Prevention of Obesity in School Children

Childhood Obesity Intervention

Since the early 1980s childhood obesity has increased three-fold and during the 2005-2006 school year an estimated 16% of American children were obese (reviewed by Gleason and Dodd, 2009). Childhood obesity and weight problems predispose a child to physical and behavioral problems that can extend into their adult years (Centers for Disease Control and Prevention [CDC], 2010) and for this reason health researchers and educators are attempting to curb this epidemic.

K-12 schools provide between 35% and 47% of a child's daily nutritional requirements (reviewed by Gleason and Dodd, 2009), providing an opportunity to reduce the prevalence of childhood obesity the United States. Towards this goal a coalition of nutrition and educational researchers conducted a 2-year pilot study to test the efficacy of a broad-based intervention strategy targeting obesity in 3,769 children attending grades 1-6 in a public school district in central Florida (Hollar et al., 2010). During this longitudinal, prospective, cohort study the intervention combined improvements in the quality of the food available in schools, by doubling the fiber content and reducing fat by 23%, supplying nutritional and lifestyle educational classes, increasing opportunities for physical activity, and instituting school-based wellness projects. Of the five schools involved in the pilot study one was chosen by the school district administrators to function as a control. The demographics of the intervention and control schools did not vary significantly, although there was a < 20% difference in the number of Hispanic and White children.

Results and Interpretation

During the first year of the study a 1.46 reduction in BMI (body mass index) was observed for children attending intervention schools, but this was not statistically significant because during the same period the control schoolchildren also lost weight (-0.95 BMI). BMI is a method used to assess whether a child or adult could be overweight or obese using weight and height measurements (CDC, 2011). For example, the overweight range for a 9-year-old boy is a BMI score between 19.5 and 21.0, so a reduction of 1.46 would represent a 6.9% to 7.5% weight loss. During the second year of the study the intervention school children experienced an average BMI reduction of 1.73, which turned out to be statistically significant in part because the control children lost less weight during this period (-0.47). Year to year though, these results suggest children enrolled in intervention schools would experience significant reductions in weight.

A related health measure used in this study was systolic and diastolic blood pressure (BP). Girls in the intervention program maintained a lower systolic and diastolic BP during the summer months when compared to controls, but the boys did not. This suggests girls tended to maintain dietary habits adopted during the school year over the summer recess. BP measurements during the school year did not differ significantly from controls.