Mokhtar Abdul Halim, Kamarudin Muhammad Ashaari, Choong Alston, Singh Lakvinder, Genisan Vinotha, Yahya Abqariyah, Zin Ruziana Mona Wan Mohd, Zain Fuziah Md, Selamat Rusidah, Ishak Zahari, Jalaludin Muhammad Yazid
Department of Sports Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, 50603, Malaysia.
Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, 50603, Malaysia.
BMC Public Health. 2025 Jan 9;24(Suppl 1):3623. doi: 10.1186/s12889-024-20723-2.
MyBFF@school program consisting physical activity in the formed small-sided games (SSG), nutrition and psychology education was designed to combat obesity among schoolchildren in Malaysia. It was expected to improve cardiorespiratory fitness, hence, contributing to obesity treatment and prevention. Thus, we aimed to study the effects of the MyBFF@school program on the cardiorespiratory fitness of overweight and obese primary schoolchildren.
Twenty-three out of 1196 government primary schools in central Peninsular Malaysia participated in this cluster-randomized control study. Schoolchildren aged 9-11 years with a body mass index (BMI) z-score greater than + 1 SD (WHO) were eligible for the study. The intervention group participated in the MyBFF@school program while the control followed the existing standard curriculum. The primary outcome was cardiorespiratory fitness using physical fitness score (PFS) measured by the modified Harvard step test. Data were collected at baseline, month-3 and month-6 and were analyzed according to the intention-to-treat principle using mixed linear models.
A total of 954 schoolchildren completed six months follow up, with 439 (n = 439) in the intervention group (n = seven schools), while 515 (n = 515) in the control group (n = 16 schools). In the first three months, there was significant within-group PFS improvement in overall (both), girls (both) and obese (control). Comparing between-groups, the mean differences favored the control in most parameters, but were not significant: overall (-0.15(-0.75, 0.45), p = 0.83), boys (-0.07(-0.98, 0.83), p = 0.83), girls (-0.27(-1.27, 0.73), p = 0.81), overweight (-0.16(-1.28, 0.94), p = 0.97), obese (-0.05(-1.03, 0.92), p = 0.93), morbidly obese (-0.68(-2.43, 1.05), p = 0.26), urban (0.07(-0.79, 0.94), p = 0.45), and rural (-0.35(-1.34, 0.62), p = 0.30). At month-six, the within-group improvements maintained. However, the mean differences now favored the intervention group although they remained not significant: overall (0.05(-0.98, 1.07), p = 0.69), boys (0.06(-1.35, 1.46), p = 0.86), girls (0.10(-1.31, 1.51), p = 0.74), overweight (0.15(-1.07, 1.36), p = 0.93), obese (0.28(-0.98, 1.55), p = 0.75), morbidly obese (-0.79(-2.74, 1.15), p = 0.47), urban (0.61(-0.56, 1.77), p = 0.47), and rural (-0.69(-2.52, 1.14), p = 0.17).
MyBFF@school program showed positive trend in cardiorespiratory fitness changes especially after six months. MyBFF@school intervention program has the potential to combat obesity in primary schoolchildren and should be at least six months.
Clinical trial number: NCT04155255, November 7, 2019 (Retrospective registered). National Medical Research Register: NMRR-13-439-16563. Registered July 23, 2013. The intervention program was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health, Malaysia and, the Educational Planning and Research Division (EPRD), Ministry of Education, Malaysia. It was funded by the Ministry of Health, Malaysia.
“学校里的我的最佳朋友”（MyBFF@school）项目包括在小型比赛（SSG）中进行体育活动、营养和心理教育，旨在对抗马来西亚学童的肥胖问题。预计该项目能提高心肺适能，从而有助于肥胖的治疗和预防。因此，我们旨在研究MyBFF@school项目对超重和肥胖小学生心肺适能的影响。
马来西亚半岛中部1196所政府小学中的23所参与了这项整群随机对照研究。年龄在9至11岁、体重指数（BMI）z评分大于+1标准差（世界卫生组织标准）的学童符合研究条件。干预组参与MyBFF@school项目，而对照组遵循现有的标准课程。主要结局是使用改良哈佛台阶试验测量的体能得分（PFS）来评估心肺适能。在基线、第3个月和第6个月收集数据，并根据意向性分析原则使用混合线性模型进行分析。
共有954名学童完成了六个月的随访，其中干预组（7所学校）有439名（n = 439），对照组（16所学校）有515名（n = 515）。在头三个月，总体（男女合计）、女孩（全部）和肥胖（对照组）的组内PFS均有显著改善。组间比较，大多数参数的均值差异有利于对照组，但不显著：总体（-0.15（-0.75，0.45），p = 0.83）、男孩（-0.07（-0.98，0.83），p = 0.83）、女孩（-0.27（-1.27，0.73），p = 0.81）、超重（-0.16（-1.28，0.94），p = 0.97）、肥胖（-0.05（-1.03，0.92），p = 0.93）、病态肥胖（-0.68（-2.43，1.05），p = 0.26）、城市（0.07（-0.79，0.94），p = 0.45）和农村（-0.35（-1.34，0.62），p = 0.30）。在第6个月，组内改善情况得以维持。然而，此时均值差异有利于干预组，尽管仍不显著：总体（0.05（-0.98，1.07），p = 0.69）、男孩（0.06（-1.35，1.46），p = 0.86）、女孩（0.10（-1.31，1.51），p = 0.74）、超重（0.15（-1.07，1.36），p = 0.93）、肥胖（0.28（-0.98，1.55），p = 0.75）、病态肥胖（-0.79（-2.74，1.15），p = 0.47）、城市（0.61（-0.56，1.77），p = 0.47）和农村（-0.69（-2.52，1.14），p = 0.17）。
MyBFF@school项目在心肺适能变化方面呈现出积极趋势，尤其是在六个月后。MyBFF@school干预项目有潜力对抗小学生肥胖问题，且该项目持续时间至少应为六个月。
临床试验编号：NCT04155255，2019年11月7日（回顾性注册）。国家医学研究注册：NMRR - 13 - 439 - 16563。2013年7月23日注册。该干预项目获得了马来西亚卫生部医学研究与伦理委员会（MREC）以及马来西亚教育部教育规划与研究司（EPRD）的批准。由马来西亚卫生部资助。
