| Group or subgroup | Meta-analysis, (95% CI) | Statistical heterogeneity (within-group), p value (I2 value, %) | Test for between-group differences, p value (I2 value, %) | No. of participants | No. of studies | Quality of evidence rating* | ||
|---|---|---|---|---|---|---|---|---|
| Outcome: Change in BMI and BMI z-score, SMD | ||||||||
| Overall | –0.07 (–0.10 to –0.03) | < 0.001 | (74) | NA | 56 342 | 76 | Very low | |
| Intervention | ||||||||
| Diet | –0.08 (–0.17 to 0.01) | < 0.001 | (81) | 0.19 | (37) | 11 568 | 15 | Very low |
| Exercise | –0.08 (–0.16 to 0.00) | < 0.001 | (79) | 15 902 | 18 | Very low | ||
| Diet + exercise | –0.10 (–0.17 to –0.03) | < 0.001 | (70) | 14 923 | 26 | Very low | ||
| Lifestyle | –0.00 (–0.06 to 0.06) | 0.004 | (53) | 13 949 | 17 | Very low | ||
| Setting | ||||||||
| Noneducation | –0.04 (–0.15 to 0.08) | 0.01 | (46) | 0.04 | (68) | 3 070 | 18 | Very low |
| Education | –0.09 (–0.13 to –0.04) | < 0.001 | (78) | 47 975 | 51 | Very low | ||
| Education + other | 0.03 (–0.05 to 0.12) | 0.04 | (52) | 5 297 | 8 | Very low | ||
| Duration | ||||||||
| ≥ 12 mo | –0.08 (–0.13 to –0.03) | < 0.001 | (67) | 0.32 | (0) | 28 220 | 54 | Very low |
| > 12 mo | –0.04 (–0.11 to 0.02) | < 0.001 | (82) | 28 122 | 22 | Very low | ||
| Sex | ||||||||
| Male | –0.16 (–0.29 to –0.03) | < 0.001 | (77) | 0.76 | (0) | 5 719 | 16 | Very low |
| Female | –0.14 (–0.24 to –0.03) | < 0.001 | (80) | 10 007 | 23 | Very low | ||
| Age, yr | ||||||||
| 0–5 | –0.06 (–0.15 to 0.02) | 0.001 | (62) | 0.54 | (0) | 6 930 | 17 | Very low |
| 6–12 | –0.06 (–0.10 to –0.01) | < 0.001 | (73) | 36 916 | 42 | Very low | ||
| 13–18 | –0.12 (–0.22 to –0.02) | < 0.001 | (80) | 12 496 | 17 | Very low | ||
| Risk of bias | ||||||||
| Low | –0.07 (–0.13 to –0.00) | 0.006 | (53) | 0.30 | (17) | 8 542 | 13 | Moderate |
| Unclear | –0.06 (–0.11 to –0.02) | < 0.001 | (76) | 47 342 | 62 | Very low | ||
| High | –0.21 (–0.40 to –0.03) | NA | 458 | 1 | Very low | |||
| Outcome: Change in BMI; MD, kg/m2 | ||||||||
| Overall | –0.09 (–0.16 to –0.03) | < 0.001 | (76) | NA | 40 214 | 57 | Very low | |
Note: BMI = body mass index, CI = confidence interval, MD = mean difference, NA = not applicable, SMD = standardized mean difference. *Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence rating reflects confidence in the estimate of effect assessed through 5 domains of the evidence (risk of bias, indirectness, imprecision, inconsistency and reporting bias): moderate = downgraded for indirectness; very low = downgraded for risk of bias, indirectness, inconsistency, imprecision or reporting bias.