Background: The aims of this systematic review were to study the effectiveness of primary school-based physical activity, sedentary behavior and nutrition interventions with direct parental involvement on children’s BMI or BMI z-score, physical activity, sedentary behavior and nutrition behavior and categorize intervention components into targeted socio-cognitive determinants and environmental types using the Environmental Research framework for weight Gain prevention. Methods: In March 2018, a systematic search was conducted in four electronic literature databases. Articles written in English about effectiveness studies on school-based interventions with direct parental involvement targeting 4–12 year olds were included. Interventions with indirect parental involvement, interventions not targeting the school environment, and pilot studies were excluded. Study and intervention characteristics were extracted. Study quality and study effectiveness were assessed and effect sizes (Cohen’s d) were calculated for the outcome measures. Types of socio-cognitive factors and environmental types targeted were distinguished. Results: In total, 25 studies were included. Most studies on BMI or BMI z-score, physical activity and sedentary behavior found favorable results: 61.1%, 81.1% and 75%, respectively. Results regarding nutrition behavior were inconclusive. Methodological study quality varied. All interventions targeted multiple environmental types in the school and family environment. Five targeted socio-cognitive determinants (knowledge, awareness, attitude, self-efficacy and intrinsic motivation) of the children were identified. No consistent pattern was found between either type of environment targeted, number of type of environment targeted, or the child’s targeted socio-cognitive determinants and intervention effectiveness. Discussion: School-based interventions with direct parental involvement have the potential to improve children’s weight status, physical activity and sedentary behavior. Based on the results, it is recommended that school-based interventions with direct parental involvement target more than one EBRB, last at least one year, and focus particularly on the physical and social environment within both the school and the family environment
Rationale: Sarcopenia and obesity are prevalent conditions and are both associated with negative health outcomes. ESPEN and EASO reached consensus on the definition and diagnostic criteria for sarcopenic obesity (SO) encompassing indicators fat mass, muscle mass, and muscle function. However, few studies report on the effect of lifestyle interventions on these SO indicators. This study aimed to evaluate the effect of combined lifestyle interventions on SO indicators and on a composite SO index.Methods: Analyses were performed on two pooled RCT’s (MPS, PROBE) in older adults with obesity participating in a 13-wk program targeting weight loss while preserving muscle mass, providing a combination of caloric restriction, higher protein intake and resistance exercise training. SO indicators measured at baseline and post-intervention included 5x chair stand test (CST) in seconds for muscle function, fat mass percentage (FM%) and appendicular lean mass divided by body weight (ALM/W) using DXA. The SO index was calculated using sex-specific z-scores: -CST(s) + ALM/W – FM%; higher scores indicating better muscle function and body composition. Mixed model analyses were performed to assess the changes from baseline to post-intervention, adjusted for sex and age.Results: A total of 154 participants (age 65±6y; 59% male, BMI 33.1±4.3kg/m2) were included. After the 13-wk lifestyle interventions, weight (-2.87kg 95%CI -4.16;-1.64) and FM% (-1.81% 95%CI -2.42;-1.21) decreased significantly, CST improved significantly (-1.51s 95%CI -2.02;-1.00) from baseline and ALM/W was maintained (0kg/kg 95%CI 0.01;0.01). The SO index improved (+1.16 z-score 95%CI 0.86;1.44).Conclusion: Lifestyle interventions combining nutrition & exercise improved individual SO indicators and the SO index in older adults with obesity. The SO index could be a useful and sensitive criterion in the prevention and management of sarcopenic obesity.
