title: Effectiveness of school programs in preventing childhood obesity: a multilevel comparison.
abstract: OBJECTIVE
  In light of the alarming increase in childhood obesity and lack of evidence for the effectiveness of school programs, we studied the effects of school programs in regard to preventing excess body weight.
  
  
  METHODS
  In 2003, we surveyed 5200 grade 5 students along with their parents and school principals. We measured height and weight, assessed dietary intake, and collected information on physical and sedentary activities. We compared excess body weight, diet, and physical activity across schools with and without nutrition programs using multilevel regression methods while adjusting for gender and socioeconomic characteristics of parents and residential neighborhoods.
  
  
  RESULTS
  Students from schools participating in a coordinated program that incorporated recommendations for school-based healthy eating programs exhibited significantly lower rates of overweight and obesity, had healthier diets, and reported more physical activities than students from schools without nutrition programs.
  
  
  CONCLUSIONS
  Our finding that school programs are effective in preventing childhood obesity supports the need for broader implementation of successful programs, which will reduce childhood obesity and, in the longer term, comorbid conditions and health care spending.
authors.affiliation: Department of Public Health Sciences, Faculty of Medicine and Dentistry, University of Alberta, Room 13-106D, Clinical Sciences Bldg, Edmonton, Alberta T6G 2G3, Canada. paul.veugelers@ualberta.ca
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Veugelers
authors.forename: Angela L
authors.initials: AL
authors.lastname: Fitzgerald
mesh_terms: D001827:Body Height; D001835:Body Weight; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D004034:Diet Surveys; D015444:Exercise; D017408:Guidelines as Topic; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D016014:Linear Models; D016015:Logistic Models; D009674:Nova Scotia / Q000453:epidemiology; D018673:Nutrition Policy; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D010290:Parents / Q000193:education / Q000523:psychology; D015397:Program Evaluation; D012307:Risk Factors; D012572:School Health Services / Q000458:organization & administration*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States
references.citation: Aust Fam Physician. 2004 Jan-Feb;33(1-2):33-6
references.pmid: 14988958
references.citation: N Engl J Med. 1999 Oct 7;341(15):1097-105
references.pmid: 10511607
references.citation: BMJ. 2000 May 6;320(7244):1240-3
references.pmid: 10797032
references.citation: Am J Epidemiol. 2001 Oct 15;154(8):725-32
references.pmid: 11590085
references.citation: Int J Obes Relat Metab Disord. 2002 Apr;26(4):538-43
references.pmid: 12075581
references.citation: Obes Rev. 2001 Aug;2(3):149-57
references.pmid: 12120100
references.citation: Lancet. 2002 Aug 10;360(9331):473-82
references.pmid: 12241736
references.citation: Ann Intern Med. 2003 Jan 7;138(1):24-32
references.pmid: 12513041
references.citation: JAMA. 2003 Jan 8;289(2):187-93
references.pmid: 12517229
references.citation: JAMA. 2003 Jan 8;289(2):229-30
references.pmid: 12517236
references.citation: Qual Saf Health Care. 2003 Feb;12(1):65-74
references.pmid: 12571349
references.citation: N Engl J Med. 2003 Apr 24;348(17):1625-38
references.pmid: 12711737
references.citation: J Epidemiol Community Health. 2003 Jun;57(6):424-8
references.pmid: 12775787
references.citation: J Nutr. 2003 Nov;133(11):3476-84
references.pmid: 14608061
references.citation: N Engl J Med. 2004 Feb 26;350(9):855-7
references.pmid: 14985480
references.citation: Am J Public Health. 2004 Jul;94(7):1181-5
references.pmid: 15226140
references.citation: Am J Epidemiol. 1981 Oct;114(4):593-603
references.pmid: 7304589
references.citation: Am J Epidemiol. 1992 May 15;135(10):1077-82
references.pmid: 1632420
references.citation: J Am Diet Assoc. 1995 Mar;95(3):336-40
references.pmid: 7860946
references.citation: MMWR Recomm Rep. 1996 Jun 14;45(RR-9):1-41
references.pmid: 8637498
references.citation: MMWR Recomm Rep. 1997 Mar 7;46(RR-6):1-36
references.pmid: 9072670
references.citation: J Am Diet Assoc. 2004 Apr;104(4):660-77
references.pmid: 15054355