title: Project Energize: whole-region primary school nutrition and physical activity programme; evaluation of body size and fitness 5 years after the randomised controlled trial.
abstract: Project Energize, a region-wide whole-school nutrition and physical activity programme, commenced as a randomised controlled trial (RCT) in the period 2004-6 in 124 schools in Waikato, New Zealand. In 2007, sixty-two control schools were engaged in the programme, and by 2011, all but two of the 235 schools in the region were engaged. Energizers (trained nutrition and physical activity specialists) work with eight to twelve schools each to achieve the goals of the programme, which are based on healthier eating and enhanced physical activity. In 2011, indices of obesity and physical fitness of 2474 younger (7·58 (sd 0·57) years) and 2330 older (10·30 (sd 0·51) years) children attending 193 of the 235 primary schools were compared with historical measurements. After adjusting for age, sex, ethnicity, socio-economic status (SES) and school cluster effects, the combined prevalence of obesity and overweight among younger and older children in 2011 was lower by 31 and 15 %, respectively, than that among 'unEnergized' children in the 2004 to 2006 RCT. Similarly, BMI was lower by 3·0 % (95 % CI - 5·8, - 1·3) and 2·4 % (95 % CI - 4·3, - 0·5). Physical fitness (time taken to complete a 550 m run) was significantly higher in the Energized children (13·7 and 11·3 %, respectively) than in a group of similarly aged children from another region. These effects were observed for boys and girls, both indigenous Māori and non-Māori children, and across SES. The long-term regional commitment to the Energize programme in schools may potentially lead to a secular reduction in the prevalence of overweight and obesity and gains in physical fitness, which may reduce the risk of developing obesity and type 2 diabetes.
authors.affiliation: Centre for Child Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Elaine
authors.initials: E
authors.lastname: Rush
authors.affiliation: Sport Waikato, Hamilton, New Zealand.
authors.forename: Stephanie
authors.initials: S
authors.lastname: McLennan
authors.affiliation: Centre for Child Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Victor
authors.initials: V
authors.lastname: Obolonkin
authors.affiliation: Faculty of Health and Environmental Sciences, Research Office, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
authors.forename: Alain C
authors.initials: AC
authors.lastname: Vandal
authors.affiliation: Department of Social Science Parks Recreation Tourism and Sport, Lincoln University, Christchurch, New Zealand.
authors.forename: Michael
authors.initials: M
authors.lastname: Hamlin
authors.affiliation: Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, UK.
authors.forename: David
authors.initials: D
authors.lastname: Simmons
authors.affiliation: Child Health, Waikato Hospital, Hamilton, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D049628:Body Size; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D010809:Physical Fitness; D012307:Risk Factors; D012572:School Health Services / Q000458:organization & administration*; D044465:White People