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Wie wirksam sind ernährungs- und bewegungsbezogene primärpräventive Interventionen im Setting Kita?

Ein Review von Reviews

The effectiveness of primary prevention interventions promoting physical activity and healthy eating in preschool children

A review of reviews

  • Originalien und Übersichten
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Hintergrund

Ungünstige Ernährungs- und Bewegungsgewohnheiten bilden sich oft bereits in der Kindheit aus und führen zu Übergewicht und Adipositas.

Fragestellung

Ziel der vorliegenden Arbeit ist es, einen Überblick über die Wirksamkeit ernährungs- und bewegungsbezogener Interventionen hinsichtlich Gewicht und Gesundheitsverhalten im Setting Kita zu geben.

Methoden

Eine systematische Literaturrecherche zu zwischen 2007 und 2014 publizierten Übersichtsarbeiten wurde in PubMed, Cochrane Library und Campbell Collaboration durchgeführt. Zehn systematische Reviews und 3 Metaanalysen mit 22 kitabasierten Interventionen wurden eingeschlossen. Die Interventionen stammten aus Nordamerika (N = 14), Europa (N = 5), Asien (N = 2) und Australien (N = 1). Die Hälfte der Interventionen richtete sich an ethnische Minoritäten oder Kinder aus sozioökonomisch benachteiligten Familien. Angaben zu Effekten auf anthropometrische Maße (z. B. Body-Mass-Index), das Ernährungs- und Bewegungsverhalten sowie Merkmale effektiver Programme wurden extrahiert und narrativ zusammengefasst.

Ergebnisse

Es konnte keine gesicherte Evidenz zu Effekten der Interventionen auf anthropometrische Maße festgestellt werden. Dagegen zeigten sich in 7 von 9 Studien positive Effekte in ernährungsbezogenen Outcomes (z. B. Obst-/Gemüsekonsum). Bezüglich des Bewegungsverhaltens ergaben sich nur vereinzelt positive Effekte. Merkmale, die mit einer erhöhten Wirksamkeit in Verbindung gebracht wurden, waren 1) die Vermittlung von Fähigkeiten und Kompetenzen, 2) eine starke Einbeziehung der Eltern und 3) Informationen über den Zusammenhang zwischen Verhalten und Gesundheit für Eltern.

Diskussion

Insgesamt ergeben sich erste Hinweise auf frühzeitige Verbesserungen im Ernährungs- und Bewegungsverhalten durch Präventionsprogramme in Kitas. Die Evidenz wird allerdings durch eine geringe Studienzahl, methodische Mängel und Inkonsistenzen in der Zielparameter-Erfassung eingeschränkt. Der Nachweis für die Wirksamkeit der Interventionen auf objektive Maße von Übergewicht steht noch aus.

Abstract

Background

During their preschool years children establish nutritional and physical activity (PA) habits that may contribute to the development of overweight and obesity.

Objective

To examine the evidence for effective interventions promoting healthy eating and PA in childcare settings.

Methods

We searched PubMed, the Cochrane Library, and Campbell Collaboration for systematic reviews published between 2007 and 2014. Ten systematic reviews and three meta-analyses met the inclusion criteria, including a total of 22 intervention studies. Intervention studies were conducted in North America (N = 14), Europe (N = 5), Asia (N = 2), and Australia (N = 1). Half of these addressed ethnic minority groups or socially disadvantaged children. We extracted information about the effects regarding anthropometric measures, eating habits, and physical activity, as well as the characteristics of effective interventions, and summarized them narratively.

Results

Evidence for intervention effects on anthropometric measurements was inconclusive. Seven out of nine studies showed beneficial effects on diet-related outcomes. Only isolated effects were reported on improvements in PA. Reviews indicated that interventions which comprised (1) the development of skills and competencies, (2) medium to high parental involvement, and (3) information on behavior-health links for parents were more effective.

Conclusion

Preschool-based interventions showed some early improvements in eating habits and PA. Evidence is limited by the small number of studies, a lack of methodological quality, and inconsistencies among outcome measures. Evidence regarding anthropometric measurements is still inconclusive.

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Danksagung

Diese Studie wurde mit finanzieller Unterstützung des AOK-Bundesverbandes durchgeführt.

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Authors and Affiliations

  1. Abteilung Prävention und Evaluation, Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Achterstraße 30, 28359, Bremen, Deutschland

    B. Steenbock, C.R. Pischke, J. Schönbach, S. Pöttgen & T. Brand

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Correspondence to B. Steenbock.

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B. Steenbock, C.R. Pischke, J. Schönbach, S. Pöttgen und T. Brand geben an, dass keine Interessenkonflikte vorliegen.

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Steenbock, B., Pischke, C., Schönbach, J. et al. Wie wirksam sind ernährungs- und bewegungsbezogene primärpräventive Interventionen im Setting Kita?. Bundesgesundheitsbl. 58, 609–619 (2015). https://doi.org/10.1007/s00103-014-2100-7

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