Effect of school-based physical activity interventions on body mass index in children: a meta-analysis
Open accessAbstract
BACKGROUND: The prevalence of childhood obesity is increasing at an alarming rate. Many local governments have enacted policies to increase physical activity in schools as a way to combat childhood obesity. We conducted a systematic review and meta-analysis to determine the effect of school-based physical activity interventions on body mass index (BMI) in children. METHODS: We searched MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials up to September 2008. We also hand-searched relevant journals and article reference lists. We included randomized controlled trials and controlled clinical trials that had objective data for BMI from before and after the intervention, that involved school-based physical activity interventions and that lasted for a minimum of 6 months. RESULTS: Of 398 potentially relevant articles that we identified, 18 studies involving 18 141 children met the inclusion criteria. The participants were primarily elementary school children. The study duration ranged from 6 months to 3 years. In 15 of these 18 studies, there was some type of co-intervention. Meta-analysis showed that BMI did not improve with physical activity interventions (weighted mean difference -0.05 kg/m(2), 95% confidence interval -0.19 to 0.10). We found no consistent changes in other measures of body composition. INTERPRETATION: School-based physical activity interventions did not improve BMI, although they had other beneficial health effects. Current population-based policies that mandate increased physical activity in schools are unlikely to have a significant effect on the increasing prevalence of childhood obesity.
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Cawley 2007, Gonzalez-Suarez 2009, and Harris 2009 found that increased MVPA in children and adolescents does not necessarily translate into reduced BMI.
“Others have found that while children and adolescents can experience increased levels of MVPA, this does not necessarily translate into reduced BMI (Cawley 2007;Gonzalez-Suarez 2009;Harris 2009).”
From School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18 (2013) · cites this paper as Harris 2009
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 [259]
Another systematic review and meta-analysis found no significant pooled effect on BMI of 18 school-based physical activity trials including a total of >18,000 children and with durations ranging from 6 months to 3 years.
“Another systematic review and meta-analysis found no significant pooled effect on BMI of 18 school-based physical activity trials including a total of >18,000 children and with durations ranging from 6 months to 3 years.259”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [259]
Findings have been more mixed for objectively measured total physical activity, fitness, and inactivity-related risk factors in school-based physical activity interventions.
“Findings have been more mixed for objectively measured total physical activity, fitness, and inactivity-related risk factors.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [259]
In 10 trials, only 3 of 18 body composition measures demonstrated significant improvements after the physical activity intervention, 1 measure demonstrated deterioration, and 14 measures did not show any significant change.
“18 measures demonstrated significant improvements after the physical activity intervention, 1 measure demonstrated deterioration, and 14 measures did not show any significant change.259”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [259]
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- Authors
- Harris, K. C., Kuramoto, L. K., Schulzer, M., & Retallack, J. E.
- Affiliations
- BC Children's Hospital (CA)
- CMJ University (IN)
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Joule Inc.
- Published
- 2009-03-31
- Volume
- 180
- Issue
- 7
- Pages
- 719-726
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC2659836
- OpenAlex
- W2127529148
- Cited by
- 497
- References
- 88
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 10 · 2023: 8 · 2022: 16 · 2021: 20 · 2020: 27 · 2019: 27 · 2018: 29 · 2017: 26 · 2016: 53 · 2015: 40 · 2014: 47 · 2013: 47 · 2012: 51
- FWCI
- 6.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- BC Children's Hospital
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- school-based physical activity intervention, childhood obesity, body mass index, children, body composition, school physical activity policy, co-interventions
- MeSH terms
- Adolescent, Body Composition, Child, Diet, Female, Health Education, Humans, Male, Obesity, Physical Education and Training, Physical Fitness, Risk Factors, School Health Services, Sensitivity and Specificity, Body Mass Index, Randomized Controlled Trials as Topic
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