School-based intervention
School-based efforts have been oriented towards prevention, targeting all students in selected classes to avoid stigmatisation of obese children. Planet Health is an interdisciplinary curriculum that aims to decrease dietary
fat consumption, increase consumption of fruits and vegetables, promote physical activity, and limit television time. Over 2 academic years, prevalence of obesity significantly decreased among girls, but not boys, in intervention versus control schools.133 The intervention effect was attributed to reduced television viewing. The APPLES (Active Programme Promoting Lifestyle Education in Schools) intervention involved nutrition
education, provision of healthy cafeteria lunches, a fitness programme, improved playground facilities, and
extracurricular activities. Implementation during an academic year elicited an increase in vegetable
consumption, but did not favourably alter other targeted behaviours or BMI.134,135 The Pathways programme for American-Indian children, who are at high risk for disease and type 2 diabetes,136 was a largescale cooperative effort among food-service personnel, classroom and physical education teachers, and families.137 The aim of the programme was to reduce dietary fat consumption and augment physical activity. Preliminary reports state that the 3-year programme produced a significant decrease in fat consumption and a trend toward increased physical activity, but BMI did not differ between children in intervention and control schools at the end of the programme.138–140 The CATCH (Child and Adolescent Trial for Cardiovascular Health) intervention, using an approach similar to Pathways although not specifically designed for obesity prevention, also aimed to reduce dietary fat consumption and increase physical activity. Once again, the intervention caused changes in the targeted behaviours, but BMI did not differ between intervention and control schools after 2 academic years.141 Thus, with the exception of Planet Health, school-based interventions, involving multiple sites, have not reduced obesity prevalence, despite their intensive and, in some instances, multi-year designs.
School-based intervention
School-based efforts have been oriented towards prevention, targeting all students in selected classes to avoid stigmatisation of obese children. Planet Health is an interdisciplinary curriculum that aims to decrease dietary
fat consumption, increase consumption of fruits and vegetables, promote physical activity, and limit television time. Over 2 academic years, prevalence of obesity significantly decreased among girls, but not boys, in intervention versus control schools.133 The intervention effect was attributed to reduced television viewing. The APPLES (Active Programme Promoting Lifestyle Education in Schools) intervention involved nutrition
education, provision of healthy cafeteria lunches, a fitness programme, improved playground facilities, and
extracurricular activities. Implementation during an academic year elicited an increase in vegetable
consumption, but did not favourably alter other targeted behaviours or BMI.134,135 The Pathways programme for American-Indian children, who are at high risk for disease and type 2 diabetes,136 was a largescale cooperative effort among food-service personnel, classroom and physical education teachers, and families.137 The aim of the programme was to reduce dietary fat consumption and augment physical activity. Preliminary reports state that the 3-year programme produced a significant decrease in fat consumption and a trend toward increased physical activity, but BMI did not differ between children in intervention and control schools at the end of the programme.138–140 The CATCH (Child and Adolescent Trial for Cardiovascular Health) intervention, using an approach similar to Pathways although not specifically designed for obesity prevention, also aimed to reduce dietary fat consumption and increase physical activity. Once again, the intervention caused changes in the targeted behaviours, but BMI did not differ between intervention and control schools after 2 academic years.141 Thus, with the exception of Planet Health, school-based interventions, involving multiple sites, have not reduced obesity prevalence, despite their intensive and, in some instances, multi-year designs.
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