Abstract
BackgroundPhysical activity (PA) intervention is a commonly recommended strategy to combat childhood obesity. However, its effectiveness has long been controversial. This paper aims to examine the effectiveness of long-term (≥12 months) school-based PA interventions on body mass index (BMI) in primary school children, who are gaining BMI.MethodsOriginal papers were retrieved from PubMed, Google Scholar, the Cochrane Library and Web of Science, published between 1990 and 2015. The inclusion criteria were those research studies that were: randomized controlled trials (RCTs), conducted in primary school settings, had valid data on BMI at baseline and at the final follow up (or on BMI changes), and involved PA intervention that lasted for at least 12 months.ResultsOut of 11,158 potentially eligible articles, 18 papers were included in the analysis, involving 22,381 primary school children with intervention durations ranging from 12 to 72 months. Compared to the control groups, the BMI increment was 2.23 kg/m2 less in the intervention groups (p < 0.05). The heterogeneity was high across the studies (99.8 %), but declined after sub-group analyses. The intervention type, intervention duration, and weekly PA intervention time were among the factors leading to the heterogeneity.ConclusionLong-term school-based interventions containing PA as a core component appear to be effective in achieving healthier BMI. However, the results should be interpreted with caution due to the high heterogeneity among the studies. More high quality school-based RCTs among diverse populations are needed to improve the homogeneity and to yield a more robust conclusion.
Highlights
Physical activity (PA) intervention is a commonly recommended strategy to combat childhood obesity
In the present meta-analysis, with stringent inclusion criteria, we aimed to more precisely and holistically understand whether long-term school-based randomized controlled trials (RCTs) PA interventions could benefit primary school children’s growth; and a further aim was to investigate if the study area, design and quality, intervention duration, weekly PA intervention time, PA intervention type, and measurement could lead to the significant benefits
The following criteria were used for paper selection: 1) primary school-aged children (6 to 12 year-old) regardless of their weight status, 2) RCT designed, 3) intervention conducted in the school setting, 4) PA intervention duration ≥12 months, 5) available data on the mean and standard deviation (SD) of body mass index (BMI) or the BMI changes from baseline to the final follow-up in both intervention and control groups
Summary
Physical activity (PA) intervention is a commonly recommended strategy to combat childhood obesity. This paper aims to examine the effectiveness of long-term (≥12 months) school-based PA interventions on body mass index (BMI) in primary school children, who are gaining BMI. The epidemic of childhood obesity has become a serious public health concern [1] due to its short and long-term physical and psychological consequences [2,3,4] and related economic burdens [5]. As all individuals are at risk of gaining extra weight [18], school-based PA intervention should target all students regardless of their weight status. This avoids the possible stigma caused by only putting the overweight/ obese students into the spotlight [19]
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