A Policy-Based School Intervention to Prevent Overweight and Obesity

Foster, Gary D.; Sherman, Stanley W; Borradaile, Kelley E.; Grundy, Karen M.; Veur, Stephanie S. Vander; Nachmani, Joan; Karpyn, Allison; Kumanyika, Shiriki; Shults, Justine

doi:10.1542/peds.2007-1365

Cited by 399 publications

(425 citation statements)

References 21 publications

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“…6,21 Many studies spanned age groups, including infancy through the preschool ages, 22,29 preschool through school age, 17,25,26,27,30 and school age through adolescence. 6,10,[18][19][20]26,32 Many studies were based on secondary analysis of datasets, including the Pediatric Nutrition Surveillance System (PedNSS; n = 3); National Longitudinal Survey of Youth (NLSY; n = 2), Cambridge Public School Health Surveillance System (n = 2); or others (n = 3). Nine studies analyzed primary data, including five intervention studies randomized at the school level and providing control arm data.…”

Section: Literature Overviewmentioning

confidence: 99%

Childhood Obesity Incidence in the United States: A Systematic Review

et al. 2016

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Background: This systematic review synthesizes the literature on incidence of obesity during childhood. Methods: We searched PubMed, Excerpta Medica database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL), and used the Web of Science tool in June 2015. Studies were included if they were published in English, presented results from primary or secondary analyses, used data about children in the US, provided obesity incidence data on children 0 to 18 years born after 1970, and did not pertain to clinically defined populations (disease, medication use, etc.). Author(s), study year, study design, location, sample size, age, and obesity incidence estimates were abstracted.Results: Nineteen studies were included, three of which used nationally representative data. The median study-specific annual obesity incidences among studies using U.S. Centers for Disease Control and Prevention (CDC) growth charts were 4.0%, 3.2%, and 1.8% for preschool (2.0-4.9 years), school aged (5.0-12.9 years), and adolescence (13.0-18.0 years), respectively. This pattern of declining obesity incidence with age was consistent between and within studies.Conclusions: Studies of childhood obesity in the US indicate declining incidence with age. Childhood obesity prevention efforts should be targeted to ages before obesity onset. Longitudinal data and consistent obesity definitions that correlate with long-term morbidity are needed to better characterize the life history of obesity.

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Section: Literature Overviewmentioning

confidence: 99%

Childhood Obesity Incidence in the United States: A Systematic Review

et al. 2016

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“…In contrast, Epstein et al 18 found that with an intervention targeting only television viewing and computer use over a 2-year period, change in BMI z-score was significant only in children from families of low SES. Similarly, Foster et al 26 showed that a multicomponent school-based intervention for 2 years involving older children (mean age 11 years) from low SES, resulted in marked reduction in the prevalence of overweight; odds ratios and 95% confidence interval were 0.65 (0.54-0.79).…”

Section: Discussionmentioning

confidence: 94%

Prevention of overweight in preschool children: results of kindergarten-based interventions

et al. 2009

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Objective: Given the increasing prevalence of pediatric obesity, we evaluated two kindergarten-based strategies for reducing overweight in preschool children in the Haute-Garonne Department in France. Methods: Kindergartens (n ¼ 79) were randomly assigned to one of the two strategies and followed for 2 years. In the first group (Epidémiologie et prévention de l'obésité infantile, EPIPOI-1), parents and teachers received basic information on overweight and health, and children underwent screening to identify those with overweight (body mass index (BMI) X90th percentile) or at risk for overweight (BMI between 75 and 90th percentile), who were then followed up by their physicians. EPIPOI-2 children, in addition, received kindergarten-based education to promote healthy practices related to nutrition, physical activity and sedentary behaviors. Data on control children from non-intervention kindergartens (n ¼ 40) were retrieved from medical records at the Division of School Health. Results: At baseline, groups differed significantly on age and school area (underprivileged/ not). Owing to a significant interaction between school area and group, analyses were stratified by school area. At baseline, groups did not differ on overweight prevalence and BMI z-scores for any school area. After intervention, prevalence of overweight, BMI z-score and change in BMI z-score were significantly lower in intervention groups compared with controls in underprivileged areas. Using multilevel analysis adjusted for potential confounders, a significant effect on overweight prevalence at the end of the study was noted for EPIPOI-1 in underprivileged areas only (odds ratio and 95% confidence interval: 0.18 (0.07-0.51). In nonunderprivileged areas, the gain in BMI z-score was lower in EPIPOI-2 group compared with control and EPIPOI-1. Conclusion: Our results suggest that simple measures involving increasing awareness on overweight and health, and periodic monitoring of weight and height with follow-up care when indicated, could be useful to reduce overweight in young children from underprivileged areas. A reinforced strategy with an education component, in addition, may be indicated in children in non-underprivileged areas.

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“…The majority of prevention programs promoted physical acti vity 4,9,[11][12]14,16,24,[26][27][28][29]38,40,46,50,51,53 and two programs recommended physical activity. 15,55 All the studies included programs that encouraged healthy dietary habits through presentations and didactic materials.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…2 When analyzed individually, the studies included in this review demonstrated positive results from lifestyle changes that reduced television, videogame and computer screentime, [14][15]50 that increased the consumption of fruits and vegetables [14][15] and that reduced the consumption of foods rich in fat. 4,14 These fi ndings reinforce the importance of developing actions and programs to change lifestyles among this age group, since their lifestyles are in formation. The literature documents the benefits of physical activity and of healthy nutrition upon skeletal health (mineral consent and bone density) [34][35][36]55 increased fl exibility and aerobic capacity 6,30,55 and in the inverse relationship with cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Efeito de intervenções sobre o índice de massa corporal em escolares

2012

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OBJECTIVE:To evaluate the effect of intervention programs using nutritional education, physical activity or both on the reduction of body mass index in school-age students. METHODS:The systematic review with meta-analysis included randomized controlled studies available from the following electronic databases for the years 1998 to 2010: PubMed, Lilacs, Embase, Scopus, Web of Science and Cochrane Library. The descriptors were: randomized controlled trial, overweight, obesity, body mass index, child, adolescent, physical activity, nutrition education and Schools. A weighted average was based on the standardized means difference and used a 95% confi dence interval. The inconsistency test was utilized to evaluate the heterogeneity of studies. RESULTS:Initially, 995 studies were identifi ed, of which 23 were included, and 3 meta-analyses were performed. Isolated physical activity interventions did not present a signifi cant reduction in body mass index, with a standardized mean difference of -0.02 (95%CI: -0.08; 0.04). A similar result (n= 3,524) was observed in the isolated interventions of nutritional education, with a standardized mean difference of -0.03 (95%CI: -0.10; 0.04).When the interventions with physical activity and nutritional education were combined, the result of the meta-analysis (n= 9,997) presented a statistically signifi cant effect in the reduction of body mass index in school-age students, with a standardized mean difference: -0.37 (95%CI: -0.63; -0.12). CONCLUSIONS:The interventions that combined physical activity and nutritional education had more positive effects in the reduction of body mass index among school-age students than when they were applied individually.

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A Policy-Based School Intervention to Prevent Overweight and Obesity

Abstract: A multicomponent school-based intervention can be effective in preventing the development of overweight among children in grades 4 through 6 in urban public schools with a high proportion of children eligible for free and reduced-priced school meals.

Cited by 399 publications

References 21 publications

Childhood Obesity Incidence in the United States: A Systematic Review

Childhood Obesity Incidence in the United States: A Systematic Review

Prevention of overweight in preschool children: results of kindergarten-based interventions

Efeito de intervenções sobre o índice de massa corporal em escolares

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