This large, rigorously conducted cluster RCT in 10-year-old children supports the notion that there is still inadequate evidence to conclude that increased physical activity in school enhances academic achievement in all children. Still, combining physical activity and learning seems a viable model to stimulate learning in those academically weakest schoolchildren.

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BackgroundAlthough school-based interventions to promote physical activity in adolescents have been suggested in several recent reviews, questions have been raised regarding the effects of the strategies and the methodology applied and for whom the interventions are effective. The aim of the present study was to investigate effects of a school-based intervention program: the HEalth in Adolescents (HEIA) study, on change in physical activity, and furthermore, to explore whether potential effects varied by gender, weight status, initial physical activity level and parental education level.MethodsThis was a cluster randomized controlled 20 month intervention study which included 700 11-year-olds. Main outcome-variable was mean count per minute (cpm) derived from ActiGraph accelerometers (Model 7164/GT1M). Weight and height were measured objectively. Adolescents reported their pubertal status in a questionnaire and parents reported their education level on the consent form. Linear mixed models were used to test intervention effects and to account for the clustering effect of sampling by school.ResultsThe present study showed an intervention effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group (95% CI −0.4, 100). Subgroup analyses showed that the effect appeared to be more profound among girls (Est 65 cpm, CI 5, 124, p = 0.03) and among participants in the low-activity group (Est 92 cpm, CI 41, 142, p < 0.001), as compared to boys and participants in the high-activity group, respectively. Furthermore, the intervention affected physical activity among the normal weight group more positively than among the overweight, and participants with parents having 13–16 years of education more positively than participants with parents having either a lower or higher number of years of education. The intervention seemed to succeed in reducing time spent sedentary among girls but not among boys.ConclusionsA comprehensive but feasible, multi-component school-based intervention can affect physical activity patterns in adolescents by increasing overall physical activity. This intervention effect seemed to be more profound in girls than boys, low-active adolescents compared to high-active adolescents, participants with normal weight compared to the overweight, and for participants with parents of middle education level as opposed to those with high and low education levels, respectively. An implementation of the HEIA intervention components in the school system may have a beneficial effect on public health by increasing overall physical activity among adolescents and possibly among girls and low-active adolescents in particular.

The HEIA study represents a theoretically informed randomised trial comprising a comprehensive set of multilevel intervention components with a thorough evaluation using reliable outcome measures. The study will contribute to a better understanding of determinants of healthy weight development among young people and how such determinants can be modified.

BackgroundSchool-based interventions that target prevention of overweight and obesity in children have been tested with mixed results. Thus, successful interventions are still called for. The aim of the present study was to investigate effects of a multicomponent school-based intervention programme targeting physical activity, sedentary and dietary behaviours on anthropometric outcomes.MethodsA 20-month intervention was evaluated in a cluster randomised, controlled study of 1324 11-year-olds. Outcome variables were body mass index (BMI), BMI-for-age z-score (BMIz), waist circumference (WC), waist-to-height ratio (WTHR) and weight status (International Obesity Task Force's cut-offs). Weight, height and WC were measured objectively; pubertal status was self-reported and parental education was self-reported by the parents. Intervention effects were determined by one-way analysis of covariance and logistic regression, after checking for clustering effects of school, and moderating effects of gender, pubertal status and parental education.ResultsBeneficial effects were found for BMI (p=0.02) and BMIz (p=0.003) in girls, but not in boys. While a beneficial effect was found for BMI (p=0.03) in participants of parents reporting a high level of education, a negative effect was found for WTHR in participants with parents reporting a low level of education (p=0.003). There were no intervention effects for WC and weight status.ConclusionsA multicomponent 20-month school-based intervention had a beneficial effect on BMI and BMIz in adolescent girls, but not in boys. Furthermore, children of higher educated parents seemed to benefit more from the intervention, and this needs attention in future interventions to avoid further increase in social inequalities in overweight and obesity.

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OBJECTIVE -The aim was to assess the net effects on risk factors for type 2 diabetes and cardiovascular disease of a community-based 3-year intervention to increase physical activity. RESEARCH DESIGN AND METHODS-A pseudo-experimental cohort design was used to compare changes in risk factors from an intervention and a control district with similar socioeconomic status in Oslo, Norway, using a baseline investigation of 2,950 30-to 67-year-old participants and a follow-up investigation of 1,776 (67% of those eligible, 56% women, 18% non-Western immigrants) participants. A set of theory-based activities to promote physical activity were implemented and tailored toward groups with different psychosocial readiness for change. All results reported are net changes (the difference between changes in the intervention and control districts). At both surveys, the nonfasting serum levels of lipids and glucose were adjusted for time since last meal.RESULTS -The increase in physical activity measured by two self-reported questionnaires was 9.5% (P ϭ 0.008) and 8.1% (P ϭ 0.02), respectively. The proportion who increased their body mass was 14.2% lower in the intervention district (P Ͻ 0.001), implying a 50% relative reduction compared with the control district, and was lower across subgroups. Beneficial effects were seen for triglyceride levels (0.16 mmol/l [95% CI 0.06 -0.25], P ϭ 0.002), cholesterolto-HDL cholesterol ratio (0.12 [0.03-0.20], P ϭ 0.007), systolic blood pressure (3.6 mmHg [2.2-4.8], P Ͻ 0.001), and for men also in glucose levels (0.35 mmol/l [0.03-0.67], P ϭ 0.03). The net proportion who were quitting smoking was 2.9% (0.1-5.7, P ϭ 0.043).CONCLUSIONS -Through a theory-driven, low-cost, population-based intervention program, we observed an increase in physical activity levels, reduced weight gain, and beneficial changes in other risk factors for type 2 diabetes and cardiovascular disease. Diabetes Care 29:1605-1612, 2006P hysical inactivity is an important risk factor for type 2 diabetes (1,2). Clinical trials (3,4) in high-risk individuals have demonstrated the importance of healthy lifestyle programs to prevent diabetes but are rather expensive and not likely to have much impact on the total burden of disease (5,6). Therefore, community-based strategies are urgently needed to stem the worldwide epidemic of obesity and type 2 diabetes, especially in low-income communities (6). Such strategies have a considerable potential effect on public health if they manage to reduce modifiable risk factors even to a small degree in a large proportion of the population.Disappointing results in previous community-based research on cardiovascular risk factors may be due to methodological weaknesses in the theoretical framework, the intervention itself, the assessment of outcomes, and beneficial secular trends for the risk factors addressed (7-10). The development of theories and models has enhanced our understanding of the processes underlying behavioral changes. A broad set of factors influencing behavior has been identified ...