Hispanic youth have the highest prevalence of pediatric obesity in the United States. Addressing the rate of pediatric obesity among Hispanics/Latinos, which is the largest minority group in the U.S. and represents a growing segment of the population, will be critical to the future health of the nation. According to U.S. Census Bureau data, Hispanics/Latinos will account for approximately 25% of the U.S. population by 2060.

The meta-analysis involved a search of articles in three publication sources, including PubMed, PsycInfo, and Scopus during a 20-year period from January 1, 2000 and October 30, 2020. Of the 1,103 articles that were screened, 105 articles were included in the meta-analysis. The study included interventions that consisted of at least 50% Hispanic youth or greater between the ages of 0-18 years old. Over 49,726 participants were included in the overall sample.

"We found that existing interventions for Hispanic youth have a small impact on their weight status, physical activity, and dietary intake. Although these findings may seem discouraging, small effects spread out across a population can have a meaningful public health impact. Beyond continuing to work on developing more efficient, impactful interventions, we need to be able to make interventions more easily scalable," said Dr. St. George.

“Despite the urgent need to address these health disparities among Hispanic youth, we were surprised to find there was no meta-analysis quantifying the effects of existing interventions. Prior reviews of the literature concluded that there was a paucity of interventions targeting this population, but our study, the first meta-analysis and comprehensive review to-date, suggests otherwise with the inclusion of more than 100 studies,” said Dr. Kobayashi.

Results/Discussion:

• Results demonstrate that the overall effects of the pediatric obesity interventions on BMI status, waist circumference, physical activity (PA), fruit and vegetable and sugar-sweetened beverage intake were significant, although small.
• Obesity interventions for Hispanic youth appear to be performing similarly to those geared towards the general populations.
• Results of the data analysis show that studies conducted during infancy and early-to-middle adolescence showed larger effects on weight status than did those conducted during other developmental periods.
• The effects of the interventions on BMI status and physical activity vary substantially by socioeconomic status (SES), with those involving higher income youth demonstrating moderate effects on weight reduction and physical activity and those involving lower income youth demonstrating small effects.
• Interventions implemented in primary care, family, and school settings showed important reductions in Hispanic youth’s BMI status.
• Dietary interventions compared to PA or multi-behavioral interventions showed greater promise in reducing weight among Hispanic youth.
• Gender, % Hispanic and weight status had little or no impact on the outcomes of the interventions.
• Overall, other systematic reviews confirm the challenges associated with increasing youth PA.
• Existing interventions have no overall effect on body fat percentage and sedentary behavior.
• Culturally-tailored interventions showed small though slightly higher results than those with no cultural targeting or only linguistic strategies.

"We wanted this paper to serve as a resource for intervention scientists working towards preventing and reducing obesity among Hispanic youth from infancy through late adolescence. Along with the effect size estimates provided in our paper, we put together an extensive online supplement that summarizes the characteristics of all included studies. I am very proud of our team’s work," added Dr. St. George.

“It is our hope that other researchers will be able to utilize our results to inform their future work to advance the field,” added Dr. Kobayashi.

Results of the comprehensive analysis highlight the factors that contribute towards the positive outcomes of the interventions. The meta-analysis also identifies priority areas of research and gaps in the field of intervention and implementation science. Moreover, the study shows that obesity and its associated lifestyle behaviors, including diet and physical activity, are complex and difficult to change. Although the outcomes of the interventions are relatively small, it is important to note that small improvements that compound over time can have a consequential public health impact.

Findings of the research study shed light on the need for more impactful and efficient pediatric obesity prevention and treatment interventions. The study also highlights the need for targeted public health policies and more easily disseminable interventions to spread the effects of the interventions across the population. New approaches for designing interventions that have the potential to scale are also essential, such as through the utilization of technology to enable widespread reach.

Written by Veronica Bustabad

Published on January 31, 2022