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Systematic review of school‐based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: an update to the obesity guidance produced by the National Institute for Health and Clinical Excellence
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Summary: To determine the effectiveness of school‐based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity. MEDLINE and EMBASE were searched (January 2006 to September 2007) for controlled trials of school‐based lifestyle interventions, minimum duration of 12 weeks, reporting weight outcome. Thirty‐eight studies were included; 15 new studies and 23 studies included within the National Institute for Health and Clinical Excellence obesity guidance. One of three diet studies, five of 15 physical activity studies and nine of 20 combined diet and physical activity studies demonstrated significant and positive differences between intervention and control for body mass index. There is insufficient evidence to assess the effectiveness of dietary interventions or diet vs. physical activity interventions. School‐based physical activity interventions may help children maintain a healthy weight but the results are inconsistent and short‐term. Physical activity interventions may be more successful in younger children and in girls. Studies were heterogeneous, making it difficult to generalize about what interventions are effective. The findings are inconsistent, but overall suggest that combined diet and physical activity school‐based interventions may help prevent children becoming overweight in the long term. Physical activity interventions, particularly in girls in primary schools, may help to prevent these children from becoming overweight in the short term.
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In a systematic review of school-based randomized policy interventions to reduce adiposity, 2 of 3 trials evaluating dietary policies demonstrated stabilization of BMI z score or overweight/obesity in the intervention groups compared with continued increases in these measures in controls.
“In a systematic review of school-based randomized policy interventions to reduce adiposity, 2 of 3 trials evaluating dietary policies demonstrated stabilization of BMI z score or overweight/obesity in the intervention groups compared with continued increases in these measures in controls.225”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
One systematic review identified 20 RCTs of school-based programs targeting both dietary and physical activity behaviors with interventions of at least 12 weeks' duration, conducted in ages ranging from kindergarten through high school; about half (9 of 20) demonstrated significant improvements in BMI z score.
“One systematic review identified 20 such RCTs with interventions of at least 12 weeks’ duration, conducted in ages ranging from kindergarten through high school.225 Overall, about half (9 of 20) studies demonstrated significant improvements in BMI z score following a school-based program targeting both dietary and physical activity behaviors.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
In one trial, an additional 2 hours per week of usual PE class reduced BMI z score at 6 months, but this improvement was not sustained over longer periods.
“For example, in 1 trial, an additional 2 hours per week of usual PE class reduced BMI z score at 6 months, but this improvement was not sustained over longer periods.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
Across individual studies, effects on BMI tended to be stronger in girls than in boys and during the first several months of the intervention, with declining success thereafter.
“Across individual studies, effects tended to be stronger in girls than in boys and during the first several months of the intervention (eg, up to 6 months), with declining success thereafter.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
In these trials, the overall duration of the intervention phase (ranging from 12 weeks to 1 school year) did not appear to be related to success.
“In these trials, the overall duration of the intervention phase (ranging from 12 weeks to 1 school year) did not appear to be related to success.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
In a recent systematic review, only 5 of 15 controlled trials showed improvements in BMI.
“In a recent systematic review, only 5 of 15 controlled trials showed improvements in BMI.225”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
In controlled trials, multicomponent interventions focused on improving physical education in schools often increase the amount and/or intensity of physical activity during school hours.
“In controlled trials, such multicomponent interventions often increase the amount and/or intensity of physical activity during school hours.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [225]
Local health organizations have to compete for schools' attention, leading to a supply-driven approach that can irritate schools due to an abundance of initiatives that do not match their needs.
“Local health organizations have to compete for the attention of schools to make them realize the importance of health promotion and its implementation. This leads to a supply-driven approach, which can irritate schools due to the abundance of initiatives offered to them that do not really match their needs [11].”
From The Healthy Primary School of the Future: A Contextual Action-Oriented Research Approach (2018) · cites this paper as [11]
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Metadata
- Authors
- Brown, T., & Summerbell, C.
- Affiliations
- Teesside University (GB)
- Durham University (GB)
- Corresponding author
- Summerbell, C.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2008-12-23
- Volume
- 10
- Issue
- 1
- Pages
- 110-141
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2161003563
- Cited by
- 697
- References
- 61
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 10 · 2023: 7 · 2022: 26 · 2021: 26 · 2020: 47 · 2019: 34 · 2018: 36 · 2017: 53 · 2016: 60 · 2015: 70 · 2014: 73 · 2013: 64 · 2012: 68
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Durham Research Online (Durham University) (acceptedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- Funders
- Economic and Social Research Council (ES/G007470/1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- childhood obesity prevention, school-based intervention, dietary intake, physical activity, lifestyle intervention, body mass index, overweight, elementary school students, sex differences, intervention effectiveness
- MeSH terms
- Age Factors, Child, Diet, Environment, Health Education, Humans, Obesity, Schools, Sex Factors, Socioeconomic Factors, Students, Health Behavior, Exercise, Process Assessment, Health Care, Controlled Clinical Trials as Topic
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