School-based physical activity and nutritional education interventions on body mass index: a meta-analysis of randomised community trials - project PANE.
OBJECTIVE
To evaluate the effect of school-based physical activity (PA) and nutritional education (NE) interventions on children's and adolescents' body mass index.


METHODS
We conducted a systematic search in fourteen databases until September 2012 for randomised controlled trials on PA and NE, conducted in the school setting, and delivered to children and adolescents. Additionally, we performed a cross-reference check in related papers. The title and abstract review and the quality assessment were performed by two independent researchers. The software EPPI-Reviewer3 was used to store, manage and analyse all data. The meta-analysis was conducted using the random-effects model, and the outcomes were reported as standardised mean difference (SMD). As a secondary analysis, we pooled together the interventions that considered PA or NE alone.


RESULTS
Thirty-eight studies met the eligibility criteria. The main analysis showed a SMD between intervention and control groups of -0.03 (95% CI: -0.09, 0.04; n=28,870; I(2)=83%). When we considered all 57 trials, there was no difference between the results of the primary analysis.


CONCLUSIONS
The synthesis of school-based PA and NE interventions showed no statistically significant mean reduction on children's and adolescents' body mass index. The high heterogeneity among studies requires caution in the generalisation of the results.
Programa de Pós-Graduação em Ciências, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Avenida Enéas de Carvalho Aguiar 44, 1º subsolo - Bloco II, CEP 05403-900 São Paulo, Brazil; Group of Studies and Researches in Physical Activity Epidemiology (GEPAF EACH-USP), Brazil. Electronic address: paulohguerra@usp.br.
Paulo Henrique
PH
Guerra
Unidade de Epidemiologia Clínica do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, CEP 05403-900 São Paulo, Brazil.
Moacyr Roberto Cuce
MR
Nobre
Departamento de Pediatria, Disciplina de Nutrologia, Universidade Federal de São Paulo, CEP 04040-032 São Paulo, Brazil.
Jonas Augusto Cardoso
JA
da Silveira
Departamento de Pediatria, Disciplina de Nutrologia, Universidade Federal de São Paulo, CEP 04040-032 São Paulo, Brazil.
José Augusto Aguiar Carrazedo
JA
Taddei
D000293:Adolescent; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D012572:School Health Services
Adolescent; Body mass index; Children; Meta-analysis; Nutrition Education; Physical Education and Training; Randomised controlled trials; Review; School