title: Follow-up of a healthy lifestyle education program (the Educació en Alimentació Study): 2 years after cessation of intervention.
abstract: OBJECTIVE
  The Educació en Alimentació (EdAl) program conducted over 28 months in primary school children reduced obesity (OB) prevalence in boys and increased voluntary physical activity (PA). The continued benefit after cessation of EdAl is unknown. We assessed the changes in OB prevalence and healthy lifestyle in 11- to 13-year-old adolescents, the age group that had complete inclusion data available 2 years after the EdAl program's conclusion.
  
  
  METHODS
  Adolescents (n = 421 intervention; n = 198 control) with data at baseline and 2-year follow-up were recruited. Analyses included body mass index (BMI), BMI z-score, and lifestyle data (from questionnaires).
  
  
  RESULTS
  Between baseline and 2-year follow-up, OB prevalence was reduced (-5.5%; p < .01) and BMI z-score (-.29; p < .001) in intervention compared with control group. BMI z-score was effectively reduced in intervention in both genders: -.26 units in boys and -.32 units in girls, compared with control group. The ≥4 hours/week after-school PA was increased significantly by 13.1% in adolescents of intervention group compared with control group (p = .023); a tendency toward increased PA in intervention girls was observed (p = .062). At 2-year follow-up, participating in ≥4 hours/week after-school PA (odds ratio, .240; p = .002) and daily fruit consumption (odds ratio, .447; p = .025) were protective factors against OB, whereas ≤2 hours/week after-school PA was a risk factor for OB.
  
  
  CONCLUSIONS
  At 2-year follow-up, the EdAl program induced a lowering of BMI z-score and OB prevalence, compared with control group. After-school PA practice can be stimulated in primary school as part of a healthy lifestyle and maintained subsequently despite cessation of the intervention program.
authors.affiliation: Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Lucia
authors.initials: L
authors.lastname: Tarro
authors.affiliation: Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Llauradó
authors.affiliation: Technological Center of Nutrition and Health (CTNS) - TECNIO - URV-CEICS, Reus, Spain; Unitat de Bioestadística, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Moriña
authors.affiliation: Unit of Lipids and Arteriosclerosis Research, CIBERDEM, Hospital Universitari Sant Joan, IISPV, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain. Electronic address: rosa.sola@urv.cat.
authors.forename: Rosa
authors.initials: R
authors.lastname: Solà
authors.affiliation: Unit of Farmacobiology, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Giralt
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015992:Body Mass Index; D002648:Child; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods* / Q000706:statistics & numerical data; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000628:therapy*; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D012572:School Health Services / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Adolescents; Cohort studies; Follow-up studies; Obesity; Physical activity; Prospective study