School-based obesity interventions: A literature review

BACKGROUND: Childhood obesity is an impending epidemic. This article is an overview of different interventions conducted in school settings so as to guide efforts for an effective management of obesity in children, thus minimizing the risk of adult obesity and related cardiovascular risk. METHODS: PubMed and OVID Medline databases were searched for school-based obesity interventions with anthropometric measures in children and adolescents between the ages of 7 and 19 years from June 1986 to June 2006. Studies were reviewed by duration, type of intervention, and defined qualitative and quantitative measures, resulting in a yield of 51 intervention studies. RESULTS: The interventions ranged from 4 weeks in length to as long as 8 continuing years. In total, 15 of the intervention studies exclusively utilized physical activity programs, 16 studies exclusively utilized educational models and behavior modification strategies, and 20 studies utilized both. In addition, 31 studies utilized exclusively quantitative variables like body mass indices and waist-to-hip ratios to measure the efficacy of the intervention programs, and another 20 studies utilized a combination of quantitative and qualitative measures that included self-reported physical activity and attitude toward physical activity and the tested knowledge of nutrition, cardiovascular health, and physical fitness. A total of 40 studies achieved positive statistically significant results between the baseline and the follow-up quantitative measurements. CONCLUSIONS: No persistence of positive results in reducing obesity in school-age children has been observed. Studies employing long-term follow-up of quantitative and qualitative measurements of short-term interventions in particular are warranted.