What we know

Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. However, what’s the case when it comes to children and adolescents?

Investigators’ research hypothesis

In the context of the NUTRISHIELD project, a scientific team from the Nutrition and Dietetics Department of the Harokopio Univesrity of Athens in Greece implemented a meta-analysis with the aim to examine the effect of technology-based interventions on overweight/obesity treatment in children and adolescents. After a systematic literature and an extensive data extraction, investigators selected in total 9 manuscripts from 8 clinical trials of 582 children/adolescents where technology-based vs. conventional interventions were applied to overweight/obese children or adolescents to manage their weight. Body mass index (BMI), BMI z-score and other BMI-related baseline metrics, during and post- intervention were considered as primary outcomes.

Here are some highlights for the selected studies:

• In 7 to 8 studies the technology-based intervention was applied on the top of conventional care.
• Six studies were conducted in USA, 1 study in Australia and 1 study in northwestern Europe.
• Five studies included adolescents while the rest addressed 9-12 year-old children.
• Intervention duration ranged from 3 to 24 months.
• Five to 8 studies reported significant difference between groups in BMI metrics change.

What investigators found

Overall an intervention which combines conventional care with technological facilities could be an effective method in weight management of overweight/obese children and adolescents and probably more effective than the conventional care alone. These observations were more evident in case of interventions of at least 6 months duration. The selected studies included eHealth and mHealth technologies, such as interactive web platforms, mobile apps, gaming, short message services with or without sensors and accompanied or not by other contact forms such as telemedicine, emails and informative websites. The focus of these technologies was more or less related either exclusively or in combination with improvement of dietary habits, enhancement of physical activity or increasing users’ self-monitoring potential. The type of technological means used in each intervention in terms of mobile-based or web-based did not seem to alter the final outcome. Interestingly, the parental involvement was related to greater outcomes of the intervention, mainly in children; however, it was not possible to isolate the separate contribution of parents to the final outcome.

To conclude …

Studies describe functional and acceptable technology-based approaches, on the top of conventional treatments, to enhance weight loss in young populations. However, the large heterogeneity in study designs, settings, intervention components, and outcomes probably eliminate the strength of this conclusion. Finally, this field is advancing so quickly that the technology used is often no longer state-of-the art; interventions that employ the full range of novel technologies, such as ubiquitous sensing and real-time feedback are currently being developed and pilot tested. Thereby, similar meta-analytic approaches should be repeated on regular basis.

More details will be published soon in the Journal of Medical Internet Research (https://www.jmir.org/).