What Change in Body Mass Index is Associated with Improvement in Percentage Body Fat in Childhood Obesity? A Meta-regression

Overview

Journal BMJ Open

Specialty General Medicine

Date 2019 Sep 2

PMID 31473614

Citations 12

Authors

Laura Birch

Rachel Perry

Linda P Hunt

Rhys Matson

Amanda Chong

Rhona Beynon

Julian Ph Shield

Affiliations

Soon will be listed here.

Abstract

Objective: Using meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.

Design: Meta-regression.

Setting: Studies were identified as part of a large-scale systematic review of the following electronic databases: AMED, Embase, MEDLINE via OVID, Web of Science and CENTRAL via Cochrane library.

Participants: Individuals aged 4-19 years with a diagnosis of obesity according to defined BMI thresholds.

Interventions: Studies of lifestyle treatment interventions that included dietary, physical activity and/or behavioural components with the objective of reducing obesity were included. Interventions of <2 weeks duration and those that involved surgical and/or pharmacological components (eg, bariatric surgery, drug therapy) were excluded.

Primary And Secondary Outcome Measures: To be included in the review, studies had to report baseline and post-intervention BMI-SDS or change measurements (primary outcome measures) plus one or more of the following markers of metabolic health (secondary outcome measures): adiposity measures other than BMI; blood pressure; glucose; inflammation; insulin sensitivity/resistance; lipid profile; liver function. This paper focuses on adiposity measures only. Further papers in this series will report on other outcome measures.

Results: This paper explores the potential impact of BMI-SDS reduction in terms of change in percentage body fat. Thirty-nine studies reporting change in mean percentage body fat were analysed. Meta-regression demonstrated that reduction of at least 0.6 in mean BMI-SDS ensured a mean reduction of percentage body fat mass, in the sense that the associated 95% prediction interval for change in mean percentage body fat was wholly negative.

Conclusions: Interventions demonstrating reductions of 0.6 BMI-SDS might be termed successful in reducing adiposity, a key purpose of weight management interventions.

Trial Registration Number: CRD42016025317.

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