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Efficacy of population‐wide diabetes and obesity prevention programs: An overview of systematic reviews on proximal, intermediate, and distal outcomes and a meta‐analysis of impact on BMI
Author(s) -
Roberts Samantha,
Pilard Louis,
Chen Junqiao,
Hirst Jennifer,
Rutter Harry,
Greenhalgh Trisha
Publication year - 2019
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.12821
Subject(s) - overweight , medicine , meta analysis , psychological intervention , obesity , systematic review , environmental health , population , body mass index , gerontology , medline , biology , biochemistry , psychiatry
Summary We conducted an overview of systematic reviews and a meta‐analysis of the impact on body mass index (BMI) of primary studies of population‐wide obesity and diabetes prevention programs, in order to evaluate their efficacy. We searched eight databases for reviews of population‐level programs reporting effect on diet, physical activity, BMI, or prevalence of obesity/overweight or type 2 diabetes mellitus (T2DM). Meta‐analysis of primary studies within reviews reporting effect on BMI. Interventions were categorized using ANGELO framework and quality assessment using AMSTAR. Fifty‐three systematic reviews were included. Primary studies were largely natural experiments or cross‐sectional studies of national data. Increased price of sugar‐sweetened beverages (SSBs) and fast food, decreased price of fruit and vegetables, food labelling, and grocery store interventions were associated with positive effects on diet. Park and playground renovations and point‐of‐choice prompts to increase stair use were associated with positive effects on physical activity. Increased price of SSBs, menu labelling, grocery store interventions, and multicomponent interventions were associated with small reductions in BMI. There was insufficient evidence of impact of any interventions on the prevalence of overweight, obesity, or T2DM. We have identified a promising suite of population‐wide actions to improve diet, increase physical activity, and reduce BMI. Impact on subsequent incidence of T2DM remains speculative.