Effectiveness of a Multifaceted Intervention for Prevention of Obesity in Primary School Children in China

• DOI: 10.1001/jamapediatrics.2021.4375
• Publication Date: 2021-11-08T16:00:38Z
• Authors: Zheng Liu; Pei Gao; Ai-Yu Gao; Yi Lin; Xiang-Xian Feng; Fang Zhang; Li-Qun Xu; Wen-Yi Niu; Hai Fang; Shuang Zhou; Wen-Hao Li; Jian-Hui Yuan; Chun-Xia Xu; Na Wu; Hui-Juan Li; Li-Ming Wen; George C. Patton; Hai-Jun Wang; Yang-Feng Wu
• Keywords: Male; 2. Zero hunger; China; Pediatric Obesity; Adolescent; 4. Education; 16. Peace & justice; Body Mass Index; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Cluster Analysis; Humans; Female; Child; Exercise; School Health Services

<h3>Importance</h3> A rapid nutritional transition has caused greater childhood obesity prevalence in many countries, but the repertoire of effective preventive interventions remains limited. <h3>Objective</h3> To determine effectiveness a novel multifaceted intervention for prevention primary school children. <h3>Design, Setting, and Participants</h3> cluster randomized clinical trial was conducted during single year (from September 11, 2018, to June 30, 2019) across 3 socioeconomically distinct regions China according prespecified protocol. Twenty-four schools were randomly allocated (1:1) or control group, with 1392 eligible children aged 8 10 years participating. Data from intent-to-treat population analyzed October 1 December 31, 2019. <h3>Interventions</h3> targeted both (promoting healthy diet physical activity) their environment (engaging families support children’s behavioral changes). The its strengthening family involvement assistance smartphone app. engaged usual practices. <h3>Main Outcomes Measures</h3> outcome change body mass index (BMI; calculated as weight kilograms divided by height square meters) baseline end trial. Secondary outcomes included changes adiposity (eg, BMI<i>z</i>score, obesity), blood pressure, activity dietary behaviors, obesity-related knowledge, fitness. Generalized linear mixed models used analyses. <h3>Results</h3> Among participants (mean [SD] age, 9.6 [0.4] years; 717 boys [51.5%]; mean BMI, 18.6 [3.7]), 1362 (97.8%) follow-up data From trial, BMI decreased whereas it increased group; between-group difference −0.46 (95% CI, −0.67 −0.25;<i>P</i> &lt; .001), which showed no evidence different regions, sexes, maternal education levels, caregivers (parents vs nonparents). 27.0% figure (a relative decrease) compared 5.6% group. also improved other outcomes, dietary, sedentary, did not moderate- vigorous-intensity activity, fitness, pressure. No adverse events observed intervention. <h3>Conclusions Relevance</h3> effectively reduced China, suggesting potential national scaling. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT03665857