Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis

Abstract

Objective: To determine the effectiveness of school-based strategies for obesity prevention and control using methods of systematic review and meta-analysis. Methods: Peer-reviewed studies published between 1966 and October 2004 were considered for review. Studies meeting eligibility criteria were published in English, targeted children aged 3-18 in a school setting, reported weight-related outcomes, included a control measurement and had at least a 6-month follow-up period. Studies employed interventions related to nutrition, physical activity, reduction in television viewing or combinations thereof. Weight related data were analyzed using RevMan software. Results: Sixty-four studies were considered for inclusion. Fourteen did not meet inclusion criteria; 29 were excluded due to poor methodological quality. Twenty-one papers describing 19 studies were included in the systematic review and 8 of these were included in the meta-analysis. Nutrition and physical activity interventions resulted in significant reductions in body weight compared with control ((standardized mean difference, SMD ¼ À0.29, 95% confidence interval (CI) ¼ À0.45 to À0.14), random effects model). Parental or family involvement of nutrition and physical activity interventions also induced weight reduction ((SMD ¼ À0.20, 95%CI ¼ À0.41 to 0.00), random effects model). Conclusion: Combination nutrition and physical activity interventions are effective at achieving weight reduction in school settings. Several promising strategies for addressing obesity in the school setting are suggested, and warrant replication and further testing.

Effectiveness of lifestyle intervention in overweight children

“…with controls (41,42) : Interventions resulted in significant reductions of -0 . 29 SDS-BMI (95 % CI -0 .…”

“…Accordingly, short-term in-patient interventions over 2-8 weeks are very unlikely to offer long-term success (20,(45)(46)(47) . The successful interventions required periods of 6-12 months (26,41,42) . However, there are no studies analysing the relationship between the duration of interventions and long-term outcomes.…”

Impact of Yoga on Exercise and Blood Pressure in Adolescents

“…However, conclusions regarding efficacy of schoolbased obesity prevention programs are limited [9]. Although some school-based interventions have reported effects on overweight or obesity [10][11][12], most, particularly those involving large cohorts [13,14], have not [15], and several short-term, school-based programs had little effect on BMI [16,17]. Schoolbased prevention programs have been shown to be feasible, acceptable, and desirable for improving students' health status [18], and improving school-related behavior [19].…”

Efeito de intervenções sobre o índice de massa corporal em escolares

“…13,31 The 23 studies included in the meta-analysis have limitations, since the majority were performed with a small sample and were considered of low quality by the Jadad scale because they did not describe the allocation randomization procedure, blinding, losses and exclusions. This implies a need for more well-designed randomized controlled clinical studies.…”