sectional studies); large numbers of subgroup analyses may lead to misleading conclusions (Oxman 1992; Yusuf 1991). We will therefore treat any conclusions with caution when performing subgroup analyses. |
Appendix 3. Intercluster correlation coefficients used for estimating the effective sample size in cluster RCTs of primary outcomes
| Study ID | ICC | 95% CI | Analysis method | Source | Intervention type |
| Grade‐Point Average | |||||
| 0.18 | 0.11 to 0.27 | One‐way ANOVA, baseline data | Re‐analysed from raw data | PA + Education | |
| 0.05 | 0.02 to 0.09 | One‐way ANOVA, baseline data | Re‐analysed from raw data | Diet + Education | |
| Mathematics Achievement | |||||
| 0.10 | 0.04 to 0.18 | One‐way ANOVA, baseline data | Re‐analysed from raw data | PA + Education | |
| 0.03 | 0.00 to 0.13 | One‐way ANOVA, baseline data | Trial authors | PA + Education | |
| 0.05 | ‐ | ‐ | Diet + Education | ||
| 0.31 | 0.08 to 0.65 | Mixed effects models using baseline data adjusted by age, sex and socioeconomic level | Trial authors | PA only | |
| 0.05 | Not reported | Not reported | Trial authors | PA + Education | |
| Reading Achievement | |||||
| 0.10 | 0.04 to 0.18 | One‐way ANOVA, baseline data | Re‐analysed from raw data | PA + Education | |
| 0.05 | ‐ | ‐ | Diet + Education | ||
| 0.05 | Not reported | Not reported | Trial authors | PA + Education | |
| Language Achievement | |||||
| 0.25 | 0.17 to 0.35 | One‐way ANOVA, baseline data | Re‐analysed from raw data | PA + Education | |
| 0.01 | 0.00 to 0.07 | One‐way ANOVA, baseline data | Trial authors | PA + Education | |
| 0.54 | 0.27 to 0.79 | Mixed effects models using baseline data adjusted by age, sex and socioeconomic level | Trial authors | PA only | |
| 0.01 | Not reported | Not reported | Report article | PA + Education | |
| Inhibition control | |||||
| 0.03 | ‐ | ‐ | PA + Education | ||
| Visuo‐spatial abilities | |||||
| 0.32 | 0.1 to 0.64 | Mixed effects models using baseline data adjusted by age, sex and socioeconomic level | Trial authors | PA only | |
| Attention | |||||
| 0.05 | ‐ | ‐ | Diet + Education | ||
| 0.03 | ‐ | ‐ | PA + Education | ||
| 0.03 | ‐ | ‐ | PA + Education | ||
| General Intelligence | |||||
| 0.44 | 0.18 to 0.73 | Mixed effects models using baseline data adjusted by age, sex and socioeconomic level | Trial authors | PA only | |
ICC: Intracluster correlation coefficient, CI: Confidence interval, ANOVA: Analysis of variance, PA: Physical Activity
Note: De Greeff 2016 and Resaland 2016 corrected the sample size for cluster randomisation a priori using an ICC of 0.10 (De Greeff 2016) and an ICC of 0.15 (Resaland 2016). The ICC used in Melnyk 2013 was not obtainable from the trial authors. The report states "A number of simulations were run to assess power for the omnibus ANOVA test and the a priori comparison of between group differences at each time point, varying both the class size and the intraclass correlation coefficient" (page 410). Johnston 2013 provided outcome data calculated using generalised linear models, which accounted for the clustered nature of the data (i.e. students nested within schools).
Appendix 4. Summary of school achievement and cognitive function measures and test tools used in included studies
| Outcomes | Tests | Cognitive processes | Standardised score/scale range | Units | Scale direction | ||
| SCHOOL ACHIEVEMENT | |||||||
| Mathematics | CAT‐3 | Number concepts, measurement, patterns, data analysis and probability, geometry and spatial sense | M = 500, SD = 70 | Number of correct answers | High = better performance | ||
| W‐J Tests of Achievement III (broad math) | Simple and complex calculation skills, math fluency (number facility), mathematical reasoning and problem analysis and solving | M = 100, SD = 15 (range zero to 200) ≥ 131 = very superior; 121 to 130 = superior; 111 to 120 = high average; 90 to 110 = average; 80 to 89 = low average; 70 to 79 = low; ≤ 69 = very low | Number of correct responses | High = better performance | |||
| Standardised Norwegian national tests | Not reported | M = 50, SD = 10 | Number of correct responses | High = better performance | |||
| BADyG‐I (Numerical quantitative concepts) | Numerical reasoning, number comprehension | Scale range: 0 to 36 | Number of correct responses | High = better performance | |||
| MCAP | Mathematics problem‐solving skills | Not obtainable | Number of correct responses | High = better performance | |||
| Danish standard test | Mathematics problem‐solving skills. The tests are diagnostic tests designed to measure math skills relative to the grade level | Scale range 3rd grade: 0 to 50 Scale range 4th grade: 0 to 69 | Number of correctly solved problems | High = better performance | |||
| Native Language | Standardised Brazilian National Test (Portuguese) | ‐ | Scale range = 0 to 10 | ‐ | ‐ | ||
| Danish standard tests for mathematics proficiency | Mathematics problem solving | Not reported | Number of correctly solved problems | High = better performance | |||
| CAT‐3 (English) | Sentence structure, writing conventions, paragraph structure, information management | M = 500, SD = 70 | Number of correct responses | High = better performance | |||
| PPVT III (English) | Receptive vocabulary acquisition | M =100, SD = 15 | Number of correct responses | High = better performance | |||
| BADyG‐I Analogical relations and Complex verbal orders scale (Spanish) | Measures the ability to discover relationships between concepts and verbal comprehension. | Scale range: 0 to 36 | Number of correct responses | High = better performance | |||
| Standardised Brazilian National Test (Portuguese) | Not obtainable | Scale range = 0 to 10 | Number of correct responses | High = better performance | |||
| Second Language | Standardised Norwegian national tests in English | Not obtainable | Mean = 50, SD = 10 | Number of correct responses | High = better performance | ||
| Reading | CAT‐3 | Reading decoding (letter‐word identification), words/phrases in context, reading comprehension (stated information, visual materials, central thought), analysis of text, critical assessment | M = 500, SD = 70 | Number of correct responses | High = better performance | ||
| W‐J Tests of Achievement III (broad reading) | Reading decoding (letter‐word identification), reading fluency (speed), reading comprehension of textual information | M = 100, SD = 15 (range zero to 200) ≥ 131 = very superior; 121 to 130 = superior; 111 to 120 = high average; 90 to 110 = average; 80 to 89 = low average; 70 to 79 = low; ≤ 69 = very low | Number of correct responses | High = better performance | |||
| AIMSweb standardised test: Reading–Curriculum‐Based Measurement | Reading fluency | Not obtainable | Number of correct responses | High = better performance | |||
| Standardised Norwegian national test | Not reported | Mean = 50, SD = 10 | Number of correct responses | High = better performance | |||
| The Sentence Reading Test 2 (Danish standard test) | Test performance draws on the working memory of the child and reflects the reading comprehension of the child, which includes accurate and fluent decoding of words, vocabulary knowledge, and thinking and reasoning skills. The sentences gradually become longer and more complicated, and as complexity increases, thoughtful analysis of content becomes more essential to comprehension in order to solve the task, e.g. the ability to make inferences | Scale range: 0 to 108 | Number of correct responses (relates to the reading proficiency) Total number of sentences read (reflects the reading speed) | High = better performance | |||
| Health Class | Health Education tests | Course content included choosing and financing health services; communicable diseases; chronic disorders; abuse of drugs, alcohol, and tobacco, exercise, accidents, immunisation, nutrition and body care | Scale range: 0 to 4 | not reported | High = better performance | ||
| COGNITIVE FUNCTION | |||||||
| Composite executive functions | D–KEFS (Design Fluency and Trail‐Making) | Subscales measure visual–spatial skills, response inhibition, motor planning, visual scanning, speed and cognitive flexibility | M = 10, SD = 3 | Number of correct responses | High = better performance | ||
| CAS (Planning Scale) | Composite of scores for matching numbers, planned codes and planned connections tests. Strategy generation and application, self‐regulation, intentionality and utilisation of knowledge | M = 100, SD = 15 | Sum of total time scale score and accuracy scale score (ratio of number of correct responses and total time) | High = better performance | |||
| Inhibition control | KiTAP (Go/No Go Task) | Impulsivity | M = 50, SD = 10 | Number of errors minus reaction time | Low = better performance | ||
| Stroop test (colour and words): Golden method | Inhibition | Scale range: 0 to100 | Interference score: score for congruent condition minus incongruent condition. | Higher = better performance | |||
| Memory | Rey Complex Figure Test (immediate recall trial) | Accuracy of reproducing a visual pattern following a 3‐minute delay. | Scale range: 0 to 36 | Number of correctly reproduced elements | Higher = better performance | ||
| CAS (successive processing scale) | Composite of word series, sentence repetition, and sentence questions tasks. Remembering or completing information in a specific order or sequence | M = 100, SD = 15 | Number of correct responses scale score and total time scale score | High = better performance | |||
| Working memory | Digit span backward | Verbal working memory task | Scale range: 0 to 21 | Correctly recalled sequences | High = better performance | ||
| Visual Span Backward test | Non‐verbal working memory task | Scale range: 0 to 12 | Correctly tapped sequences | High = better performance | |||
| Visuo‐spatial abilities | CAS (Simultaneous processinga scale) | Composite of nonverbal matrices, verbal‐spatial relations and figure memory tasks. Nonverbal and verbal processing, analyses and synthesis of logical and grammatical components of language and comprehension of word relationships, nonverbal matrices, verbal spatial relations and figure memory | M = 100, SD = 15 | Scale score of number of correct responses | High = better performance | ||
| Rey Complex Figure Test (Copy trial) | Accuracy of processing and reproducing a visual pattern | Scale range: 0 to 36 | Number of correctly reproduced elements | Higher = better | |||
| BADyG‐I | Non‐verbal logical puzzle figures | Scale range: 0 to 36 | Number of correct responses | Higher = better | |||
| Cognitive flexibility | Modified version WCST | Set shifting | Not reported | Categorising efficiency score: for every correctly sorted rule 6 points were awarded and 1 point for each of the 48 cards not used. | Higher = better performance | ||
| WCST Computer Version 4 ‐Research Edition | Set shifting | Not reported | Total number of errors | Lower = better performance | |||
| Attention | CASb (attention scale) | Composite of expressive attention, number detection and receptive attention tasks. Requires sustained, selective and focused attention including inhibiting responses | M = 100, SD = 15 | Sum of scale scores of accuracy 1 and accuracy 2; accuracy 1 (ratio of number of correct responses and total time); accuracy 2 (ratio of (number of correct responses minus number of false detections) and total time) | High = better performance | ||
| d2‐R test of attention | The test determines the capacity to focus on 1 stimulus/fact, while suppressing awareness of competing distractors. Selective attention was also required. The performance on this test reflects visual perceptual speed and concentration capacities | Not reported | The total number of items processed (processing speed); Number of letters correctly marked minus errors of commission (concentration performance) | Higher = better | |||
| d2 test of attention | Involves mental concentration, visual perception, visual scanning ability and perceptual speed | ‐359 to 299 | Processed characters (defined as the number of correctly marked target characters minus errors of commission (incorrectly marked distractor characters) = concentration performance | Higher = better | |||
| KiTAP | Sustained attention including aspects of working memory and mental flexibility | M = 50, SD = 10 (range zero to 100) | Number of correct | High = better performance | |||
| General intelligence | BADyG‐I | Composite of non‐verbal tests (e.g. reasoning and logical puzzle figures), verbal tests (e.g. numerical quantitative concepts) and additional tests (e.g. auditory perception) | Scale range: 0 to 108 | Number of correct responses | High = better performance | ||
CAT‐3: Canadian Achievement Test, version 3; W‐J: Woodcock‐Johnson; MCAT ‐ Mathematics Concepts and Applications Test, M‐CBM: Mathematics–Curriculum‐Based Measurement, PPVT III: Peabody Picture Vocabulary Test, version 3; CAS: Das‐Naglieri‐Cognitive Assessment System; KiTAP: [Kinderversion der Testbatterie zur Aufmerksamkeitsprüfung] Attention test battery for children; D–KEFS: Delis‐Kaplan Executive Function System. BADyG‐I: [Batería de aptitudes diferenciales y generals] Differential Aptitude Battery‐ General scale, WCST: Wisconsin card sorting test. aSimultaneous processing includes tests of memory and executive function. bCAS also includes measures that could be categorised as speed or executive function.
Potential causal links between obesity and impaired cognitive function, school achievement and future success. Reverse causation may also occur when cognitive function, school achievement and future success can impact the 'mediating factors', and both in turn may cause worsening of obesity.
Study flow diagram.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Forest plot of comparison: 4 Lifestyle intervention versus control, outcome: 4.1 BMI z‐score.
Forest plot of comparison: 4 Lifestyle intervention versus control, outcome: 4.2 Total body fat (%).
Comparison 1 Physical activity intervention versus standard practice, Outcome 1 Mathematics achievement.
Comparison 1 Physical activity intervention versus standard practice, Outcome 2 Reading achievement.
Comparison 1 Physical activity intervention versus standard practice, Outcome 3 Language achievement.
Comparison 1 Physical activity intervention versus standard practice, Outcome 4 2nd Language achievement.
Comparison 1 Physical activity intervention versus standard practice, Outcome 5 Composite executive functions.
Comparison 1 Physical activity intervention versus standard practice, Outcome 6 Inhibition control.
Comparison 1 Physical activity intervention versus standard practice, Outcome 7 Attention.
Comparison 1 Physical activity intervention versus standard practice, Outcome 8 Verbal working memory.
Comparison 1 Physical activity intervention versus standard practice, Outcome 9 Non‐verbal working memory.
Comparison 1 Physical activity intervention versus standard practice, Outcome 10 Visuo‐spatial abilities.
Comparison 1 Physical activity intervention versus standard practice, Outcome 11 Cognitive flexibility.
Comparison 1 Physical activity intervention versus standard practice, Outcome 12 Non‐verbal memory.
Comparison 1 Physical activity intervention versus standard practice, Outcome 13 General intelligence.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 1 Average school achievement.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 2 Mathematics achievement.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 3 Reading achievement.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 4 Language achievement.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 5 Health class achievement.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 6 Inhibition control.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 7 Attention.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 8 Visuo‐spatial abilities.
Comparison 2 Physical activity plus healthy lifestyle education interventions versus standard practice, Outcome 9 Non‐verbal memory.
Comparison 3 Dietary interventions versus standard practice, Outcome 1 Average school achievement.
Comparison 3 Dietary interventions versus standard practice, Outcome 2 Mathematics achievement.
Comparison 3 Dietary interventions versus standard practice, Outcome 3 Reading achievement.
Comparison 3 Dietary interventions versus standard practice, Outcome 4 Attention.
Comparison 4 Lifestyle intervention versus control, Outcome 1 BMI z‐score.
Comparison 4 Lifestyle intervention versus control, Outcome 2 Total body fat (%).
| Physical activity interventions compared to standard practice for improving cognition and school achievement in children and adolescents with obesity or overweight | ||||||
| Patient or population: Children and adolescents with obesity or overweight | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | № of participants | Quality of the evidence | Comments | |
| Assumed risk Standard practice | Corresponding risk Physical activity | |||||
| School achievement: Average achievement across subjects taught at school | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| School achievement: Mathematics Assessed with: standardised national tests, BADyG‐I (numerical quantitative concepts) Follow‐up: range 13 weeks to 1 year immediately post‐intervention | ‐ | Compared to the control group, the mean mathematics achievement score in the intervention group was0.49 standard deviations higher (0.04 lower to 1.01 higher) | ‐ | 255 | ⊕⊕⊕⊝ | A standard deviation of 0.49 represents a moderate difference between groups |
| School achievement: Reading Assessed with: WJ‐II test of achievement, standardised national tests Follow‐up: range 13 weeks to 7 months immediately post‐intervention | ‐ | Compared to the control group, the mean reading achievement score in the intervention group was 0.10 standard deviations higher (0.30 lower to 0.49 higher) | ‐ | 308 | ⊕⊕⊕⊝ | A standard deviation of 0.10 represents a small difference between groups |
| School achievement: Additional educational support needs | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| Cognitive function: Composite executive functions Assessed with: CAS Follow‐up: 13 weeks immediately post‐intervention | The mean composite executive functions score in the control group was 102 scale points | The mean composite executive functions score in the intervention group was 5.00 points higher (0.68 higher to 9.32 higher) | ‐ | 116 | ⊕⊕⊕⊕ | ‐ |
| Cognitive function: Inhibition control Assessed with: SCWT, scale range: 0 to 100 Follow‐up: mean 18 months immediately post‐intervention | The mean inhibition control score in the control group was 20.55 scale points | The mean inhibition control score in the intervention group was 1.55 points lower (5.85 lower to 2.75 higher) | ‐ | 84 | ⊕⊝⊝⊝ | ‐ |
| Adverse events | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| *The effect sizes are differences in standard deviations. To facilitate interpretation we have used rules of thumb in interpretation of effect size (section 12.6.2 in Higgins 2011), where a standard deviation of 0.2 represents a small difference between groups, 0.5 represents a moderate difference, and 0.8 represents a large difference. ** Different assessment tools were used to assess school and cognitive outcomes. We therefore calculated standardised mean differences to assess the effect size between intervention and control groups. WJ: Woodcock‐Johnson; SCWT: Stroop test (colour and words); CAS: Das‐Naglieri‐Cognitive Assessment System; D–KEFS: Delis‐Kaplan Executive Function System; BADyG‐I: [Batería de aptitudes diferenciales y generals] Differential Aptitude Battery‐ General scale. MD: Mean difference, SMD: Standardised mean difference CI: Confidence interval | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1Downgraded one level due to high risk of attrition bias. | ||||||
| Physical activity plus healthy lifestyle education interventions compared to standard practice for improving cognition and school achievement in children and adolescents with obesity or overweight | ||||||
| Patient or population: Children and adolescents with obesity or overweight | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | № of participants | Quality of the evidence | Comments | |
| Assumed risk Standard practice | Corresponding risk Physical activity plus healthy lifestyle education | |||||
| School achievement: Average achievement across subjects taught at school Assessed with: CAT‐3, scale mean 500, SD 70 Follow‐up: 12 months immediately post‐intervention | The mean score for average achievement across subjects taught at school in the control group was 19.50 grade points | The mean score for average achievement across subjects taught at school in the intervention group was 6.37 grade points lower (36.83 lower to 24.09 higher) | ‐ | 31 (1 RCT) | ⊕⊕⊝⊝ | ‐ |
| School achievement: Mathematics Assessed with: CAT‐3, standardised national tests, M‐CAT Follow‐up: range 4 months to 12 months immediately post‐intervention | ‐ | Compared to the control group, the mean mathematics achievement score in the intervention group was 0.02 standard deviations higher (0.19 lower to 0.22 higher) | ‐ | 384 | ⊕⊝⊝⊝ | A standard deviation of 0.02 represents a small difference between groups |
| School achievement: Reading Assessed with: CAT‐3, R‐CBM Follow‐up: mean 1 year immediately post‐intervention | ‐ | Compared to the control group, the mean reading achievement score in the intervention group was 0 standard deviations higher (0.24 lower to 0.24 higher) | ‐ | 284 | ⊕⊕⊝⊝ | A standard deviation of zero represents no difference between groups |
| School achievement: Additional educational support needs | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| Cognitive function: Composite executive functions | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| Cognitive function: Inhibition control Assessed with: SCWT, KiTAP (Go/No‐go) Follow‐up: range 12 months to 13 months immediately post‐intervention | ‐ | Compared to the control group, the mean inhibition control score in the intervention group was0.67 standard deviations lower (1.50 lower to 0.16 higher) | ‐ | 110 | ⊕⊕⊝⊝ | A standard deviation of 0.67 represents a moderate difference between groups |
| Adverse events | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| *The effect sizes are differences in standard deviations. To facilitate interpretation we have used rules of thumb in interpretation of effect size (section 12.6.2 in Higgins 2011), where a standard deviation of 0.2 represents a small difference between groups, 0.5 represents a moderate difference, and 0.8 represents a large difference. ** Different assessment tools were used to assess school and cognitive outcomes. We therefore calculated standardised mean differences to assess the effect size between intervention and control groups. CAT‐3: Canadian Achievement Test, version 3; M‐CAT: Mathematics Concepts and Applications Test; R‐CBM: Reading–Curriculum‐Based Measurement; PPVT III: Peabody Picture Vocabulary Test, version 3; SCWT: Stroop test (colour and words); KiTAP: [Kinderversion der Testbatterie zur Aufmerksamkeitsprüfung] Attention test battery for children; RCFT: Rey Complex Figure Test; CI: Confidence interval; SMD: Standardised mean difference | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1Downgraded two levels due high risk of bias in attrition and unclear risk of bias for randomisation. | ||||||
| Dietary interventions compared to control for improving cognition and school achievement in children and adolescents with overweight and obesity | ||||||
| Patient or population: Children and adolescents with obesity or overweight | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | № of participants | Quality of the evidence | Comments | |
| Assumed risk Standard practice | Corresponding risk Dietary intervention | |||||
| School achievement: Average achievement across subjects taught at school Assessed with: teacher‐assessed grades Follow‐up: range 1 year to 2 years immediately post‐intervention | ‐ | Compared to the control group, the mean score for average achievement across subjects taught at school was 0.46 standard deviations higher (0.25 higher to 0.66 higher) in the intervention group | ‐ | 382 | ⊕⊕⊝⊝ | A standard deviation of 0.46 represents a moderate difference between groups |
| School achievement: Mathematics Assessed with: standard national test, scale range 0 to 69 Follow‐up: mean 3 months immediately post‐intervention | The mean change in mathematics achievement score ranged across control groups from 8.00 to 10.70 scale points | The mean change in mathematics achievement score in the intervention group was 2.18 scale points lower (5.83 lower to 1.47 higher) | ‐ | 76 | ⊕⊕⊝⊝ | ‐ |
| School achievement: Reading Assessed with: standard national test, scale range 0 to 108 Follow‐up: mean 3 months immediately post‐intervention | The mean change in reading achievement score ranged across control groups from 7.40 to 9.20 scale points | The mean change in reading achievement score in the intervention group was 1.17 scale points higher (4.40 lower to 6.73 higher) | ‐ | 67 | ⊕⊕⊝⊝ | ‐ |
| School achievement: Additional educational support needs | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| Cognitive function: Composite executive function | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| Cognitive function: Inhibition control | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| Adverse events | ‐ | ‐ | ‐ | (0 studies) | ‐ | No data available |
| *The effect sizes are differences in standard deviations. To facilitate interpretation we have used rules of thumb in interpretation of effect size (section 12.6.2 in Higgins 2011), where a standard deviation of 0.2 represents a small difference between groups, 0.5 represents a moderate difference, and 0.8 represents a large difference. ** Different assessment tools were used to assess school and cognitive outcomes. We therefore calculated standardised mean differences to assess the effect size between intervention and control groups. SMD: Standardised mean difference; MD: mean difference; CI: Confidence interval | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1Downgraded two levels due to high risk of detection and attrition bias. | ||||||
| STUDY | INTERVENTION CONTENT |
| Physical activity only interventions | |
| Group physical activity programme including multiple types of moderate‐intensity exercises performed 4 times/week for 40 minutes per session (5 minutes each for warm‐up and cool‐down, 30 minutes for the main exercise). The participants were free to choose one of the provided exercise types (e.g. fast walking, stair climbing, jumping rope, or aerobic dancing), with an emphasis on maintaining a moderate intensity of 60% to 70% of the maximal heart rate. Intervention was offered during the school day in the morning, during lunch break, or after school for 3 months | |
| Aerobic group exercise for 40 minutes 5 times/week, over a mean total of 13 weeks. Five‐minute warm‐up phase consisted of brisk walking and static and dynamic stretching. Children were encouraged to maintain a heart rate > 150 beats/minute during running games, tag games, jump rope, modified basketball and football. The intervention involved no competition or skill enhancement and was delivered in an after‐school setting | |
| Fit en Vaardig op school (Fit and academically proficient at school) involved physically active academic lessons which ran over 44 weeks in total over 2 school years with 3 lessons/week. The lessons had a duration of 20 – 30 minutes, with 10 – 15 minutes spent on solving mathematical problems and 10 – 15 minutes spent on language. During the lessons all children started with performing a basic exercise, such as jogging, hopping in place or marching. A specific exercise was performed when the children solved an academic task. The physical activities were aimed to be of moderate‐to‐vigorous intensity | |
| The 2 intervention conditions had the same structure and took place in the school. They included 15 minutes of warm‐up, 30 minutes of moderate‐to‐vigorous physical activities, and 15 minutes of cool‐down and stretching. The traditional physical activity intervention consisted of continuous aerobic circuit training followed by a sub‐maximal shuttle run exercise. This intervention focused on the improvement of cardiovascular endurance by performing different types of gaits (e.g. fast walking, running, skipping) without any specific co‐ordinative request. The co‐ordinative physical activity intervention focused on the development of psychomotor competences and expertise in movement‐based problem‐solving through functional use of a common tool (e.g. basketball), and considering various tasks that involved decision‐making motor tasks and manipulative ball‐handling skills | |
| See Davis 2011b. The intervention duration was extended to 8 months. | |
| MOVI‐KIDS is a multidimensional intervention that consisted of a standardised extra‐curricular non‐competitive physical activity programme of 4½ hours/week; informative sessions to parents and teachers about how schoolchildren can become more active, and interventions in the playground (environmental changes: equipment, facilities, painting, etc.) aimed to promote physical activity during recess (MOVI‐Playground) | |
| Nintendo Wii EA Sports Active exergame played in competitive condition individually or in co‐operative condition in pairs for 30 to 60 minutes, 5 days/week, over a period of 10 weeks in total. The fitness video game included cardio activities (e.g. inline skating), sports games (basketball, volleyball, tennis, baseball) and strength training | |
| The Active Smarter Kids (ASK) programme comprised 3 components: i) physically active lessons for 90 minutes/week, conducted in the playground; physically active educational lessons were delivered in 3 core subjects – Norwegian (30 minutes/ week), mathematics (30 minutes/week) and English (30 minutes/week); ii) physical activity breaks (5 minutes/day) implemented in the classroom during academic lessons; and iii) physical activity homework (10 minutes/day) | |
| Physical activity plus healthy lifestyle education | |
| Action Schools! BC was a comprehensive, multicomponent intervention providing tools for schools and teachers to use in promoting physical activity and healthy eating in different settings. These include the school environment (healthy eating posters), scheduled Physical Education, classroom action, family and community (e.g. walking school bus), extracurricular activities (e.g. dance club) and school spirit (e.g. Hike across Canada challenge) | |
| Fortaleça sua Saúde ('Strengthen your health') focused on teachers' training and activities on health in the curriculum (including a specific training to Physical Education teachers), active opportunities in the school environment (availability of spaces and materials for physical activity) and health education (production and exhibition of health material at school, and distributing pamphlets to students and parents) | |
| The day‐camp intervention comprised 2 parts: an intensive six‐week day camp intervention and a subsequent 46‐week family‐based intervention programme (13‐month [52 weeks] in total). Children were engaged in physical activity and sports for at least 3 hours a day, achieving about 90 minutes of moderate‐to‐vigorous physical activity per day measured by accelerometry. After the day camp, one physical activity day was offered as part of the family‐based intervention programme. Healthy lifestyle education topics during the 6‐week day camp included nutrition, physical activity and health, and goal‐setting. The family‐based intervention programme comprised 4 parents‐involved meetings targeting daily physical activity and dietary behaviour. In the day camp, 3 meals and 3 snacks were prepared and served according to the national dietary recommendations with no caloric restrictions | |
| COPE (Creating Opportunities for Personal Empowerment) programme was a manualised 15‐session educational and cognitive–behavioural skills‐building programme. Each session of COPE contains 15 – 20 minutes of physical activity (e.g. walking, dancing, kick‐boxing movements), not intended as an exercise training programme, but rather to build beliefs in the participants that they can engage in and sustain some level of physical activity on a regular basis. Pedometers were used throughout the intervention. Participants were asked to increase their step counts by 10% each week, regardless of baseline levels, and to keep track of their daily steps. The COPE Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Programme was delivered once a week as part of a school health curriculum. Participants received a COPE manual with homework activities for each of the 15 sessions that reinforced the content and skills in the programme: cognitive‐behavioural skill building (e.g. problem‐solving and emotional and behavioural regulation), nutrition (e.g. food groups, portion sizes, food labelling), and physical activity (e.g. ways to increase physical activity and associated benefits) | |
| The standard intervention arm of the ASCEND intervention consisted of the Nutrition Detectives (ND) programme and the ABC for Fitness (ABC) programme. ND was a 90‐minute programme that aimed to convey the link between food choices and health, convince students of the need to become "supermarket spies" to learn the truth about the foods that they eat. ABC for Fitness offered brief bursts of physical activity in the classroom, spread over the school day. Classroom teachers offered 30 daily minutes of activity bursts. The activity bursts were designed to include a brief warm‐up and cool‐down (e.g. stretching or low‐intensity activity) along with one or more core activities of higher intensity (e.g. hopping, running in place, jumping jacks, or dancing to music). The enhanced intervention arm included the ND and ABC programmes plus reinforcements of their messages to participants and their families in the school, home, and a supermarket. Family‐focused kits were send home including pedometers, walking tips to increase daily steps, a family log for recording steps, local walking trail guides, walking maps for local grocery stores, physical activity tips sheet, suggestions for activity bursts, family activity challenge cards, a 3‐ minute sand timer to be used for activity challenges, and a log to record the number of activities and repetitions completed, Nutrition Detectives DVD, a reminder card with the programme’s "five clues" to make healthful food choices, grocery store coupons, and a family "homework assignment" to watch the DVD, review the ND clues together, complete an activity applying the clues to foods in the family kitchen. Family nights were held at a) the local supermarket, with stations set up to teach families about healthful food choices with games, demonstrations, and taste tests; b) schools offering stations throughout the building to try out different kinds of exercises, including Frisbee golf and Zumba, and received information or coupons from local fitness‐related businesses | |
| The Healthy & Ready to Learn intervention involved parents and teachers reading children's books on health‐related themes including nutrition and obesity prevention to the participants. Teachers and parents were trained to increase children's time spent physically active in moderate‐to‐vigorous activity for 60 minutes/day. Activities were play‐based and targeted specific gross motor skills. Physical activity equipment was provided | |
| Komm mit in das gesunde Boot (‘Join the healthy boat') comprised healthy lifestyle education of 20 teaching sessions a year focusing on increased physical activity, reduced consumption of sugar‐sweetened beverages and reduced screen time. It included 2 physically‐active breaks per school day of 5 to 7 minutes, and a physical activity task to be performed at home involving parents | |
| Dietary interventions (including health education) | |
| In the OPUS School Meal intervention children received the New Nordic Diet (NND) containing seasonal, health‐promoting ingredients, for example, berries, root vegetables, whole grains, fish, shellfish, seaweed and rapeseed oil. Children received daily servings of a mid‐morning snack, ad libitum hot lunch meal and afternoon snack (fruit dessert twice/week). The children were encouraged to taste everything and to keep a reasonable plate distribution with vegetables and starchy foods filling most of the plate. Each child spent 3 – 5 school half‐days in the kitchen cooking, presenting, and serving the menu of the day to the other children. The teachers were encouraged to participate in the lunch meals. Class teachers were given a box of teaching materials about the human body, the clinical measurements, and taste sensorics, including background information about NND and suggestions for related educational activities and games | |
| The whole‐school lifestyle education programme involved curriculum material taught by trained teachers, school meal modification towards nutrient‐dense food and nutrition counselling. Teachers were provided with 50 integrated lessons‐worth of curriculum material aiming to improve healthy diet (increased fruit and vegetable, breakfast, healthy snack, water consumption) and increase physical activity. Teachers were encouraged to teach lifestyle‐integrated lessons once a week, to conduct health‐related activities every 2 weeks and to hold a school‐wide health event once a semester | |
| The Project breakFAST (Fuelling Academics and Strengthening Teens) aimed to improve students’ school breakfast programme (SBP) participation by implementing a grab‐and‐go‐style cart or breakfast line located outside the cafeteria in a high‐traffic hallway, atrium or common area. School‐wide marketing campaigns were developed by a community partner which worked with a group of students to design the marketing campaign at each school. Positive interactions and social support were created by developing school policies, to allow students to eat breakfast in the hallway. Schools were also encouraged to allow eating breakfast in some classrooms when appropriate | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Mathematics achievement Show forest plot | 3 | Std. Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 1.1 Change from baseline | 2 | 255 | Std. Mean Difference (IV, Random, 95% CI) | 0.49 [‐0.04, 1.01] |
| 1.2 Endpoint | 2 | 314 | Std. Mean Difference (IV, Random, 95% CI) | 0.19 [‐0.03, 0.42] |
| 2 Reading achievement Show forest plot | 2 | 308 | Std. Mean Difference (IV, Random, 95% CI) | 0.10 [‐0.30, 0.49] |
| 3 Language achievement Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 4 2nd Language achievement Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 5 Composite executive functions Show forest plot | 2 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 5.1 Change from baseline | 1 | 54 | Mean Difference (IV, Random, 95% CI) | 8.45 [‐1.67, 18.56] |
| 5.2 Endpoint | 1 | 116 | Mean Difference (IV, Random, 95% CI) | 5.0 [0.68, 9.32] |
| 6 Inhibition control Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 7 Attention Show forest plot | 2 | 157 | Std. Mean Difference (IV, Random, 95% CI) | 0.46 [‐0.16, 1.08] |
| 8 Verbal working memory Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 9 Non‐verbal working memory Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 10 Visuo‐spatial abilities Show forest plot | 2 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 10.1 Change from baseline | 1 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 10.2 Endpoint | 1 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 11 Cognitive flexibility Show forest plot | 2 | 162 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.06 [‐0.37, 0.25] |
| 12 Non‐verbal memory Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 13 General intelligence Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Average school achievement Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 2 Mathematics achievement Show forest plot | 3 | 384 | Std. Mean Difference (IV, Random, 95% CI) | 0.02 [‐0.19, 0.22] |
| 3 Reading achievement Show forest plot | 2 | 284 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.00 [‐0.24, 0.24] |
| 4 Language achievement Show forest plot | 3 | 244 | Std. Mean Difference (IV, Random, 95% CI) | 0.13 [‐0.12, 0.39] |
| 5 Health class achievement Show forest plot | 1 | 263 | Mean Difference (IV, Random, 95% CI) | ‐0.05 [‐0.38, 0.29] |
| 6 Inhibition control Show forest plot | 2 | 110 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.67 [‐1.50, 0.16] |
| 7 Attention Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 8 Visuo‐spatial abilities Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 9 Non‐verbal memory Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Average school achievement Show forest plot | 2 | 434 | Std. Mean Difference (IV, Random, 95% CI) | 0.32 [‐0.07, 0.70] |
| 1.1 Children with obesity | 2 | 379 | Std. Mean Difference (IV, Random, 95% CI) | 0.45 [0.25, 0.66] |
| 1.2 Children with overweight | 1 | 55 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.17 [‐0.70, 0.36] |
| 2 Mathematics achievement Show forest plot | 1 | 76 | Mean Difference (IV, Random, 95% CI) | ‐2.18 [‐5.83, 1.47] |
| 3 Reading achievement Show forest plot | 1 | 67 | Mean Difference (IV, Random, 95% CI) | 1.17 [‐4.40, 6.73] |
| 4 Attention Show forest plot | 1 | 61 | Mean Difference (IV, Random, 95% CI) | 1.68 [‐7.86, 11.22] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 BMI z‐score Show forest plot | 7 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Beneficial effect on school achievement | 3 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 No beneficial effect on school achievement | 2 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.3 Beneficial effects on cognitive functions | 3 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.4 No beneficial effect on cognitive functions | 3 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 2 Total body fat (%) Show forest plot | 3 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 2.1 Beneficial effect on cognitive functions | 1 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 2.2 No beneficial effect on cognitive functions | 3 | Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
