Division of Pediatrics, Karolinska Institutet, Department of Clinical Science, Intervention and Technology, National Childhood Obesity Centre, Stockholm, Sweden.
Int J Obes (Lond). 2009 Apr;33(4):408-17. doi: 10.1038/ijo.2009.38. Epub 2009 Mar 17.
To assess the efficacy of a school-based intervention programme to reduce the prevalence of overweight in 6 to 10-year-old children.
Cluster-randomized, controlled study.
A total of 3135 boys and girls in grades 1-4 were included in the study.
Ten schools were selected in Stockholm county area and randomized to intervention (n=5) and control (n=5) schools. Low-fat dairy products and whole-grain bread were promoted and all sweets and sweetened drinks were eliminated in intervention schools. Physical activity (PA) was aimed to increase by 30 min day(-1) during school time and sedentary behaviour restricted during after school care time. PA was measured by accelerometry. Eating habits at home were assessed by parental report. Eating disorders were evaluated by self-report.
The prevalence of overweight and obesity decreased by 3.2% (from 20.3 to 17.1) in intervention schools compared with an increase of 2.8% (from 16.1 to 18.9) in control schools (P<0.05). The results showed no difference between intervention and controls, after cluster adjustment, in the longitudinal analysis of BMIsds changes. However, a larger proportion of the children who were initially overweight reached normal weight in the intervention group (14%) compared with the control group (7.5%), P=0.017. PA did not differ between intervention and control schools after cluster adjustment. Eating habits at home were found to be healthier among families with children in intervention schools at the end of the intervention. There was no difference between children in intervention and control schools in self-reported eating disorders.
A school-based intervention can reduce the prevalence of overweight and obesity in 6 to 10-year-old children and may affect eating habits at home. The effect of the intervention was possibly due to its effect on healthy eating habits at school and at home rather than on increased levels of PA.
评估一项针对 6 至 10 岁儿童的学校干预计划对超重患病率的影响。
整群随机对照研究。
共有 3135 名 1 至 4 年级的男童和女童被纳入研究。
在斯德哥尔摩县选择了 10 所学校，并将其随机分为干预组（n=5）和对照组（n=5）。在干预学校推广低脂乳制品和全麦面包，消除所有糖果和含糖饮料。在学校时间内，目标是增加 30 分钟的体育活动（PA），并在课后照管时间限制久坐行为。通过加速度计测量 PA。通过家长报告评估家庭饮食习惯。通过自我报告评估饮食失调。
与对照组相比，干预组超重和肥胖的患病率下降了 3.2%（从 20.3%降至 17.1%），而对照组则上升了 2.8%（从 16.1%升至 18.9%）（P<0.05）。经过聚类调整后，纵向分析 BMI 标准差变化，干预组与对照组之间无差异。然而，在干预组中，最初超重的儿童中有更大比例达到正常体重（14%），而对照组为 7.5%（P=0.017）。经过聚类调整后，干预组和对照组之间的 PA 没有差异。干预结束时，干预学校儿童的家庭饮食习惯被发现更为健康。干预组和对照组儿童在自我报告的饮食失调方面没有差异。
基于学校的干预可以降低 6 至 10 岁儿童的超重和肥胖患病率，并可能影响家庭饮食习惯。干预的效果可能是由于其对学校和家庭健康饮食习惯的影响，而不是由于 PA 水平的提高。
