title: Association between a school-based intervention and adiposity outcomes in adolescents: The Italian "EAT" project.
abstract: OBJECTIVE
  To evaluate whether a school-based multicomponent educational program could improve adiposity measures in middle-school adolescents.
  
  
  METHODS
  A non-randomized controlled pilot study was conducted in six state middle schools (487 adolescents, 11-15 years) in townships in an urban area around Milan, three schools (n = 262 adolescents) being assigned to the intervention group and three schools (n = 225 adolescents) to the control group. The two-school-year intervention included changes in the school environment (alternative healthy vending machines, educational posters) and individual reinforcement tools (school lessons, textbook, text messages, pedometers, re-usable water bottles). The main outcome measure was change in BMI z-score. The secondary outcomes were changes in waist-to-height ratio (WHtR) and behavioral habits.
  
  
  RESULTS
  The intervention was associated with a significant difference in BMI z-score (-0.18 ± 0.03, P<0.01) and in WHtR (-0.04 ± 0.002, P < 0.001), after controlling for baseline covariates. Subgroup analysis showed the maximum association between the intervention and the difference in BMI z-score for girls with overweight/obesity. Physical activity increased and consumption of sugar-sweetened beverages and high-energy snacks decreased in adolescents after the intervention.
  
  
  CONCLUSIONS
  A school-based multicomponent intervention conducted at both environmental and individual levels may be effective for reducing adiposity measures mainly in adolescents with overweight/obesity.
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ermetici
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Roberta F
authors.initials: RF
authors.lastname: Zelaschi
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Briganti
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Dozio
authors.affiliation: Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Gaeta
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Ambrogi
authors.affiliation: Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Pelissero
authors.affiliation: I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Tettamanti
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.|Operative Unit Service of Laboratory Medicine-1 Clinical Pathology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Massimiliano Marco
authors.initials: MM
authors.lastname: Corsi Romanelli
authors.affiliation: Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, University of Milan, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Carruba
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Lelio
authors.initials: L
authors.lastname: Morricone
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Malavazos
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001628:Beverages / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007558:Italy; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D010865:Pilot Projects; D012572:School Health Services / Q000458:organization & administration; D012574:Schools / Q000458:organization & administration; D062410:Snacks / Q000523:psychology; D013334:Students / Q000706:statistics & numerical data