Three-Year Follow-Up of the POIBA Intervention on Childhood Obesity: A Quasi-Experimental Study

Abstract

Childhood obesity has increased worldwide over the past four decades. This quasi-experimental study aimed to assess the effectiveness of a multicomponent and multilevel school-based intervention (POIBA) at 3 years of follow-up. The nutrition intervention focused on food groups, food pyramid, nutrients, portions, and balanced menus. In total, 3624 children participated in the study. Anthropometric measurements and information on food frequency and behavior, physical activity, and daily screen use were collected in the intervention (IG) and comparison group (CG). Positive unadjusted changes toward adherence to recommendations were found for water, meat, sweets, and fried potato consumption, proper breakfast, not having dinner in front of the TV, out-of-school physical activity, and daily screen use. Three scores were used to calculate the proportion of children making more than one change to improve healthy habits regarding physical activity (global Activity score), nutrition (global Nutrition score), and both (global score). Students exposed to the intervention had a significantly better global Activity score (16.2% IG vs. 11.9% CG; p = 0.012) and Global score (63.9% IG vs. 58.5% CG; p = 0.025). Intervention effects on obesity incidence at 3-year follow-up lost significance but maintained the positive trend. In conclusion, school-based interventions including a family component could be useful to address the childhood obesity problem.

Lifestyle Risk Factors and the Population Attributable Fractions for Overweight and Obesity in Chinese Students of Zhejiang Province

“…Overall, the prevalence of obesity/overweight was higher in males than that in females in this study, which was similar to what was found in other populations ( 27 , 28 ). Our findings were also consistent with previous studies, which showed that unhealthy lifestyle behaviors, including poor oral hygiene ( 13 ), irregular breakfast habits ( 18 ), alcohol use ( 29 ), excessive TV time ( 12 , 18 , 30 ), and insufficient sleep time ( 11 , 31 ) were associated with obesity in students ( 18 ). The mechanism why skipping breakfast would cause obesity may be related to the greater thermogenesis, which was found in those having breakfast regularly ( 32 ).…”

Nutrition, Physical Activity, and New Technology Programs on Obesity Prevention in Primary Education: A Systematic Review

“…Xu et al [ 55 ] did not find improvements in dietary diversity and the variety of foods in general (effect = 0) but did find improvements in the variety of foods consumed at breakfast (effect = 0.1) and in an increase of the consumption of cereals and fruit (effect 1.4). Finally, Sánchez-Martínez et al [ 56 ] found non-significant positive changes in the consumption of water, meat, sweets and chips, but did not find significant differences in the global nutrition score between the experimental group (44.3%) and the control group (41.1%).…”

“…Wadolowska et al [ 52 ] observed that the probability of adherence to the WHO recommendation on PA was significantly higher at 74%, although they also found a decrease in PA in the experimental group. Finally, Sánchez-Martínez et al [ 56 ] found a non-significant increase in PA outside school and a significant difference in the global activity score between the experimental group and the control group. On the other hand, Silva et al [ 48 ] and Mack et al [ 54 ] did not find significant differences in terms of total daily PA.…”

“…Wadolowska et al [ 52 ] observed a greater decrease in z-WHtR and waist circumference z. Finally, Sánchez-Martínez et al [ 56 ] found no differences in BMI between groups.…”

“…Regarding the improvements found in knowledge about food and food intake, these could be due to the use of the nutrition-education approach in the tasks carried out in the programmes [ 56 ], or to the appropriate duration of the intervention programme [ 43 ]. In the case of Burke et al [ 46 ], this improvement was higher in the first two years than in the third.…”