Abstract
BackgroundOverweight and obesity in children and adolescents are major public health challenges affecting quality of life and representing important risk factors in the development of non-communicable diseases. School environments provide great possibilities for the primary prevention of overweight and obesity and different school-based nutrition interventions are available. However, existing research on school-based nutrition interventions has important limitations and no network meta-analysis (NMA) has been performed yet to compare all available interventions. Therefore, the present research project aims to investigate the impact of different nutrition interventions in the school setting by comparing and ranking them using NMA methodology.Methods/designA systematic literature search will be performed in 11 electronic databases (PubMed, the Cochrane Library, Web of Science, ERIC, PsycINFO, CAB s, Campbell Library, BiblioMap EPPI, Australian Education Index, Joanna Briggs Institute Evidence-Based Practice Database and Practice-based Evidence in Nutrition Database). Parallel or cluster randomized controlled trials (RCTs) meeting the following criteria will be included: (1) generally healthy school students aged 4–18 years, (2) school-based intervention with ≥ 1 nutrition component, and (3) assessed anthropometric (overweight/obesity risk, body weight change, weight Z-score, [standardized] body mass index, body fat, waist circumference) and/or diet-quality measures (daily intake of fruits and vegetables, fat, and sugar-sweetened beverages). Random effects pairwise and NMA will be performed for these outcomes and surface under the cumulative ranking curve (SUCRA) estimated (P-score). Where possible, component NMA (CNMA) will be used additionally. Subgroup analyses are carried out for intervention duration, gender, age of school students, socioeconomic status, and geographical location, and sensitivity analyses by excluding high risk of bias RCTs.DiscussionThis systematic review and NMA will be the first to both directly and indirectly compare and rank different school-based nutrition interventions for the primary prevention of overweight and obesity in childhood and adolescence. Our analyses will provide important insights about the effects of the different interventions and show which are the most promising. The results of our study can help inform the design of new studies and will be of value to anyone interested in developing successful, evidence-based nutrition interventions in school settings.Systematic review registrationPROSPERO: CRD42020220451.
Highlights
Overweight and obesity in children and adolescents are major public health challenges affecting quality of life and representing important risk factors in the development of non-communicable diseases
The results of our study can help inform the design of new studies and will be of value to anyone interested in developing successful, evidence-based nutrition interventions in school settings
We are confident that the current research project will significantly contribute to identifying gaps in the current evidence and help address issues related to the study design of existing studies on this topic
Summary
This systematic review and NMA will be the first to summarize and compare the effects of different nutrition intervention strategies for the primary prevention of overweight and obesity in school settings. We are confident that the current research project will significantly contribute to identifying gaps in the current evidence and help address issues related to the study design of existing studies on this topic This may lead to new insights into target group specificity, in particular on intervention effects in different age and gender groups, which are closely linked to contextual aspects. With regard to the planning and design of future school-based preventive measures, the current project will provide interesting insights into whether and in what shape collaboration took place between (newly) implemented school nutrition intervention strategies and, for example, already existing school nutrition education classes and teachers This might be of great importance and could lead to important recommendations, depending on the relevance of curricula-based nutrition education as a part of general education in primary and secondary schools in collaboration with nutrition intervention strategies in school settings.
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