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Wie wirksam sind ernährungs- und bewegungsbezogene primärpräventive Interventionen im Setting Kita?

Ein Review von Reviews

The effectiveness of primary prevention interventions promoting physical activity and healthy eating in preschool children

A review of reviews

  • Originalien und Übersichten
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Hintergrund

Ungünstige Ernährungs- und Bewegungsgewohnheiten bilden sich oft bereits in der Kindheit aus und führen zu Übergewicht und Adipositas.

Fragestellung

Ziel der vorliegenden Arbeit ist es, einen Überblick über die Wirksamkeit ernährungs- und bewegungsbezogener Interventionen hinsichtlich Gewicht und Gesundheitsverhalten im Setting Kita zu geben.

Methoden

Eine systematische Literaturrecherche zu zwischen 2007 und 2014 publizierten Übersichtsarbeiten wurde in PubMed, Cochrane Library und Campbell Collaboration durchgeführt. Zehn systematische Reviews und 3 Metaanalysen mit 22 kitabasierten Interventionen wurden eingeschlossen. Die Interventionen stammten aus Nordamerika (N = 14), Europa (N = 5), Asien (N = 2) und Australien (N = 1). Die Hälfte der Interventionen richtete sich an ethnische Minoritäten oder Kinder aus sozioökonomisch benachteiligten Familien. Angaben zu Effekten auf anthropometrische Maße (z. B. Body-Mass-Index), das Ernährungs- und Bewegungsverhalten sowie Merkmale effektiver Programme wurden extrahiert und narrativ zusammengefasst.

Ergebnisse

Es konnte keine gesicherte Evidenz zu Effekten der Interventionen auf anthropometrische Maße festgestellt werden. Dagegen zeigten sich in 7 von 9 Studien positive Effekte in ernährungsbezogenen Outcomes (z. B. Obst-/Gemüsekonsum). Bezüglich des Bewegungsverhaltens ergaben sich nur vereinzelt positive Effekte. Merkmale, die mit einer erhöhten Wirksamkeit in Verbindung gebracht wurden, waren 1) die Vermittlung von Fähigkeiten und Kompetenzen, 2) eine starke Einbeziehung der Eltern und 3) Informationen über den Zusammenhang zwischen Verhalten und Gesundheit für Eltern.

Diskussion

Insgesamt ergeben sich erste Hinweise auf frühzeitige Verbesserungen im Ernährungs- und Bewegungsverhalten durch Präventionsprogramme in Kitas. Die Evidenz wird allerdings durch eine geringe Studienzahl, methodische Mängel und Inkonsistenzen in der Zielparameter-Erfassung eingeschränkt. Der Nachweis für die Wirksamkeit der Interventionen auf objektive Maße von Übergewicht steht noch aus.

Abstract

Background

During their preschool years children establish nutritional and physical activity (PA) habits that may contribute to the development of overweight and obesity.

Objective

To examine the evidence for effective interventions promoting healthy eating and PA in childcare settings.

Methods

We searched PubMed, the Cochrane Library, and Campbell Collaboration for systematic reviews published between 2007 and 2014. Ten systematic reviews and three meta-analyses met the inclusion criteria, including a total of 22 intervention studies. Intervention studies were conducted in North America (N = 14), Europe (N = 5), Asia (N = 2), and Australia (N = 1). Half of these addressed ethnic minority groups or socially disadvantaged children. We extracted information about the effects regarding anthropometric measures, eating habits, and physical activity, as well as the characteristics of effective interventions, and summarized them narratively.

Results

Evidence for intervention effects on anthropometric measurements was inconclusive. Seven out of nine studies showed beneficial effects on diet-related outcomes. Only isolated effects were reported on improvements in PA. Reviews indicated that interventions which comprised (1) the development of skills and competencies, (2) medium to high parental involvement, and (3) information on behavior-health links for parents were more effective.

Conclusion

Preschool-based interventions showed some early improvements in eating habits and PA. Evidence is limited by the small number of studies, a lack of methodological quality, and inconsistencies among outcome measures. Evidence regarding anthropometric measurements is still inconclusive.

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Literatur

  1. Nagel G, Wabitsch M, Galm C et al (2009) Secular changes of anthropometric measures for the past 30 years in South-West Germany. Eur J Clin Nutr 63:1440–1443

    Article  CAS  PubMed  Google Scholar 

  2. Moss A, Klenk J, Simon K, Thaiss H, Reinehr T, Wabitsch M (2012) Declining prevalence rates for overweight and obesity in German children starting school. Eur J Pediatr 171:289–299

    Article  PubMed  Google Scholar 

  3. Harrington JW, Nguyen VQ, Paulson JF, Garland R, Pasquinelli L, Lewis D (2010) Identifying the „tipping point“ age for overweight pediatric patients. Clin Pediatr (Phila) 49:638–643

    Article  Google Scholar 

  4. Juonala M, Magnussen CG, Berenson GS et al (2011) Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 365:1876–1885

    Article  CAS  PubMed  Google Scholar 

  5. Park MH, Sovio U, Viner RM, Hardy RJ, Kinra S (2013) Overweight in childhood, adolescence and adulthood and cardiovascular risk in later life: pooled analysis of three British birth cohorts. PLoS One 8:e70684

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Paulis WD, Silva S, Koes BW, van Middelkoop M (2014) Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review. Obes Rev 15:52–67

    Article  CAS  PubMed  Google Scholar 

  7. Lang JE (2012) Obesity, nutrition, and asthma in children. Pediatr Allergy Immunol Pulmonol 25:64–75

    Article  PubMed Central  PubMed  Google Scholar 

  8. Russell-Mayhew S, McVey G, Bardick A, Ireland A (2012) Mental health, wellness, and childhood overweight/obesity. J Obes 2012:281801

    Article  PubMed Central  PubMed  Google Scholar 

  9. Puhl RM, King KM (2013) Weight discrimination and bullying. Best Pract Res Clin Endocrinol Metab 27:117–127

    Article  PubMed  Google Scholar 

  10. Hill JO, Wyatt HR, Peters JC (2012) Energy balance and obesity. Circulation 126:126–132

    Article  PubMed Central  PubMed  Google Scholar 

  11. Statistisches Bundesamt (2012) Statistisches Jahrbuch 2012 – Bevölkerung, Familie, Lebensformen. Statistisches Bundesamt, Wiesbaden.

  12. Kliche T, Gesell S, Nyenhuis N et al (2008) Prävention und Gesundheitsförderung in Kindertagesstätten. [Prevention and health promotion in child day-care facilities]. Juventa, Weinheim und München.

  13. Pott E (2012) Eröffnungsrede: Mit generalisierbarem Präventionswissen zu evidenzgestützter Versorgungssteuerung. In: BZgA (Hrsg) Gesund aufwachsen in Kita, Schule, Familie und Quartier. BZgA, Köln, 8–13

    Google Scholar 

  14. Strauss A, Herbert B, Mitschek C, Duvinage K, Koletzko B (2011) TigerKids. Successful health promotion in preschool settings. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 54:322–329

    Article  CAS  PubMed  Google Scholar 

  15. Shea BJ, Grimshaw JM, Wells GA et al (2007) Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 7:10

    Article  PubMed Central  PubMed  Google Scholar 

  16. Nixon CA, Moore HJ, Douthwaite W et al (2012) Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4–6-year-olds: a systematic review. Obes Rev 13(Suppl 1):106–117

    Article  PubMed  Google Scholar 

  17. Monasta L, Batty GD, Macaluso A et al (2011) Interventions for the prevention of overweight and obesity in preschool children: a systematic review of randomized controlled trials. Obes Rev 12:e107–118

    Article  CAS  PubMed  Google Scholar 

  18. Hendrie GA, Brindal E, Corsini N, Gardner C, Baird D, Golley RK (2012) Combined home and school obesity prevention interventions for children: what behavior change strategies and intervention characteristics are associated with effectiveness? Health Educ Behav 39:159–171

    Article  PubMed  Google Scholar 

  19. Hesketh KD, Campbell KJ (2010) Interventions to prevent obesity in 0–5 year olds: an updated systematic review of the literature. Obesity (Silver Spring) 18(Suppl 1):S27–S35

    Article  Google Scholar 

  20. Bond M, Wyatt K, Lloyd J, Welch K, Taylor R (2009) Systematic review of the effectiveness and cost-effectiveness of weight management schemes for the under fives: a short report. Health Technol Assess 13:1–75, iii

    Google Scholar 

  21. Bond M, Wyatt K, Lloyd J, Taylor R (2011) Systematic review of the effectiveness of weight management schemes for the under fives. Obes Rev 12:242–253

    Article  CAS  PubMed  Google Scholar 

  22. D’Onise K, Lynch JW, Sawyer MG, McDermott RA (2010) Can preschool improve child health outcomes? A systematic review. Soc Sci Med 70:1423–1440

    Article  PubMed  Google Scholar 

  23. Connelly JB, Duaso MJ, Butler G (2007) A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: a realistic synthesis of the evidence. Public Health 121:510–517

    Article  CAS  PubMed  Google Scholar 

  24. DeMattia L, Lemont L, Meurer L (2007) Do interventions to limit sedentary behaviours change behaviour and reduce childhood obesity? A critical review of the literature. Obes Rev 8:69–81

    Article  CAS  PubMed  Google Scholar 

  25. Waters E, de Silva-Sanigorski A, Hall BJ et al (2011) Interventions for preventing obesity in children. Cochrane Database Syst Rev 12:CD001871

    PubMed  Google Scholar 

  26. van Grieken A, Ezendam NP, Paulis WD, van der Wouden JC, Raat H (2012) Primary prevention of overweight in children and adolescents: a meta-analysis of the effectiveness of interventions aiming to decrease sedentary behaviour. Int J Behav Nutr Phys Act 9(1), 61

    Article  PubMed Central  PubMed  Google Scholar 

  27. Zask A, Adams JK, Brooks LO, Hughes DF (2012) Tooty Fruity Vegie: an obesity prevention intervention evaluation in Australian preschools. Health Promot J Austr 23:10–15

    PubMed  Google Scholar 

  28. Adams J, Zask A, Dietrich U (2009) Tooty Fruity Vegie in preschools: an obesity prevention intervention in preschools targeting children’s movement skills and eating behaviours. Health Promot J Austr 20:112–119

    PubMed  Google Scholar 

  29. Frisvold DE (2006) Head Start participation and childhood obesity. http://dx.doi.org/10.2139/ssrn.887433. Zugegriffen: 07. Mai 2014

  30. Williams CL, Strobino BA, Bollella M, Brotanek J (2004) Cardiovascular risk reduction in preschool children: the „Healthy Start“ project. J Am Coll Nutr 23:117–123

    Article  PubMed  Google Scholar 

  31. Wolfenden L, Wyse RJ, Britton BI et al (2012) Interventions for increasing fruit and vegetable consumption in children aged 5 years and under. Cochrane Database Syst Rev 11:CD008552

    PubMed Central  PubMed  Google Scholar 

  32. Cooke LJ, Chambers LC, Anez EV et al (2011) Eating for pleasure or profit: the effect of incentives on children’s enjoyment of vegetables. Psychol Sci 22:190–196

    Article  PubMed Central  PubMed  Google Scholar 

  33. Vereecken C, Huybrechts I, van Houte H, Martens V, Wittebroodt I, Maes L (2009) Results from a dietary intervention study in preschools „Beastly Healthy at School“. Int J Public Health 54:142–149

    Article  PubMed  Google Scholar 

  34. Zask A, Barnett LM, Rose L et al (2012) Three year follow-up of an early childhood intervention: is movement skill sustained? Int J Behav Nutr Phys Act 9:127. doi: 10.1186/1479-5868-9-127

    Article  PubMed Central  PubMed  Google Scholar 

  35. Hu C, Ye D, Li Y et al (2010) Evaluation of a kindergarten-based nutrition education intervention for pre-school children in China. Public Health Nutr 13:253–260

    Article  PubMed  Google Scholar 

  36. Trost SG (2007) State of the art reviews: measurement of physical activity in children and adolescents. Am J Lifestyle Med 1:299–314

    Article  Google Scholar 

  37. Burrows TL, Martin RJ, Collins CE (2010) A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water. J Am Diet Assoc 110:1501–1510

    Article  PubMed  Google Scholar 

  38. Hebestreit A, Bornhorst C, Barba G et al (2014) Associations between energy intake, daily food intake and energy density of foods and BMI z-score in 2–9-year-old European children. Eur J Nutr 53:673–681

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Bühler A, Kröhl C, Bergmann S, Shaw R (2008) Immer Zirkus ums Essen – Entwicklung und Evaluation einer kindergartenbasierten Intervention zur Prävention von Übergewicht und Adipositas. Dissertation, IFT Institut für Therapieforschung

  40. Tremblay MS, LeBlanc AG, Kho ME et al (2011) Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 8:98

    Article  PubMed Central  PubMed  Google Scholar 

  41. Nicklas TA, Hayes D, American Dietetic Association (2008) Position of the American Dietetic Association: nutrition guidance for healthy children ages 2 to 11 years. J Am Diet Assoc 108(1038–1044):1046–1047

    Google Scholar 

  42. Plachta-Danielzik S, Landsberg B, Bosy-Westphal A, Johannsen M, Lange D, J Muller M (2008) Energy gain and energy gap in normal-weight children: longitudinal data of the KOPS. Obesity (Silver Spring) 16:777–783

    Article  Google Scholar 

  43. Hall KD, Butte NF, Swinburn BA, Chow CC (2013) Dynamics of childhood growth and obesity: development and validation of a quantitative mathematical model. Lancet Diabetes Endocrinol 1:97–105

    Article  PubMed Central  PubMed  Google Scholar 

  44. Plachta-Danielzik S, Kehden B, Müller MJ (2014) Wie groß muss die Wirkung von Prävention auf das Übergewicht von Kindern und Jugendlichen sein? Vortrag auf der 9. Jahrestagung der DGEpi, Ulm

  45. Daniels SR, Arnett DK, Eckel RH et al (2005) Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 111:1999–2012

    Article  PubMed  Google Scholar 

  46. World Health Organization (2010) Global recommendations on physical activity for health. Geneva

  47. Tremblay MS, Leblanc AG, Carson V et al (2012) Canadian Sedentary Behaviour Guidelines for the early years (aged 0–4 years). Appl Physiol Nutr Metab 37:370–391

    Article  PubMed  Google Scholar 

  48. Craig P, Dieppe P, Macintyre S et al (2008) Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 337:a1655

    Article  PubMed Central  PubMed  Google Scholar 

  49. Biddle SJ, O’Connell S, Braithwaite RE (2011) Sedentary behaviour interventions in young people: a meta-analysis. Br J Sports Med 45:937–942

    Article  PubMed  Google Scholar 

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Danksagung

Diese Studie wurde mit finanzieller Unterstützung des AOK-Bundesverbandes durchgeführt.

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Authors and Affiliations

  1. Abteilung Prävention und Evaluation, Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Achterstraße 30, 28359, Bremen, Deutschland

    B. Steenbock, C.R. Pischke, J. Schönbach, S. Pöttgen & T. Brand

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Correspondence to B. Steenbock.

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B. Steenbock, C.R. Pischke, J. Schönbach, S. Pöttgen und T. Brand geben an, dass keine Interessenkonflikte vorliegen.

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Steenbock, B., Pischke, C., Schönbach, J. et al. Wie wirksam sind ernährungs- und bewegungsbezogene primärpräventive Interventionen im Setting Kita?. Bundesgesundheitsbl. 58, 609–619 (2015). https://doi.org/10.1007/s00103-014-2100-7

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