Selamat Rusidah, Raib Junidah, Aziz Nur Azlina Abdul, Zulkafly Norlida, Ismail Ainan Nasrina, Mohamad W Nurul Ashikin W, Zulkiply Ainol Aizuddin, Jalaludin Muhammad Yazid, Zain Fuziah Md, Ishak Zahari, Yahya Abqariyah, Mokhtar Abdul Halim
Nutrition Division, Federal Government Administrative Centre, Ministry of Health Malaysia, Level 1, Block E3, Complex E, Putrajaya, 62590, Malaysia.
Department of Pediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, 50603, Malaysia.
BMC Public Health. 2025 Jan 9;24(Suppl 1):3624. doi: 10.1186/s12889-024-21090-8.
The increasing global and national prevalence of childhood obesity particularly among schoolchildren has warranted a more viable school-based obesity intervention. Apart from physical activity, nutrition is important in any obesity intervention package. This study examined the effects of the MyBFF@school program with nutrition education intervention (NEI) on nutrition knowledge and attitude of overweight and obese secondary schoolchildren.
This is a cluster randomized controlled trial which involved schoolchildren aged 13, 14 and 16 years old from 15 out of 415 government secondary schools in central Peninsular Malaysia which were randomly assigned into six intervention (N = 579 schoolchildren) and nine control (N = 462 schoolchildren). The intervention group was given NEI consisting of a nutrition education module carried out by trained personnel for 24 weeks on top of the existing curriculum while the control group only followed the existing school curriculum by the Ministry of Education. The primary outcomes were the nutrition knowledge and attitude score. The mixed effect model taking into consideration the cluster effect was used to assess the changes of nutrition knowledge and attitude scores from baseline until 6 months.
Overall, there was no significant increase in the adjusted mean difference (AMD) of nutrition knowledge score (AMD = 0.33%, Confident Interval (95 CI): -4.35% to 5.01) between the intervention and control group after 6 months of intervention after controlling for nutrition knowledge score at baseline, gender, location and ethnicity. Similarly, after controlling for the nutrition attitude score at baseline, ethnicity, location and gender as well as taking into account the cluster effects, there was no significant increase on the AMD of nutrition attitude score in the overall (AMD = 0.194, (95 CI): -1.17 to 1.56) and also among girls, location (urban vs rural) and Malays. There was also no significant reduction of AMD in the nutrition attitude score among boys and non-Malays.
MyBFF@school with NEI resulted with no significant improvement for nutrition knowledge and attitude among older schoolchildren. Therefore, to effectively impart the nutrition knowledge and change their nutrition attitude requires an in-depth study and multi-pronged and customized approach.
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 Educational Planning and Research Division (EPRD), Ministry of Education Malaysia. It was funded by the Ministry of Health Malaysia.
全球和各国儿童肥胖率不断上升，尤其是在校儿童，这就需要一种更可行的基于学校的肥胖干预措施。除体育活动外，营养在任何肥胖干预方案中都很重要。本研究考察了“学校里的最佳朋友”（MyBFF@school）营养教育干预（NEI）项目对超重和肥胖中学生营养知识及态度的影响。
这是一项整群随机对照试验，涉及马来西亚半岛中部415所政府中学中15所学校的13、14和16岁学童，这些学校被随机分为6个干预组（N = 579名学童）和9个对照组（N = 462名学童）。干预组在现有课程基础上，由经过培训的人员开展为期24周的营养教育模块组成的营养教育干预，而对照组仅遵循教育部的现有学校课程。主要结局是营养知识和态度得分。采用考虑整群效应的混合效应模型评估从基线到6个月营养知识和态度得分的变化。
总体而言，在控制基线营养知识得分、性别、地点和种族后，干预6个月后，干预组与对照组之间营养知识得分的调整平均差异（AMD）没有显著增加（AMD = 0.33%，置信区间（95 CI）：-4.35%至5.01）。同样，在控制基线营养态度得分、种族、地点和性别并考虑整群效应后，总体（AMD = 0.194，（95 CI）：-1.17至1.56）以及女孩、地点（城市与农村）和马来人群体中，营养态度得分的AMD没有显著增加。男孩和非马来人群体的营养态度得分AMD也没有显著降低。
“学校里的最佳朋友”（MyBFF@school）营养教育干预项目在大龄学童的营养知识和态度方面没有带来显著改善。因此，要有效传授营养知识并改变他们的营养态度，需要深入研究以及多管齐下的定制方法。
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。
