Effectiveness of a population‐scaled, school‐based physical activity intervention for the prevention of childhood obesity

Abstract

ObjectiveThe aim of this study was to examine the effectiveness of a real‐world, population‐scaled, school‐based physical activity (PA) intervention that provided two to three additional physical education lessons per week to children aged 6 to 14 years in Slovenia.MethodsMore than 34,000 participants from over 200 schools were compared with a similar number of nonparticipants from the same schools. Generalized estimating equations were used to estimate the effects of differing levels of exposure to the intervention (i.e., from 1–5 years) on BMI in children with normal weight, overweight, or obesity at baseline.ResultsBMI was lower in the intervention group, irrespective of participation duration or baseline weight status. The difference in BMI increased with the program duration, with maximal effects being seen after 3 to 4 years of participation, and was consistently larger for children with obesity (peaking at 1.4 kg/m2 [95% CI: 1.0–1.9] for girls with obesity and peaking at 0.9 kg/m2 [95% CI: 0.6–1.3] for boys with obesity). The program started to become effective at reversing obesity after 3 years, whereas the lowest numbers needed to treat (NNTs) were observed after 5 years (NNTs = 17 for girls and 12 for boys).ConclusionsThe population‐scaled, school‐based PA intervention was effective in preventing and treating obesity. The effects were the greatest in children initially presenting with obesity, such that the program was able to benefit children needing support the most.

Physical fitness among children with diverse weight status during and after the COVID-19 pandemic: a population-wide, cohort study based on the Slovenian physical fitness surveillance system (SLOfit)

“…The impact of COVID-19 measures on children’s physical activity was global, but Slovenia might have been more affected by the COVID-19 measures (especially school closures) than most other countries as they do not have so many physical activity initiatives implemented through the school system. Our recent analysis of a scaled-up physical activity intervention showed that the Slovenian advantage in terms of maintaining and improving the physical fitness of children lies in the educational setting, 49 and demonstrates that Slovenia has the knowledge and experience needed to combat the current situation. Results of this study were already presented in front of the Slovenian parliament which decided to prepare the grounds for the re-launch of a nationwide physical activity programme in schools (i.e., Healthy Lifestyle Intervention ), which still did not happen.…”

“…Promoting physical activity and healthy habits in children can be challenging, but there are a variety of strategies that can be used to encourage children to engage in physical activity and maintain healthy lifestyles. These include promoting active transportation, such as walking or biking to school, 50 providing opportunities for structured physical activity during the school day, 49 , 51 and providing access to safe and affordable recreational facilities. 52 Additionally, educating parents and caregivers about the importance of physical activity and healthy lifestyles can help to promote healthy habits in children from an early age.…”

Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

“…Slovenia was successful in achieving economic recovery and has become an integrated part of the Western European market. 64 After the transition period that Slovenia was experiencing the trends were in part reversed in the 2010s with an effective school-based national physical activity programme "Healthy Lifestyle", 65 and an aggressive media campaign about proper diet and media consumption. Therefore, as Slovenia has been facing negative lifestyle changes in recent decades, it seems that implementing several nationwide initiatives and curriculum updates, especially within the educational system, could have led to the improvements in fitness witnessed during the 2010s in this study and earlier studies from Slovenia.…”

Challenges of social change: The 2021 Republic of Slovenia report card on physical activity of children and adolescents

“…By launching a free-for-use, multi-lingual, online child fitness portal based on updated reference values, 35 there is concerted efforts being made to close the gap in terms of child fitness standardisation, accessibility and monitoring worldwide (available online here: fitbackeurope.eu/en-us/). Establishing long-duration, population-scaled PA intervention studies can reverse negative health trends (like obesity), 36 but this must come with a willingness to invest in future health outcomes now. Maintaining childhood fitness will become increasingly important in an ever-changing world, especially as global warming, 32 conflict, and rapid changes in technology continue to push societies in continuous and unexpected ways.…”