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Anti-obesity efforts in schools unlikely to succeed

Other approaches needed to cut child obesity, says study

Adrian O'Dowd

Thursday, 08 February 2018

Efforts by schools in using programmes designed to prevent obesity are unlikely to have much impact on childhood obesity, claims a randomised controlled trial* published today by The BMJ.

Researchers said that although schools were an important setting for promoting healthy lifestyles, wider influences such as families, local communities and the food industry, could have a greater effect than any school-run intervention.

Currently in the UK, around a quarter of children are overweight when they start school at age four or five years and the proportion of very overweight children doubles during the subsequent six years (from around 9% to 19%).

Previous reviews of the evidence suggest that school-based interventions could be effective in reducing the proportion of overweight children, but these studies have been considered weak, thus preventing any firm conclusions.

Therefore, a team of researchers led by Professor Peymane Adab at the University of Birmingham’s Institute of Applied Health Research, set out to assess the effectiveness of a specific lifestyle and healthy eating programme compared with usual practice, in preventing childhood obesity.

The programme they focused on was called West Midlands ActiVe lifestyle and healthy Eating in School children or WAVES, a 12-month school delivered intervention focusing on healthy eating and physical activity among primary school children.

Data was analysed from 1,467 children aged six and seven at 54 randomly selected state run primary schools in the West Midlands, monitored over a two and a half year period.

At the start of the trial, height and weight was recorded for each child, along with other measurements relating to body fat, diet and physical activity levels.

The WAVES programme included daily additional physical activity opportunities in schools, a physical activity and healthy eating programme in conjunction with local sporting heroes, regular information to parents about local physical activity opportunities, and workshops on healthy cooking for families at schools.

After analysing the data, the researchers found no significant difference in weight status and no meaningful effect on body fat measurements, diet or physical activity levels at 15 and 30 months in children taking part in the programme, compared with those not taking part.

The researchers acknowledged some limitations in their study, such as possible imbalances between the groups at the start of the trial, but said the study’s strengths included the large number of schools involved, and lengthy follow-up.

They concluded: “It [WAVES] did not result in any meaningful effect on adiposity, dietary intake, or physical activity after 15 or 30 months. Although such interventions can fulfil the responsibility of schools for wider education, without upstream support they are unlikely to halt the childhood obesity epidemic.

“Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments.”

*Adab, P et al. Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study). BMJ 2018;360:k211. DOI:10.1136/bmj.k211.

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