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A Policy-Based School Intervention to Prevent Overweight and Obesity
Abstract
BACKGROUND. The prevalence and seriousness of childhood obesity has prompted calls for broad public health solutions that reach beyond clinic settings. Schools are ideal settings for population-based interventions to address obesity. OBJECTIVE. The purpose of this work was to examine the effects of a multicomponent, School Nutrition Policy Initiative on the prevention of overweight (85.0th to 94.9th percentile) and obesity (>95.0th percentile) among children in grades 4 through 6 over a 2-year period. METHODS. Participants were 1349 students in grades 4 through 6 from 10 schools in a US city in the Mid-Atlantic region with ≥50% of students eligible for free or reduced-price meals. Schools were matched on school size and type of food service and randomly assigned to intervention or control. Students were assessed at baseline and again after 2 years. The School Nutrition Policy Initiative included the following components: school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach. RESULTS. The incidences of overweight and obesity after 2 years were primary outcomes. The prevalence and remission of overweight and obesity, BMI z score, total energy and fat intake, fruit and vegetable consumption, body dissatisfaction, and hours of activity and inactivity were secondary outcomes. The intervention resulted in a 50% reduction in the incidence of overweight. Significantly fewer children in the intervention schools (7.5%) than in the control schools (14.9%) became overweight after 2 years. The prevalence of overweight was lower in the intervention schools. No differences were observed in the incidence or prevalence of obesity or in the remission of overweight or obesity at 2 years. CONCLUSION. A multicomponent school-based intervention can be effective in preventing the development of overweight among children in grades 4 through 6 in urban public schools with a high proportion of children eligible for free and reduced-priced school meals.
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“Another cluster-randomized trial in 10 US schools evaluated a comprehensive educational initiative that included school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach.238 After 2 years, the intervention lowered the incidence of overweight by 50% (7.5% versus 14.9%).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [238]
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Metadata
- Authors
- Foster, G. D., Sherman, S., Borradaile, K. E., Grundy, K. M., Vander Veur, S. S., Nachmani, J., Karpyn, A., Kumanyika, S., & Shults, J.
- Affiliations
- Temple University (US)
- The Food Trust (US)
- Bryn Mawr College (US)
- Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania
- School District of Philadelphia (US)
- University of Pennsylvania (US)
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2008-04-01
- Volume
- 121
- Issue
- 4
- Pages
- e794-e802
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2167662032
- Cited by
- 496
- References
- 34
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 9 · 2023: 14 · 2022: 16 · 2021: 36 · 2020: 14 · 2019: 22 · 2018: 22 · 2017: 27 · 2016: 19 · 2015: 46 · 2014: 35 · 2013: 39 · 2012: 55
- FWCI
- 44.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (R06/CCR321534-01)
- 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 › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- childhood obesity prevention, overweight prevention, school-based intervention, nutrition policy, school nutrition, nutrition education, social marketing, parent outreach, school self-evaluation, BMI z-score, fruit and vegetable intake, energy intake, dietary fat intake, physical activity, body dissatisfaction, urban public schools, low-income children
- MeSH terms
- Adolescent, Child, Child Health Services, Child Nutritional Physiological Phenomena, Female, Health Promotion, Humans, Male, Obesity, Policy Making, Probability, School Health Services, Sensitivity and Specificity, Program Evaluation, Incidence, Confidence Intervals, Odds Ratio, Age Distribution, Sex Distribution, Risk Assessment, Overweight
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