Mölenberg Famke J M, Smit Michel S, Nieboer Daan, Voortman Trudy, Jansen Wilma
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
Pediatr Obes. 2025 Mar;20(3):e13200. doi: 10.1111/ijpo.13200. Epub 2025 Jan 6.
This study investigated the long-term impact of the primary school-based multicomponent lifestyle intervention "Lekker Fit!" (LF) on obesity-related outcomes, and studied whether the impact differed between population subgroups.
Children from the Generation R Study (Rotterdam, the Netherlands) were categorized into the LF group (6 years exposure, between the ages 6/7 to 12/13 years) or regular school group (no exposure). BMI and DXA-derived fat mass were assessed after 4 years of intervention (age 10 years), and 1.5 years post-intervention (age 14 years). A propensity score matching model was fitted to examine the intervention effect on BMI-z-score and percent fat mass, and we tested for differences by sex, pre-intervention weight status, ethnic background, and income.
We found no effect on BMI-z-score [0.06 (95% confidence interval [CI]: -0.04 to 0.17)] and percent fat mass (0.4%-point [95% CI: -0.2 to 1.1]) after 4 years of intervention. 1.5 years post-intervention and after 6 years of exposure, BMI-z-score (0.11 [95% CI: 0.00-0.22]) and percent fat mass (1.1%-point [95% CI: 0.2-1.9]) were significantly higher for children in the LF group. No subgroup differences were found.
Findings suggest the need for obesity prevention programs that extend beyond primary education.
本研究调查了以小学为基础的多成分生活方式干预措施“健康活力！”（LF）对肥胖相关结局的长期影响，并研究了不同人群亚组之间的影响是否存在差异。
来自代际R研究（荷兰鹿特丹）的儿童被分为LF组（6年暴露期，年龄在6/7至12/13岁之间）或常规学校组（无暴露）。在干预4年后（10岁）和干预后1.5年（14岁）评估体重指数（BMI）和双能X线吸收法（DXA）得出的脂肪量。采用倾向得分匹配模型来检验干预对BMI z评分和体脂百分比的影响，并按性别、干预前体重状况、种族背景和收入进行差异检验。
干预4年后，我们发现对BMI z评分[0.06（95%置信区间[CI]：-0.04至0.17）]和体脂百分比（0.4个百分点[95%CI：-0.2至1.1]）没有影响。干预后1.5年以及暴露6年后，LF组儿童的BMI z评分（0.11[95%CI：0.00 - 0.22]）和体脂百分比（1.1个百分点[95%CI：0.2 - 1.9]）显著更高。未发现亚组差异。
研究结果表明需要开展超越小学教育阶段的肥胖预防项目。
