Background
Childhood obesity is a growing epidemic and has become a
public health priority in developed countries [1,2]. Over the
past few decades, prevalence rates of childhood obesity
have tripled, with recent estimates indicating that 16.9%
and 8.6% of children are obese in United States and Canada
respectively [3-6]. Obesity negatively impacts a child’s self
esteem and results in diminished quality of life [7]. Moreover,
children with high body mass index (BMI) often
become obese adults, who are at increased risk of developing
obesity-related diseases, such as type 2 diabetes, cardiovascular
disease, and certain types of cancer, and place
significant financial burden on healthcare systems [8-10].
Poor diets and inadequate physical activity are widely
acknowledged as the main drivers of the obesity epidemic
[11-13]. As childhood obesity rates continue to rise, the
effects of unhealthy eating, compounded by increasingly
sedentary lifestyles, emphasize the need to identify comprehensive
health promotion approaches to curb the worsening
trends. Recent reviews suggest the use of schoolbased
interventions to address the childhood obesity