Systematic review and meta-analysis of school-based interventions to reduce body mass index

Lavelle, H.V., Mackay, D.F. and Pell, J.P. (2012) Systematic review and meta-analysis of school-based interventions to reduce body mass index. Journal of Public Health, 34(3), pp. 360-369. (doi: 10.1093/pubmed/fdr116)

Abstract

<b>Background</b> Childhood obesity predisposes to adult obesity and increases the risk of many diseases. Schools provide a vehicle to deliver public health interventions to all children.<p></p> <b>Methods</b> Medline and Embase were used to undertake a systematic review of published studies of school-based interventions aimed at reducing the body mass index (BMI) of children ≤ 18 years. Preferred reporting items for systematic reviews and meta-analyses guidelines were followed, and eligible studies subjected to a random effects meta-analysis.<p></p> <b>Results</b> Between 1991 and 2010, 43 published studies provided 60 measurements of effect. The pooled effect was a 0.17 (95% CI: 0.08, 0.26, P< 0.001) reduction in BMI. Heterogeneity was high (I2= 93.4%) but there was no significant small study bias (Egger's test, P= 0.422) nor significant variation by length of follow-up. The intervention comprised physical activity only in 11 (26%) studies, education only in three (7%), and combinations of these and improved nutrition in the remaining 29 (67%). On stratified analysis, physical activity used in isolation (−0.13, 95% CI: −0.22, −0.04, P= 0.001) or combined with improved nutrition (−0.17, 95% CI: −0.29, −0.06, P< 0.001) was associated with significant improvements in BMI. Interventions targeted at overweight/obese children reduced their BMI by 0.35 (95% CI: 0.12, 0.58, P= 0.003). Those delivered to all children reduced it by 0.16 (95% CI: 0.06, 0.25, P= 0.002)<p></p> <b>Conclusions</b> There is growing evidence that school-based interventions that contain a physical activity component may be effective in helping to reduce BMI in children.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mackay, Professor Daniel and Pell, Professor Jill
• Authors: Lavelle, H.V., Mackay, D.F., and Pell, J.P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Journal of Public Health
• ISSN: 1741-3842
• ISSN (Online): 1741-3850
• Published Online: 20 January 2012