Dietary Interventions for Weight Management in Adolescents: Preliminary Evidence‐Mapping Analysis Results

Abstract

ObjectiveTo summarize published evidence on dietary interventions for weight management in adolescents using evidence mapping, an emerging method that aims to identify relevant literature on a broad field in order to assess both the existing evidence and the remaining gaps.MethodsA comprehensive literature search on Ovid MEDLINE® (from 1994 to 2015) was performed to identify dietary intervention studies in adolescents (≥10 to ≤19y), with changes in weight, body mass index, and/or body composition parameters as primary or secondary outcomes. Interventions consisted of various types of dietary manipulation, including changes in macronutrient intakes, dietary patterns, food groups, and individual food components or ingredients, individually or in combination with physical activity. The search strategy was designed to be broad in order to identify a wide range of publications to be further refined against pre‐designated inclusion and exclusion criteria. The resulting titles, abstracts, and keywords of all articles identified were screened using a web‐based citation screening tool, AbstrackrTM (http://abstrackr.cebm.brown.edu/) with a low threshold to exclude irrelevant abstracts. Data relevant to PICOD (Population, Intervention, Comparator, Outcome, and study Design) were extracted and preliminary descriptive analyses were performed.ResultsThe initial literature search yielded 5,555 citations. The first 1,500 (27%) abstracts were reviewed independently by two researchers based on pre‐defined study eligibility criteria and discrepancies were resolved by discussion, the remaining abstracts were single screened. Of these 1,500 abstracts screened, 114 full‐text articles were reviewed and 16 studies met inclusion criteria. After full‐text review, the most common reason for exclusion was that the studies did not use specific dietary manipulations as their primary intervention, and only addressed diet as part of larger lifestyle counseling and behavioral interventions. The mean age of the participants ranged from 11.2 to 17.9 years and 58.3% of them were female. Out of the 16 included studies, 14 were randomized controlled trials (RCTs) and 2 were single‐arm, before‐and‐after trials. The dietary interventions varied between the studies: the most common interventions were manipulations of dietary patterns (43.8%) or foods (31.2%) followed by dietary manipulations in combination with physical activity (25.0%). The durations of the interventions ranged from 2 weeks to 23 months. Each study assessed multiple outcomes of interest with the most studied outcome measures being changes in waist circumference (81.3%), weight (75.0%), and body mass index (68.8%).ConclusionOur preliminary results show that research evaluating the effects of dietary manipulation on body weight and related outcomes in adolescents is limited. Evidence mapping is a useful method to inform researchers, policy makers and funders on the research gaps in our understanding of dietary approaches for weight management in this population.Support or Funding InformationFunding provided by Biofortis Clinical Research (Addison, IL).