School-based obesity interventions in the metropolitan area of Rio De Janeiro, Brazil: pooled analysis from five randomised studies

Br J Nutr. 2021 Nov 14;126(9):1373-1379. doi: 10.1017/S0007114521000076. Epub 2021 Jan 14.

Abstract

School-based studies, despite the large number of studies conducted, have reported inconclusive results on obesity prevention. The sample size is a major constraint in such studies by requiring large samples. This pooled analysis overcomes this problem by analysing 5926 students (mean age 11·5 years) from five randomised school-based interventions. These studies focused on encouraging students to change their drinking and eating habits, and physical activities over the one school year, with monthly 1-h sessions in the classroom; culinary class aimed at developing cooking skills to increase healthy eating and attempts to family engagement. Pooled intention-to-treat analysis using linear mixed models accounted for school clusters. Control and intervention groups were balanced at baseline. The overall result was a non-significant change in BMI after one school year of positive changes in behaviours associated with obesity. Estimated mean BMI changed from 19·02 to 19·22 kg/m2 in the control group and from 19·08 to 19·32 kg/m2 in the intervention group (P value of change over time = 0·09). Subgroup analyses among those overweight or with obesity at baseline also did not show differences between intervention and control groups. The percentage of fat measured by bioimpedance indicated a small reduction in the control compared with intervention (P = 0·05). This large pooled analysis showed no effect on obesity measures, although promising results were observed about modifying behaviours associated with obesity.

Keywords: Adolescents; Obesity prevention; Pooled analyses; Randomised controlled trials; School-based interventions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Brazil
  • Child
  • Exercise
  • Health Promotion / methods*
  • Humans
  • Overweight* / prevention & control
  • Pediatric Obesity* / prevention & control
  • Program Evaluation*
  • School Health Services
  • Schools