基于学校的营养和身体活动干预对随机对照试验停止后 8 年的体重指数的影响（AVall 研究）。

Impact of school-based nutrition and physical activity intervention on body mass index eight years after cessation of randomized controlled trial (AVall study).

机构信息

Internal Medicine Department, Granollers General Hospital, Granollers, Spain; Medicine Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Catalonia, Spain.

Primary Care, ABS Montornès-Montmeló, Catalan Institute of Health, Spain; Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Sabadell, Spain.

出版信息

Clin Nutr. 2019 Dec;38(6):2592-2598. doi: 10.1016/j.clnu.2018.12.029. Epub 2019 Jan 24.

DOI:10.1016/j.clnu.2018.12.029

PMID:30737048

Abstract

BACKGROUND & AIMS: The prevalence of obesity and overweight among children is increasing, representing a new and pressing societal problem. Excess weight in childhood is an independent risk factor for adult obesity. Although school-based interventions are generally considered effective in the short term, few studies analyze their longterm impact. The aim of study was to assess if the effect of the intervention on body mass Index (BMI) immediately after the intervention remained eight years later (AVall Study).

METHODS

In 2006-2008, an intervention for primary school children promoted healthy eating habits and physical activity in the school setting using the Investigation, Vision, Action and Change (IVAC) educational methodology, which involves children as active participants in healthy change. At baseline, parents reported their weight, height and educational level by questionnaire. Children's weight and height were measured in situ in 2006, 2008, 2010, 2012 and 2016, and levels of physical activity were assessed by questionnaire. Multilevel mixed effects linear regression was used to assess changes in BMI over time.

RESULTS

Increases in BMI from 2006 to 2016 were 0.68 kg/m (95% CI, 0.02, 1.34; P = 0.045) higher in the control group than in the intervention group. The prevalence of obesity and overweight combined in 2006 and 2016 was 22.2% and 27.9%, respectively, in the control group and 25.6% and 21.2% respectively, in the intervention group. Changes in BMI in the intervention group were maintained from 2006 on: at the end of the intervention in 2008, -0.4 kg/m (P = 0.001); in 2010, -0.23 g/m (P = 0.012); in 2012, -0.63 kg/m (P < 0.001) and in 2016, -0.27 kg/m (P = 0.025). The child's BMI increased by 0.52 kg/m (P = 0.046) if the father was obese, by 1.26 kg/m (p = 0.011) if the mother was obese, and by 2.37 kg/m (P < 0.001) if both parents were obese. Parental education levels were not associated with childhood obesity.

CONCLUSIONS

A school-based healthy eating habits and physical activity intervention using IVAC methodology contributed to lower increases in BMI among children in primary school. Although parental BMI also influenced children's BMI, the intervention was effective.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01156805.

摘要

背景与目的

儿童肥胖和超重的患病率正在增加，这是一个新的紧迫的社会问题。儿童时期超重是成年肥胖的独立危险因素。尽管基于学校的干预措施通常被认为在短期内有效，但很少有研究分析其长期影响。本研究旨在评估干预对体重指数（BMI）的影响是否在干预结束后 8 年仍然存在（AVall 研究）。

方法

2006-2008 年，一项针对小学生的干预措施在学校环境中使用调查、愿景、行动和变化（IVAC）教育方法促进健康饮食习惯和身体活动，该方法涉及儿童作为健康变革的积极参与者。在基线时，家长通过问卷报告他们的体重、身高和教育水平。2006 年、2008 年、2010 年、2012 年和 2016 年在现场测量了儿童的体重和身高，并通过问卷评估了身体活动水平。使用多水平混合效应线性回归来评估 BMI 随时间的变化。

结果

与干预组相比，对照组从 2006 年到 2016 年 BMI 增加了 0.68kg/m（95%CI，0.02，1.34；P=0.045）。对照组 2006 年和 2016 年肥胖和超重的患病率分别为 22.2%和 27.9%，干预组分别为 25.6%和 21.2%。干预组的 BMI 变化从 2006 年开始保持不变：2008 年干预结束时，-0.4kg/m（P=0.001）；2010 年，-0.23kg/m（P=0.012）；2012 年，-0.63kg/m（P<0.001）；2016 年，-0.27kg/m（P=0.025）。如果父亲肥胖，儿童 BMI 增加 0.52kg/m（P=0.046）；如果母亲肥胖，儿童 BMI 增加 1.26kg/m（p=0.011）；如果父母双方都肥胖，儿童 BMI 增加 2.37kg/m（P<0.001）。父母的教育水平与儿童肥胖无关。