Ermetici Federica, Zelaschi Roberta F, Briganti Silvia, Dozio Elena, Gaeta Maddalena, Ambrogi Federico, Pelissero Gabriele, Tettamanti Guido, Corsi Romanelli Massimiliano Marco, Carruba Michele, Morricone Lelio, Malavazos Alexis E
Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Obesity (Silver Spring). 2016 Mar;24(3):687-95. doi: 10.1002/oby.21365. Epub 2016 Feb 1.
To evaluate whether a school-based multicomponent educational program could improve adiposity measures in middle-school adolescents.
A non-randomized controlled pilot study was conducted in six state middle schools (487 adolescents, 11-15 years) in townships in an urban area around Milan, three schools (n = 262 adolescents) being assigned to the intervention group and three schools (n = 225 adolescents) to the control group. The two-school-year intervention included changes in the school environment (alternative healthy vending machines, educational posters) and individual reinforcement tools (school lessons, textbook, text messages, pedometers, re-usable water bottles). The main outcome measure was change in BMI z-score. The secondary outcomes were changes in waist-to-height ratio (WHtR) and behavioral habits.
The intervention was associated with a significant difference in BMI z-score (-0.18 ± 0.03, P<0.01) and in WHtR (-0.04 ± 0.002, P < 0.001), after controlling for baseline covariates. Subgroup analysis showed the maximum association between the intervention and the difference in BMI z-score for girls with overweight/obesity. Physical activity increased and consumption of sugar-sweetened beverages and high-energy snacks decreased in adolescents after the intervention.
A school-based multicomponent intervention conducted at both environmental and individual levels may be effective for reducing adiposity measures mainly in adolescents with overweight/obesity.
评估一项以学校为基础的多组分教育项目能否改善初中青少年的肥胖指标。
在米兰周边市区乡镇的六所公立中学（487名11至15岁青少年）开展了一项非随机对照试验性研究，三所学校（n = 262名青少年）被分配到干预组，另外三所学校（n = 225名青少年）被分配到对照组。为期两年的干预措施包括学校环境的改变（更换为健康自动售货机、张贴教育海报）以及个人强化工具（学校课程、教科书、短信、计步器、可重复使用的水瓶）。主要结局指标为体重指数（BMI）z评分的变化。次要结局指标为腰高比（WHtR）和行为习惯的变化。
在控制基线协变量后，干预与BMI z评分（-0.18±0.03，P<0.01）和WHtR（-0.04±0.002，P<0.001）的显著差异相关。亚组分析显示，干预与超重/肥胖女孩的BMI z评分差异之间存在最大关联。干预后，青少年的身体活动增加，含糖饮料和高能量零食的摄入量减少。
在环境和个人层面开展的以学校为基础的多组分干预可能对主要降低超重/肥胖青少年的肥胖指标有效。
