Traditional knowledge-based lifestyle interventions in the prevention of obesity and type 2 diabetes in Indigenous children in Canada: a systematic review protocol

Rebecca Crawford,Laura Banfield,M Constantine Samaan,Ajantha Nadarajah,Lehana Thabane,Angelica Rivas,E Danielle Sims,Michael Youssef,Kuan-Wen Wang

doi:10.1186/s13643-019-0961-4

Abstract

BackgroundApproximately 50% of all youth-onset type 2 diabetes mellitus (T2DM) in Canada occurs in Indigenous children. In adults, cardiovascular disease is one of the leading causes of mortality in First Nations communities, and diabetes is a significant contributor to the risk of developing this disorder. The early onset of diabetes may predispose these children to premature cardiovascular disease and influence their longevity and quality of life. As a result, the implementation of culturally tailored obesity and T2DM primary prevention programs is vital. This systematic review aims to assess the effectiveness of existing traditional knowledge-based lifestyle intervention programs on preventing obesity and T2DM in Indigenous children in Canada.MethodsWe will conduct database searches in MEDLINE, Embase, PsycINFO, SPORTDiscus, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, and the Cochrane Controlled Register of Trials. We will also conduct grey literature searches of central repository of trials (ClinicalTrials.gov), ProQuest Dissertations, Theses A&I, and Indigenous studies portal research tools. Reviewers will independently review titles, abstracts, and full-text articles retrieved from databases to assess potentially eligible studies, and relevant articles will be assessed for risk of bias and quality. The primary outcomes include the change in body mass index z-scores or a diagnosis of diabetes. The secondary outcomes include the change in measures of adiposity as well as lifestyle and metabolic profiles. A meta-analysis will be performed if two or more studies have used similar study designs, comparable intervention techniques , similar populations and measured similar outcomes.DiscussionThis review will provide a summary of current interventions to prevent obesity and T2DM in Indigenous children in Canada and help determine the gaps in the literature so that interventions can be developed to control the surge in pediatric T2DM in Indigenous communities.Systematic review registrationPROSPERO CRD42017072781

Highlights

50% of all youth-onset type 2 diabetes mellitus (T2DM) in Canada occurs in Indigenous children
This review will provide a summary of current interventions to prevent obesity and T2DM in Indigenous children in Canada and help determine the gaps in the literature so that interventions can be developed to control the surge in pediatric T2DM in Indigenous communities
The Creative Commons Public Domain Dedication waiver applies to the data made available in this article, unless otherwise stated

Summary

Introduction

50% of all youth-onset type 2 diabetes mellitus (T2DM) in Canada occurs in Indigenous children. The rates of pediatric obesity and type 2 diabetes mellitus (T2DM) are rising in Indigenous communities in North. 11% of Indigenous children in North America are overweight, and these rates increase rapidly to 40% in the 9–. There are several drivers of diabetes and obesity epidemics in Indigenous communities, including historical and social factors related to the legacy of colonialism, cultural suppression, and systemic poverty [3, 11, 12]. These factors interact with genetic and environmental elements that may further augment the rise in

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