title: A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children.
abstract: OBJECTIVE
  In the context of a 6-mo obesity program, incorporating school- and family-based components, nutritional education, fun-type skill-learning physical activities, and exercise training, this study examined relationships among changes in nutritional status, physical fitness, and some psychosocial and behavioral treatment-related outcomes, using a before and after comparison.
  
  
  METHODS
  Eighteen obese and overweight children ages 10 to 12 y were assessed with respect to body weight, height, circumferences, skinfold thickness, and fat mass. Health-related fitness tests, and self-reported physical activity enjoyment and perceived physical ability also were administered. Health-related quality of life (HRQoL) was evaluated using the Pediatric Quality of Life Inventory; dietary habits were collected using a 7-d food diary. The WinFood software was used for the estimation of nutrient and caloric intake.
  
  
  RESULTS
  After treatment, children showed decreases in body mass index z-score (P = 0.001), body fat percentage (P < 0.001), arm (P = 0.003) and waist circumferences (P = 0.004), and skinfold thickness (P < 0.008). Actual (P < 0.001) and perceived (P < 0.03) physical abilities, physical activity enjoyment (P = 0.03), and psychosocial HRQoL (P < 0.05) also improved from pre- to postintervention. Participants reported reductions in total and commercial food caloric intakes (P < 0.001), with higher protein and lower fat consumptions (P < 0.001) after the program.
  
  
  CONCLUSIONS
  The findings from the present study highlight the importance of combined dietary-behavioral-physical activity interventions in overweight children, and place emphasis on directing such interventions toward improving perceived physical competence that could lead to increased exercise adherence and promotion of the health benefits associated with it.
authors.affiliation: Parisi-De Sanctis Institute, Italian Ministry of Education, University and Research, Foggia, Italy. Electronic address: Milenamorano@gmail.com.
authors.forename: Milena
authors.initials: M
authors.lastname: Morano
authors.affiliation: Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Rutigliano
authors.affiliation: Parisi-De Sanctis Institute, Italian Ministry of Education, University and Research, Foggia, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Rago
authors.affiliation: Department of Medical and Surgical Sciences, Pediatrics, University of Foggia, Foggia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Pettoello-Mantovani
authors.affiliation: Department of Medical and Surgical Sciences, Pediatrics, University of Foggia, Foggia, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Campanozzi
mesh_terms: D050154:Adiposity; D015992:Body Mass Index; D002648:Child; D003131:Combined Modality Therapy; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D007558:Italy; D008297:Male; D009765:Obesity / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012574:Schools
keywords: Food intake; Nutritional status; Overweight; Physical activity; Physical fitness; Quality of life