Nikooyeh Bahareh, Yari Zahra, Hariri Zahra, Baghdadi Ghazal, Yazdani Hootan, Motlagh Mohammad Esmail, Neyestani Tirang R
Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Instituteand, Shahid Beheshti University of Medical Sciences , Tehran, Iran.
Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Syst Rev. 2025 Jun 10;14(1):125. doi: 10.1186/s13643-025-02871-7.
Adolescent obesity is linked to a higher risk of becoming obese adults and developing chronic diseases. School-based interventions, focusing on nutritional education and physical activity (PA), are crucial for preventing childhood obesity. This study aimed to evaluate the effectiveness of such interventions using network meta-analysis.
We searched PubMed, Scopus, Web of Science, and the Cochrane Library for studies on school-based obesity interventions. Interventions included behavioral, nutritional, and physical activity components. Network meta-analysis (NMA) employed random-effects models, generating network plots. Surface under the cumulative ranking curve (SUCRA) ranked intervention efficacy.
Sixty-one studies were included. School-based interventions significantly reduced body mass index z-score (z-BMI; mean difference [MD]: - 0.06; 95% CI: - 0.1, - 0.03) and BMI (MD: - 0.351; 95% CI: - 0.566, - 0.135). NMA indicated that combined interventions, PA + health education (HE) + school policy (SP), were more effective in reducing BMI than HE alone (MD: - 0.61; 95% CI: - 1.2, - 0.02). SUCRA rankings highlighted PA + HE + SP and PA alone as the most effective interventions in reducing BMI and z-BMI, respectively.
School-based interventions are effective long-term strategies for managing childhood obesity. Combining PA, HE, and SP showed the highest efficacy in reducing BMI. Meanwhile, intervention duration and parental involvement did not show any significant additional effect, necessitating further prospective studies.
青少年肥胖与成年后肥胖及患慢性病的风险增加有关。以学校为基础的干预措施，侧重于营养教育和体育活动（PA），对于预防儿童肥胖至关重要。本研究旨在通过网络荟萃分析评估此类干预措施的有效性。
我们在PubMed、Scopus、Web of Science和Cochrane图书馆中检索了关于以学校为基础的肥胖干预措施的研究。干预措施包括行为、营养和体育活动等方面。网络荟萃分析（NMA）采用随机效应模型，并生成网络图。累积排名曲线下面积（SUCRA）对干预效果进行排名。
纳入了61项研究。以学校为基础的干预措施显著降低了体重指数z评分（z-BMI；平均差值[MD]：-0.06；95%置信区间：-0.1，-0.03）和体重指数（MD：-0.351；95%置信区间：-0.566，-0.135）。NMA表明，综合干预措施，即体育活动+健康教育（HE）+学校政策（SP），在降低体重指数方面比单独的健康教育更有效（MD：-0.61；95%置信区间：-1.2，-0.02）。SUCRA排名突出显示，体育活动+健康教育+学校政策和单独的体育活动分别是降低体重指数和z-BMI最有效的干预措施。
以学校为基础的干预措施是管理儿童肥胖的有效长期策略。结合体育活动、健康教育和学校政策在降低体重指数方面显示出最高的疗效。同时，干预持续时间和家长参与度并未显示出任何显著的额外效果，需要进一步的前瞻性研究。
