Pennington Biomedical Research Center, Baton Rouge, LA, USA.
Obesity (Silver Spring). 2012 Aug;20(8):1653-61. doi: 10.1038/oby.2012.60. Epub 2012 Mar 8.
This study tested the efficacy of two school-based programs for prevention of body weight/fat gain in comparison to a control group, in all participants and in overweight children. The Louisiana (LA) Health study utilized a longitudinal, cluster randomized three-arm controlled design, with 28 months of follow-up. Children (N = 2,060; mean age = 10.5 years, SD = 1.2) from rural communities in grades 4-6 participated in the study. Seventeen school clusters (mean = 123 children/cluster) were randomly assigned to one of three prevention arms: (i) primary prevention (PP), an environmental modification (EM) program, (ii) primary + secondary prevention (PP+SP), the environmental program with an added classroom and internet education component, or (iii) control (C). Primary outcomes were changes in percent body fat and BMI z scores. Secondary outcomes were changes in behaviors related to energy balance. Comparisons of PP, PP+SP, and C on changes in body fat and BMI z scores found no differences. PP and PP+SP study arms were combined to create an EM arm. Relative to C, EM decreased body fat for boys (-1.7 ± 0.38% vs. -0.14 ± 0.69%) and attenuated fat gain for girls (2.9 ± 0.22% vs. 3.93 ± 0.37%), but standardized effect sizes were relatively small (<0.30). In conclusion, this school-based EM programs had modest beneficial effects on changes in percent body fat. Addition of a classroom/internet program to the environmental program did not enhance weight/fat gain prevention, but did impact physical activity and social support in overweight children.
本研究测试了两种基于学校的预防体重/脂肪增加的方案在所有参与者和超重儿童中的有效性，与对照组相比。路易斯安那州（LA）健康研究采用了纵向、聚类随机三臂对照设计，随访时间为 28 个月。来自农村社区 4-6 年级的儿童（N=2060；平均年龄=10.5 岁，标准差=1.2）参加了这项研究。17 个学校集群（平均=123 名儿童/集群）被随机分配到三个预防组之一：（i）初级预防（PP），环境修改（EM）计划，（ii）初级+二级预防（PP+SP），在环境计划中增加课堂和互联网教育内容，或（iii）对照组（C）。主要结果是体脂肪百分比和 BMI z 分数的变化。次要结果是与能量平衡相关的行为变化。对体脂肪和 BMI z 分数的变化进行比较，发现 PP、PP+SP 和 C 之间没有差异。将 PP 和 PP+SP 研究组合并为 EM 组。与 C 相比，EM 减少了男孩的体脂肪（-1.7±0.38%对-0.14±0.69%）和女孩的脂肪增加（2.9±0.22%对 3.93±0.37%），但标准化效应大小相对较小（<0.30）。总之，基于学校的 EM 方案对体脂肪百分比的变化有适度的有益影响。在环境方案中增加课堂/互联网方案并没有增强体重/脂肪增加的预防效果，但确实影响了超重儿童的身体活动和社会支持。
