Diet therapy for the management of obesity in children and adolescents: Overview of systematic reviews and meta-analysis of randomized controlled trials

This overview of reviews analyzes the impact of diet therapy in the treatment of overweight and obesity in children and adolescents 0-19 years of age. A literature search was conducted in the Cochrane Library, Medline, EMBASE, and ClinicalTrials.gov. Systematic reviews and meta-analyses of randomized controlled trials in obesity treatment from June 2016 to November 2022 were retrieved. Obesity outcomes included body weight, body mass index (BMI), BMI z-score, among others. Twenty-three reviews on diet therapy and lifestyle interventions including diet were selected from 364 review records. Diet therapy showed limited effect on short-term obesity reduction. Moderate energy intake reduction (-500 kcal/day) with balanced diet was feasible and effective in obesity reduction in 6- to 18-year-olds, irrespective of macronutrient distribution. Very low-energy diet (≤800 kcal/day) should only be prescribed under strict monitoring. Diet as part of multicomponent lifestyle interventions may be beneficial in achieving small, short- to long-term reductions in body weight in children and adolescents across all age groups and settings. Obesity treatment in adolescents may improve self-esteem and health-related quality of life. Dietary strategies should focus on the reduction of total energy intake through the promotion of food-based initiatives/approaches guidance that target modification of usual eating patterns and behaviors.