Abstract
BackgroundChildhood obesity has been increasing rapidly worldwide. There is limited evidence for effective lifestyle interventions to prevent childhood obesity worldwide, especially in developing countries like China. The objective of this study was to assess the effectiveness of a school-based multi-component lifestyle childhood obesity prevention program (the CLICK-Obesity study) in Mainland China.MethodsA cluster randomized controlled trial was developed among grade 4 students from 8 urban primary schools (638 students in intervention, 544 as control) in Nanjing City, China. Students were randomly allocated to the control or intervention group at school-level. A one-year multi-component intervention program (classroom curriculum, school environment support, family involvement and fun programs/events) together with routine health education was provided to the intervention group, while the control group received routine health education only. The main outcome variables assessed were changes in body mass index, obesity occurrence, obesity-related lifestyle behaviors and knowledge.ResultsOverall, 1108 (93.7%) of the 1182 enrolled students completed the intervention study. The intervention group had a larger marginal reduction than did the control group in overall mean BMI value (-0.32±1.36 vs. -0.29±1.40, p = 0.09), although this was not significant. Compared with the control group, the intervention group was more likely to decrease their BMI (OR = 1.44, 95%CI = 1.10, 1.87) by 0.5 kg/m2 or above, increase the frequency of jogging/running (OR = 1.55, 95%CI = 1.18, 2.02), decrease the frequency of TV/computer use (OR = 1.41, 95%CI = 1.09, 1.84) and of red meat consumption (OR = 1.50, 95%CI = 1.15, 1.95), change commuting mode to/from school from sedentary to active mode (OR = 2.24, 95%CI = 1.47, 3.40), and be aware of the harm of selected obesity risk factors.ConclusionsThe school-based lifestyle intervention program was practical and effective in improving health behaviors and obesity-related knowledge for children in China. This study provides important policy implications on school-based intervention programs for modifications of obesity-related lifestyles.Trial RegistrationChinese Clinical Trial Registry ChiCTR-ERC-11001819
Highlights
Childhood obesity has become a serious public health problem in both developed countries and developing societies including China [1,2,3,4,5]
The intervention group had a larger marginal reduction than did the control group in overall mean body mass index (BMI) value (-0.32±1.36 vs. -0.29±1.40, p = 0.09), this was not significant
We developed a school-based multi-component lifestyle intervention, the CLICK-Obesity study, which aimed to reduce childhood obesity in China
Summary
Childhood obesity has become a serious public health problem in both developed countries and developing societies including China [1,2,3,4,5]. Reducing childhood obesity requires effective lifestyle and behavior interventions that target healthy eating and physical activity (HEPA) among the general child population. Most intervention studies regarding lifestyle and behavior modifications among children are school-based trials that have been conducted in Western societies with very few relevant studies in China [8,9,10,11,12]. We developed a school-based multi-component lifestyle intervention, the CLICK-Obesity study, which aimed to reduce childhood obesity in China. There is limited evidence for effective lifestyle interventions to prevent childhood obesity worldwide, especially in developing countries like China. The objective of this study was to assess the effectiveness of a school-based multi-component lifestyle childhood obesity prevention program (the CLICKObesity study) in Mainland China
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