title: Two-year follow-up of an obesity prevention initiative in children: the APPLE project.
abstract: BACKGROUND
  In a 2-y intervention targeting increased physical activity and healthy eating in primary school children, the adjusted body mass index (BMI) z score was 0.26 units (95% CI: 0.21, 0.32) lower in intervention than in control children. Few obesity prevention initiatives in children have undertaken follow-up analyses.
  
  
  OBJECTIVE
  The objective was to determine whether differences in BMI persisted approximately 2 y after the cessation of the intervention.
  
  
  METHODS
  All children who had at least one measurement of height and weight at any time during the study (baseline and years 1 or 2) were invited to participate in follow-up measurements (height and weight).
  
  
  RESULTS
  Five hundred fifty-four of 727 eligible children (76%) participated. Children who refused to participate (n = 14) or had moved from the study area (n = 159) did not differ from the remaining participants in baseline age, sex, or BMI. The mean BMI z score (and 95% CI) remained significantly lower in intervention children at follow-up in the whole group (n = 554; -0.17; -0.25, -0.08) and in the group who underwent at least 1 (n = 389; -0.19; -0.24, -0.13) or 2 (n = 256; -0.21; -0.29, -0.14) full years of intervention. Intervention children were less likely to be overweight, but only in those who were present for the full intervention (n = 256; RR: 0.81; 95% CI: 0.69, 0.94).
  
  
  CONCLUSIONS
  Despite the main intervention initiative (school-based activity coordinators charged with the responsibility of enhancing physical activity and promoting healthy eating) being discontinued at the end of the intervention, continued benefits to BMI remained apparent in intervention children approximately 2 y later.
authors.affiliation: Edgar National Centre for Diabetes Research, University of Otago, Dunedin, New Zealand. rachael.taylor@otago.ac.nz
authors.forename: Rachael W
authors.initials: RW
authors.lastname: Taylor
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: McAuley
authors.forename: Wyn
authors.initials: W
authors.lastname: Barbezat
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Farmer
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Williams
authors.forename: Jim I
authors.initials: JI
authors.lastname: Mann
mesh_terms: D001628:Beverages; D015992:Body Mass Index; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D004032:Diet / Q000592:standards*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D012574:Schools; D016896:Treatment Outcome; D014675:Vegetables