title: Effect of an environmental school-based obesity prevention program on changes in body fat and body weight: a randomized trial.
abstract: This study tested the efficacy of two school-based programs for prevention of body weight/fat gain in comparison to a control group, in all participants and in overweight children. The Louisiana (LA) Health study utilized a longitudinal, cluster randomized three-arm controlled design, with 28 months of follow-up. Children (N = 2,060; mean age = 10.5 years, SD = 1.2) from rural communities in grades 4-6 participated in the study. Seventeen school clusters (mean = 123 children/cluster) were randomly assigned to one of three prevention arms: (i) primary prevention (PP), an environmental modification (EM) program, (ii) primary + secondary prevention (PP+SP), the environmental program with an added classroom and internet education component, or (iii) control (C). Primary outcomes were changes in percent body fat and BMI z scores. Secondary outcomes were changes in behaviors related to energy balance. Comparisons of PP, PP+SP, and C on changes in body fat and BMI z scores found no differences. PP and PP+SP study arms were combined to create an EM arm. Relative to C, EM decreased body fat for boys (-1.7 ± 0.38% vs. -0.14 ± 0.69%) and attenuated fat gain for girls (2.9 ± 0.22% vs. 3.93 ± 0.37%), but standardized effect sizes were relatively small (<0.30). In conclusion, this school-based EM programs had modest beneficial effects on changes in percent body fat. Addition of a classroom/internet program to the environmental program did not enhance weight/fat gain prevention, but did impact physical activity and social support in overweight children.
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA, USA. williada@pbrc.edu
authors.forename: Donald A
authors.initials: DA
authors.lastname: Williamson
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.forename: David W
authors.initials: DW
authors.lastname: Harsha
authors.forename: Hongmei
authors.initials: H
authors.lastname: Han
authors.forename: Corby K
authors.initials: CK
authors.lastname: Martin
authors.forename: Robert L
authors.initials: RL
authors.lastname: Newton
authors.forename: Melinda S
authors.initials: MS
authors.lastname: Sothern
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Stewart
authors.forename: Larry S
authors.initials: LS
authors.lastname: Webber
authors.forename: Donna H
authors.initials: DH
authors.lastname: Ryan
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002652:Child Behavior; D003376:Counseling; D004734:Energy Metabolism; D004777:Environment; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005522:Food Services; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D008145:Louisiana; D008297:Male; D009765:Obesity / Q000378:metabolism / Q000517:prevention & control*; D050177:Overweight / Q000628:therapy; D015397:Program Evaluation; D012424:Rural Population; D012574:Schools; D012737:Sex Factors; D012944:Social Support; D015430:Weight Gain; D061217:Weight Reduction Programs