| Author(s), year | Name of trial | Main outcomes | Secondary outcomes | Assessment | Results |
|---|---|---|---|---|---|
| PeÑalvo et al., 2013 |
The Program SI! |
Children's change in knowledge, attitudes and habits (KAH) |
Parents', teachers' and school environment's change in knowledge, attitudes and habits |
Questionnaires (KAH-diet, KAH-physical activity, and KAH-human body; for children: Test of Emotional Comprehension (TEC) assessed by psychologists |
Increased children's KAH scores, both overall (3.45, 95% CI, 1.84-5.05) and component-specific (Diet: 0.93, 95% CI, 0.12-1.75; Physical activity: 1.93, 95% CI, 1.17-2.69; Human body: 0.65, 95% CI, 0.07-1.24) score. No difference on emotions. |
| Tarro et al., 2014 |
The EdAl (EducaciÓ en AlimentaciÓ) study |
BMI |
BMI z-score, waist circumference, eating habits and Physical Activity |
Anthropometric measurements, questionnaires (Krece Plus Questionnaire for eating patterns, and AVall Questionnaire for PA) |
At 28 months, obesity prevalence decreased in boys in the intervention compared to the control group (p= 0.02). BMI z-score was significantly lower in the intervention group compared to controls (overall: p < 0.001; boys: p < 0.001; girls: p < 0.001). For pre- versus post-intervention, the BMI z-score increase was significant only in boys in the control group (p= 0.015). Waist circumference changed significantly between the first and third year of the study in the intervention and control groups (p= 0.043). At 28 months, BMI was not statistically different in the intervention and control groups (p= 0.381). The incidence of overweight was significantly higher in the control group than in the intervention group (p= 0.021), particularly in boys in the control group compared to boys in the intervention group (p= 0.011). Girls did not present significant differences between the control and intervention groups. Remission of excess weight was not significantly different between the intervention and control groups, nor in relation to gender. The percentage of pupils that perform >5 hours/week PA significantly increased in the intervention group (boys: p< 0.001; girls: p= 0.005), while did not in the control group. In the intervention group, the percentage of pupils consuming pastry before setting off for school and in the mid-morning break decreased (respectively p= 0.005 and p< 0.001). In the control group, the percentage of pupils consuming pastries in the mid-morning break also decreased (p= 0.002) while the consumption of fruit or natural juice increased (p= 0.05). There were no significant differences between groups with respect to other nutritional habits. |
| Ardoy et al., 2011 |
EDUFIT (EDUcational for FITness Study) |
Fasting levels of total cholesterol, high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc) and triglycerides | Cardiorespiratory fitness, BMI, skinfold thicknesses |
Blood samples, anthropometric measurements and shuttle run test |
The intervention did not positively affect cardio-metabolic parameters except for LDLc, that was marginally yet significantly reduced in EG2 compared with the CG (p = 0.04); no differences were observed however for the LDLc/HDLc ratio. No significant effects were observed in EG1. |
| LlarguÉs et al., 2011 and 2012 |
The AVall Study | BMI | Changes in PA and food habits |
Anthropometric measurements, questionnaires |
At the end of the study period of 2 years, the intervention group presented a lower increase of the BMI (p<0.001) than controls. In the intervention group, there was a non-significant increase in nut intake (p=0.056) and also a slight reduction of daily time devoted to sedentary activities (p=0.061). |
| Martinez VizcaÌno et al., 2011 |
The MOVI Program | BMI, triceps skin-fold thickness (TST), percentage fat mass, blood lipides |
Anthropometric measurements, bioimpedenzometry, blood samples |
There were no differences in BMI between the intervention and control groups. Compared with controls, intervention children showed a decrease in TST in both boys (p<0.001) and girls (p<0.001), as well as a reduction in the percentage of body fat in girls (p=0.02). The intervention boys exhibited a decrease in apolipoprotein (apo) B levels (p=0.03) and an increase in apo A-I levels (p<0.001). Blood lipid results in girls were very similar. No changes in total cholesterol, triglycerides or blood pressure were associated with the intervention in either sex, except for an increase in diastolic blood pressure (p=0.03) in the intervention versus control boys. | |
| Moya Martinez et al., 2011 |
The MOVI Program | BMI, triceps skin-fold thickness (TST), percentage fat mass, blood lipides |
Cost effectiveness of the intervention |
Anthropometric measurements, bioimpedenzometry, blood samples |
The intervention costs totaled 125,469.75€, representing 269.83 €/year/child. The usual after-school care was estimated at 844,56 €/year/child. Intervention children showed a decrease in TST (p<.001). Intervention children with body mass index (BMI) between the percentiles 25 and 75 showed a decrease in the percentage of body fat (p<.001), and those with a BMI percentile>75 showed a decrease in TST (p<.001), and percentage of body fat (p<.05). |
| Brandstetter et al., 2012 |
URMEL-ICE (Ulm Research on Metabolism, Exercise, and Lifestyle Intervention in Children) |
BMI |
Waist circumference and skinfold thickness, child's behavior (soft-drinks consumption, playing outdoor frequency, TV watching) |
Anthropometric measurements, parent's questionnaire |
There was not statistically significant effect of the intervention on BMI, but on waist circumference (-0.85; 95% confidence interval (95% CI) -1.59 to -0.12) and subscapular skinfold thickness (-0.64; 95% CI -1.25 to -0.02). After additional adjustment for individual time lag between baseline and follow-up, these effects were reduced to -0.60 (95% CI -1.25 to 0.05) and -0.61 (95% CI -1.26 to 0.04) and lost their statistical significance. |
| Siegrist et al., 2013 |
The JuvenTUM project |
Daily PA |
BMI, waist circumference, physical fitness, media consuption |
Daily physical activity (≥ 60 min/day), physical fitness (Munich Fitness Test, six-item test battery), and anthropometric data | Physical activity and physical fitness increased in IS, but it failed to reach significant intervention effects. Nevertheless, a reduction in waist circumference was observed for all children (p< 0.001). This effect was more pronounced in overweight children (> 90th percentile, p < 0.001). |
| Walther et al., 2009 |
Change in VO2max |
BMI, BMI–standard deviation score, blood pressure, heart rate, coordination, total cholesterol, low-density lipoprotein, high-density lipoprotein cholesterol, and triglycerides; circulating endothelial progenitor cells (CPCs), migratory function of CPCs |
Anthropometric measurements, tredmill exercise test with spirometry, Body Coordination Test for Children, blood sample |
The significant effects of intervention estimated from ANCOVA adjusted for intraclass correlation were the following: increase of peak O(2) (3.7 mL/kg per minute; 95% confidence interval, 0.3 to 7.2) and increase of circulating progenitor cells evaluated by flow cytometry (97 cells per 1 x 10(6) leukocytes; 95% confidence interval, 13 to 181). No significant difference was seen for BMI standard deviation score (-0.08; 95% confidence interval, -0.28 to 0.13); however, there was a trend to reduction of the prevalence of overweight and obese children in the intervention group (from 12.8% to 7.3%). No treatment effect was seen for motor and coordinative abilities (4; 95% confidence interval, -1 to 8) and high-density lipoprotein cholesterol (0.03 mmol/L; 95% confidence interval, -0.08 to 0.14). | |
| Graf et al., 2004 |
Children's Health InterventionaL Trial (CHILT) project |
BMI, motor abilities |
Anthropometric measurements, body gross motor development test for children (KÖperkoordinationstest fÜr Kinder; KTK) and a 6-min run. |
The children were 6.70±0.42 y old, 122.72±5.36 cm tall and weighed 24.47±4.59 kg, the average BMI was 16.17±2.27 kg/m2. KTK showed an average motor quotient (MQ) of 93.49±15.01, the 6-min run an average of 835.24±110.87 m. Both tests were inversely correlated with BMI (KTK and BMI r=-0.164 (p<0.001); 6-min run and BMI r=-0.201 (p<0.001)); the group of overweight/obese children showed poorer results than the normal/underweight ones, even after adjustment for gender and age (in each case p<0.001). Children with the greatest extent of exercise achieved the highest MQ (p=0.035). | |
| Graf et al., 2005 |
Children's Health InterventionaL Trial (CHILT) project |
BMI, motor abilities |
Anthropometric measurements, lateral jumping and endurance performance by a 6-minute run. |
No difference in the prevalence of overweight and obesity was found between the intervention and control schools either at baseline or following intervention (each p> 0.05). The increase in the number of lateral jumps was significantly higher in the intervention group than in the controls (p< 0.001). For the 6-minute run the increase in distance run was significantly improved in intervention group (p= 0.020). Overweight and obese children in both groups produced significantly lower scores in coordination and endurance tasks than normal and underweight children during both examinations (each p≤ 0.001), adjusted for gender and age. | |
| Graf et al., 2008 |
Children's Health InterventionaL Trial (CHILT) project (4 year follow up) |
BMI, physical performance |
Anthropometric measurements, coordination test for children (balancing backwards, one-legged obstacle jumping, lateral jumping, sideways movements) and a 6-min run (endurance). |
No difference in the prevalence and incidence of overweight and obesity was found between the intervention and control schools before and after the intervention. Remission of overweight was higher in the intervention schools (23.2 vs. 19.2%), but not significant. An increase in coordination related to lateral jumping and balancing backwards was apparent in the intervention schools (respectively, p= 0.005 and p= 0.007), and the increase in endurance performance was higher in intervention schools (p= 0.055), adjusted for age, sex, baseline test result, and BMI at final examination. | |
| Kriemler et al., 2010 |
KISS (Kinder-Sportstudie) |
Body fat (sum of four skinfolds), aerobic fitness, physical activity (accelerometry), and quality of life (QoL). |
BMI and cardiovascular risk score (average z score of waist circumference, mean blood pressure, blood glucose, inverted HDL-cholesterol, and triglycerides). |
Anthropometric measurements, 20-m shuttle test (20–MST), accelerometer, Child Health Questionnaire (QoL), blood sample |
Children in the intervention group compared with controls showed a decrease in the z score of the sum of four skinfolds (p=0.009). In the intervention group, z scores for aerobic fitness increased more favourably (p=0.04), as well as moderate-vigorous PA in school (p<0.001), all day moderate-vigorous PA (p=0.03), and total PA in school (p=0.003). Z scores for overall daily PA, physical and psychological QoL did not change significantly. |
| Hartmann et al., 2010 a |
KISS (Kinder-Sportstudie) |
Quality of Life |
BMI |
Child Health Questionnaire |
Physical QoL in first graders and physical and psychosocial QoL in fifth graders were not affected by the intervention. In first graders, the PA intervention had a positive impact on psychosocial QoL (p < .05). Subpopulation analyses revealed that this effect was caused by an effect in urban (p < .05) and overweight first graders (p < .05). |
| Hartmann et al., 2010 b |
KISS (Kinder-Sportstudie) |
Perceived Physical Health, Fear of Negative Evaluation (FNE) |
Physical activity |
Child Health Questionnaire, Social Anxiety Scale for Children—Revised, accelerometer. |
Cross-sectional analyses indicated that children high in FNE exercised less, reported lower levels of PPH and had higher BMI z-scores (p<0.01). Using mixed linear models, the school-based PA intervention did not manage to reduce FNE scores. Overweight children demonstrated a greater increase in FNE (p<0.05) indicating that enhanced weight may be a risk factor for FNE. |
| Meyer et al., 2011 |
KISS (Kinder-Sportstudie) |
Bone Mineral Content (BMC) and Bone Mineral Density (BMD) |
Physical activity |
Dual-energy X-ray absorptiometry (DXA), accelerometer |
Compared to controls, children in intervention group showed statistically significant increases in BMC of total body, femoral neck, and lumbar spine (all p<0.05), respectively, and BMD of total body and lumbar spine (both p<0.01), respectively. There was no gender *group, but a pubertal stage *group interaction consistently favoring prepubertal children. |
| Meyer et al., 2013 |
KISS (Kinder-Sportstudie) 3 year follow up |
Bone Mineral Content (BMC) and Bone Mineral Density (BMD) |
Dual-energy X-ray absorptiometry (DXA) |
At follow-up, the intervention group showed significantly higher Z-scores of BMC at total body (p=0.015), femoral neck (p=0.042) and at total hip (p=0.016) and higher Z-scores of aBMD for total body (p=0.030) compared to controls, representing 6-8% higher values in favour of intervention groups. No differences could be found for the remaining bone parameters. For the subpopulation with baseline VPA (n=163), effect sizes became stronger after baseline VPA adjustment. After adjustment for baseline and current VPA (n=101), intervention effects were no longer significant, while effect sizes remained the same. | |
| Puder et al., 2011 |
The Ballabeina Study | Aerobic fitness, BMI |
Motor agility, balance, percentage body fat, waist circumference, physical activity, eating habits, media use, sleep, quality of life, and cognitive abilities. |
Anthropometric measurements, 20-m shuttle test (20–MST), accelerometer, dynamic and static balance tests, accelerometer, bioelectrical impedence, QoL questionnaire (PedsQL 4.0), attention and spatial working memory tests, eating, sleep and screen view habits questionnaires. |
Compared with controls, children in the intervention group had an increase in aerobic fitness at the end of the intervention (p=0.01) in motor agility (p=0.004), percentage body fat (p=0.02), and waist circumference (p=0.001), but no difference in BMI (p=0.31). There were also significant benefits in the intervention group in reported physical activity, media use, and eating habits, but not in the remaining secondary outcomes. |
| Niederer et al., 2013 |
The Ballabeina Study |
Aerobic fitness, BMI |
Sum of four skinfolds, waist circumference and motor agility. |
Anthropometric measurements, 20-m shuttle test (20–MST) |
Compared to their counterparts, overweight children (n = 130) had more beneficial effects on waist circumference (p for interaction= 0.001), and low fit children (n= 154) more beneficial effects on all adiposity outcomes (p for interaction≤0.03). The intervention effects on both fitness outcomes were not modified by BMI- or fitness-group (all p for interaction ≥0.2). |
| Bergh et al., 2012 a |
The HEalth in Adolescents (HEIA) Study |
Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools |
Covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants |
At mid-way, enjoyment (p= .03), perceived social support from teachers (p= .003) and self-efficacy (p= .05) were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p= .001), while a negative effect was found for self-efficacy (p= .02). Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Positive effects on several determinants were observed among those receiving a high as opposed to a low intervention dose. | |
| Bergh et al., 2012 b |
The HEalth in Adolescents (HEIA) Study |
Six theoretical mediators of the PA intervention: enjoyment of PA, self-efficacy, perceived social support from parents, friends and teachers, perceived environmental opportunities |
Questionnaire |
None of the personal, social or physical-environmental constructs targeted in the intervention were found to mediate the PA outcome. The only mediator positively affected by the intervention was perceived social support from teachers. The subgroup analyses revealed that this effect was present in girls and normal weight adolescents only. | |
| Grydeland et al., 2013 |
The HEalth in Adolescents (HEIA) Study |
Increase PA, decrease sedentary activities |
BMI |
Accelerometer, anthropometric measurements |
Intervention effect on overall physical activity at the level of p=0.05, with a net effect of 50 cpm (count per minute), increased from baseline to post intervention in favour of the intervention group. Subgroup analyses showed that the effect appeared to be more profound among girls (p=0.03) and among participants in the low-activity group (p<0.001), as compared to boys and participants in the high-activity group, respectively. Furthermore, the intervention affected physical activity among the normal weight group more positively than among the overweight, and participants with parents having 13-16 years of education more positively than participants with parents having either a lower or higher number of years of education. The intervention seemed to reduce sedentary activities among girls but not among boys. |
| Ezendam et al., 2012 |
FATaintPHAT | Self-reported behaviors (diet, physical activity, sedentary behavior), PA (at 4 months assessment) |
BMI, body fat and physical fitness (at 2 year follow up) |
Questionnaire, pedometer, anthropometric measurements, shuttle-run test |
The intervention had no effect on BMI and waist circumference. However, it was associated with lower odds (0.54) of drinking more than 400 mL of sugar-sweetened beverages per day and with lower snack intake (β = -0.81 snacks/d) and higher vegetable intake (β = 19.3 g/d) but also with a lower step count (β = -10 856 steps/wk) at 4-month follow-up. In addition, among students at risk, FATaintPHAT had a positive effect on fruit consumption (β = 0.39 g/d) at 4-month follow-up and on step count (β = 14 228 steps/wk) at 2-year follow-up but an inverse effect on the odds of sports participation (odds ratio, 0.45) at 4-month follow-up. No effects were found for sedentary behavior. |
| Collard et al., 2010 |
iPlay intervention |
PA IID (number of injuries per 1000 hours of sports participation) and injury severity |
Questionnaire, anthropometric measurements |
The IID (number of injuries per 1000 hours of sports participation) for total PA participation was 0.38 (95% CI, 0.31-0.46) in the intervention group, compared with 0.48 (95% CI, 0.38-0.57) in the control group. In the low active group, effects of the iPlay program were much larger, with a 50% reduction in total injuries (HR,0.47; 95% CI, 0.21-1.06) and a more than 50% reduction for sports injuries (HR,0.23; 95% CI, 0.07-0.75) and leisure time injuries (HR,0.43; 95% CI, 0.16-1.14). Children in the intervention group reported fewer severe injuries than those in the control group. The multilevel logistic regression analyses showed that there was no significant difference between the intervention and control groups in the percentage of children with sporting time lost. | |
| Singh et al. 2007 |
Dutch Obesity Intervention in Teenagers (DOiT) |
Waist and hip circumference, skinfolds, and BMI class |
Aerobic fitness |
Anthropometric measurements, 18 m shuttle run test |
Multilevel analyses showed significant differences in changes after the 8-month intervention period in favor of the intervention group with regard to hip circumference (mean difference, 0.53 cm; 95% confidence interval, 0.07 to 0.98) and sum of skinfolds among girls (mean difference, −2.31 mm; 95% confidence interval, −4.34 to −0.28). In boys, the intervention resulted in a significant difference in waist circumference (mean difference, −0.57 cm; 95% confidence interval, −1.10 to −0.05). No significant intervention effects were found related to BMI and aerobic fitness. |
| Singh et al. 2009 |
DOiT (Dutch Obesity Intervention in Teenagers) |
BMI, waist circumference, 4 skinfold thickness measurements |
Changes in dietary and physical activity behavior |
Anthropometric measurements, questionnaires |
The intervention remained effective in preventing unfavorable increases in important measures of body composition after 20-month follow-up in girls (biceps skinfold and sum of 4 skinfolds) and boys (triceps, biceps, and subscapular skinfolds). No significant effect was found on BMI. Consumption of sugar-containing beverages was significantly lower in intervention schools both after intervention (boys: -287 mL/d; 95% confidence interval [CI], -527 to -47; girls: -249; -400 to -98) and at 12-month follow-up (boys: -233; -371 to -95; girls: -271; -390 to -153). For boys, screen-viewing behavior was significantly lower in the intervention group after 20 months (-25 min/d; 95% CI, -50 to -0.3). No significant intervention effects on consumption of snacks or active commuting to school were found. |
| Bonsergent et al., 2013 |
PRALIMAP (PRomotion de l'ALIMentation et de l'ActivitÉ Physique) |
BMI percentile |
BMI z-score , prevalence of overweight and obesity, eating attitudes, anxiety and depression |
Anthropometric measurements, questionnaires (Eating Attitudes Test 40 (EAT-40) and Hospital Anxiety and Depression (HAD)) |
The 2-year change of outcomes was more favorable in the 12 screening and care high schools compared to the no-screening ones: a 0.11 lower increase in BMI (p=0.0303); a 0.04 greater decrease in BMI z-score (p=0.0173); and a 1.71% greater decrease in overweight/obesity prevalence (p=0.0386). Education and environment strategies were not more effective than no strategy intervention. |
| Thivel et al., 2011 |
BMI, body fat |
Aerobic and anaerobic fitness |
Anthropometric measurements, 4 skinfold thickness, 20-m shuttle run test, cycling peak power test |
The intervention did not yield positive anthropometric improvements, but appears effective in terms of aerobic and anaerobic physical fitness in both lean and obese children. | |
| Simon et al., 2008 |
ICAPS (ntervention Centered on Adolescents’ Physical activity and Sedentary behavior) |
BMI |
Changes in body composition, PA, PA attitudes, self-efficacy, cardiovascular risk factors |
Anthropometric measurements, bioelectrical impedance analysis, blood samples, self-reported leisure PA (Modifiable Activity Questionnaire for adolescents), self efficacy (Stanford Adolescent Heart Health Program’s questionnaire), blood sample (plasma glucose, total and high-density lipoproteincholesterol, triacylglycerols and insulin) |
Intervention students had a lower increase in BMI (p=0.01) and age- and gender-adjusted BMI (p<0.02) over time than controls. An interaction with baseline weight status was noted. The intervention had a significant effect throughout the study in initially non-overweight adolescents, corresponding to a lower increase in fat mass index (p<0.001). In initially overweight adolescents, the differences observed across groups at 2 years did not persist over time. At 4 years, 4.2% of the initially non-overweight adolescents were overweight in the intervention schools, 9.8% in the controls (p<0.01). Independent of initial weight status, intervention adolescents had an increase in supervised physical activity (p<0.0001), a decrease of TV/video viewing (p<0.01) and an increase of high-density cholesterol concentrations (p<0.0001) compared with controls. |
| De Coen et al., 2012 |
POP (Prevention of Overweight among Pre-school and schoolchildren) |
BMI z-score |
Eating behavior, physical activity and screen-time. |
Anthropometric measurements, questionnaires |
No significant effects were found on BMI Z-scores for the total sample. However, there was a significant decrease in BMI Z-score of 0·11 in the low-SocioEconomicStatus intervention community compared with the low-SES control community, where the BMI Z-score increased by 0·04 (p= 0·01). No significant intervention effects could be found for eating behaviour, physical activity or screen-time. There were no significant interaction effects of age and gender of the children on the outcome variables |
| Haerens et al., 2006 |
Physical Activity |
Fat intake, fruit, water and soft drink consumption |
Questionnaires (Flemish Physical Activity Questionnaire (FPAQ), questionnaire on food intake), accelerometer |
The intervention showed significant effects on PA in both genders and on fat intake in girls. Parental involvement did not increase intervention effects. In boys, significant 2-year post-baseline intervention effects on levels of PA, but not on eating behaviours, were found. School-related PA increased significantly more in the intervention groups compared with controls (p< 0.05). Accelerometer data revealed a trend for significant lower decreases in low-intensity PA in the intervention groups compared with controls (p< 0.001). Time spent in MVPA remained stable in the intervention group, while it significantly decreased in the controls (p< 0.05). In girls, significant 2-year post-baseline intervention effects were found for both PA and eating behaviours. In girls, the intervention was effective in preventing decreases of low intensity PA. Time spent in low-intensity PA decreased significantly less in the intervention groups compared with the controls (p< 0.05). Decreases in fat intake and percent energy from fat were significantly higher in the intervention groups compared with the controls (p< 0.05). | |
| Haerens et al., 2007 |
PA levels |
Accelerometer, questionnaire |
The intervention with parental support led to an increase in self-reported school-related PA of, on average, 6.4 minutes per day (p≤ .05). Low intensity PA measured with accelerometers decreased with, on average, 36 minutes per day as a result of the intervention with parental support (p≤.05). MVPA measured with accelerometers significantly increased with on average 4 minutes per day in the intervention group with parental support, while it decreased with almost 7 minutes per day in the controls (p ≤ .05, d = .46). | ||
| Kipping et al., 2008 |
Active for Life year 5 |
Hours of screen activities, body mass index, mode of transport to school and teachers' views of the intervention. |
Anthropometric measurements, questionnaires |
Children from intervention schools spent less time on screen-viewing activities after the intervention but these differences were imprecisely estimated: mean difference in minutes spent on screen viewing at the end of the intervention (intervention schools minus control schools) adjusted for baseline levels and clustering within schools was -11.6 (95% CI -42.7 to 19.4) for a week day and was -15.4 (95% CI -57.5 to 26.8) for a Saturday. There was no difference in mean body mass index or the odds of obesity. | |
| Sahota et al., 2001 a |
APPLES (Active Program Promoting Lifestyle Education in Schools) |
BMI, diet, physical activity, and psychological state. |
Anthropometric measurements, 3-day food diary and 24h-recall, questionnaires |
Vegetable consumption by 24 hour recall was higher in children in the intervention group than the control group (weighted mean difference 0.3 portions/day, 95% confidence interval 0.2 to 0.4), representing a difference equivalent to 50% of baseline consumption. Fruit consumption was lower in obese children in the intervention group (-1.0, -1.8 to -0.2) than those in the control group. The three day diary showed higher consumption of high sugar foods (0.8, 0.1 to 1.6)) among overweight children in the intervention group than the control group. Sedentary behaviour was higher in overweight children in the intervention group (0.3, 0.0 to 0.7). Global self worth was higher in obese children in the intervention group (0.3, 0.3 to 0.6). There was no difference in body mass index, other psychological measures, or dieting behaviour between the groups. | |
| Sahota et al., 2001 b |
APPLES (Active Program Promoting Lifestyle Education in Schools) |
Response rates to questionnaires, teachers' evaluation of training and input, success of school action plans, content of school meals, and children's knowledge of healthy living and self reported behaviour. |
Questionnaire |
All 10 schools participated throughout the study. 76 (89%) of the action points determined by schools in their school action plans were achieved, along with positive changes in school meals. A high level of support for nutrition education and promotion of physical activity was expressed by both teachers and parents. 410 (64%) parents responded to the questionnaire concerning changes they would like to see implemented in school. 19 out of 20 teachers attended the training, and all reported satisfaction with the training, resources, and support. Intervention children showed a higher score for knowledge, attitudes, and self reported behaviour for healthy eating and physical activity. | |
| Butcher et al., 2007 |
Steps/minutes |
Pedometer |
Students in the FB+I group achieved significantly more steps per minute than those in the FB (p= 0.003) and CON (p= 0.0001) groups. | ||
| Hardman et al., 2011 |
Fit 'n' Fun Dude |
Physical Activity |
BMI, waist circunference |
Steps per day, anthropometric measurements |
During the intervention, the full intervention school showed the largest increase in physical activity relative to baseline (p< 0.001). There was a smaller increase in the no-rewards school (p< 0.03), and no significant change in the control. At the end of the taper phase, physical activity in the no-rewards school continued to increase (p< 0.001) but had returned to baseline in the full intervention school. The intervention that used only peer-modelling and pedometer goals produced better effects over time. No effect was found for either intervention on BMI and waist circumference compared with controls. |
| Chatzisarantis & Hagger, 2009 |
Self reported vigorous PA |
Teacher's autonomy support perceived, intention to perform leisure time PA, |
Leisure Time Exercise Questionnaire |
Pupils who were taught by autonomy-supportive teachers reported stronger intentions to exercise during leisure time and participated more frequently in leisure-time physical activities than pupils in the control condition. Autonomous motivation and intentions mediated the effects of the intervention on self-reported physical activity behaviour. | |
| Magnusson et al., 2011 |
Physical Activity |
BMI percentile |
PA was assessed by means of accelerometers and subjectively at the intervention schools via teachers' PA log-books; anthropometric measurements |
There was no difference in PA intensity (minutes of moderate-to-vigorous physical activity - min of MVPA) between the two study groups at baseline, but children in the intervention schools were more physically active at moderate-to-vigorous intensity compared to those in control schools after one year of intervention (p= 0.04). A significantly greater increase of MVPA was showed among the boys in the intervention schools compared to girls (p= .02). No difference in PA was detected between the study groups at the end of the study period after two years of intervention. | |
| Magnusson et al., 2012 |
BMI, skinfolds, waist circumference, percentage lean mass, percentage fat mass |
Relationship between the change in cardiorespiratory fitness over time and the change in body fat. |
Anthropometric measurements, dual energy x-ray scan (DEXA), ergometer bike |
None of the effect sizes of body composition were statistically significant. Children in the intervention group increased their fitness by an average of 0.37 z score units more than the controls (p= 0.18). Boys had higher fitness (p= 0.001) than girls, independent of study group, fitness z score at baseline andBMI. Post hoc analysis showed that the intervention school with the highest fitness z score change was significantly different from two of the lowest control schools (respectively, p< 0.0001 and p= 0.01), but it was also significantly different from the lowest intervention school (p= 0.05). | |
| Sacchetti et al., 2013 |
SAMBA project (Sorveglianza dell'AttivitÀ Motoria nei Bambini) |
Physical abilities |
Physical fitness, BMI |
Sport participation and daily activity habits were assessed by a self-administered questionnaire (PAQ-C). Anthropometric measurements. Physical performance was assessed by means of standardized tests (Sit & Reach test: flexibility; 2 kg medicine-ball forward throw test: upper limbs explosive strength; standing long jump test: lower body and legs explosive strength; 20m running speed test: speed and anaerobic power; forward roll test: self-perception in space and dynamic total body coordination). | The enhanced program of physical education was effective in improving physical abilities of children and determining a decrease (boys: 10%; girls: 12%) in daily sedentary activities (preintervention versus postintervention, p < .05; intervention versus control group, p < .01). The percentages of overweight and obese children did not vary significantly, but the experimental group showed a significantly lower rise in BMI compared to the control group (p < .001). |
| AraÚjo-Soares et al., 2009 |
Moderate to vigorous Physical Activity |
Social Cognitive Theory (SCT), Self-regulation Theory (SRT) and planning variables |
Questionnaires (International Physical Activity Questionnaire, Questionnaires on SCT and SRT) |
At post-test, participants in the intervention group 18 min more PA, adjusted for pre-intervention, age and sex, than those in the control group (p = 0.249). This difference increased to 33 min (p = 0.082) at three months and to 57 min (p = 0.008) at nine-month follow-up. Moreover, the intervention resulted in changes of some of the theoretical target variables, including outcome expectancies and coping planning. However, no evidence was found for the changes in theoretical moderators to mediate the intervention effects on behaviour. | |
| Angelopoulos et al., 2009 |
The CHILDREN study |
BMI, blood pressure |
Moderate to vigorous PA, diet |
Anthropometric measurements, blood pressure measures, questionnaire |
The intervention group increases leisure timpe moderate to vigorous PA, while controls decrease it (p=0.04). IG had higher consumption of fruits (p=0.04) and lower consumption of fats/oils (p=0.02) and sweets/beverages (0.03) compared with the CG. Intervention's effect on BMI (p=0.04) could be explained by the changes in fruit and fats/oils intake whereas the reduction of systolic and diastolic BP (p= 0.016 and p= 0.05) could be explained by the reduction of BMI. |
| Marcus et al., 2009 |
STOPP (School and after school care-based Obesity Prevention Programme) |
BMI, Physical Activity |
Healthy eating habits |
Accelerometer, anthropometric measurements, questionnaire (ChEAT (Children’s Eating Attitude Test). |
The prevalence of overweight and obesity decreased by 3.2% in intervention schools compared with an increase of 2.8% in control schools (p<0.05). The results showed no difference between intervention and controls, after cluster adjustment, in the longitudinal analysis of BMIsds changes. However, a larger proportion of the children who were initially overweight reached normal weight in the intervention group compared with the control group (p=0.017). PA did not differ between intervention and control schools after cluster adjustment. Eating habits at home were found to be healthier among families with children in intervention schools at the end of the intervention. There was no difference between children in intervention and control schools in self-reported eating disorders. |