{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T01:38:23Z","timestamp":1776217103884,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["POCI-01-0145-FEDER-030334; PTDC\/SAU-EPI\/30334\/2017"],"award-info":[{"award-number":["POCI-01-0145-FEDER-030334; PTDC\/SAU-EPI\/30334\/2017"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["IF\/01350\/2015"],"award-info":[{"award-number":["IF\/01350\/2015"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Several dietary interventions have been conducted to prevent\/reduce childhood obesity, but most of them are known to have failed in tackling the obesity epidemic. This study aimed to review the existing literature on dietary interventions for the prevention of childhood obesity and their effectiveness. A literature search was conducted using PubMed Central\u00ae. Only articles published between 2009 and 2021, written in English, conducted in humans, and including children and\/or adolescents (&lt;18 years old) were considered. The majority of studies were school-based interventions, with some addressing the whole community, and including some interventions in the food sector (e.g., taxation of high fat\/sugar foods, front-of-pack labelling) and through mass media (e.g., restrictions on food advertising for children) that directly or indirectly could help to manage childhood obesity. Most of the programs\/interventions conducted focus mainly on person-based educational approaches, such as nutrition\/diet education sessions, allied to the promotion of physical activity and lifestyles to students, parents, and school staff, and less on environmental changes to offer healthier food choices. Only a few trials have focused on capacity building and macro-policy changes, such as the adaptation of the built environment of the school, serving smaller portion sizes, and increasing the availability and accessibility of healthy foods and water in schools, and restricting the access to vending machines, for example. Overall, most of the intervention studies showed no consistent effects on changing the body mass index of children; they have only reported small weight reductions, clinically irrelevant, or no effects at all. Little is known about the sustainability of interventions over time.<\/jats:p>","DOI":"10.3390\/nu13103447","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T21:38:09Z","timestamp":1632865089000},"page":"3447","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Dietary Interventions to Prevent Childhood Obesity: A Literature Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Ana Rita","family":"Pereira","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences (Nutrition Sciences), University Fernando Pessoa, Rua Carlos da Maia 296, 4200-150 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6714-5939","authenticated-orcid":false,"given":"Andreia","family":"Oliveira","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica da Universidade do Porto (Institute of Public Health of the University of Porto), Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1017\/S0029665110003903","article-title":"Impact on Body Composition","volume":"70","author":"Popkin","year":"2011","journal-title":"Proc. Nutr. Soc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/S0140-6736(16)30054-X","article-title":"Trends in adult body-mass index in 200 countries from 1975 to 2014: A pooled analysis of 1698 population-based measurement studies with 19\u00b72 million participants","volume":"387","author":"Null","year":"2016","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1741-7015-12-17","article-title":"Unexpected plateauing of childhood obesity rates in developed countries","volume":"12","author":"Wabitsch","year":"2014","journal-title":"BMC Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1093\/ajcn\/87.2.398","article-title":"Evidence for a strong genetic influence on childhood adiposity despite the force of the obesogenic environment","volume":"87","author":"Wardle","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.physbeh.2015.07.006","article-title":"Behavioral susceptibility to obesity: Gene-environment interplay in the development of weight","volume":"152","author":"Llewellyn","year":"2015","journal-title":"Physiol. Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1046\/j.1467-789x.2001.00036.x","article-title":"Childhood overweight: A contextual model and recommendations for future research","volume":"2","author":"Davison","year":"2001","journal-title":"Obes. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/14635240.2017.1415765","article-title":"The Ottawa Charter 30 years on: Still an important standard for health promotion","volume":"56","author":"Thompson","year":"2018","journal-title":"Int. J. Health Promot. Educ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1159\/000471514","article-title":"Determining Factors and Critical Periods in the Formation of Eating Habits: Results from the Habeat Project","volume":"70","author":"Issanchou","year":"2017","journal-title":"Ann. Nutr. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e865","DOI":"10.1542\/peds.2011-3296","article-title":"Attributable Risks for Childhood Overweight: Evidence for Limited Effectiveness of Prevention","volume":"130","author":"Kehden","year":"2012","journal-title":"Pediatrics"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kopelman, P., Jebb, S.A., and Butland, B. (2007). Executive summary: Foresight \u2018tackling obesities: Future choices\u2019 project. Obes. Rev., 8.","DOI":"10.1111\/j.1467-789X.2007.00344.x"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bleich, S.N., Segal, J., Wu, Y., Wilson, R., and Wang, Y. (2013). Systematic review of community-based childhood obesity prevention studies. Pediatrics, 132.","DOI":"10.1542\/peds.2013-0886"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Niederer, I., Kriemler, S., Zahner, L., B\u00fcrgi, F., Ebenegger, V., Hartmann, T., Meyer, U., Schindler, C., Nydegger, A., and Marques-Vidal, P. (2009). Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): Study design of a cluster randomized controlled trial. BMC Public Health, 9.","DOI":"10.1186\/1471-2458-9-94"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-6-304","article-title":"Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): Systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents","volume":"6","author":"Singh","year":"2006","journal-title":"BMC Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1001\/archpediatrics.2009.2","article-title":"Dutch obesity intervention in teenagers: Effectiveness of a school-based program on body composition and behavior","volume":"163","author":"Singh","year":"2009","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1038\/sj.ijo.0802611","article-title":"School-based obesity prevention in Chilean primary school children: Methodology and evaluation of a controlled study","volume":"28","author":"Kain","year":"2004","journal-title":"Int. J. Obes."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"646","DOI":"10.2105\/AJPH.2009.165746","article-title":"Effect of a two-year obesity prevention intervention on percentile changes in body mass index and academic performance in low-income elementary school children","volume":"100","author":"Hollar","year":"2010","journal-title":"Am. J. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.ypmed.2013.06.001","article-title":"Shape Up Somerville two-year results: A community-based environmental change intervention sustains weight reduction in children","volume":"57","author":"Economos","year":"2013","journal-title":"Prev. Med."},{"key":"ref_19","first-page":"755","article-title":"A six month randomized school intervention and an 18-month follow-up intervention to prevent childhood obesity in Mexican elementary schools","volume":"27","year":"2012","journal-title":"Nutr. Hosp."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e794","DOI":"10.1542\/peds.2007-1365","article-title":"A Policy-Based School Intervention to Prevent Overweight and Obesity","volume":"121","author":"Foster","year":"2008","journal-title":"Pediatrics"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1002\/j.1550-8528.1996.tb00541.x","article-title":"Nutrition and Physical Activity Program to Attenuate Obesity and Promote Physical and Metabolic Fitness in Elementary School Children","volume":"4","author":"Donnelly","year":"1996","journal-title":"Obes. Res."},{"key":"ref_22","unstructured":"U.S. Department of Health and Human Services (1990). Healthy People 2000: National Health Promotion and Disease Prevention Objectives, DHHS Publication No. (PHS) 91-50212."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Liu, Z., Wu, Y., Niu, W.-Y., Feng, X., Lin, Y., Gao, A., Zhang, F., Fang, H., Gao, P., and Li, H.-J. (2019). A school-based, multi-faceted health promotion programme to prevent obesity among children: Protocol of a cluster-randomised controlled trial (the DECIDE-Children study). BMJ Open, 9.","DOI":"10.1136\/bmjopen-2018-027902"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Xu, H., Ecker, O., Zhang, Q., Du, S., Liu, A., Li, Y., Hu, X., Li, T., Guo, H., and Li, Y. (2020). The effect of comprehensive intervention for childhood obesity on dietary diversity among younger children: Evidence from a school-based randomized controlled trial in China. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0235951"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.jneb.2019.08.011","article-title":"Implementation and Evaluation of the Abriendo Caminos Program: A Randomized Control Trial Intervention for Hispanic Children and Families","volume":"51","author":"Hannon","year":"2019","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/ijpo.12736","article-title":"Primary prevention of fat and weight gain among obesity susceptible healthy weight preschool children. Main results from the \u201cHealthy Start\u201d randomized controlled intervention","volume":"16","author":"Olsen","year":"2021","journal-title":"Pediatr. Obes."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-021-02697-x","article-title":"Family-based intervention to prevent childhood obesity among school-age children of low socioeconomic status: Study protocol of the FIVALIN project","volume":"21","author":"Homs","year":"2021","journal-title":"BMC Pediatr."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Li, B., Pallan, M., Liu, W.J., Hemming, K., Frew, E., Lin, R., Martin, J., Zanganeh, M., Hurley, K., and Cheng, K.K. (2019). The CHIRPY DRAGON intervention in preventing obesity in Chinese primary-school--aged children: A cluster-randomised controlled trial. PLoS Med., 16.","DOI":"10.1371\/journal.pmed.1002971"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjopen-2018-025584","article-title":"Kids in Action: The protocol of a Youth Participatory Action Research project to promote physical activity and dietary behaviour","volume":"9","author":"Anselma","year":"2019","journal-title":"BMJ Open"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hamulka, J., Wadolowska, L., Hoffmann, M., Kowalkowska, J., and Gutkowska, K. (2018). Effect of an education program on nutrition knowledge, attitudes toward nutrition, diet quality, lifestyle, and body composition in polish teenagers. The ABC of healthy eating project: Design, protocol, and methodology. Nutrients, 10.","DOI":"10.3390\/nu10101439"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/j.2047-6310.2013.00164.x","article-title":"Childhood obesity prevention and control in city recreation centres and family homes: The MOVE\/me Muevo Project","volume":"9","author":"Elder","year":"2014","journal-title":"Pediatr. Obes."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1365-2214.2010.01205.x","article-title":"Obesity prevention in the family day care setting: Impact of the Romp & Chomp intervention on opportunities for children\u2019s physical activity and healthy eating","volume":"37","author":"Elea","year":"2011","journal-title":"Child Care Health Dev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s12160-011-9332-7","article-title":"Results of a Multi-level Intervention to Prevent and Control Childhood Obesity among Latino Children: The Aventuras Para Ni\u00f1os Study","volume":"43","author":"Crespo","year":"2012","journal-title":"Ann. Behav. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1467-789X.2011.00950.x","article-title":"EPODE approach for childhood obesity prevention: Methods, progress and international development","volume":"13","author":"Borys","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1467-789X.2011.00921.x","article-title":"The Pacific Obesity Prevention in Communities project: Project overview and methods","volume":"12","author":"Swinburn","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.1467-789X.2011.00911.x","article-title":"Experiences and challenges in implementing complex community-based research project: The Pacific Obesity Prevention in Communities project","volume":"12","author":"Schultz","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1001\/jama.282.16.1561","article-title":"Reducing children\u2019s television viewing to prevent obesity: A randomized controlled trial","volume":"282","author":"Robinson","year":"1999","journal-title":"JAMA"},{"key":"ref_38","unstructured":"World Health Organization (2021, September 02). Marketing of Foods High in Fat, Salt and Sugar to Children: Update 2012\u20132013. Available online: https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0019\/191125\/e96859.pdf."},{"key":"ref_39","unstructured":"Assembley of the Republic (2021, September 02). Law no 30\/2019. Di\u00e1rio da Rep\u00fablica n.o 79\/2019, S\u00e9rie I de 2019-04-23. Available online: https:\/\/dre.pt\/application\/conteudo\/122151046."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"854","DOI":"10.2105\/AJPH.90.6.854","article-title":"Small Taxes on Soft Drinks and Snack Foods to Promote Health | Center for Science in the Public Interest","volume":"90","author":"Jacobson","year":"2000","journal-title":"Am. J. Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Goiana-Da-Silva, F., Severo, M., Silva, D.C.E., Greg\u00f3rio, M.J., Allen, L.N., Muc, M., Nunes, A.M., Torres, D., Miraldo, M., and Ashrafian, H. (2020). Projected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling study. PLoS Med., 17.","DOI":"10.1371\/journal.pmed.1003036"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1111\/obr.12868","article-title":"Impact of sugar-sweetened beverage taxes on purchases and dietary intake: Systematic review and meta-analysis","volume":"20","author":"Teng","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1038\/s41387-017-0001-1","article-title":"A rapid review examining purchasing changes resulting from fiscal measures targeted at high sugar foods and sugar-sweetened drinks","volume":"7","author":"Roberts","year":"2017","journal-title":"Nutr. Diabetes"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.appet.2019.03.025","article-title":"The relationship between food label use and dietary intake in adults: A systematic review","volume":"138","author":"Anastasiou","year":"2019","journal-title":"Appetite"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/heapro\/17.1.13","article-title":"Impact of the Pick the Tick food information programme on the salt content of food in New Zealand","volume":"17","author":"Young","year":"2002","journal-title":"Health Promot. Int."},{"key":"ref_46","unstructured":"WHO (2021, September 02). European Food and Nutrition Action Plan 2015\u20132020 (2014). Denmark: WHO Regional Office for Europe. Available online: https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0003\/294474\/European-Food-Nutrition-Action-Plan-20152020-en.pdf."},{"key":"ref_47","unstructured":"Kelly, B., and Jewell, J. (2021, September 02). What Is the Evidence on the Policy Specifications, Development Processes and Effectiveness of Existing Front-of-Pack Food Labelling Policies in the WHO European Region. Available online: https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0007\/384460\/Web-WHO-HEN-Report-61-on-FOPL.pdf."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1001\/jama.289.4.450","article-title":"Patterns and trends in food portion sizes, 1977\u20131998","volume":"289","author":"Nielsen","year":"2003","journal-title":"JAMA"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.amepre.2012.07.024","article-title":"Reducing portion sizes to prevent obesity","volume":"43","author":"Young","year":"2012","journal-title":"Am. J. Prev. Med."},{"key":"ref_50","unstructured":"World Health Organisation (2021, September 02). Global Nutrition Policy Review 2016\u20132017: Country Progress in Creating Enabling Policy Environments for Promoting Healthy Diets and Nutrition. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241514873."},{"key":"ref_51","unstructured":"World Health Organization (2021, September 02). Population-Based Approaches to Childhood Obesity Prevention. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/80149\/9789241504782_eng.pdf;jsessionid=C20C82A9D40706BE6D43BDAB600599FF?sequence=1."},{"key":"ref_52","unstructured":"Monteiro, R., and Martins, M. (2020). Social and health behaviour determinants of obesity. Recent Advances in Obesity: Understanding Obesity\u2014From Its Origins to Impact on Life, Bentham Science Publishers."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/10\/3447\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:06:58Z","timestamp":1760166418000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/10\/3447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,28]]},"references-count":52,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["nu13103447"],"URL":"https:\/\/doi.org\/10.3390\/nu13103447","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,28]]}}}