title: School-based individualised lifestyle intervention decreases obesity and the metabolic syndrome in Mexican children.
abstract: BACKGROUND
  Currently, there is limited evidence about effective strategies to manage childhood obesity and the metabolic syndrome in school settings. The present study aims to analyse changes in the prevalence of being overweight/obese and having the metabolic syndrome in relation to a 10-month lifestyle intervention based on individualised face-to-face sessions and parental education in school settings.
  
  
  METHODS
  The study sample comprised a cross-sectional sample of 96 overweight/obese Mexican children aged 6-12 years from eight schools. Clinical, anthropometric measurements and 24-h recalls were obtained during each of 13 visits. Laboratory measurements were determined at the beginning and end. The energy-reduced diet was based on dietary recommended intakes. Individualised structured daily meals and a physical activity plan, tailored-made for each child, were provided every 3 weeks at the schools. Parental attendance was required. Student's t-test, McNemar and Shapiro-Wilk tests and simple linear regression were used for the statistical analysis.
  
  
  RESULTS
  The prevalence of metabolic syndrome fell significantly from 44% to 16% (P < 0.01), high blood pressure fell from 19% to 0%, hypertrigliceridaemia fell from 64% to 35%, high-density lipoprotein-cholesterol ≤ 40 fell from 60% to 41%, hyperglycaemia fell from 1% to 0%, and waist circumference ≥90th percentile fell from 72% to 57%. There was a 2.84 [95% confidence interval (CI) = -4.10 to -1.58; P < 0.01] significant decrease in body mass index percentile and in body-fat percentage (95% CI = -3.31 to -1.55; P < 0.01). Of the overweight children, 32% achieved normal-weight, whereas 24% of the obese ones converted to overweight and 1% reached normal-weight. Physical activity increased 16 min/day(-1) (P = 0.02) and 2 days/week(-1) .
  
  
  CONCLUSIONS
  A school-setting lifestyle intervention led to a decreased prevalence of being overweight/obese and to a striking reduction in the prevalence of the metabolic syndrome in a sample of Mexican children.
authors.affiliation: Clinical Nutrition and Obesity Research Center, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, NL, Mexico. lelizond@itesm.mx
authors.forename: L
authors.initials: L
authors.lastname: Elizondo-Montemayor
authors.forename: N G
authors.initials: NG
authors.lastname: Gutierrez
authors.forename: D M
authors.initials: DM
authors.lastname: Moreno
authors.forename: U
authors.initials: U
authors.lastname: Martínez
authors.forename: D
authors.initials: D
authors.lastname: Tamargo
authors.forename: M
authors.initials: M
authors.lastname: Treviño
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D005522:Food Services; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000178:diet therapy / Q000453:epidemiology / Q000628:therapy*; D008800:Mexico / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000178:diet therapy / Q000628:therapy*; D050177:Overweight; D010290:Parents; D015995:Prevalence; D012572:School Health Services; D012574:Schools; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL