Strategies to Manage Metabolic Health During the Holidays

Interventions during holidays and school vacations can help prevent children and adults gaining weight, according to a recent systematic review and meta-analysis published in Obesity Reviews.

Evidence suggests that certain times of the year, such as the Christmas holidays and summer vacations, are associated with weight gain. In adults, up to 50% of the total annual weight gain occurs during December.

In 2023, the United Nations Children’s Fund reported that more than four million children younger than 5 years and nearly 50 million children and adolescents aged 5-19 years in Latin America and the Caribbean were affected by overweight. Among adults, more than 50% of individuals in every country in the region live with obesity.

These alarming figures call for urgent action from governments, healthcare professionals, and multidisciplinary teams to implement prevention strategies and promote further research.

Study Significance

Michelle Maree Haby de Sosa, PhD, an epidemiologist and researcher at the Department of Chemical-Biological and Nutritional Sciences at the University of Sonora, Hermosillo, Mexico, led the study. She explained that the research team first conducted a narrative review on weight gain during the festive season. “We found that the 6 weeks between December and mid-January represent a critical period when people gain half the weight they put on all year. This highlights the importance of addressing obesity and overweight by promoting lifestyle changes and prevention strategies to tackle this public health issue.”

The researchers then conducted a systematic review of global interventions not only to publish findings but also to educate healthcare professionals and stakeholders. They searched databases such as Medline, EMBASE, PsycINFO, SciELO, LILACS, and Cochrane, focusing on randomized controlled trials. These were supplemented with gray literature and references from relevant articles, as well as additional data requested from study authors.

Key Findings

The review included studies from the United States (10), the United Kingdom (one), and Chile (one). Of these, two had a low risk for bias, two moderate, seven high, and one critical.

Most interventions targeted school-aged children or adults. According to Haby de Sosa, achieving consistent results in adolescents was challenging due to the difficulty of changing behaviors in this age group. In contrast, interventions for school-aged children were implemented primarily during day camp visits, where participants were divided into control and intervention groups.

The interventions included nutrition classes, physical activity, and the provision of healthy meals, which resulted in less weight gain compared with control groups.

In children, the meta-analysis of four of seven studies conducted during summer vacations (six interventions) found a small but significant reduction in body mass index z-scores in the intervention group (−0.06; 95% CI, −0.10 to −0.01; P = .01; I² = 0%; very low-certainty evidence).

Among adults, interventions also generally proved effective, despite variations in implementation. A meta-analysis of five studies involving 462 participants (234 intervention, 228 control) showed a slight reduction in body weight (−0.99 kg; 95% CI, −2.15 to 0.18; P = 0.10; I² = 89%).

Three key intervention areas were identified: Nutrition, physical activity, and psychological support including behavioral and cognitive elements. Strict diets were generally not a priority; instead, participants were advised to reduce consumption of high-calorie food and sugary beverages while increasing their intake of vegetables.

Promising Interventions

The study highlighted specific interventions for children and adults:

• Children: 6- to 8-week summer camps with daily physical activities such as sports and crafts, complemented by free, nutritious meals.
• Adults: Daily weight monitoring paired with nutrition counselling based on social cognitive theory. Interventions lasted 4 to 8 weeks, spanning mid-November to early January.

Expert Recommendations

Carlos Cristi-Montero, PhD, a researcher at Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile, and an author of a Chilean intervention study, shared insights with Medscape Spanish edition.

He emphasized the importance of portion control for children. “During the holidays, families prepare calorie-rich dishes but often fail to consider portion sizes,” he noted. “Children are treated like adults, which contributes to excessive caloric intake. Our interventions focused on teaching people about portion control, the caloric content of their meals, and the risks of overweight and obesity, as well as the benefits of healthy eating.”

He also stressed the importance of evaluating not just weight but body composition, using tools like dual-energy x-ray absorptiometry to measure fat and muscle mass.

Cristi-Montero also highlighted the importance of physical activity: “We emphasize the value of exercise and staying active as key strategies to prevent weight gain.”

Steps for Successful Interventions

Educating teachers and parents to reinforce healthy behaviors is also vital, according to Cristi-Montero, as obesity impacts not only metabolic health but also academic performance and mental health.

Both Haby de Sosa and Cristi-Montero agreed that primary care professionals have an important role in driving effective interventions, alongside participation in research to refine prevention strategies. Multidisciplinary teams — including nutritionists, psychologists, exercise specialists, teachers, and parents — can play a part in preventing weight gain during holidays.

Future Directions

The University of Sonora research team is currently conducting a controlled trial in Hermosillo, Mexico, involving adult participants divided into intervention and control groups. Preliminary results, already published online, highlight the effectiveness of strategies such as nutrition education, physical activity, regular weight goals, and psychological support in promoting habit changes.

“Interventions to prevent weight gain during the holidays and summer vacations are necessary,” the authors concluded, emphasizing the need for further research to evaluate their effectiveness in the region.

Haby de Sosa or Cristi-Montero declared no relevant financial conflicts of interest.

This story was translated fromMedscape’s Spanish edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.