title: Four-year follow-up of school-based intervention on overweight children: the KOPS study.
abstract: OBJECTIVE
  To evaluate the 4-year outcome of a school-based health promotion on weight status as part of the Kiel Obesity Prevention Study (KOPS).
  
  
  METHODS
  Within a cluster-sampled quasi-randomized controlled trial, 1764 children at 6 and 10 years of age were assessed between 1996 and 2005 in 32 primary schools in Kiel, North Germany. Six nutrition units followed by 20-minute running games were performed within the first year at school. Prevalence, incidence, and remission of overweight were main outcome measures.
  
  
  RESULTS
  The 4-year change in BMI was +11.6%, with increases in prevalence of overweight and obesity from 5.2% to 11.1% and 3.9% to 5.1%, respectively. Cumulative 4-year incidence of overweight and obesity was 9.2% and 3.1%, respectively. Intervention had no effect on mean BMI. The effect on prevalence was significant in children from families with high socioeconomic status [odds ratio (OR), 0.35; 95% confidence interval (CI), 0.14 to 0.91] and marginally significant in children of normal-weight mothers (OR, 0.57; 95% CI, 0.33 to 1.00). Cumulative 4-year incidence of overweight was lower only in intervention children from families with high socioeconomic status (OR, 0.26; 95% CI, 0.07 to 0.87). Remission of overweight was most pronounced in children of normal-weight mothers (OR, 5.43; 95% CI, 1.28 to 23.01). Prevalence of underweight was unchanged. The intervention had minor but favorable effects on lifestyle.
  
  
  CONCLUSIONS
  A school-based health promotion has sustainable effects on remission and incidence of overweight; it was most pronounced in children of normal-weight mothers and children from families with high socioeconomic status. There was no effect on obesity. The data argue in favor of additional measures of prevention.
authors.affiliation: Institute of Human Nutrition and Food Science, Christian-Albrechts University, Düsternbrooker Weg 17, D-24105 Kiel, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Plachta-Danielzik
authors.forename: Svenja
authors.initials: S
authors.lastname: Pust
authors.forename: Inga
authors.initials: I
authors.lastname: Asbeck
authors.forename: Mareike
authors.initials: M
authors.lastname: Czerwinski-Mast
authors.forename: Kristina
authors.initials: K
authors.lastname: Langnäse
authors.forename: Carina
authors.initials: C
authors.lastname: Fischer
authors.forename: Anja
authors.initials: A
authors.lastname: Bosy-Westphal
authors.forename: Peter
authors.initials: P
authors.lastname: Kriwy
authors.forename: Manfred J
authors.initials: MJ
authors.lastname: Müller
mesh_terms: D001835:Body Weight / Q000502:physiology; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise / Q000502:physiology; D005195:Family Relations; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D015995:Prevalence; D012574:Schools; D012923:Social Class