A School-Based Comprehensive Intervention for Childhood Obesity in China: A Cluster Randomized Controlled Trial

Liu, Zheng; Li, Qin; Maddison, Ralph; Mhurchú, Cliona Ní; Jiang, Yannan; Wei, Dongmei; Cheng, Lan; Cheng, Yu Ching; Wang, Di

doi:10.1089/chi.2018.0251

Cited by 28 publications

(60 citation statements)

References 29 publications

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“…A total of 21 studies (presented in 34 articles) were found to be eligible for inclusion in this review (see Figure 1). 44–77 Two of the 34 papers reporting two of the included studies required translation 71,74…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of school‐based interventions to prevent obesity among children aged 4 to 12 years old in middle‐income countries: A systematic review and meta‐analysis

et al. 2020

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Summary Economic and accompanying nutrition transition in middle‐income countries is resulting in rapidly increasing childhood obesity prevalence, exceeding acceleration rates in the West. Previous school‐based obesity prevention reviews have mainly included studies from high‐income countries. This review aimed to summarize the evidence from randomized controlled trials evaluating the effectiveness of school‐based interventions in preventing childhood obesity in middle‐income countries. Six electronic databases were searched: MEDLINE, EMBASE, CINAHL Plus, LILACS, IBECS and WPRIM. Eligibility criteria included middle‐income country setting, randomized/cluster‐randomized controlled trials, children aged 4–12 years and school‐based interventions targeting dietary intake and/or physical activity. Twenty‐one cluster‐randomized controlled trials, conducted in Asia (n = 10), South America (n = 4), North America (n = 4) and the Middle East (n = 3), were included. Fifteen studies reported a significant intervention effect on at least one adiposity‐related outcome. Characteristics of effective interventions included combined diet and PA interventions, school teacher‐delivery, duration of >8 months, parental involvement, education sessions and school food modifications. The risk of bias in these trials was mixed. The pooled estimate of the odds ratio for obesity in intervention versus control schools (nine studies) was 0.77; 95% CI, 0.63 to 0.94; p = 0.009. In conclusion, there is some evidence to support school‐based interventions in preventing childhood obesity in middle‐income countries.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of school‐based interventions to prevent obesity among children aged 4 to 12 years old in middle‐income countries: A systematic review and meta‐analysis

et al. 2020

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“…Behavioral interventions include components such as lifestyle modification comprising nutrition education and/or physical activity sessions with students and parents. Food environment interventions include components such as increasing the availability of healthy foods within the school ( 15–22 , 24–29 , 31 ), developing school policies regarding the sale or marketing of food ( 17–19 , 23 , 24 , 28 , 29 ), and promotion of healthy foods or water consumption ( 28 , 29 ). The duration of interventions varied from 3 mo to 3 y.…”

Section: Resultsmentioning

confidence: 99%

Effect of Food Environment Interventions on Anthropometric Outcomes in School-Aged Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Carducci

Keats

et al. 2020

Current Developments in Nutrition

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ABSTRACT Food environments may promote access to unhealthy foods, contributing to noncommunicable diseases in low- and middle- income countries (LMICs). This review assessed published evidence on the effects of food environment interventions on anthropometric (BMI and weight status) outcomes in school-aged children (5–9 y) and adolescents (10–19 y) (SACA) in LMICs. We summarized randomized controlled trials (RCTs) and quasi-experimental studies (QES) published since 2000 to August 2019 in the peer-reviewed and gray literature that assessed the effects of food-related behavioral and environmental interventions on diet-related health outcomes in SACA in LMICs. Electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Library) were searched using appropriate keywords, Medical Subject Headings, and free text terms. Eleven RCTs and 6 QES met the inclusion criteria, testing multicomponent behavioral and environmental interventions in schools. Analysis of 6 RCTs (n = 17,054) suggested an overall effect on change in BMI [mean difference (MD): −0.11, 95% CI: −0.19 , −0.03], whereas there was no observed effect in 5 studies using endline BMI (n = 17,371) (MD: 0.05, 95% CI: −0.32, 0.21). There was no significant pooled effect among the 3 QES (n = 5,023) that reported differences in change in BMI or endline (MD: −0.37, 95% CI: −0.95, 0.22). There is limited evidence to support the modification of diet-related health outcomes through school-based food environment interventions in SACA in LMICs. Further studies are needed to understand the impact of school and community-based food environment interventions on nutritional status in this population.

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“…In addition, setting multiple goals (at least five portions of fruits and vegetables daily consumption, no more than 2 h/day on screen viewing, etc.) and leading peer competitions were adopted to strengthen the cultivation of healthy lifestyles [20].…”

Section: Whole Intervention Core Membersmentioning

confidence: 99%

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

et al. 2020

Nutrients

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This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.

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A School-Based Comprehensive Intervention for Childhood Obesity in China: A Cluster Randomized Controlled Trial

Cited by 28 publications

References 29 publications

Effectiveness of school‐based interventions to prevent obesity among children aged 4 to 12 years old in middle‐income countries: A systematic review and meta‐analysis

Effectiveness of school‐based interventions to prevent obesity among children aged 4 to 12 years old in middle‐income countries: A systematic review and meta‐analysis

Effect of Food Environment Interventions on Anthropometric Outcomes in School-Aged Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

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