We found strong evidence to support beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeted to children aged six to 12 years. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously. A broad range of programme components were used in these studies and whilst it is not possible to distinguish which of these components contributed most to the beneficial effects observed, our synthesis indicates the following to be promising policies and strategies:
·         school curriculum that includes healthy eating, physical activity and body image
·         increased sessions for physical activity and the development of fundamental movement skills throughout the school week
·         improvements in nutritional quality of the food supply in schools
·         environments and cultural practices that support children eating healthier foods and being active throughout each day
·         support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities)
·         parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activities
However, study and evaluation designs need to be strengthened, and reporting extended to capture process and implementation factors, outcomes in relation to measures of equity, longer term outcomes, potential harms and costs.
Childhood obesity prevention research must now move towards identifying how effective intervention components can be embedded within health, education and care systems and achieve long term sustainable impacts.
A family-based approach to preventing excessive weight gain.
Preventing weight gain in adults and excessive weight gain in children is a high priority. We evaluated the ability of a family-based program aimed at increasing steps and cereal consumption (for breakfast and snacks) to reduce weight gain in children and adults.
                Families (n = 105) with at least one 8- to 12-year-old child who was at-risk-for-overweight or overweight (designated as the target child) were recruited for the study. Eighty-two families were randomly assigned to receive the family-based intervention and 23 families to the control condition. The 13-week intervention consisted of specific increases in daily steps (an additional 2000 steps/d) and consumption of 2 servings/d of ready-to-eat cereal.
                The intervention was successful in increasing walking (steps) and cereal consumption. The intervention had positive, significant effects on percentage BMI-for-age and percentage body fat for target children and weight, BMI, and percentage body fat for parents. On further analysis, the positive effects of the intervention were seen largely in target girls and moms, rather than in target boys and dads.
                This family-based weight gain prevention program based on small changes holds promise for reducing excessive weight gain in families and especially in growing overweight children.