Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study

Abstract

Design-Non-randomised non-blinded school-based intervention study.Setting-Two schools in the cities of Pune and Nasik, India. Participants-The intervention group comprised children attending one Pune school from 7-10 years until 12-15 years of age. Two controls groups comprised (1) children of the same age attending a similar school in Nasik, and (2) children in the Pune intervention school but aged 12-15 years at the start of the study. Europe PMC Funders GroupIntervention-A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extra-and intra-curricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a 'scoring' subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families.Main outcome measures-Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing).Results-After five years the intervention children were fitter than controls in running, longjump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing, and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004).Conclusions-It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity.

School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review

“…The studies revealed the main outcomes, including: BMI (kg/m 2 ), waist circumference, skinfold and body fat percentage related to obesity parameters [40][41][42][43][45][46][47][49][50][51][52][53]56], the level of PA [45,[48][49][50][51][52]54,55,57,58] and various variables related to PF components [42,49,[52][53][54]56] during school years. Measurements of MVPA recommended in these studies were interpreted by measuring with the survey method in some studies [40,50,57] and by way of pedometer or accelerometer in some others [44,45,[47][48][49]51,52,54,55,58].…”

“…In the studies where BMI (kg/m 2 ) measurements were reported, it was found that body mass index was measured by taking height and weight measurements with standard tools. Three studies were also interpreted by measuring waist circumference [42,46,56]. Skinfold measurements were also performed in three studies [49,50,57].…”

“…Skinfold measurements were also performed in three studies [49,50,57]. In these studies, results regarding variables such as aerobic endurance, flexibility, muscular strength, muscular endurance, power, and speed which belong to fitness components were stated [42,45,49,[52][53][54]56]. See Table 4 for details.…”

Yoga in school settings: a research review

“…97 Two studies in which yoga practice was a relatively small component of the intervention were also not included. 98,99 The studies in the analyzed publications were conducted mostly in elementary school settings (n = 18), followed by high school (n = 13), middle school (n = 7), and one preschool within an elementary school (n = 1), with the remaining studies examining a combination of grades, primarily elementary and middle school (n = 6 in both elementary and middle school; n = 2 in both middle and high school). Sample sizes (calculated as the total sample of all subjects in all arms completing the intervention) were often small within individual studies, with a median of 74 and a range of 20-660 in the quantitative studies.…”

An evaluation of outdoor school environments to promote physical activity in Delhi, India

“…They found improvements related to physical activity—more intervention schools adopted physical activity policies and student participation in physical training classes increased significantly in intervention compared to control schools [33]. Next, two schools in Pune and Nasik implemented a five-year school-based intervention that consisted of daily yoga, breathing exercises, physical activity lessons taught in school, healthier school meals, and health and nutrition education for teachers, students, and their families [34]. Results from the study showed that children in the intervention group were more fit than controls in running, long jump, sit-up, and push-up tests.…”