Cited by 496Obesity, Physical Activity, DietSchool Health and Nursing EducationNutrition, Health and Food Behavior

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A Policy-Based School Intervention to Prevent Overweight and Obesity

Foster, Gary D., Sherman, Sandy, Borradaile, Kelley E., Grundy, Karen M., Vander Veur, Stephanie S., Nachmani, Joan, Karpyn, Allison, Kumanyika, Shiriki, Shults, Justine·2008·Pediatrics

DOI 10.1542/peds.2007-1365

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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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Jones, A., Armstrong, B., Weaver, R. G., Parker, H., von Klinggraeff, L., & Beets, M. W. (2021) · Figshare · doi:10.6084/m9.figshare.16633418
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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
ORCID: Foster, Gary D.
Karpyn, Allison
Kumanyika, Shiriki
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
DOI: 10.1542/peds.2007-1365
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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A Policy-Based School Intervention to Prevent Overweight and Obesity

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