Table 1:
Summary of findings table
| Intervention Outcome Age group |
Number of studies, study design | Reason for downgraded quality | Effect estimate and direction of effects | GRADE |
|---|---|---|---|---|
| Food labeling | ||||
| Energy consumed | none | NA | NA | NA |
| Energy expended | none | NA | NA | NA |
| Fiscal measures | ||||
| Energy consumed | 1 RCT | Consistency could not be assessed Study limitation |
No statistically significant difference (SMD 0.10; CI −0.24, 0.44) | Very low |
| Energy expended | none | NA | NA | NA |
| Physical environment and transportation | ||||
| Energy consumed | 1 CT 1 Cohort study |
Inconsistent | ES could not be calculated for the CT (but favored the intervention group); the control group had lower intake in the cohort study (SMD 0.41; CI 0.14, 0.69; 1 Cohort study) | Very low |
| Energy expended | none | NA | NA | NA |
| Supply of food and lifestyle commodities | ||||
| Energy consumed | 3 RCTs 1 CT |
Inconsistent Study limitations |
RCTs report positive but not statistically significant differences (SMD −0.23; CI −0.45, −0.00; 3 RCTs); the CT reported insufficient data | Low |
| Energy expended | none | NA | NA | NA |
| Worksite interventions | ||||
| Energy consumed | 2 RCTs 1 CT 1 pre-post study |
Inconsistency Study limitation |
2 studies reported positive results but ES could not be computed, 2 studies reported conflicting results and were based on diverse study designs (SMD −0.20; CI −0.53, 0.13; 1 RCT; SMD −0.98; CI −1.32, −0.65; 1 pre-post study) | Very low |
| Energy expended | 6 RCTs 1 CT 2 pre-post studies |
Inconsistency Imprecision |
4 RCTs found no statistically significant difference (SMD 0.22; CI −0.17, 0.61; 4 RCTs); 2 pre-post studies reported improvements but could not be combined in a summary estimate | Low |
| Population-based healthcare initiatives | ||||
| Energy consumed | 15 RCTs | Inconsistency (sensitivity analysis) | Reduced consumption (SMD −0.13; CI −0.18, −0.08; 9 RCTs) | Moderate |
| Energy consumed children only | 2 RCTs | Imprecision | No statistically significant difference (SMD −0.19; CI −0.61, 0.24; 2 RCTs) | Low |
| Energy expended | 5 RCTs | Study limitations Inconsistency |
Studies could not be combined, effect varied | Very low |
| School-based interventions | ||||
| Energy consumed Children |
10 6 RCTs 3 CTs 1 cohort study |
Inconsistency | Significant reduction (SMD −0.11; CI −0.19, −0.04; 6 studies) | Moderate |
| Energy expended Children |
5 RCTs 1 CT 2 pre-post studies |
Inconsistency | No systematic effect (SMD −0.08; CI −0.65, 0.49; 6 trials) | Low |
| Health education campaigns | ||||
| Energy consumed | 17 RCTs 3 pre-post studies |
Inconsistency | RCTs showed a statistically significant effect (SMS −0.17; CI −0.26, −0.08; 10 RCTs), pre-post studies both positive but could not be combined | Moderate |
| Energy consumed Children only |
3 RCTs | Inconsistency Imprecision |
SMD −0.20; CI −0.41, 0.01; 3 RCTs) | Very low |
| Energy expended | 13 RCTs 2 pre-post studies |
Inconsistency | Positive pooled effects but individual results varied (SMD 0.37; 0.07, 0.67; 10 RCTs; SMD 0.48; CI 0.16, 0.79; 2 pre-post studies) | Low |
| Energy expended Children only |
2 RCTs | Inconsistency Imprecision |
Difference not statistically significant (SMD 0.06; CI −0.41, 0.52; 2 RCTs) | Very low |
| Social group approaches | ||||
| Energy consumed | 2 RCTs 1 CT |
Inconsistency Imprecision |
Studies could not be combined, conflicting results | Very low |
| Energy expended | 7 RCTs 1 CT 1 pre-post study |
Inconsistency | Statistically significant increase (SMD 0.26; CI −0.07, 0.44; 8 trials) | Moderate |
| Energy expended Children only |
3 RCTs | Imprecision | Not statistically significant (SMD 0.17; CI −0.17, 0.51; 3 RCTs) | Low |
Note: CI confidence interval, CT controlled trial, ES effect size, RCT randomized controlled trial, SMD standardized mean difference