title: A primary-school-based study to reduce the prevalence of childhood obesity--the EdAl (Educació en Alimentació) study: a randomized controlled trial.
abstract: BACKGROUND
  Obesity is one of the main determinants of avoidable disease burden.To implement a program by university students acting as "health promoting agents" (HPAs) and to evaluate the effects on obesity prevalence of the primary-school-based program that promotes healthy lifestyle, including dietary and physical activity recommendations over 28 months.
  
  
  METHODS
  Two school clusters were randomly assigned to intervention (24 schools, 1,222 pupils) or control (14 schools, 717 pupils); 78% of pupils were Western European. Mean age (±SD) was 8.4±0.6 years (49.9% females) at baseline. Generalized linear mixed models were used to analyze differences in primary outcome between both groups. Data collected included body mass index (BMI) every year. Dietary habits and lifestyle questionnaires were filled in by the parents at baseline and at the end of the study. The interventions focused on eight lifestyle topics covered in 12 activities (1 hour/activity/session) implemented by HPAs over 3 school academic years.
  
  
  RESULTS
  At 28 months, obesity prevalence in boys was decreased -2.36% in the intervention group (from 9.59% to 7.23%) and increased 2.03% (from 7.40% to 9.43%) in the control group; the difference was 4.39% (95% CI 3.48 to 5.30; P=0.01). The boys in the intervention group had an effective reduction of -0.24 units in the change of BMI z-score (from 0.01 to -0.04), compared to control (from -0.10 to 0.09); 5.1% more intervention pupils undertook physical activity>5 hours/week than control pupils (P=0.02).Fish consumption was a protector (odds ratio 0.39; 95% CI 0.23 to 0.67) while "fast-food" consumption was a risk factor for childhood obesity (odds ratio: 2.27; 95% CI 1.08 to 4.77).
  
  
  CONCLUSIONS
  Our school-based program, conducted by HPA students, successfully reduced childhood obesity prevalence in boys.
  
  
  BACKGROUND
  International Standard Randomized Controlled Trial Number: ISRCTN29247645.
authors: Lucia
authors: L
authors: Tarro
authors: Elisabet
authors: E
authors: Llauradó
authors: Rosa
authors: R
authors: Albaladejo
authors: David
authors: D
authors: Moriña
authors: Victoria
authors: V
authors: Arija
authors: Unit of Farmacobiology, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, Reus 43201, Spain. rosa.sola@urv.cat.
authors: Rosa
authors: R
authors: Solà
authors: Montse
authors: M
authors: Giralt
mesh_terms: D000367:Age Factors; D002648:Child; D004032:Diet / Q000009:adverse effects; D015444:Exercise; D057140:Fast Foods / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D006293:Health Promotion; D006801:Humans; D016014:Linear Models; D008297:Male; D016017:Odds Ratio; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012572:School Health Services; D017747:Seafood; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome