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Vázquez-Polo M, Churruca I, Perez-Junkera G, Larretxi I, Lasa A, Esparta J, Cantero-Ruiz de Eguino L, Navarro V. Study Protocol for a Controlled Trial of Nutrition Education Intervention about Celiac Disease in Primary School: ZELIAKIDE Project. Nutrients 2024; 16:338. [PMID: 38337623 PMCID: PMC10857138 DOI: 10.3390/nu16030338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
The only treatment for celiac disease (CD) is a strict and lifelong gluten-free diet (GFD), which must be safe and nutritionally balanced. Avoiding gluten brings difficulties with following the diet and can affect the social life of people with CD. The Zeliakide Project is a nutrition education program aimed at increasing the knowledge of the general population about healthy diets, CD and GFD, and, therefore, to improve the social inclusion and quality of life of people with CD. It is a one-month intervention program, two-armed cluster, non-randomised and controlled trial, conducted among 10-12-year-old children. Pre- and post-intervention evaluation and 1 month follow-up will be carried out to assess the effectiveness of the program. It is based on competencies and their respective learning outcomes. The teaching methodology chosen is a STEAM methodology: inquiry-based learning (IBL). A teaching unit has been created to develop the project, which, in the future, will be useful for the self-application of the program. This study will provide a valid and useful tool to achieve changes in the diet at the school level and will help to promote the social inclusion of people with CD. Moreover, it will enforce the STEAM competences of children.
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Affiliation(s)
- Maialen Vázquez-Polo
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Itziar Churruca
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Gesala Perez-Junkera
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Idoia Larretxi
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
- Centro Integral de Atención a Mayores San Prudencio, 01006 Vitoria-Gasteiz, Spain
| | - Arrate Lasa
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Jon Esparta
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
| | - Leire Cantero-Ruiz de Eguino
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
| | - Virginia Navarro
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
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Drouka A, Brikou D, Causeret C, Al Ali Al Malla N, Sibalo S, Ávila C, Alcat G, Kapetanakou AE, Gurviez P, Fellah-Dehiri N, Masson M, Kontogianni MD, Yannakoulia M. Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1676. [PMID: 37892339 PMCID: PMC10605522 DOI: 10.3390/children10101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6-10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers' training.
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Affiliation(s)
- Archontoula Drouka
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Dora Brikou
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | | | | | | | - Concha Ávila
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | - Gabriela Alcat
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | | | - Patricia Gurviez
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Nawel Fellah-Dehiri
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Marine Masson
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Meropi D. Kontogianni
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Mary Yannakoulia
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
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Cholley-Gomez M, Laujac S, Delpierre C, Carayol M. Effectiveness of multilevel interventions based on socio-ecological model to decrease sedentary time in children: a systematic review of controlled studies. Front Public Health 2023; 11:1106206. [PMID: 37333527 PMCID: PMC10272417 DOI: 10.3389/fpubh.2023.1106206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/08/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives Preventive actions of sedentary behavior (SB) based on the socio-ecological model are needed among children and young adolescents. The aim of this systematic review is to ascertain the effectiveness of multilevel interventions (i.e., involving consideration of at least two interventional levels) in reducing sedentary time (ST) in children aged 5-12 years. Methods Adhering to PRISMA guidelines, a systematic literature search was conducted in three databases (PsyInfo, PubMed and ERIC) until July 2021. Results 30 trials met the eligibility criteria and were included. They showed acceptable (< 8, n = 18) and high (≥ 8, n = 12) methodological quality. Among studies targeting 2 (n = 2), 3 (n = 19) and 4 levels (n = 9), 1 (50%), 9 (47%) and 7 (78%) were effective and reported significant reduction of ST, respectively. Conclusion Interventions tend to be more effective when they involve 4 levels, using both agentic and structural strategies (targeting intrinsic determinants, in the organizational environment of the child). Findings underline the relevance of multilevel strategies to reduce ST in children, but also raise issues about operationalization of the socio-ecological perspective. Systematic review registration PROSPERO, identifier: CRD42020209653.
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Affiliation(s)
- Marie Cholley-Gomez
- IAPS Laboratory “Impact of Physical Activity on Health”, University of Toulon, Toulon, France
- ACTES Laboratory, University of Antilles, Pointe-à-Pitre, Guadeloupe
| | - Steven Laujac
- IAPS Laboratory “Impact of Physical Activity on Health”, University of Toulon, Toulon, France
- Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer, Hôpital Sainte Musse, Toulon, France
| | - Cyrille Delpierre
- EQUITY Team, CERPOP UMR 1295, Inserm-Université Toulouse III, Toulouse, France
| | - Marion Carayol
- IAPS Laboratory “Impact of Physical Activity on Health”, University of Toulon, Toulon, France
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Frenn M, Salzman N, Lam V, Holtz M, Moosreiner A, Garnier-Villarreal M. Body Mass Index and Gut Microbiome: A Cluster-Randomized, Controlled, Pilot Feasibility Study. Child Obes 2023. [PMID: 36730730 DOI: 10.1089/chi.2022.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have been conducted mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity. Methods: This cluster-randomized, controlled feasibility trial included an online program designed to improve diet and PA along with administration of a prebiotic fiber for 12 weeks in 123 students of 4th and 5th grade where 98% were eligible for free or reduced-fee lunch. Of these 56% were male; 71% Latinx; 15% African American; and 14% other. Results: Decrease in body fat (BF) was associated with higher pretest BF. Lower body mass index (BMI) was associated with decrease in fecal Tenericutes and increase in Actinobacteria. Conclusions: Prebiotic fiber can be helpful in supporting healthy weight, so inclusion in culturally congruent foods usually eaten by children from groups at high risk for obesity should be considered following additional studies. Determining those most responsive to prebiotic fibers can also permit individual recommendations for greater inclusion in usual diet choices. Clinical Trial Registration Number NCT05671731.
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Affiliation(s)
- Marilyn Frenn
- College of Nursing, Marquette University, Milwaukee, WI, USA
| | - Nita Salzman
- Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Vy Lam
- Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mary Holtz
- Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
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Silva Filho RCDS, Sasaki JE, Gordia AP, Andaki ACR. Effects of a Physical Exercise Program and Health Advice on Sedentary Behavior of Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1064. [PMID: 36673819 PMCID: PMC9859598 DOI: 10.3390/ijerph20021064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 06/17/2023]
Abstract
Sedentary behavior (SB) is a risk factor for chronic non-communicable diseases. This study aimed to assess the effects of an extracurricular physical exercise program and health advice on SB in adolescents. This was a non-randomized experimental study involving 19 adolescents divided into an intervention group (IG) and a control group (CG), aged 13-16 years from a public school in a Brazilian municipality. SB was measured using self-reports and accelerometers. The intervention included physical exercise and health advice. Repeated measures analysis of variance with a significance level of α = 5% was used. There was a time*group interaction for the subscapular fold ((pre IG = 16.30 mm vs. CG = 13.44 mm, post IG = 14.00 mm vs. CG = 15.89 mm) p = 0.001), and VO2MAX ((pre IG = 32.75 mL/kg/min vs. CG = 30.66 mL/kg/min, post IG = 35.76 mL/kg/min vs. CG = 29.28 mL/kg/min) p = 0.008). The accelerometer showed significant differences between groups in the total SB ((pre IG = 647.49 min/day vs. CG = 535.24 min/day, post IG = 614.02 min/day vs. CG = 586.97 min/day) p = 0.045), with a significant decrease in the IG. In conclusion, an extracurricular physical exercise program and health advice was effective in reducing SB in adolescents.
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Affiliation(s)
| | - Jeffer Eidi Sasaki
- Postgraduate Program in Physical Education, Federal University of Triângulo Mineiro, Uberaba 38061-500, MG, Brazil
| | - Alex Pinheiro Gordia
- Teachers Training Center, Federal University of Recôncavo da Bahia, Amargosa 45300-000, BA, Brazil
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Magee L, Goldsmith LP, Chaudhry UAR, Donin AS, Wahlich C, Stovold E, Nightingale CM, Rudnicka AR, Owen CG. Nonpharmacological Interventions to Lengthen Sleep Duration in Healthy Children: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:1084-1097. [PMID: 36094530 PMCID: PMC9468945 DOI: 10.1001/jamapediatrics.2022.3172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/09/2022] [Indexed: 12/15/2022]
Abstract
Importance Adequate sleep duration is necessary for many aspects of child health, development, and well-being, yet sleep durations for children are declining, and effective strategies to increase sleep in healthy children remain to be elucidated. Objective To determine whether nonpharmaceutical interventions to improve sleep duration in healthy children are effective and to identify the key components of these interventions. Data Sources CENTRAL, MEDLINE, Embase, PsycINFO, Web of Science Core collection, ClinicalTrials.gov, and WHO trials databases were searched from inception to November 15, 2021. Study Selection Randomized clinical trials of interventions to improve sleep duration in healthy children were independently screened by 2 researchers. A total of 28 478 studies were identified. Data Extraction and Synthesis Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline. Random-effects meta-analytic models were used to estimate pooled effect sizes. Main Outcomes and Measures Difference in sleep duration, measured in minutes. Results A total of 13 539 child participants from 45 randomized clinical trials were included. Of these, 6897 (50.9%) were in the intervention group and 6642 (49.1%) in the control group, and the mean age ranged from 18 months to 19 years. Pooled results indicate that sleep interventions were associated with 10.5 minutes (95% CI, 5.6-15.4) longer nocturnal sleep duration. There was substantial variation between trials. Sources of variation that were not associated with the study effect size included age group, whether the population was identified as having a sleep problem or being at a socioeconomic disadvantage (eg, coming from a low-income family or area), method of assessment of sleep duration (objective vs subjective), location of intervention delivery (home vs school), whether interventions were delivered in person or used parental involvement, whether behavioral theory was used, environmental change, or had greater or lower intensity. Interventions that included earlier bedtimes were associated with a 47-minute sleep extension (95% CI, 18.9-75.0; 3 trials) compared with remaining studies (7.4 minutes; 95% CI, 2.9-11.8; 42 trials) (P = .006 for group difference). Trials of shorter duration (6 months or less) had larger effects. Conclusions and Relevance Interventions focused on earlier bedtimes may offer a simple, pragmatic, effective way to meaningfully increase sleep duration that could have important benefits for child health.
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Affiliation(s)
- Lucia Magee
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Lucy P. Goldsmith
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Umar A. R. Chaudhry
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Angela S. Donin
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Charlotte Wahlich
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Elizabeth Stovold
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Claire M. Nightingale
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Alicja R. Rudnicka
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Christopher G. Owen
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
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Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
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Ospina Romero AM, Carvajal Carrascal G, Chinchilla Salcedo TC, Niño Hernández CA, Sarmiento González P, Mayorga Alvarez H. Effects of a Healthy Habit Promotion Strategy on Colombian Schoolchildren. AQUICHAN 2021. [DOI: 10.5294/aqui.2021.21.4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chronic non-communicable diseases (CNCD) show an increasing tendency, especially in low- and medium-income countries. It is necessary to develop and evaluate strategies to strengthen healthy habits at an early age in these countries. Objective: To determine the effect of the health promotion strategy “United for Healthier Kids” (U4HK) on health lifestyle habits of a group of Colombian schoolchildren for the 2018-2020 period. Materials and methods: This quasi-experimental study features treatment and control groups and pre- and post-intervention measurements. The study involved 1,011 schoolchildren between six and twelve years old from seven rural and urban schools of the Sabana Centro region of Colombia. We used the Healthy Habits Measurement Tool, previously validated in Colombia. Results: When comparing within and between groups, the UHK strategy showed statistically significant differences in healthy habits (p < 0.05) related to nutrition and physical activity in schoolchildren. Conclusions: The U4HK strategy had a positive effect and impact on the schoolchildren’ healthy habits, especially in the ‘chooses to drink water’ and ‘moves more’ components. There were statistically significant differences (p < 0.05) between groups in four out of the five categories: drinks more water, chooses nutritios and varied options, eats and cooks as a family, and moves more. The U4HK strategy responds to current and future health problems in schoolchildren and helps prevent chronic diseases. It could be replicated in similar populations.
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Rigney G, Watson A, Gazmararian J, Blunden S. Update on school-based sleep education programs: how far have we come and what has Australia contributed to the field? Sleep Med 2021; 80:134-157. [PMID: 33607553 DOI: 10.1016/j.sleep.2021.01.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE School-based sleep education programs help to promote sleep health information to many children and adolescents. The aim of this systematic review was to identify and describe school-based sleep education programs, to update previous reviews and identify recent advances and improvements in this field worldwide. METHODS Four electronic databases were searched. Eligibility criteria included children aged 5-18 years, sleep education intervention conducted in a school setting, and at least one pre-post-measure of a sleep variable. RESULTS A total of 32 articles met eligibility criteria with Australian sleep researchers constituting ∼ one quarter of these studies. Studies dated from 2007 to 2020 with sample sizes ranging from 9 to 3713 students. The majority of participants were high school students and predominantly female. Education programs generally took 4-6 weeks and content was consistent across studies. Overall, exposure to sleep education increased sleep knowledge, however changes in sleep behaviour variables and secondary outcome variables (eg, mental health; cognitive function; sleep hygiene practices) presented varied results. Studies conducted since 2015 were more likely to be randomised controlled trials and to include more interactive, online designs utilising innovative content such as mindfulness. CONCLUSIONS An exponential growth in school sleep education programs was identified since 2016. Future studies should consider utilising objective sleep measures, longer-term follow-ups, innovative delivery methods, and stronger attempts at implementing a knowledge-to-action approach for more sustainable programs.
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Affiliation(s)
- Gabrielle Rigney
- Central Queensland University, Appleton Institute, Adelaide, SA, Australia
| | - Autumn Watson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sarah Blunden
- Central Queensland University, Appleton Institute, Adelaide, SA, Australia.
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Smiley A, Ramos W, Elliott L, Wolter S. Comparing the Trail Users with Trail Non-Users on Physical Activity, Sleep, Mood and Well-Being Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176225. [PMID: 32867170 PMCID: PMC7503490 DOI: 10.3390/ijerph17176225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/24/2022]
Abstract
Background: The current study sought to understand whether trail users reported better wellness and health status compared to the non-users, and to recognize the associated factors. Methods: Eight trails from different locations and settings within Indiana were selected to sample trail users for the study. Additionally, areas surrounding these eight trails were included in the study as sample locations for trail non-users. Trail users and non-users were intercepted and asked to participate in a survey including demographics, socioeconomic status, physical activity, mood, smoking, nutrition, and quality of sleep. Information was collected and compared between the trail users and the non-users. Association of self-rated health, age, sex, race, marital status, employment, income, education, smoking, nutrition, sleep, and mood with trail use was evaluated by multivariable linear regression model. Results: The final sample size included 1299 trail users and 228 non-users. Environmental factors (access to nature and scenery) were important incentives for 97% and 95% of trail users, respectively. Age, sex, mood, and sleep quality were significantly associated with using the trail. Mean (SD) self-rated wellness and health out of 10 was 7.6 (1.4) in trail users and 6.5 (1.9) in non-users (p < 0.0001). Importantly, trail users were significantly more physically active outside of the trail compared to the non-users (207 vs. 189 min/week respectively, p = 0.01) and had better sleep qualities and mood scores. Using the trails was significantly associated with higher self-rated wellness and health score. The longer the use of trails, the higher the self-rated wellness and health index (β = 0.016, p = 0.03). Conclusion: Compared to not using the trails, trail use was significantly associated with more physical activity, better sleep quality, and higher self-rated wellness and health.
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Affiliation(s)
- Abbas Smiley
- Westchester Medical Center, New York Medical College, New York, NY 10595, USA;
| | - William Ramos
- Recreation Park, and Tourism Studies Department, Indiana University School of Public Health-Bloomington, Bloomington, IN 47404, USA;
| | - Layne Elliott
- Eppley Institute for Parks and Public Lands, Indiana University School of Public Health-Bloomington, Bloomington, IN 47404, USA;
| | - Stephen Wolter
- Eppley Institute for Parks and Public Lands, Indiana University School of Public Health-Bloomington, Bloomington, IN 47404, USA;
- Correspondence:
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12
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Dabravolskaj J, Montemurro G, Ekwaru JP, Wu XY, Storey K, Campbell S, Veugelers PJ, Ohinmaa A. Effectiveness of school-based health promotion interventions prioritized by stakeholders from health and education sectors: A systematic review and meta-analysis. Prev Med Rep 2020; 19:101138. [PMID: 32612906 PMCID: PMC7322344 DOI: 10.1016/j.pmedr.2020.101138] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/15/2020] [Accepted: 05/23/2020] [Indexed: 01/28/2023] Open
Abstract
Childhood obesity and associated modifiable risk factors exert significant burden on the health care system. The goal of this systematic review and meta-analysis was to examine the effectiveness of school-based intervention types perceived by Canadian stakeholders in health and education as feasible, acceptable and sustainable in terms of improving physical activity (PA), fruit and vegetable intake, and body weight. We searched multiple databases for studies that evaluated school-based interventions to prevent obesity and associated risk factors (i.e., unhealthy diet, physical inactivity, sedentary behaviour) in children aged 4–18 years from January 1, 2012 to January 28, 2020. From 10,871 identified records, we included 83 and 80 studies in our systematic review and meta-analysis, respectively. Comprehensive School Health (CSH) and interventions which focused on modifications to school nutrition policies showed statistically significant positive effects on fruit intake of 0.13 (95% CI: 0.04, 0.23) and 0.30 (95% CI: 0.1, 0.51) servings per day, respectively. No intervention types showed statistically significant effect on vegetable intake. CSH, modifications to physical education (PE) curriculum, and multicomponent interventions showed statistically significant difference in BMI of −0.26 (95% CI: −0.40, −0.12), −0.16 (95% CI: −0.3, −0.02), and −0.18 (95% CI: −0.29, −0.07), respectively. CSH interventions showed positive effect on step-count per day, but no other types of interventions showed significant effect on any of PA outcome measures. Thus, the results of this systematic review and meta-analysis suggest that decision-makers should carefully consider CSH, multicomponent interventions, modifications to PE curricula and school nutrition policies to prevent childhood obesity.
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Key Words
- BMI, body mass index
- CI, confidence interval
- CSH, Comprehensive School Health
- Childhood obesity prevention
- FV, fruit and vegetable
- HSAT, Healthy School Action Tools
- Health promotion
- MVPA, moderate to vigorous physical activity
- Meta-analysis
- PA, physical activity
- PE, physical education
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
- RCT, randomized controlled trial
- SES, socioeconomic status
- School-based interventions
- Systematic review
- UK, United Kingdom
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Affiliation(s)
| | | | - John Paul Ekwaru
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Xiu Yun Wu
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
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13
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Lambrinou CP, Androutsos O, Karaglani E, Cardon G, Huys N, Wikström K, Kivelä J, Ko W, Karuranga E, Tsochev K, Iotova V, Dimova R, De Miguel-Etayo P, M. González-Gil E, Tamás H, JANCSÓ Z, Liatis S, Makrilakis K, Manios Y. Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component. BMC Endocr Disord 2020; 20:52. [PMID: 32370795 PMCID: PMC7201517 DOI: 10.1186/s12902-020-0526-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. METHODS Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. RESULTS From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. CONCLUSIONS Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.
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Affiliation(s)
- Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Winne Ko
- International Diabetes Federation European Region, Brussels, Belgium
| | - Ernest Karuranga
- International Diabetes Federation European Region, Brussels, Belgium
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Pilar De Miguel-Etayo
- Growth, Exercise, NUtrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | - Esther M. González-Gil
- Growth, Exercise, NUtrition and Development (GENUD) Research Group. Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
- Institute of Nutrition and Food Technology. Department of Biochemistry and Molecular Biology II, Center of Biomedical Research, University of Granada, Granada, Spain
| | - Hajnalka Tamás
- University of Debrecen, Department of Family and Occupational Medicine, Debrecen, Hungary
| | - Zoltán JANCSÓ
- University of Debrecen, Department of Family and Occupational Medicine, Debrecen, Hungary
| | - Stavros Liatis
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
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14
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Liu Z, Xu HM, Wen LM, Peng YZ, Lin LZ, Zhou S, Li WH, Wang HJ. A systematic review and meta-analysis of the overall effects of school-based obesity prevention interventions and effect differences by intervention components. Int J Behav Nutr Phys Act 2019; 16:95. [PMID: 31665040 PMCID: PMC6819386 DOI: 10.1186/s12966-019-0848-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/16/2019] [Indexed: 01/28/2023] Open
Abstract
Background Childhood obesity is a serious public health concern. School-based interventions hold great promise to combat the rising trend of childhood obesity. This systematic review aimed to assess the overall effects of school-based obesity prevention interventions, and to investigate characteristics of intervention components that are potentially effective for preventing childhood obesity. Methods We systematically searched MEDLINE, CENTRAL and Embase databases to identify randomized- or cluster randomized- controlled trials of school-based obesity interventions published between 1990 and 2019. We conducted meta-analyses and subgroup analyses to determine the overall effects of obesity prevention programs and effect differences by various characteristics of intervention components on body mass index (BMI) or BMI Z-score of children. Results This systematic review included a total of 50 trials (reported by 56 publications). Significant differences were found between groups on BMI (− 0.14 kg/m2 (95% confidence interval: − 0.21, − 0.06)) and BMI Z-score (− 0.05 (− 0.10, − 0.01)) for single-component interventions; significant differences were also found between groups on BMI (− 0.32 (− 0.54, − 0.09) kg/m2) and BMI Z-score (− 0.07 (− 0.14, − 0.001)) for multi-component interventions. Subgroup analyses consistently demonstrated that effects of single-component (physical activity) interventions including curricular sessions (− 0.30 (− 0.51, − 0.10) kg/m2 in BMI) were stronger than those without curricular sessions (− 0.04 (− 0.17, 0.09) kg/m2 in BMI); effects of single-component (physical activity) interventions were also strengthened if physical activity sessions emphasized participants’ enjoyment (− 0.19 (− 0.33, − 0.05) kg/m2 in BMI for those emphasizing participants’ enjoyment; − 0.004 (− 0.10, 0.09) kg/m2 in BMI for those not emphasizing participants’ enjoyment). The current body of evidence did not find specific characteristics of intervention components that were consistently associated with improved efficacy for multi-component interventions (P > 0.05). Conclusions School-based interventions are generally effective in reducing excessive weight gain of children. Our findings contribute to increased understandings of potentially effective intervention characteristics for single-component (physical activity) interventions. The impact of combined components on effectiveness of multi-component interventions should be the topic of further research. More high-quality studies are also needed to confirm findings of this review.
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Affiliation(s)
- Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Han-Meng Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Li-Ming Wen
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Yuan-Zhou Peng
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Li-Zi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Wen-Hao Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
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