Research articleSchool-Based Interventions on Childhood Obesity: A Meta-Analysis
Section snippets
Background
Childhood obesity has been recognized as an increasing health problem worldwide over the past decade. In the U.S., the prevalence of overweight children aged 5–14 years rose from 15% in 1973 to 32% in 1994, while that of obesity increased from 5% in 1973 to 22% in 1994.1 Similar increases have been reported in countries such as the United Kingdom, Germany, Australia, and China.2, 3, 4, 5
Childhood obesity has been associated with diseases in childhood such as asthma, early-onset diabetes
Participants
The review considered schoolchildren of any nationality who were of normal BMI, overweight or obese, and in pre-adolescent and adolescent phases, with fatness classified by an age- and gender-specific cutoff point system developed by the International Obesity Task Force or by country-specific norms. Children of normal BMI were included in the study because the study investigated both the prevention and treatment of overweight and obesity.
Intervention
The interventions that were considered for inclusion in
Results
The search identified 41 papers based on their title for possible inclusion in the review, of which 19 papers were included in the meta-analysis (Figure 1).
Prevalence of Overweight and Obesity
Figure 2 shows the forest plot of the comparison of intervention and control arms in decreasing the number of participants who were overweight and obese. The odds of participants being overweight and obese in the combined intervention arms compared with the combined comparison arms were significantly protective (OR=0.74, 95% CI=0.60, 0.92). This highlights that the intervention arm was more effective in decreasing the number of participants who become overweight or obese. In analyzing the
Discussion
This meta-analysis provided sound evidence to support schools as favorable settings for obesity prevention in children. Although the Katz et al. study19 was the most recent comparable meta-analysis, Table 3 outlines the differences between the two meta-analyses. The current meta-analysis is more comprehensive in terms of recency and number of studies, number of outcome measures included, as well as coverage of both short- and long-term effects.
This meta-analysis found that school-based
Conclusion
This meta-analysis showed that long-running school-based interventions were effective in preventing childhood overweight and obesity. It found that combined interventions of physical activity and classroom curriculum were effective in preventing childhood overweight and obesity. The duration of the intervention was positively associated with its effectiveness. Given these results, school principals and policymakers should consider implementing school-based interventions as long-term strategies
References (61)
- et al.
Change in the prevalence of overweight and obesity among young Australians, 1969–1997
Am J Clin Nutr
(2003) - et al.
Associations between blood pressure and overweight defined by new standards for body mass index in childhood
Prev Med
(2004) - et al.
A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: a realistic synthesis of the evidence
Public Health
(2007) - et al.
Stage based interventions for low fat diet with middle school students
J Pediatr Nurs
(2003) - et al.
Pathways: a school based randomized controlled trial for the prevention of obesity in American Indian schoolchildren
Am J Clin Nutr
(2003) - et al.
New Moves: a school based obesity prevention program for adolescent girls
Prev Med
(2003) - et al.
Effects of school based intervention to reduce cardiovascular disease risk factors in elementary school children: the Cardiovascular Health in Children (CHIC) study
J Pediatr
(1996) - et al.
Secular increases in the relative weight and adiposity among children over two decades: the Bogalusa Heart Study
Pediatrics
(1997) - et al.
Prevalence and trends in overweight and obesity in three cross sectional studies in British children, 1974–1994
Br Med J
(2001) - et al.
Body mass index in 7–9 year old French children: frequency of obesity, overweight and thinness
Int J Obes
(2000)