School-Based Obesity Prevention Programs: An Evidence-Based Review.”

Vanderbilt Center for Evidence-based Medicine, Nashville, Tennessee, USA.
Obesity (Impact Factor: 3.73). 05/2008; 16(5):1009-18. DOI: 10.1038/oby.2008.29
Source: PubMed


This review seeks to examine the effectiveness of school-based programs for reducing childhood overweight or obesity.
A systematic review of the research literature published since 1990 was conducted to identify experimental or quasi-experimental school-based curricular or environmental preventive interventions, with evaluation>or=6 months after baseline, which reported outcomes in terms of a measure of overweight.
Fourteen studies were identified, including one involving a nutrition-only program, two physical activity promotion interventions and eleven studies combining nutrition and physical activity components. Most studies (n=10) offered weak (grade 2) quality evidence. One study offered strong (grade 4) evidence reducing the odds ratio for overweight in girls only, while four grade 2 studies reported significant improvements in BMI or at-risk-for overweight or overweight prevalence in boys, girls, or both. Twelve studies reported significant improvement in at least one measure of dietary intake, physical activity, and/or sedentary behavior.
Our ability to draw strong conclusions as to the efficacy of school-based obesity prevention programs is limited by the small number of published studies and by methodological concerns. Qualitative analysis suggests programs grounded in social learning may be more appropriate for girls, while structural and environmental interventions enabling physical activity may be more effective for boys. High-quality evaluation protocols should be considered essential components of future programs.

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    • "Approaches involving parents showed positive results regarding measures of obesity. Kropski et al., 2008 17 14 Only four of the 14 studies were rated as high quality. Methodological concerns and the small number of publications limits the formulation of inferences about the effectiveness of school interventions. "
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    ABSTRACT: Objective: To organize the main findings and list the most frequent recommendations from systematic reviews of interventions developed at the school environment aimed at reducing excess weight in children and adolescents. Data source: Searches for systematic reviews available until December 31, 2014 were conducted in five electronic databases: Cochrane, PubMed, SciELO, SPORTDiscus, and Web of Science. Manual search for cross-references were also performed. Summary of the findings: Of the initial 2139 references, 33 systematic reviews adequately met the inclusion criteria and were included in the descriptive summary. In this set, interventions with periods of time greater than six months in duration (nine reviews), and parental involvement in the content and/or planned actions (six reviews) were identified as the most frequent and effective recommendations. Additionally, it was observed that boys respond more effectively to structural interventions, whereas girls respond to behavioral interventions. None of the included reviews was able to make inferences about the theoretical basis used in interventions as, apparently, those in charge of the interventions disregarded this component in their preparation. Conclusions: Although the summary identified evidence with important applications in terms of public health, there are still gaps to be filled in this field of knowledge, such as the effectiveness of different theoretical models, the identification of the best strategies in relation to gender and age of participants and, finally, the identification of moderating variables to maximize the benefits provided by the interventions.
    Jornal de pediatria 10/2015; DOI:10.1016/j.jped.2015.06.005 · 1.19 Impact Factor
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    • "For this reason, different governments and the WHO promote overweight and obesity prevention programmes during childhood and adolescence, when it is easier to modify lifestyles compared with adulthood. Such programmes usually suggest strategies to favour a correct diet and adequate exercise (Kropski et al. 2008; Erdol et al. 2014). Generally, these programmes aimed at children do not have a more correct body perception among their aims. "
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    ABSTRACT: Background Body perception has been mainly studied in adolescents and adults in relation to eating disorders and obesity because such conditions are usually associated with distortion in the perception of body size. The development of body perception in children was rather neglected despite the relevance of this issue in understanding the aetiology of health eating problems. The main aim of this study was to investigate body weight and body height perception in children by gender, age and body mass index (BMI), taking into account differences among underweight, healthy weight, overweight and obese children.MethodsA school-based sample of 572 Italian children (49% boys) aged 6–10 were involved in a cross-sectional survey. Current weight and height were measured by standard protocols, and BMI was calculated and converted in centile categories using the Italian growth curves for children. Perceived weight and height were assessed using visual methods (figures representing children of different weight and height).ResultsAbout a third of the children do not show to have an accurate perception of their weight and height (weight: 36%; height: 32%): as for weight, an error of underestimation prevails and as for height, an error of overestimation prevails. In general, children who have different weight and height from the average tend to perceive their physical characteristics closer to average. However, overweight children underestimate their weight much more than obese children.Conclusions Distortions in the perception of their physical features, weight and height, appear to be related to the aesthetic models of Western culture. The tendency to underestimate weight, particularly in overweight children, has implications in interventions for health promotion and healthy lifestyle in school-aged children.
    Child Care Health and Development 12/2014; DOI:10.1111/cch.12216 · 1.69 Impact Factor
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    • "Schools with very physically active children may be more apt to participate in the interventions, which may result in an upward bias in the results. In contrast, other schools may try to compensate for inactivity among children, thus resulting in a downward bias of the results (Kropski et al., 2008). Another serious problem is the potential influence of an omitted variable that may spuriously arise if randomisation is imperfect. "

    10/2014; 2(1). DOI:10.5617/njhe.603
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