Evidence supporting the recommendation of a specific dietary approach to weight loss in children is insufficient.

During the past decade, the worldwide incidence of childhood and adolescent obesity has increased dramatically. The long-term effects of the condition include chronic health problems (such as diabetes and higher mortality rates) and psychosocial problems (such as social abuse and low self-esteem). Obesity may also lead to lower educational and professional achievement, lower income, and singlehood. This systematic review presents scientific evidence about optimal dietary treatment and management of children younger than age 18 who are overweight or obese. These conditions are determined by the body mass index (BMI), the BMI percentile, or weight in relation to height. The authors discussed 116 articles, of which 49 described 37 randomized, controlled trials and 67 described 51 nonrandomized or noncontrolled trials. The studies differed in design and degree of scientific rigor, rendering comparisons difficult. Metaanalysis of eight randomized, controlled trials involving a dietary intervention group revealed that interventions with a dietary component helped children lose weight, at least in the short term. Few studies reported children's adherence to the dietary change. Dietary intervention was most effective when combined with physical activity, behavioral or cognitive- behavioral therapy, or a reduction in sedentary activity.

The crux of the matter. Despite multiple studies of dietary interventions for childhood obesity, little scientific evidence supports the superiority of any one intervention. The authors of this review identified the modification of diet as beneficial to a weight-loss program for children, but couldn't recommend a specific approach. The evidence showed that dietary interventions were less successful in maintaining long-term weight loss. The review suggests that certain interventions for childhood obesity&-such as high-protein diets and those that reduce the glycemic index&-warrant further investigation.