Abstract
BackgroundAn important challenge of school-based childhood obesity (OB) intervention programs is understanding the maintenance of the effects after cessation of the intervention to overcome the limitations of follow-up studies. The aim of this study is to verify the sustainability of the benefits achieved at a 4-year follow-up of the post-Educació en Alimentació (EDAl) program intervention cessation by assessing the OB-related outcomes and lifestyles of 13- to 15-year-old adolescents.MethodsThis paper describes a 4-year follow-up study after the cessation of a school-based randomized controlled intervention in adolescents (n = 349, intervention; n = 154, control) with baseline and 4-year follow-up data from high schools in Reus (intervention group), Salou, Cambrils and Vila-seca (control group). The outcomes are body mass index (BMI), BMI z-score, and OB prevalence according to the World Health Organization and International Obesity Task Force criteria and lifestyle data (obtained from questionnaires).ResultsCompared with the control girls, the intervention girls showed reduced BMI z-scores (−0.33 units, p < 0.01) from baseline (2007) to the 4-year follow-up post-intervention (2014). Compared with the control boys, the intervention boys showed reduced OB prevalence (−7.7%; p = 0.02). Compared with the control boys, more boys in the intervention group (19% increase; p = 0.059) showed ≥4 h/week after-school physical activity (PA). A decrease in the consumption of dairy products, fruits and fish was observed in both groups.ConclusionsAt the 4-year post-intervention follow-up of the EdAl program, compared with the control groups, girls had lower BMI z-scores and boys had lower OB prevalence from the intervention. The encouragement in after-school PA was long-lasting and maintained after the cessation of the intervention, whereas healthy food habits must be further reinforced in adolescents.Trial registrationISRCTN29247645.
Highlights
An important challenge of school-based childhood obesity (OB) intervention programs is understanding the maintenance of the effects after cessation of the intervention to overcome the limitations of follow-up studies
We have previously shown that the effects of the primary school-based Educació en Alimentació (EdAl) program that was applied in a Spanish area (24 schools, n = 1222 in the intervention group and 14 schools and n = 717 in the control group) resulted in a successful reduction in the prevalence of childhood OB in boys by 4.39%
Design and setting of the study The aim of the present study is to verify the sustainability of the benefits that were achieved at 4-year follow-up post-EdAl intervention by assessing the OB-related outcomes and lifestyles in 13- to 15-year-old adolescents in 2014, 4 years after the cessation of EdAl intervention participation
Summary
An important challenge of school-based childhood obesity (OB) intervention programs is understanding the maintenance of the effects after cessation of the intervention to overcome the limitations of follow-up studies. The aim of this study is to verify the sustainability of the benefits achieved at a 4-year follow-up of the post-Educació en Alimentació (EDAl) program intervention cessation by assessing the OB-related outcomes and lifestyles of 13- to 15-year-old adolescents. To discover effective interventions that reduce OB over the long-term after the cessation of an intervention is challenging, and scarce information is available for this purpose [6]. A Cochrane review of interventions for preventing OB in children and adolescents emphasized that education may make it possible to prevent OB and that the long-term effects of an intervention should be assessed [6]
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