The causes of obesity worldwide are complex and multilevel, including changing food environments, physical activity levels, policies, and food production systems. This intricate context requires multilevel and multicomponent (MLMC) interventions to improve health outcomes. We conducted a literature review of MLMC interventions for obesity prevention and mitigation; 14 studies meeting search criteria were identified. We found examples of successes in preventing obesity, reducing overweight, improving healthful behaviors, and enhancing some psychosocial indicators. Of eight studies that reported health and behavioral results, five showed no significant impact and three showed reductions in obesity. Four studies showed significant improvement in dietary behavior, and five reported significant desirable effects in physical activity or screen time. Five studies reported psychosocial impacts, and three of these showed significant improvements. MLMC approaches show promising results, particularly when they are able to integrate components at the policy, community, and interpersonal levels.

/pdf/whole-of-community-obesity-prevention-a-review-of-challenges-3mkm25apqs.pdf

"Whole-of-Community" Obesity Prevention: A Review of Challenges and Opportunities in Multilevel, Multicomponent Interventions

Background: Oral administration of pro- and prebiotics has recently been considered as an effective way for nonalcoholic fatty liver disease (NAFLD) recovery. Objectives: The current study aimed at evaluating the effect of supplementation with probiotics and/or prebiotics on liver function tests in patients with NAFLD. Methods: In this double blind, placebo-control clinical trial, 75 subjects with NAFLD were voluntarily recruited from May 2013 to March 2014, in Iran. Participants were randomly assigned to 1 of 4 groups using a block randomization procedure. Group 1 received probiotic capsules (Bifidobacterium longum (BL) and Lactobacillus acidophilus (LA): 2 × 107 CFU/day), group 2 received prebiotic inulin high performance (HP): 10 g/day, group 3 received probiotic and the prebiotic, and group 4 received a placebo for 3 months. The sample size was determined on the basis of a primary outcome of a change in aspartate aminotransferase (AST) level. Results: An intergroup comparison indicated that the AST (P = 0.006) and alanine aminotransferase (ALT) (P = 0.04) levels decreased at the end of the study. Aspartate Aminotransferase (mean difference of group1 versus placebo with P value of 0.001, group2 versus placebo with P value of 0.045, group3 versus placebo with P value of 0.015) and ALT (mean difference of group 1 versus placebo with P value of 0.009, group 2 versus placebo with P value of 0.041, and group 3 versus placebo with P value of 0.046) serum levels decreased significantly in all of the intervention groups compared to the placebo. The grade of fatty liver in group 1 (P of 0.027, and number needed to treat (NNT) = 3) and group 3 (P = 0.019 and NNT = 3) decreased compared to the placebo group with no significant changes in group 2. Conclusions: Supplementation with probiotics and/or prebiotics improved aminotransferase enzymes, and supplementation with probiotics or pro- and prebiotics recovered the grade of fatty liver in NAFLD patients.

The Effect of Probiotic and/or Prebiotic on Liver Function Tests in Patients with Nonalcoholic Fatty Liver Disease: A Double Blind Randomized Clinical Trial

This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.

https://www.mdpi.com/2072-6643/12/1/194/pdf

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China.

Prevalence of obesity and acanthosis nigricans among young children in the children's healthy living program in the United States Affiliated Pacific.

/pdf/wealthy-but-unhealthy-overweight-and-obesity-in-asia-and-the-rkp76uzj9v.pdf

Wealthy But Unhealthy: Overweight and Obesity in Asia and the Pacific: Trends, Costs, and Policies for Better Health

Objectives
Anthropometric standardization is essential to obtain reliable and comparable data from different geographical regions. The purpose of this study is to describe anthropometric standardization procedures and findings from the Children’s Healthy Living (CHL) Program, a study on childhood obesity in 11 jurisdictions in the US-Affiliated Pacific Region, including Alaska and Hawai‘i.

/pdf/anthropometric-measurement-standardization-in-the-us-1exax8dva6.pdf

Anthropometric measurement standardization in the US‐affiliated pacific: Report from the Children's Healthy Living Program

Anthropometric standardization in the U.S. Affiliated Pacific: The Children’S Healthy Living Program (1024.6)

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Anthropometric measurement standardization in the US‐affiliated pacific: Report from the Children's Healthy Living Program

Anthropometric standardization in the U.S. Affiliated Pacific: The Children’S Healthy Living Program (1024.6)