Abstract
This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.
Highlights
Childhood obesity is a serious public health challenge worldwide
Recent systematic reviews indicated that the proportion of individuals with three or more abnormal metabolic indicators from blood test was much higher among children with obesity than normal-weight children (61.1% vs. 0.6%) [4]
Children in the control group (CG) had a significantly higher height than those in the intervention group (IG), no significant differences in sex ratio, age, weight, and monthly household income level were found between the two groups
Summary
The global prevalence of overweight and obesity combined for children rose by 47.1% between 1980 and 2013 [1]. China is one of the largest contributors, accounting for 5.1% (15.4 million individuals) of global obesity in 2015 [2]. The National Surveys on Chinese Students’ Constitution and Health reported that 20.3% of children aged 7–12 years suffered from obesity [3]. As a result of possessing unhealthy lifestyle factors such as poor diet and lack of physical activity, children with obesity have increased risks for metabolic diseases and poor mental health [4,5]. Children with obesity were more likely to suffer from depression (Odds ratio, OR = 1.46) and anxiety (OR = 1.47) [6]. The prevalence of depression and anxiety among children/adolescents with overweight or obesity in China is alarming, at 21.7% and
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