title: Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study.
abstract: METHODS
  Non-randomised non-blinded school-based intervention study.
  
  
  METHODS
  Two schools in the cities of Pune and Nasik, India.
  
  
  METHODS
  The intervention group comprised children attending a Pune school from 7-10 years until 12-15 years of age. Two control groups comprised children of the same age attending a similar school in Nasik, and children in the Pune intervention school but aged 12-15 years at the start of the study.
  
  
  METHODS
  A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extracurricular and intracurricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a 'scoring' subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families.
  
  
  METHODS
  Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing).
  
  
  RESULTS
  After 5 years the intervention children were fitter than controls in running, long jump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004).
  
  
  CONCLUSIONS
  It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These changes resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity.
authors.affiliation: Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India.
authors.forename: Sheila
authors.initials: S
authors.lastname: Bhave
authors.affiliation: Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Pandit
authors.affiliation: Faculty of Health and Biomedical Sciences, Symbiosis International University, Pune, Maharashtra, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Yeravdekar
authors.affiliation: Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Madkaikar
authors.affiliation: Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India.
authors.forename: Trushna
authors.initials: T
authors.lastname: Chinchwade
authors.affiliation: Department of Statistics, ZVMU Medical College, Pune, Maharashtra, India.
authors.forename: Nasreen
authors.initials: N
authors.lastname: Shaikh
authors.affiliation: Excellentstat, Pune, Maharashtra, India.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Shaikh
authors.affiliation: Chandrashekhar Agashe College of Physical Education, Pune, Maharashtra, India.
authors.forename: Shraddha
authors.initials: S
authors.lastname: Naik
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Ella
authors.initials: E
authors.lastname: Marley-Zagar
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Caroline H D
authors.initials: CH
authors.lastname: Fall
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D002648:Child; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007194:India / Q000453:epidemiology; D008019:Life Style; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control; D010809:Physical Fitness / Q000502:physiology*; D015397:Program Evaluation / Q000379:methods; D012572:School Health Services / Q000458:organization & administration*
keywords: Obesity; Outcomes research; School Health