Effectiveness of a primary school-based intervention to reduce overweight
Abstract
OBJECTIVES: The purpose of this study was to evaluate the effect of a school-based intervention program to reduce overweight and improve fitness in primary school children. METHODS: A cluster randomized controlled design was used over one school year with schools as unit of randomization. In total 20 schools and 2,622 children aged 6-12 years (grades 3-8) from multi-ethnic, low income inner-city neighbourhoods in Rotterdam, Netherlands, participated. The intervention, named Lekker Fit! (Enjoy being fit!) was a multi-component intervention based on behavioural and ecological models. Main components of the intervention are the implementation of three physical education (PE) sessions a week by a professional PE teacher, additional sport and play activities outside school hours and an educational program. Main primary outcome measures were weight status, body mass index (BMI), waist circumference and fitness (20 m shuttle run). RESULTS: Significant positive intervention effects were found for percentage overweight children (OR 0.53; 95% CI 0.36-0.78), waist circumference (-1.29 cm; 95% CI -2.16 to -0.42 cm) and 20 m shuttle run (0.57 laps; 95% CI 0.13-1.01 laps) among pupils of grades 3-5 (6-9-year olds). The prevalence of overweight in grades 3-5 increased by 4.3% in the control group and by 1.3% in the intervention group. No significant effects were found for BMI or for grades 6-8 (9-12-year olds). CONCLUSIONS: Our results provide evidence for the effectiveness of the multi-component intervention Lekker Fit! among pupils of grades 3-5 and adds to the growing body of evidence that school-based programs with a focus on PA are most effective in reducing childhood obesity. [ISRCTN84383524].
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More recent multicomponent school-based PE/physical activity interventions in Europe demonstrated improvements over 1 academic year in aerobic fitness, skin-fold thickness, and/or BMI z score overall or in certain subgroups.
“More recent multicomponent school-based PE/physical activity interventions in Europe demonstrated improvements over 1 academic year in aerobic fitness, skin-fold thickness, and/or BMI z score overall or in certain subgroups.257,261”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [261]
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 [261]
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“Jansen 2011 [43] Lekker Fit Obesity/overweight, Physical Activity Netherlands Grades 3-8 8 months Theory of planned behaviour, Ecological model”
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- Authors
- Jansen, W., Borsboom, G., Meima, A., Zwanenburg, E. J.-V., Mackenbach, J. P., Raat, H., & Brug, J.
- Affiliations
- Erasmus MC (NL)
- GGD Rotterdam-Rijnmond (NL)
- Venue
- International Journal of Pediatric Obesity
- Publisher
- Informa UK Limited
- Published
- 2011-06
- Volume
- 6
- Issue
- 2-2
- Pages
- e70-e77
- ISSN
- 1747-7166 (ISSN-L)
- 1747-7174
- OpenAlex
- W2094226309
- Cited by
- 93
- References
- 45
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 7 · 2023: 1 · 2022: 1 · 2021: 8 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 12 · 2015: 5 · 2014: 14 · 2013: 18 · 2012: 3
- FWCI
- 10.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Pediatric Obesity (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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
- childhood overweight, childhood obesity prevention, school-based intervention, physical activity promotion, physical education, body mass index, waist circumference, cardiorespiratory fitness, multicomponent intervention, elementary school students
- MeSH terms
- Child, Child Behavior, Female, Health Promotion, Humans, Male, Netherlands, Physical Education and Training, Physical Fitness, School Health Services, Schools, Time Factors, Weight Loss, Health Behavior, Body Mass Index, Chi-Square Distribution, Linear Models, Logistic Models, Treatment Outcome, Overweight, Waist Circumference
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