Adolescent Health, Medicine and Therapeutics (Sep 2023)

The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review

  • Kshatriya M,
  • Wang KW,
  • Hildebrand J,
  • Crawford R,
  • Nadarajah A,
  • Youssef M,
  • Rivas A,
  • Kaushal A,
  • Banfield LE,
  • Thabane L,
  • Samaan MC

Journal volume & issue
Vol. Volume 14
pp. 175 – 193

Abstract

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Maya Kshatriya,1– 3 Kuan-Wen Wang,1,2 Julia Hildebrand,1,2 Rebecca Crawford,1,2,4 Ajantha Nadarajah,1– 3 Michael Youssef,1,2 Angelica Rivas,1,2,5 Ashleen Kaushal,1,2 Laura E Banfield,6 Lehana Thabane,7– 10 M Constantine Samaan1– 3,5,7 1Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; 2Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada; 3Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada; 4Indigenous Undergraduate Summer Research Program, McMaster University, Hamilton, Ontario, Canada; 5Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada; 6Health Sciences Library, McMaster University, Hamilton, Ontario, Canada; 7Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; 8Biostatistics Unit, St. Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada; 9Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; 10Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, CanadaCorrespondence: M Constantine Samaan, Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada, Tel +1-905-521-2100, ext. 75926, Fax +1-905-308-7548, Email [email protected]: Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada.Methods: Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence.Results: Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs.Conclusion: Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada.Systematic Review Registration: PROSPERO CRD42017072781.Keywords: child, ethnicity, obesity, diabetes, prevention

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