Department of Health, Central Health Education Unit, Hong Kong.
Department of Health, Surveillance and Epidemiology Branch, Hong Kong.
Glob Health Promot. 2019 Dec;26(4):70-78. doi: 10.1177/1757975918764318. Epub 2018 May 29.
Childhood obesity is an increasing threat to the health of primary school students in Hong Kong. Obesity results from energy excess from food relative to energy expenditure through physical activity. In Hong Kong, a whole day primary schooling policy has been implemented since 1993 and today most primary school students have their lunch on campus and some also purchase snacks and drinks from school tuck shops or vending machines. The EatSmart School Accreditation Scheme (ESAS) aiming at combating childhood obesity was launched in 2009/2010. Professional (health promotion, dietary, programme, etc.) support is provided to help schools formulate policies, introduce structures and implement measures to help students develop the habit of healthy eating. The aim of this study is to investigate the change of childhood obesity (including overweight) rates over time among schools awarded with ESAS accreditation. Seven-year retrospective data on obesity status were obtained for the period 2007/2008-2013/2014 (number of students = 113,322, number of measurements = 314,746) from all 105 ESAS-accredited schools. Before schools were geared up for the accreditation scheme obesity rates were fairly stable (slope test > 0.05) among their student population ranging from 23.2% to 21.9%, whereas the rates dropped significantly (slope test < 0.05) from 21.9% to 19.3% after intervention. For ESAS-accredited schools, there was an average annual reduction of 0.49% point in obesity rate which was 0.18% point higher than that of 0.31% point among non-ESAS-accredited schools. These results show that schools achieving ESAS accreditation are associated with a bigger improvement in the student obesity problem.
香港小学生的肥胖问题日益严重，影响他们的健康。肥胖是由于食物提供的能量超过了身体活动所消耗的能量。1993 年起，香港实施全日制小学教育政策，现今大部分小学生在学校吃午餐，有些还会购买校园小吃店或自动售货机的零食和饮料。“健康饮食学校认证计划”（EatSmart School Accreditation Scheme，简称 ESAS）于 2009/2010 年推出，旨在对抗儿童肥胖。该计划为学校提供专业（健康推广、饮食、计划等）支持，帮助学校制定政策，引入架构，并实施措施，帮助学生养成健康饮食的习惯。本研究旨在探讨获得 ESAS 认证的学校的儿童肥胖（包括超重）率随时间的变化。从所有 105 所获得 ESAS 认证的学校获取 2007/2008 年至 2013/2014 年（学生人数=113322，测量次数=314746）为期 7 年的肥胖状况回顾性数据。在获得认证计划之前，学生人群的肥胖率相当稳定（斜率检验>0.05，范围在 23.2%至 21.9%之间），而在干预后，肥胖率显著下降（斜率检验<0.05，从 21.9%降至 19.3%）。对于获得 ESAS 认证的学校，肥胖率平均每年下降 0.49%，比未获得 ESAS 认证的学校的 0.31%高出 0.18%。这些结果表明，获得 ESAS 认证的学校在改善学生肥胖问题方面取得了更大的进展。
