Abstract
BackgroundExcessive weight gain among youth is an ongoing public health concern. Despite evidence linking both policies and the built environment to adolescent and adult overweight, the association between health policies or the built environment and overweight are often overlooked in research with children. The purpose of this study was to examine if school-based physical activity policies and the built environment surrounding a school are associated with weight status among children.MethodsObjectively measured height and weight data were available for 2,331 grade 1 to 4 students (aged 6 to 9 years) attending 30 elementary schools in Ontario, Canada. Student-level data were collected using parent reports and the PLAY-On questionnaire administered to students by study nurses. School-level policy data were collected from school administrators using the Physical Activity Module of the Healthy School Planner tool, and built environment data were provided by the Enhanced Points of Interest data resource. Multi-level logistic regression models were used to examine the school- and student-level characteristics associated with the odds of a student being overweight or obese.ResultsThere was significant between-school random variation in the odds of a student being overweight [σ2μ0 = 0.274(0.106), p < 0.001], but not for being obese [σ2μ0 = 0.115(0.089)]. If a student attended a school that provided student access to a variety of facilities on and off school grounds during school hours or supported active transportation to and from school, he/she was less likely to overweight than a similar student attending a school without these policies. Characteristics of the built environment were not associated with overweight or obesity among this large cross-sectional sample of children.ConclusionsThis new evidence suggests that it may be wise to target obesity prevention efforts to schools that do not provide student access to recreation facilities during school hours or schools that do not support active transportation for students. Future research should evaluate if school-based overweight and obesity prevention programming might be improved if interventions selectively targeted the school characteristics that are putting students at the greatest risk.
Highlights
Excessive weight gain among youth is an ongoing public health concern
It would be informative to understand how the different preferences youth have for being active are associated with their weight status as affective attitudes are an important predictor of children’s PA [7] and because student preferences are amenable to modification
Considering that a recent systematic review identified that interventions to prevent overweight are ineffective among preschool children [29], our results suggest that there is the potential for overweight and obesity prevention programs to be effective if robust interventions are implemented early in elementary school settings; this would require evaluation
Summary
Excessive weight gain among youth is an ongoing public health concern Despite evidence linking both policies and the built environment to adolescent and adult overweight, the association between health policies or the built environment and overweight are often overlooked in research with children. Research has identified that dietary factors are associated with overweight among adolescents, data from the Continuing Survey of Food Intake for Individuals (CSFII) and the National Health and Nutrition Examination Survey III (NHANES) [4], and a recent research review [6], suggest that dietary factors are not strongly associated with overweight in children. It would be informative to understand how the different preferences youth have for being active are associated with their weight status as affective attitudes (i.e., preferences for behaviour) are an important predictor of children’s PA [7] and because student preferences are amenable to modification
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