title: School and family-based interventions for promoting a healthy lifestyle among children and adolescents in Italy: a systematic review.
abstract: OBJECTIVE
  Cardiovascular diseases affect adult population but risk factors develop as a result of known or assumed behavior since childhood. In Italy, up to 22.2% of children are overweight, 10.6% are obese, and 2.5% have severe obesity.
  
  
  METHODS
  We performed a systematic review of the literature to identify studies and initiatives addressing health promotion among children in Italy. Given the high heterogeneity of interventions and outcomes assessed we opted to perform a qualitative synthesis of the results. We described also nonrandomized trial where the intervention of primary prevention was very innovative, explained in detail, and reached an improving outcome for participants.
  
  
  RESULTS
  We identified 11 projects since 1983, only five were randomized control trials. Three involved children and teachers of primary and secondary schools and were based on specific curricular lectures about health. One was based on a game developed for high schools with the purpose to promote healthy lifestyle and physical activity. The fifth project was based on an enhanced physical activity program.
  
  
  CONCLUSIONS
  Our results show that school and family should be considered as the privileged places for health promotion. In Italy, the development of scientific-validated lifestyle interventions for children is still an unmet need.
authors.affiliation: aCardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy bMount Sinai Cardiovascular Institute, New York, USA; Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Madrid, Spain.
authors.forename: Elio
authors.initials: E
authors.lastname: Gorga
authors.forename: Valentina
authors.initials: V
authors.lastname: Regazzoni
authors.forename: Sameer
authors.initials: S
authors.lastname: Bansilal
authors.forename: Valentina
authors.initials: V
authors.lastname: Carubelli
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Trichaki
authors.forename: Mara
authors.initials: M
authors.lastname: Gavazzoni
authors.forename: Carlo
authors.initials: C
authors.lastname: Lombardi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Raddino
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D015444:Exercise; D005190:Family; D006293:Health Promotion / Q000379:methods*; D000070497:Healthy Lifestyle; D006801:Humans; D007558:Italy / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D011322:Primary Prevention / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012574:Schools