Pediatric Obesity Interventions in Racial and Ethnic Minorities: A Systematic Review

Background: The prevalence of childhood obesity has increased dramatically in the United States, disproportionately afflicting racial and ethnic minorities and producing lifelong health consequences. Various lifestyle and pharmacologic obesity interventions have been analyzed with inadequate representation of minority populations. Systematic reviews that address obesity interventions in minority populations have not been published. Even with the increasing research on pediatric obesity, many clinicians and public health professionals are uncertain of effective interventions in minority populations. Purpose: To identify pediatric obesity intervention studies in minority populations and assess the effectiveness of these interventions. Data Sources: The MEDLINE database (inception through February 2008). Study Selection: The author selected prospective studies of various pediatric obesity interventions with adequate racial and ethnic minority participation that reported an outcome related to body mass index. Data Extraction: Predefined criteria were used to extract details on study design, study duration, study population, intervention type and outcomes. The studies were then graded as good, fair or poor. The overall body of evidence was then graded as high, moderate or low. Results: Ten eligible articles were included in the systematic review, seven of which were randomized controlled trials (RCT), one of which was a secondary analysis of an existing RCT, and two of which were prospective cohort studies. African-American and Hispanic children were the most common minority population represented. Five studies were effective in reducing adiposity. Only two studies were graded as good, while many had serious methodological flaws. Moderate evidence exists for some pharmacological interventions in decreasing adiposity, but evidence for lifestyle interventions alone is limited. Conclusions: Studies that address racial and ethnic minorities are limited. Available evidence does not clearly support any obesity intervention in minority populations, although pharmacotherapy in patients at high risk for comorbidities or combined with lifestyle changes may offer some benefit.Master of Public Healt